Chapter 65: Caring for Clients with Skin, Hair, and Nail Disorders

A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition?

infection

A client has been diagnosed with shingles. Shingles, also known as herpes zoster, is a skin disorder that develops years after an infection with varicella (chickenpox). Which is not an assessment finding with shingles?

nausea and vomiting

What percent of those undergoing piercings suffer complications?

31%

A night-shift nurse receives a call from the emergency department about a client with herpes zoster who is going to be admitted to the floor. Based on this diagnosis, where should the nurse assign the client?

Private room

A nurse is caring for a client whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?

Teach the client about self-care after treatment.

A nurse is working with a family whose 5-year-old daughter has been diagnosed with impetigo. What educational intervention should the nurse include in this family's care?

Teaching about the importance of maintaining high standards of hygiene

A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants' risks of basal cell carcinoma (BCC)?

Teaching participants to limit sun exposure

Which term describes a fungal infection of the scalp?

Tinea capitis

A nurse receives a report on a client who has circular lesions on his neck. Which condition is the client most likely to have?

Tinea corporis

A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide?

Use gloves with application.

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include?

Use shampoo with piperonyl butoxide.

When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of

a furuncle.

Onychomycosis is a fungal dermatophyte infection of the fingernails or toenails. Which is not a factor for promotion of this infection?

alternating pairs of shoes daily

To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application?

Tretinoin (retinoic acid [Retin-A])

Which drug is an oral retinoid used to treat acne?

Isotretinoin

Which assessment finding indicates an increased risk of skin cancer?

A deep sunburn

Which infecting agent causes scabies?

Itch mite

Which statements are accurate with regard to methotrexate? Select all that apply.

The medication is teratogenic.

While in a skilled nursing facility, a client contracts scabies, which is diagnosed the day after discharge. The client is living at her daughter's home with six other people. During her visit to the clinic, the client asks a staff nurse, "What should my family do?" The most accurate response from the nurse is:

"All family members need to be treated."

Development of malignant melanoma is associated with which risk factor?

History of severe sunburn

When writing a plan of care for a client with psoriasis, the nurse would know that an appropriate nursing diagnosis for this client would be what?

Impaired Skin Integrity Related to Scaly Lesions

The nurse assesses the client and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which condition?

Kaposi sarcoma

A client comes to the dermatology clinic requesting the removal of epidermal nevi on his right cheek. The nurse knows that the procedure especially useful in treating such lesions is what?

Laser treatment

A client has just undergone surgery for malignant melanoma. Which of the following nursing actions should be prioritized?

Anticipate the need for, and administer, appropriate analgesic medications.

When caring for a client with toxic epidermal necrolysis (TEN), the critical care nurse assesses frequently for high fever, tachycardia, and extreme weakness and fatigue. The nurse is aware that these findings are potential indicators of what? Select all that apply.

Epidermal necrosis,Increased metabolic needs,Possible gastrointestinal mucosal sloughing

A client comes to the clinic reporting a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with this diagnosis?

Grouped vesicles in linear patches along a dermatome

A 35-year-old kidney transplant client comes to the clinic exhibiting new skin lesions. The diagnosis is Kaposi sarcoma. The nurse caring for this client recognizes that this is what type of Kaposi sarcoma?

Iatrogenic

A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder?

Isotretinoin (Accutane)

A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?

Nits may have to be manually removed from the child's hair shafts.

A female client is worried she might have lice. Which finding should the nurse look for?

Oval, white dots stuck to the hair shafts

A client diagnosed with a stasis ulcer has been hospitalized. There is an order to change the dressing and provide wound care. Which activity should the nurse first perform when providing wound care?

Perform hand hygiene.

A client's blistering disorder has resulted in the formation of multiple lesions in the client's mouth. What intervention should be included in the client's plan of care?

Provide chlorhexidine solution for rinsing the client's mouth.

A 30-year-old male client has just returned from the operating room after having a "flap" done following a motorcycle accident. The client's wife asks the nurse about the major complications following this type of surgery. What would be the nurse's best response?

"The major complication is when the blood supply fails and the tissue in the flap dies."

A nurse is planning the care of a client with herpes zoster. What medication, if given within the first 24 hours of the initial eruption, can arrest herpes zoster?

Acyclovir

The nurse is caring for a patient with extensive bullous lesions on the trunk and back. Prior to initiating skin care, what is a priority for the nurse to do?

Administer analgesic pain medication.

A nurse is caring for a client who has a diagnosis of bullous pemphigoid and who is being treated on the medical unit. When providing hygiene for this client, the nurse should perform which of the following actions?

Apply cornstarch to the client's skin after bathing to facilitate mobility.

A nurse is providing care for a client who has psoriasis. Following the appearance of skin lesions, the nurse should prioritize what assessment?

Assessment of the client's joints for pain and decreased range of motion

The nurse caring for a client with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which information should the nurse include?

Avoid cosmetics with fragrance.

An older adult resident of a long-term care facility has been experiencing generalized pruritus that has become more severe in recent weeks. What intervention should the nurse add to this resident's plan of care?

Avoid using hot water during the client's baths

A patient is diagnosed with seborrheic dermatitis on the face and is prescribed a corticosteroid preparation for use. What should the nurse educate the patient about regarding use of the steroid on the face?

Avoid using the medication around the eyelids because it may cause cataracts and glaucoma.

Which statement indicates a characteristic of a basal cell carcinoma (BCC)?

It begins as a small, waxy nodule with rolled translucent, pearly borders.

A nurse practitioner is seeing a 16-year-old male client who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?

Benzoyl peroxide and erythromycin

A 65-year-old man presents at the clinic reporting nodules on both legs. The man tells the nurse that his son, who is in medical school, encouraged him to seek prompt care and told him that the nodules are related to the fact that he is Jewish. What health problem should the nurse suspect?

Classic Kaposi sarcoma

A public health nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?

Educating participants about the early signs and symptoms of skin cancer

Dry, rough, scaly skin with the presence of itching is best described as:

Pruritus

A patient is diagnosed with psoriasis after developing scales on the scalp, elbows, and behind the knees. The patient asks the nurse where this was "caught." What is the best response by the nurse?

Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin.

A client is admitted to the intensive care unit with what is thought to be toxic epidermal necrolysis (TEN). When assessing the health history of the client, the nurse would be alert to what precipitating factor?

Recent administration of new medications

A 10-year-old child is brought to the office with complaints of severe itching in both hands that's especially annoying at night. On inspection, the nurse notes gray-brown burrows with epidermal curved ridges and follicular papules. The physician performs a lesion scraping to assess this condition. Based on the signs and symptoms, what diagnosis should the nurse expect?

Scabies

A client presents at the free clinic with a black, wartlike lesion on his face, stating, "I've done some research, and I'm pretty sure I have malignant melanoma." Subsequent diagnostic testing results in a diagnosis of seborrheic keratosis. The nurse should recognize what significance of this diagnosis?

The client requires no treatment unless he finds the lesion to be cosmetically unacceptable.

A client has had a surgical procedure to correct an ingrown toenail. Which care recommendation would not help to prevent recurrences?

Use scissors to trim toenails.