Performance by chapter What's this? Chapter 61: Management of Patients with Dermatologic Disorders

A young college student recently had her tongue and lip pierced. She has developed a superinfection of candidiasis from the antibacterial mouthwash. Which of the following would be the correct recommendation for her? Use an antifungal mouthwash or salt water. Use a soft-bristled toothbrush. Rinse the mouth after eating food. Move the piercing back and forth during washing.

1

Which term refers to a graft derived from one part of a client's body and used on another part of that same client's body? Autograft Allograft Homograft Heterograft

1

The classic lesions of impetigo manifest as comedones in the facial area. honey-yellow crusted lesions on an erythematous base. abscessed skin and subcutaneous tissue. patches of grouped vesicles on red and swollen skin.

2

The nurse notes that the client's lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened. The nurse notes the finding as dermatitis. acantholysis. lichenification. pyodermas.

3

Which of the following is also known as "jock itch"? Tinea cruris Tinea corporis Tinea pedis Tinea unguium

1

Which of the following nonsedating antihistamines is appropriate for daytime pruritus? Fexofenadine (Allegra) Diphenhydramine (Benadryl) Hydroxyzine (Atarax) Lorazepam (Ativan)

1

A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: Overnight to enhance absorption. Hourly to prevent evaporation. Every 3 to 4 hours for sustained effectiveness. Twice a day to prevent crusting on the skin.

3

A client is being treated for acne vulgaris. What contributes to follicular irritation? overproduction of sebum chocolate stress potato chips

1

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? Use shampoo with piperonyl butoxide. Use shampoo with Kwell. Wash clothes in cold water. Disinfect brushes and combs with bleach.

1

The nurse is instructing the patient in how to apply a corticosteroid cream to lesions on the arm. What intervention can the nurse instruct the patient to do to increase the absorption of the medication? Apply an occlusive dressing over the site after application. Make sure that the skin is slightly dehydrated so that the medication can absorb through the skin cracks. Apply a thick layer of cream over the lesions so that if some rubs off, there is more to absorb. Apply the medication every 2 hours.

1

The nurse is providing teaching to a client with acne who is using isotretinoin therapy. Which statement should the nurse make? It is teratogenic in humans. Contraceptives are not needed during treatment. Take vitamin A supplements. The side effects are irreversible.

1

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? Impetigo Scabies Contact dermatitis Dermatophytosis

2

A client has a rash on the arm that has been treated with an antibiotic without eradicating the rash. What type of examination can be used to determine if the rash is a fungal rash using ultraviolet light? Skin biopsy Fungal culture Potassium hydroxide test A Wood's light examination

4

The school nurse is instructing a parent in the care and elimination of lice from their child's hair. The parent brings all of the products for care in a bag. Which contents are not appropriate for use? Shampoo and conditioner Permethrin (Nix) Plastic wide-toothed comb New hair clips

1

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. a carbuncle. cheilitis. a comedone.

1

Which assessment finding indicates an increased risk of skin cancer? A deep sunburn A dark mole on the client's back An irregular scar on the client's abdomen White irregular patches on the client's arm

1

There is an increase in the incidence of skin cancer being reported. Which have been identified as factors that predispose to malignant changes in the skin? Select all that apply. thinning ozone layer residence in high-altitude areas where the atmosphere is thinner than at sea level prolonged, repeated exposure to UV rays in those who do farming, fishing, road construction, etc. use of sun block

1,2,3

A nurse is assessing a client with a new skin disorder. Which questions would the nurse include when asking the client about the change in skin condition? Select all that apply. When did the disorder first begin, and where did it first appear? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? Do you exercise daily?

1,2,3,4

A client is coming to the office to have a growth removed by the doctor. The client asks "What does cryosurgery do to the growth?" What is the correct response? Removes the entire growth Through the application of extreme cold, the tissue is destroyed. Freezes the growth, so the physician can remove it at the next appointment Lasers the growth off

2

A patient is scheduled for Mohs microscopic surgery for removal of a skin cancer lesion on his forehead. The nurse knows to prepare the patient by explaining that this type of surgery requires: Destruction of the tissue by electrical energy. Removal of the tumor, layer by layer. A process of deep-freezing the tumor, thawing and refreezing. The use of radiation therapy.

2

The nurse is caring for a client with questionable lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff? Nits are located near the scalp. Dandruff is throughout the hair. Nits are difficult to move from hair shafts. Dandruff looks white and flakey.

3

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? Shopping mall Swimming pool College dormitory Gymnasium

3

While examining a client's leg, a nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressing should the nurse apply? Dry sterile dressing Sterile petroleum gauze Moist sterile saline gauze Povidone-iodine-soaked gauze

3

The nurse is assessing a client's skin when the client points out a mole. The nurse brings the mole to the physician's attention when which characteristic is noted? Symmetrical appearance Distinct borders Uniform light brown color Diameter exceeding 6 mm

4

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions? Antiviral Corticosteroids Analgesics Antipyretics

1

A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? Isotretinoin (Accutane) Benzoyl peroxide Retin-A Salicylic acid

1

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." "If someone develops symptoms, tell him to see a physician right away." "Just be careful not to share linens and towels with family members." "After you're treated, family members won't be at risk for contracting scabies."

1

With repeated reactions of contact dermatitis, which of the following can occur? Secondary bacterial infection Pain along the sensory nerve Sepsis Hemorrhage

1

Which medication classification may be used for contact dermatitis? Corticosteroids Saline irrigations Antifungals Antivirals

1

The nurse teaches the client who demonstrates herpes zoster (shingles) that once the client has had shingles, they will not have it a second time. a person who has had chickenpox can contract it again upon exposure to a person with shingles. the infection results from reactivation of the chickenpox virus. no known medications affect the course of shingles.

3

While assessing the skin of a 45-year-old, fair-skinned female client, the nurse notes a lesion on the medial aspect of her lower leg. It has irregular borders, with various shades of black and brown. The client states that the lesion itches occasionally and bled slightly a few weeks ago. She also reveals a history of sunburns. Based on these signs and symptoms, the nurse suspects: squamous cell carcinoma. actinic keratoses. melanoma. basal cell carcinoma.

3

The nurse prepares a patient with a benign skin lesion for surgical excision, intralesional corticosteroid therapy, and radiation. Which of the following is most likely the lesion described? Angioma Keloid Wart Seborrheic keratoses

2

To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application? Minoxidil (Rogaine) Tretinoin (retinoic acid [Retin-A]) Zinc oxide gelatin Fluorouracil (5-fluorouracil, 5-FU [Efudex])

2

What advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified? Use wool, synthetics, and other dense fibers. Wear rubber gloves when in contact with soaps. Rub the skin vigorously to dry. Use hot water for bathing.

2

Which drug is an oral retinoid used to treat acne? Estrogen Isotretinoin Tetracycline Benzoyl peroxide

2

Which of the following is a true statement regarding psoriasis? It is a chronic, infectious inflammatory disease. It is characterized by patches of redness covered with silvery scales. A cure is possible with prompt treatment. The onset typically occurs in young children.

2

A day care worker comes to the clinic for mild itching and rash of both hands. The nurse suspects contact dermatitis. The diagnosis is confirmed if the rash appears: erythematous with raised papules. dry and scaly with flaking skin. inflamed with weeping and crusting lesions. excoriated with multiple fissures.

1

A client comes into the hospital with a Tegaderm dressing in place on the buttocks. The nurse documents this as being which type of dressing? Active Inactive Passive Interactive

3

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? Platelet disorders Kaposi sarcoma Allergic reactions Syphilis

2

A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have? psoriasis plantar warts undesired tattoo dandruff

1

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 a superficial infection with Staphylococcus aureus. Psoriasis comes from dermal abrasion. Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Psoriasis results from excess deposition of subcutaneous fat.

1

What advice should the nurse give a client with a furuncle to prevent the spread of the infection? Keep hair short, clean, and away from the face and forehead. Never pick or squeeze a furuncle. Avoid the use of cosmetics. Use tepid bath water.

2

A client has undergone dermabrasion to decrease scarring from severe acne endured as a teen. After completion of the procedure, the nurse reviews the client's home care instructions. Which instruction is appropriate for this client? Don't touch the area treated. Wash the area three times daily until healed. Dermabrasion is a painless procedure. Apply moisturizer after each washing until the area is healed.

1

The nurse is developing a plan of care for a client with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome. Which action should the nurse include? Frequently inspect the oral cavity. Use friction when repositioning the client. Limit fluids. Apply a continuous current of warm air.

1

A client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. Which instruction best prevents skin damage? "Minimize sun exposure from 1 to 4 p.m., when the sun is strongest." "Use a sunscreen with a sun protection factor of 6 or higher." "Apply sunscreen even on overcast days." "When at the beach, sit in the shade to prevent sunburn."

3

A physician orders an emollient for a client with pruritus of recent onset. The client asks why the emollient should be applied immediately after a bath or shower. How should the nurse respond? "To make the skin feel soft." "To prevent evaporation of water from the hydrated epidermis." "To minimize cracking of the dermis." "To prevent skin inflammation."

2

Photochemotherapy has been used as a treatment for which of the following skin disorders? Shingles Psoriasis Allergic dermatitis Rosacea

2