Chapter 23
The nurse assesses an elevated, dry, hyperkeratotic, scaly papule in an older adult patient. What condition does the assessment data correlate? 1 Actinic keratosis 2 Dysplastic nevus 3 Basal cell carcinoma 4 Squamous cell carcinoma
Answer 1
Which cosmetic procedure is teratogenic? 1 Use of tretinoin 2 Use of chemical peels 3 Use of α-hydroxy acids 4 Use of microdermabrasion
Answer: 1
The nurse is caring for four patients. Which patient will benefit from treatment with gabapentin for postherpetic neuralgia? 1 Patient A 2 Patient B 3 Patient C 4 Patient D
Answer: 4
The nurse is assessing four patients. Which patient should be advised to refrain from having sex? 1 Patient A 2 Patient B 3 Patient C 4 Patient D
Answer:4
A nurse is assessing an obese patient with skin that is dry and irritated. The nurse understands that the most likely reason the patient is experiencing the skin condition is what? 1 Obese people drink less water. 2 Obese people have lowered immunity. 3 Obese people are prone to overheating and sweating. 4 Obese people have improved arterial and venous flow
Answer: 3
A patient diagnosed with malignant melanoma has been prescribed vemurafenib. The nurse recalls that the medication was prescribed on the basis of what test? 1 Genetic testing 2 Clark level testing 3 Microdermabrasion 4 Breslow's measurement
Answer: 1
A patient is being treated for scaly skin lesions. The results of a potassium hydroxide (KOH) test that was performed using the scrapings of the lesions are positive. How should the nurse interpret the result? 1 The patient has scabies. 2 The patient has a fungal infection. 3 The patient has contact dermatitis. 4 The patient has basal cell carcinoma
Answer 2
In teaching a patient with basal cell carcinoma (BCC) about this disorder, the nurse considers that which statement about this skin cancer is true? 1 BCC is the deadliest type of skin cancer. 2 BCC is the most common type of skin cancer. 3 Prognosis depends upon the thickness of the lesion. 4 The cancerous cells of BCC usually spread beyond the skin
Answer 2
When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin cancer cases have been reported in white patients than in African American patients. What could be the most likely cause of such an occurrence? 1 Whites usually have less exposure to the sun than African Americans. 2 Whites have less melanin content in their skin than African Americans. 3 Whites usually have more exposure to the sun than African Americans. 4 Whites have greater melanin content in their skin than African Americans
Answer 2
Which intervention would be most helpful in managing cellulitis in an 83-year-old patient with heart failure? 1 Maintain strict bed rest 2 Apply moist heat and elevation 3 Soak the extremity in cool, sterile saline 4 Perform passive range of motion exercises
Answer 2
Which surgical therapy can only be used to remove small, soft skin tumors and superficial lesions? 1 Excision 2 Curettage 3 Skin scraping 4 Punch biopsy
Answer 2
During an admission assessment, the nurse decides to implement contact precautions if which of these disorders is present in a patient? 1 Psoriasis 2 Tinea unguium 3 Impetigo on the lower legs 4 Candidiasis in the groin area
Answer 3
The nurse is caring for patients who have undergone various treatments. According to the chart, which patient may have squamous cell carcinoma? 1 Patient A 2 Patient B 3 Patient C 4 Patient D
Answer 3
Which does the nurse suspect in a patient who reports severe nighttime body itching and has red, crusted papules? 1 Lice 2 Ticks 3 Scabies 4 Bedbugs
Answer 3
The nurse is caring for patients at a camp with bites and stings inflicted by insects or arachnids. Which patient may require the application of topical corticosteroids? 1 Patient bitten by lice 2 Patient stung by a bee 3 Patient bitten by mites 4 Patient bitten by bedbugs
Answer 4
A nurse observes that a group of patients has a darker skin tone after being outside for a period of time. The nurse recalls that the reason for this finding is what? 1 The UVA rays of the sun cause tanning. 2 The UVB rays of the sun cause sunburn. 3 The UVC rays of the sun cause collagen damage. 4 The UVC rays of the sun cause increased melanin production
Answer: 1
A patient exhibits small, red pruritic lesions between the fingers and toes. On examination the nurse discovers that the lesions appear in a pattern of small lines. Which condition do these symptoms most likely represent? 1 Scabies 2 Varicella 3 Contusions 4 Herpes zoster
Answer: 1
A patient has sharply demarcated red plaques on the face that are hot, hard, and painful, along with a body temperature of 101o F as a result of a β-hemolytic Streptococcus infection. About what treatment should the nurse educate the patient? 1 Systemic penicillin 2 Warm, moist compresses on the plaques 3 Application of retapamulin to the affected area 4 Cleansing with antistaphylococcal soap and water
Answer: 1
A patient with a skin infection is prescribed a topical ointment. What action should the nurse take when applying this treatment? 1 Applying a thin layer of the ointment on the affected area 2 Spreading the ointment on the affected area in a circular motion 3 Applying a thick layer of ointment with a gloved hand for better results 4 Applying the ointment on the affected area and then applying a dressing
Answer: 1
A patient with psoriasis tells the nurse that the patient has quit his or her job as a restaurant hostess because the patient believes the lesions on his or her hands and arms are unattractive to customers. Which nursing diagnosis best describes this patient response? 1 Social isolation related to fear of rejection 2 Ineffective coping related to lack of social support 3 Impaired skin integrity related to presence of lesions 4 Ineffective health maintenance because of presence of lesions
Answer: 1
In a patient admitted with cellulitis of the left foot, which clinical manifestation would the nurse expect to find on assessment of the left foot? 1 Erythema and swelling 2 Pallor and poor turgor 3 Cyanosis and coolness 4 Edema and brown skin discoloration
Answer: 1
The nurse is caring for four patients with skin infections. In which patient does the nurse suspect infection with group A β-hemolytic streptococci? 1 Patient 1 2 Patient 2 3 Patient 3 4 Patient 4
Answer: 1
A patient is diagnosed with herpes zoster and is at risk for developing postherpetic neuralgia. What action should the nurse take to prevent postherpetic neuralgia in the patient? 1 Administer mild sedatives at night. 2 Apply wet compresses to the affected area. 3 Administer acyclovir as prescribed within 72 hours. 4 Apply silver sulfadiazine on the ruptured vesicles.
Answer: 3
A patient presents with tiny skin lesions on the chest and back that have a diameter less than 0.5 cm. Which procedure should be used to obtain a sample of these lesions? 1 Curettage 2 Skin scraping 3 Punch biopsy 4 Electrodessication
Answer: 3
The nurse assesses a vesiculopustular lesion with a thick, honey-colored crust surrounded by erythema on the left side of a patient's arm. The patient states that he or she had a few bumps in the area that the patient had been scratching. What complication has the patient developed from this condition? 1 Cellulitis 2 Furuncle 3 Impetigo 4 Folliculitis
Answer: 3
The nurse, preparing educational information about types of skin cancer, recalls that which type has a higher risk for metastasis and poor prognosis unless it is treated early? 1 Myeloma 2 Basal cell 3 Melanoma 4 Squamous cell
Answer: 3
What condition does the nurse suspect in an asthmatic patient who reports erythema, oozing vesicles, and severe itching of the skin? 1 Urticaria 2 Drug reaction 3 Atopic dermatitis 4 Allergic contact dermatitis
Answer: 3
Which fungal infection manifests on the surface of a patient's skin with an erythematous and typical annular scaly appearance and well-defined margins? 1 Tinea pedis 2 Tinea cruris 3 Tinea corporis 4 Tinea unguium
Answer: 3
he nurse is caring for patients who are experiencing side effects of different cosmetic topical procedures. Which patient may have been treated for fine wrinkling? 1 A patient with severe redness, flaking, and oozing at the treated area 2 A patient who has photosensitivity and a pink tone that lasts for 24 hours 3 A patient with redness and inflammation and increase in the pigmentation 4 A patient who is experiencing photosensitivity and has redness lasting for seven weeks
Answer: 3
About which treatments should the nurse educate the patient with scaly, ringlike lesions with well-defined margins on both arms? Select all that apply. 1 Cryosurgery 2 Oral penicillin 3 Cool compress 4 Mupirocin cream 5 Miconazole cream
Answer: 3,5
A nurse is assessing a patient who reports extreme fatigue and muscle pain. The patient reports spending very little time outdoors. The skeletal muscles of the patient are very weak. Which deficiency is most likely to cause such symptoms? 1 Vitamin A deficiency 2 Vitamin B deficiency 3 Vitamin C deficiency 4 Vitamin D
Answer:4
A patient with a history of persistent macular eruption notices the gradual appearance of hard, reddened plaques on his or her trunk that are similar in appearance to psoriasis lesions. Which treatment does the nurse suspect will be beneficial in this patient? 1 Chemical peels 2 Surgical excision 3 Electrodesiccation 4 Topical nitrogen mustard
Answer:4
What action should the nurse take to help a patient with pruritus? 1 Keep the area as dry as possible. 2 Administer fexofenadine to control itching. 3 Allow the patient to gently rub the itching area for quick relief. 4 Wet cotton sheets with warm water and place them over the itching area
Answer:4
A patient has itchy red papules that are circumscribed with vesicles. Which drug treatments should the nurse expect to be prescribed for this patient? Select all that apply. 1 Cetirizine 2 Mupirocin 3 Fluorouracil 4 Hydroxyzine 5 Corticosteroids
Answer:4, 5
A patient diagnosed with actinic keratosis is prescribed fluorouracil. To prevent side effects of the medication, what action should the nurse take? 1 Administer an antihistamine. 2 Instruct the patient to avoid sunlight. 3 Advise the patient to use antipruritic lotion. 4 Administer gamma-benzene hexachloride
Answer 2
The nurse should teach a patient who is taking which drug to avoid prolonged sun exposure? 1 Tetracycline 2 Ipratropium 3 Morphine sulfate 4 Oral contraceptives
Answer 1
Which patient would be more likely to have the highest risk of developing malignant melanoma? 1 A fair-skinned woman who uses a tanning booth regularly 2 An African American patient with a family history of cancer 3 An adult who required phototherapy as an infant for the treatment of hyperbilirubinemia 4 A Hispanic male with a history of psoriasis and eczema who responded poorly to treatment
Answer 1
A nurse advises a patient with skin that is extremely sensitive to the sun to select a sunscreen which blocks both UVA and UVB rays. Which statements by the patient indicate that the teaching is effective? Select all that apply. 1 "The sunscreen should be water resistant." 2 "The sunscreen should have an SPF of at least 15." 3 "The sunscreen should be labeled as broad spectrum." 4 "The sunscreen should have benzophenone as the major constituent." 5 "The sunscreen should have para-aminobenzoic acid (PABA) as the major constituent."
Answer 1, 3, 4
The nurse is caring for a patient with purulent drainage from an inflamed site. Which are the most appropriate actions for the nurse to take? Select all that apply. 1 Soak the affected area in salt water. 2 Use cool, sterile water for wet dressing. 3 Use tap water at room temperature for wet dressing. 4 Leave the wet dressing in place for 10 to 30 minutes. 5 Replace the wet dressing if the patient's skin appears macerated
Answer 1, 4
A nurse is assessing a woman who has nodulocystic acne. While administering isotretinoin, which interventions are necessary to ensure patient safety? Select all that apply. 1 Conduct a pregnancy test. 2 Conduct a liver function test. 3 Conduct a cholesterol level test. 4 Perform a hemoglobin level test. 5 Determine if the patient has a history of depression
Answer 1,2,3,5
The nurse receives a patient from the postanesthesia care unit (PACU) who has just undergone a rhytidectomy to remove the redundant soft tissue of the neck as a result of sun damage. Which postoperative nursing interventions are appropriate? Select all that apply. 1 Ice packs 2 Mild analgesics 3 Circulation assessments 4 Loose, noncompressing dressings 5 Supporting the patient's decision for elective surgery
Answer 1,2,3,5
A nurse is caring for a patient diagnosed with shingles. The primary health care provider prescribes acyclovir to be administered as soon as possible. The most likely reason for the medication is to prevent what? 1 To prevent pain 2 To prevent postherpetic neuralgia 3 To prevent worsening of symptoms 4 To prevent the patient from getting restless
Answer 2
The nurse is caring for patients who have undergone various cosmetic topical procedures and are experiencing side effects. Which patient had the epidermis and top dermal layer removed by application of aluminum oxide? 1 A patient with a light pink tone skin for about 24 hours 2 A patient with moderate swelling and crusting for a week 3 A patient with photosensitivity with slight irritation of the skin 4 A patient with erythema, swelling, flaking, and changes in pigmentation
Answer: 1
The patient has been diagnosed with tinea unguium (onychomycosis) under the nails and does not like the oral antifungal medication. What is the best alternate treatment the nurse should describe for the patient? 1 Nail avulsion 2 Antifungal cream 3 Thinning of fingernails 4 Soaking nails in salt water
Answer: 1
A patient has a growth on the bottom of one foot, which is growing inward, is painful when pressure is applied, and has interrupted skin markings. Which treatments may the patient receive? Select all that apply. 1 Cryosurgery 2 White petroleum 3 Silver sulfadiazine 4 Topical immunotherapy 5 Blunt dissection with scissors
Answer: 1 , 4
Which treatments would be beneficial for a patient with papular, wheal-like lesions and severe pruritus? Select all that apply. 1 Spinosad 2 Doxycycline 3 Chlorocyclohexane 4 γ-Benzene hexachloride 5 Permethrin topical solution
Answer: 1, 4
A patient complains of excessive itching along the abdomen near the umbilicus. What instructions should the nurse give to the patient to relieve pruritus? Select all that apply. 1 Rub the affected area gently. 2 Place moist cotton sheets on the affected area. 3 Warm the affected area with warm compresses. 4 Apply menthol or camphor locally to the affected area. 5 Use good-quality moisturizers on the affected area after drying it.
Answer: 1, 4, 5
A nurse is assessing a patient who has numerous nevi on the face. The nurse determines that the nevi are not cancerous. Which observations led the nurse to conclude that the nevi are normal? Select all that apply. 1 The nevi are dark in color. 2 The nevi are well circumscribed. 3 The skin over the nevi is eroded. 4 There is discharge from the nevi. 5 The nevi are larger than 5 mm in size
Answer: 1,2
The patient is in the hospital for a surgical procedure and has dry skin and pruritus on the legs that cause the patient to scratch at the skin uncontrollably. What measures can the nurse use to help stop the itch/scratch cycle? Select all that apply. 1 Moisturize the skin on the legs. 2 Provide a warm blanket and room. 3 Administer antihistamines at bedtime. 4 Use careful hand washing after rubbing her legs. 5 Cleanse the legs with a saline solution twice daily
Answer: 1,3
A nurse works in a dermatology clinic and counsels many patients in a day. Which patients should the nurse consider at high risk of developing skin malignancies? Select all that apply. 1 A farmer 2 A school teacher 3 A baseball player 4 A software engineer 5 A construction worker
Answer: 1,3,5
A patient diagnosed with actinic keratosis is prescribed fluorouracil. To prevent side effects of the medication, what action should the nurse take? 1 Administer an antihistamine. 2 Instruct the patient to avoid sunlight. 3 Advise the patient to use antipruritic lotion. 4 Administer gamma-benzene hexachloride
Answer: 2
A patient tells a nurse, "I think I might have head lice." Which assessment findings would the nurse observe with this infestation? 1 Diffuse pruritic wheals 2 Oval white dots stuck to hair shafts 3 Pruritic papules with linear burrows at the hairline 4 Itchy redness and edema over the area of infestation
Answer: 2
The nurse is caring for four patients in a dermatology unit. Which patient may be treated with liquid nitrogen therapy? 1 Patient A 2 Patient B 3 Patient C 4 Patient D
Answer: 2
When a patient has psoriasis, which sign would a nurse expect to find? 1 Pustules in skinfolds 2 Itchy, scaly patches on scalp 3 Macular rash on the trunk area 4 Vesicular rash on the extremities
Answer: 2
Which assessment finding of a 70-year-old male patient's skin should the nurse prioritize? 1 The patient's complaint of dry skin that is frequently itchy. 2 The presence of an irregularly shaped mole that the patient states is new. 3 The presence of veins on the back of the patient's leg that are blue and tortuous. 4 The presence of a rash on the patient's hand and forearm to which the patient applies a corticosteroid ointment
Answer: 2
Which laboratory result is the best indicator that a patient with cellulitis is recovering from this infection? 1 White blood cells (WBC) of 2900/µL 2 White blood cells (WBC) of 8200/µL 3 White blood cells (WBC) of 12,700/µL 4 White blood cells (WBC) of 16,300/µL
Answer: 2
Which patient does the nurse determine will benefit the most from treatment with methotrexate? 1 The patient with a benign adipose tumor 2 The patient with autoimmune chronic dermatitis 3 The patient with inflammatory disorder of sebaceous glands 4 The patient with an increase in normal melanocytes in the basal layer of epidermis
Answer: 2
Which patient does the nurse suspect is most at risk for contracting Lyme disease? 1 The patient bitten by lice 2 The patient bitten by ticks 3 The patient bitten by mites 4 The patient stung by wasps
Answer: 2
Which therapy uses subfreezing temperatures to destroy epidermal lesions? 1 Excision 2 Cryosurgery 3 Punch biopsy 4 Electrodesiccation
Answer: 2
A patient is diagnosed with vaginal candidiasis. What nursing interventions are appropriate for this patient? Select all that apply. 1 Administer antibiotics as advised. 2 Instruct the patient to keep the area clean and dry. 3 Instruct the patient to avoid any vaginal suppositories. 4 Inform the patient to abstain from sex or use condoms. 5 Instruct the patient to use antifungal powder on the affected skin
Answer: 2, 4,5
A middle-aged obese patient presents with small, skin-colored, soft, pedunculated papules on the neck, axillae, and upper trunk. How should the nurse interpret these findings? 1 The patient has nevi. 2 The patient has lentigo. 3 The patient has acrochordons. 4 The patient has seborrheic keratoses.
Answer: 3
A patient complains of frequently having bleeding gums as well as widespread bruising and small red and purple dots all over the body. The patient is most likely deficient in which vitamin? 1 Vitamin A 2 Vitamin B 3 Vitamin C 4 Vitamin K
Answer: 3
A 26-year-old patient tells the nurse that the patient is afraid to use the treatment recommended for psoriasis because the patient's mother had a lot of problems with all the creams she used to try to treat her psoriasis. How should the nurse respond to the patient? 1 "You will only know if you try it and see." 2 "You may need to get counseling to help you cope." 3 "No treatment is medically necessary, but it can be removed." 4 "Topical, light therapy, and systemic medications are now available."
Answer: 4
A patient describes having small, firm reddened raised lesions with flat, rough patches causing intense pruritus to the nurse. What would be the nurse's next assessment? 1 History of seasonal allergies 2 Initiation of new medication 3 Previous pruritic skin lesions 4 Activities in past two to seven days
Answer: 4
A patient has sensitive skin and breaks out with rashes when using ordinary soap. What advice should the nurse give the patient regarding hygienic skin measures? 1 Rub the skin vigorously. 2 Avoid antibacterial soaps. 3 Use hot water to take a bath. 4 Use mild, moisturizing soaps.
Answer: 4
A patient who is obese and has a diagnosis of diabetes is at risk for a bacterial skin infection. For what infection should the nurse educate the patient to monitor? 1 Cellulitis 2 Impetigo 3 Carbuncle 4 Furunculosis
Answer: 4
A patient with skin lesions is advised to have a patch test. The nurse applies the patch on the patient's skin and instructs the patient to come back after two days for further treatment. What is the likely reason the patch test was performed? 1 To determine the presence of melanoma in the patient. 2 To determine the prognosis of skin cancer in the patient. 3 To determine the presence of skin infections in the patient. 4 To determine the causative agents of allergies in the patient.
Answer: 4
During the assessment of a patient, the nurse notes an area of irregularly round verrucous papules with well-defined shapes. The patient states that they have become darker over the past few months and are often itchy and irritating. The nurse recognizes this finding as what? 1 Lentigo 2 Psoriasis 3 Acne vulgaris 4 Seborrheic keratosi
Answer: 4
The nurse assesses a scaly, ringlike rash with a clear center on a patient's leg. Regarding which skin infection should the nurse educate the patient? 1 Cellulitis 2 Tinea cruris 3 Plantar warts 4 Tinea corporis
Answer: 4
The nurse has been discussing sun safety guidelines with a patient who plans to go to the beach after recovery from surgery. Which of these statements by the patient reflects a need for further education? 1 "I will apply sunscreen liberally and often." 2 "I will avoid going to the beach during the midday hours." 3 "I will wear a large-brimmed hat and sunglasses while I'm outside." 4 "If the weather is overcast, I don't need to worry about wearing sunscreen."
Answer: 4
The nurse is assessing a patient who had a face-lift procedure earlier in the day. The nurse notes that the skin in the surgical area is warm and pink and blanches with gentle pressure. What is the appropriate action by the nurse, based on this assessment finding? 1 Apply moist heat to the area. 2 Take the patient's temperature. 3 Notify the health care provider immediately. 4 Document the assessment finding as normal.
Answer: 4
The nurse is caring for a patient in whom chickenpox is suspected. The patient has pustules and redness only on the left side of the face. Which skin condition may the patient have? 1 Furuncle 2 Candidiasis 3 Verruca vulgaris 4 Herpes zoster (shingles)
Answer: 4
The nurse is caring for a patient who has lost excessive hair from the scalp and some other parts of the body. The patient is also unable to sweat. Which therapy does the nurse suspect that the patient has been undergoing? 1 Drug therapy 2 Phototherapy 3 Laser technology 4 Radiation therapy
Answer: 4
The nurse is teaching the residents of an independent living facility about preventing skin infections and infestations. What should be included in the teaching? 1 Use cool compresses if an infection occurs. 2 Oral antibiotics will be needed for any skin changes. 3 Antiviral agents will be needed to prevent outbreaks. 4 Inspect skin for changes when bathing with mild soap
Answer: 4
The nurse reviews lab values for a male patient with herpes zoster. With which result should the nurse be most concerned? 1 Calcium: 9.0 mg/dL 2 Hemoglobin: 14 g/dL 3 Platelets: 150,000/mm3 4 White blood cell count: 1000/mm3
Answer: 4
Which surgical approach is used for coagulation of bleeding deep vessels to obtain hemostasis? 1 Curettage 2 Cryosurgery 3 Electrodesiccation 4 Electrocoagulation
Answer: 4
Which cosmetic procedure improves the appearance of both acne scarring and actinic and seborrheic keratoses? 1 Use of chemical peels 2 Application of tretinoin 3 Use of α-hydroxy acids 4 Use of microdermabrasion
Answer:1
Which nursing intervention would be most helpful in managing a patient newly admitted with cellulitis of the right foot? 1 Applying warm, moist heat 2 Encouraging frequent ambulation 3 Not elevating the affected extremity 4 Wrapping the foot snugly in blankets
Answer:1
Which base used for topical agents produces a drying effect of the skin? 1 Gel 2 Paste 3 Cream 4 Ointment
Answer:2
patient has chills, malaise, and a body temperature of 100° F. Further assessment reveals a hot, tender, reddened, edematous area with a diffuse border on one leg. Which skin infection does the nurse suspect the patient initially had? 1 Impetigo 2 Cellulitis 3 Carbuncle 4 Furunculosis
Answer:2
The nurse assesses circumscribed, hypertrophic, flesh-colored papules on a patient's knee. The patient states they are recurring even after removal. How should the nurse document these findings? 1 Plantar warts 2 Herpes zoster 3 Verruca vulgaris 4 Herpes simplex virus type 1
Answer:3
The nurse is caring for a patient with a skin suture. How should the nurse care for this wound? 1 Clean daily with saline solution. 2 Cover with a wet sterile dressing. 3 Apply an antibiotic and leave open to air. 4 Administer diphenhydramine to treat inflammation
Answer:3