Chapter 23 - Skin Disorders, Infection/Inflammation, Irritation/Trauma

What concentration of oxygen is used in hyperbaric oxygen therapy to facilitate wound healing?

100% Hyperbaric oxygen therapy involves the administration I have 100% O2 under high pressure. This raises the tissue oxygen concentration that enhances the ability of white blood cells to kill bacteria and reduce swelling.

Plaque psoriasis is commonly found on which area of the body? Scalp Lower back Knees Facial Skin Elbows

1235

Which surgical technique helps to remove full-thickness skin in the area of a lesion? Cryosurgery Wide excision Mohs' surgery Excisional biopsy

2 Cryosurgery is used to treat isolated lesions, causing cell death and destruction. Mohs surgery is a specialized form of excision that is usually preferred for basil and squamous cell carcinomas. Excisional biopsy refers to total surgical removal of the small lesions for pathologic examination.

Which of the following is the most common type of psoriasis? Axillary psoriasis Psoriasis vulgaris Exfoliative psoriasis Palmoplantar psoriasis

2 Psoriasis vulgaris is the most common type of psoriasis, with thick, reddened papules or plaques covered by silvery white scales. Exfoliative psoriasis (erythrodermic psoriasis) is an explosively eruptive and inflammatory form. Palmoplantar pustulosis (PPP) is a type of psoriasis that forms pustules on the palms of the hands and soles of the feet. Psoriasis is not axillary in nature.

Which part of the body is least likely to be affected by psoriasis? Scalp Trunk Knees Facial skin

4

Which term is used to describe a layer of black non-viable, denatured collagen that covers a full thickness pressure injury? cellulitis urticarial undermining wound eschar

4 Cellulitis is the inflammation of skin cells. Urticaria is the formation of white or red edematous papules or plaques of different sizes (hives). Separation of skin layers at the wound margin from the underlying granulation tissue is known as undermining.

Which medication is commonly used for the treatment of multiple actinic keratosis? 1. Systemic therapy of cisplatin 2. Topical therapy of vismodegib 3. Systemic therapy of cetuximab 4. Topical therapy of fluorouracil

4 Topical therapy with fluorouracil is used in the treatment of multiple actinic keratosis. Systemic therapy of cisplatin and cetuximab are used to treat advanced or metastatic squamous cell carcinoma. Topical therapy of vismodegib is used to treat advanced or metastatic basal cell skin cancer.

What is the cause of primary osteoarthritis? Aging Obesity Joint injury Heavy manual work

A

Which systemic drug is most commonly used to treat psoriasis? Bexarotene Azathioprine Cyclosporine Methotrexate

A

Which type of allergy is associated with linear streaks of vesicles? Latex Plants Nickel Toothpaste

B

Which is a common area for candidial infections to occur? Neck Hands Vagina Abdomen

C

Which term describes the process that will replace damage dermis and subcutaneous tissue for a patient with a loss of tissue integrity? granulation contraction resurfacing re-epithelialization

1 Loss of tissue integrity that occurs as a result of damage to the deeper layers of dermis and subcutaneous tissue is a characteristic feature of a deep partial and full thickness wound. Granulation replaces damaged tissue with scar tissue and aids in wound healing. Contraction involves the pulling of wound edges inward along the path of least resistance. Resurfacing involves regrowth across the open area. Re-epithelialization involves the production of new skin cells by undamaged epidermal cells in the basal layer of the dermis.

The first phase of wound healing lasts how long? 3 to 5 days 5 to 7 days 2 to 4 weeks Three weeks or longer

1 The first phase of wound healing is the inflammatory phase. The duration of wound healing that occurs in partial wound thickness is 5 to 7 days. The duration of wound healing that occurs in the proliferative phase is 2 to 4 weeks. Wound healing last for 3 weeks or longer in the maturation phase.

Which factor is known to cause urticaria? exposure to allergens aseptic surgical incision compression of underlying soft tissue distress caused by stimulation of its specific receptors

1 An aseptic surgical incision may cause skin trauma by affecting the tissue integrity. The compression of underlying soft tissue between a bony prominence over an extended period may cause deep pressure injuries by causing a loss of tissue integrity. Pruritus causes distress resulting from stimulation of the H specific receptors.

Which surgical therapy involves the isolated lesion's cell destruction by local application of liquid nitrogen? cryosurgery Mohs surgery wide excision curettage and electrodesiccation

1 And may cause cell death and tissue destruction. In Mohs surgery, tissue is sectioned horizontally in layers, and then each layer is examined histologically to determine the presence of residual tumor cells. Wide excision therapy involves the removal at full thickness skin in the area of the lesion. Curettage and electrodesiccation involves the removal of cancer cells with a use of a dermal curette.

Which medication acts as a strong irritant and causes chemical burns in patients with psoriasis? Anthralin Calcitriol Tazarotene Calcipotriene

1 Calcitriol, tazarotene, and calcipotriene are not skin irritants; hence, these will not cause chemical burns in a patient being treated with these drugs for psoriasis.

Which disease may cause urticaria? cancer vasculitis lymphedema diabetes mellitus

1 Cancer is one of the causative factors of urticaria. It is caused by exposure to allergens, which releases histamines into the skin. Vasculitis, lymphedema, and DM cause altered inflammatory responses in wound healing.

Which condition will occur from stimulation of the itch-specific nerve fibers? pruritus cellulitis urticaria pressure ulcer

1 Cellulitis is caused by inflammation or infection of the skin and subcutaneous tissue. Urticaria is caused by exposure to allergens, which release histamine into the skin. Pressure injuries occur when the skin and underlying soft tissue are compressed between a bony prominence and an external surface for an extended period.

Which process involves the replacement of damaged tissue with scar tissue that aids in wound healing? granulation contraction resurfacing re-epithelialization

1 Granulation involves the replacement of dead tissue with scar tissue that aids in healing. Contraction involves pulling the wound edges along the path of least resistance with the help of fibroblasts. Resurfacing involves regrowth across the open area. Re-epithelialization involves the production of new skin cells by undamaged epidermal cells in the basal layer of the dermis.

Which type of lesion occurs as a result of necrosis? Eschar Papule Vesicle Macule

1 In cutaneous anthrax, the lesion first appears as a vesicle with raised borders. After a few days, necrosis is seen in the center of the lesion, which eventually forms eschar. A papule is a small, firm, elevated lesion less than 1 cm in diameter. A vesicle is the early lesion of cutaneous anthrax that appears red in color. A macule is a flat lesion less than 1 cm in diameter. Its color is different from that of the surrounding skin, which is most often white, red, or brown.

Which issue may cause a systemic altered inflammatory response? leukemia heart failure hypovolemia lymphedema

1 Leukemia may cause a systemic altered inflammatory response by systemic inhibition of the leukocytic response, which resulted in an impaired host resistance to infection. Heart failure and hypovolemia may cause impaired cellular proliferation. Lymphedema may cause a local altered inflammatory response.

Which skin cancer often occurs at the site of a nevus (mole)? Melanoma actinic keratosis basal cell carcinoma squamous cell carcinoma

1 Melanomas or pigmented cancers arising in the melanin producing epidermal cells. Most often they start at the benign growth of a nevus or mole. Normal never I have regular, well-defined borders and our uniform in color, ranging from white colors to dark brown. The lesions surface may be rough or smooth; those with irregular or spreading borders or multiple colors are abnormal. Other suspicious features include sudden changes in lesion size and reports of itching or bleeding. Actinic keratosis may be distributed on the cheek, temples, forehead, ears, neck, backs of hands, and forearms. Basal cell carcinoma occurs on sun exposed areas, especially the head, neck, and central portion of the face. Squamous cell carcinoma occurs on sun exposed areas.

Which condition may trigger recurrence of herpes simplex virus (HSV) infection in an otherwise healthy man? fatigue menses bell palsy eye infection

1 Menses is a stressor for HSV infection for healthy female. Bell's palsy and eye infections are complications of Herpes zoster but not triggering factors.

Which skin information is often relieved by photo therapy with UV light? psoriasis atopic dermatitis contact dermatologist nonspecific eczematous dermatitis

1 Psoriasis is an auto immune disorder that leads to increased skin cell production. UV irradiation has been shown to be beneficial in controlling psoriatic lesions. Steroid therapy or Antihistamines may be prescribed to treat the symptoms caused by atopic dermatologist or contact dermatitis. The cause of nonspecific eczematous dermatitis is not always known; therefore treating the cause includes topical creams and ointments.

Which process occurs in a third intention of wound healing? Removal of debris elimination of dead space inward pulling of wound edges replacement of dead tissue with scar tissue

1 Removal of debris and exudate is done and third intention with healing after a reduction in inflammation; the wound is enclosed surgically. The elimination of dead space in a closed wound is done in the first intention wound healing, which would shorten the phase of tissue repair. The inward pulling of wound edges that occurs along the path of least resistance is called contraction, which occurs in second intention. The replacement of dead tissue with scar tissue represents granulation; this occurs in second intention.

Which process of wound healing involves the production of keratin? resurfacing granulation contraction re-epithelialization

1 Resurfacing involves regrowth across open surfaces, which is one cell layer thick. As healing continues, the cell layer stratifies and produces keratin. Granulation replaces damaged tissue with scar tissue and aids in wound healing. Contraction involves pulling wound edges inward along the path of least resistance. Reepithelialization involves the production of new skin cells by undamaged epidermal cells in the basal layer of the dermis.

Which skin infection is associated with postherpetic neuralgia? Shingles Cellulitis Furuncle Folliculitis

1 Shingles is associated with postherpetic neuralgia, as the virus resides in the dorsal root ganglia. Cellulitis, furuncle, and folliculitis may not be associated with postherpetic neuralgia, as the organisms do not reside in the dorsal root ganglia.

Which is a synonym of "athlete's foot"? Tinea pedis Tinea cruris Tinea manus Tinea corporis

1 Tinea is the common term that is used to describe dermatophytoses. If the dermatophytoses is seen on the foot, it is termed as tinea pedis; this is a synonym of athlete's foot. If dermatophytoses is seen in the groin, it is termed as tinea cruris, or jock itch. If this lesion is seen on the hand, it is termed as tinea manus. Similarly, tinea corporis describes the involvement of the rest of the body, or ringworm.

Pressure injuries can cause which complication? SATA sepsis uremia diabetes cirrhosis kidney failure

15 Pressure injuries may lead to sepsis because there is a possibility of infection through the wound. Pressure injuries may also affect kidney function, leading to kidney failure. Diabetes can't put a patient at higher risk for the formation of injuries, but it is not a complication of pressure injuries.

Which condition may worsen itching in patients with pre-existing pruritus? Dehydration Perspiration Overexertion Alcohol consumption

2

Which features are associated with basal cell carcinoma? Small papule with dry, rough, adherent yellow scales. Pearly papule with a central crater and rolled waxy borders. Firm nodular lesions topped with a crust with a central area of ulceration. Irregular shaped, pigmented papule, and variegated colors with red tones.

2 Actinic keratosis includes small papules with dry, rough, adherent yellow or brown scales. Squamous cell carcinoma involves firm nodular lesions topped with a crust with a central area of ulceration. Melanoma may be manifested by the appearance of irregular shaped, pigmented papule, and variegated colors with red tones.

What is the triggering factor for the recurrence of herpes simplex skin infection? Cold Fever Cough Headache

2 Fever is a triggering factor for the recurrence of herpes simplex skin infections. Cold, cough, and headache are not be associated with herpes simplex infection.

Which type of allergy is associated with linear streaks of vesicles? Latex Plants Nickel Toothpaste

2 Having an allergy to plants such as poison ivy is associated with linear streaks of vesicles. Latex, nickel, and toothpaste allergies are associated with localized eczematous eruptions that have well-defined, geometric margins.

Which drug is used to treat both scabies and pediculosis? Infliximab Permethrin Famciclovir Cephalosporins

2 Infliximab is used to treat plaque psoriasis. Famciclovir is used to treat viral infections. Cephalosporins are used to treat bacterial infections.

Which clinical manifestation is observed during the inflammation phase of wound healing? itching erythema injuries on the body surface white edematous papules

2 It is characterized by redness or swelling of the skin that exist from skin trauma resulting from an aseptic surgical incision or a pressure injury. Itching is a clinical feature that occurs in pruritus. Injuries on body surfaces such as the sacrum, hips, and ankles are a characteristic feature in pressure injuries. A rash of white edematous papules or plaques occurs in urticaria.

Which skin inflammation is characterized by extreme itching? Drug eruption Atopic dermatitis Contact dermatitis Nonspecific eczematous dermatitis

2 Moderate itching is associated with drug eruption. Contact dermatitis can cause mild itching. Moderate and extreme itching are not associated with nonspecific eczematous dermatitis but itching is common.

A patient with contact dermatitis reports redness in the earlobes. What could be the reason for this? Latex allergy Nickel allergy Cosmetic allergy Airborne contact allergy

2 Nickel allergy is most commonly seen in patients who are exposed to nickel. If the earlobes are red, the nurse should ask about earrings that might cause inflammation of the ears. A latex allergy will manifest when a person comes into contact with latex. Cosmetic allergies involve the head and neck. Airborne contact allergy is seen in patients who come into contact with paint or ragweed.

Care for a patient with urticaria is focused on which goal? Increasing patient comfort Removing triggering substance Preventing skin injury with loss of tissue integrity Checking for the presence of necrotic tissue and amount of exudates.

2 Removing the triggering substance and relieving its manifestations are important nursing interventions in the management of urticaria. Increasing patient comfort and preventing skin injury with loss of tissue integrity are the interventions used in a management of pruritus. Checking for the presence of necrotic tissue and amount of exudates is an intervention used to manage pressure injuries.

Which organisms is increasingly common as a result of travel and resistance to pesticides? scabies mite cimex lectularius pediculosis capitis bacillus anthracis

2 This is the scientific name for a bedbug. Infestations are increasingly common as a result of travel and resistance to pesticides. Bedbugs often live in mattresses and fabric upholstery, and in cracks and crevices of furniture. Scabies mite infestations cause scabies. Pediculosis capitis is associated with pediculosis, an infestation of lice. The spores of bacillus anthracis cause cutaneous anthrax. This is transmitted through contact with an infected animal.

Which process is required for restoring skin integrity? maturation granulation inflammation reepithelialization wound contraction

245 After injury, the body restores skin integrity through three processes: granulation, reepithelialization, and wound contraction. In granulation, the damage tissue is removed and filled with scar tissue. In re-epithelialization, the production of new skin takes place. In wound contraction, the wound size decreases in fibroblasts deposit new collagen to replace the damaged tissue. Closing the wound occurs in wound contraction. Maturation and inflammation are phases of wound healing and not the processes involved in wound healing.

Which skin infection is associated with a typical "satellite lesion"? Shingles Furuncle Candidiasis Dermatophytosis

3 " Satellite lesions" are erythematous macular eruptions that occur with isolated pustules or papules at the border. This typical feature is associated with candidiasis. Shingles is a skin infection caused by the varicella-zoster virus and does not have satellite lesions. The infection follows the path of the affected nerve. A furuncle is a skin infection caused by bacteria, involving deeper portions of the follicle. These are characterized by erythematous lesions filled with pus. Dermatophytosis is a fungal infection characterized by serpiginous (having wavy borders) patches.

Which description is characteristic of a wound that is healing by third intention? The wound is made aseptically. It is a chronic wound with tissue damage. It is a potentially infected surgical wound. The edges cannot be smoothly approximated.

3 A potentially infected surgical wound heals by third intention. The wound is debrided and left open for several days until the inflammation subsides. The wound is then surgically closed. A wound that is made aseptically has minimal tissue destruction and begins to heal as soon as the edges are approximated by close sutures or staples; this wound heals by first intention. A chronic wound with tissue damage such as a pressure injury with extensive damage cannot be smoothly approximated. The wound is left open and left to heal from inside out. Scar tissue is extensive and healing is prolonged; this wound heals by second intention.

Which body area is most commonly affected by psoriasis? Neck Chest Elbow Facial skin

3 Other areas are rarely affected with psoriasis.

Which process promotes the healing of partial thickness wound? granulation maturation reepithelialization wound contraction

3 Partial thickness wounds are more superficial, and a partial thickness wound only the epidermidis and upper layers of the dermis or damage. Such wounds heal by reepithelialization. Granulation is a major process for deep wounds. Maturation is not involved in the healing of partial thickness wound. In wound contraction, the size of the wound decreases and the wound finally closes.

Which is a common area for candidial infections to occur? Neck Hands Vagina Abdomen

3 The vagina is a common area for candidial infections. The neck, hands, and abdomen may not be associated with candidial infection. Herpes zoster and dermatophytoses can be seen on the neck, hands, and abdomen.

Which condition is characterized by the presence of a rash of white or red edematous papules? pruritus trauma urticaria pressure injuries

3 Urticaria is characterized by the presence of rash of white or red papules or plaques of various sizes. Pruritus is characterized by itching. Trauma is characterized by the presence of cuts or bruises. Pressure injuries are characterized by the presence of red skin and blisters.

Which systemic drug is commonly used to treat psoriasis? Acyclovir Ivermectin Allopurinol Methotrexate

4 Oral systemic therapies are often prescribed for patients with more than 5% body surface area affected by psoriasis. Methotrexate, folic acid, and systemic retinoids or vitamin A derivatives are examples of systemic therapy. Antiviral drugs such as acyclovir are prescribed to treat viral infections such as herpes zoster. Ivermectin is an oral agent used to treat pediculosis. Allopurinol is commonly associated with Stevens-Johnson syndrome.

Which skin condition is characterized by fever, extensive necrosis, epidermal detachment of less than 10% of the body surface, and mucous membrane involvement? psoriasis basal cell carcinoma toxic epidermal necrolysis TEN Stevens-Johnson syndrome SJS

4 SJS & TEN are life-threatening cutaneous reactions most commonly triggered by a drug. The disorder is characterized by fever, extensive necrosis, epidermal detachment, and mucous membrane involvement in most cases. The disorders are classified by percentage of body surface affected. SJS involves skin detachment of less than 10% of the body surface. SGS / TEN overlap describes patients in whom more than 10% but less than 30% of the body surface is detached. TEN involves detachment of more than 30% of the body surface. In psoriasis, the lesions are scaled and underlying dermal information. Basal cell carcinoma appears as papules with central craters and rolled waxy borders.

Which skin cancer mostly occurs at the site of moles and birthmarks? Melanoma Actinic keratosis Basal cell carcinoma Squamous cell carcinoma

A

Which condition is characterized by the presence of a rash of white or red edematous papules? Pruritus Trauma Urticaria Pressure injuries

C

What are the most common triggers for allergic rhinitis? Select all that apply. Hay fever Latex gloves Plant pollens Animal dander Dust and molds

CDE