Chapter 56 PrepU: Dermatological

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

a. Tretinoin (retinoic acid [Retin-A])

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? a. apply an occlusive dressing over the site after application

a. apply an occlusive dressing over the site after application

The nurse is teaching a client about the correct use of topical concentrated corticosteroids. The nurse includes which statement(s)? Select all that apply. a. avoid applying to the face b. avoid prolonged use c. hypertrichosis is normal d. apply to intertigi

a. avoid applying to the face b. avoid prolonged use

The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply. a. chocolate b. onions c. bananas d. ice cream

a. chocolate d. ice cream

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

a. wear rubber gloves when in contact with soaps

Which of the following is a local side effect of topical corticosteroids? a. symptoms of Cushing's syndrome b. altered immunity c. telangiectasia d. hyperglycemia

c. telangiectasia: condition where there are visible small linear red blood vessels (broken capillaries)

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. What is the appropriate teaching by the nurse to prevent skin damage? a. "Minimize sun exposure from 1 to 4 p.m., when the sun is strongest." b. "Use a sunscreen with a sun protection factor of 6 or higher." c. "When at the beach, sit in the shade to prevent sunburn." d. "Apply sunscreen even on overcast days."

d. "Apply sunscreen even on overcast days."

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

d. Fexofenadine (Allegra)

The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair? a. Use a donut device while the client is in the chair. b. Tilt the chair back when moving the client. c. Encourage the client to slide up without assistance. d. Lift the client, do not slide them.

d. Lift the client, do not slide them.

Photochemotherapy has been used as a treatment for which of the following skin disorders? a. allergic dermatitis b. rosacea c. shingles d. psoriasis

d. psoriasis

The nurse should assess all possible causes of pruritus for a patient complaining of generalized pruritus. What does the nurse understand can be another cause for this condition? a. end-stage renal disease b. myasthenia gravis c. pneumonia d. hyperthyroidism

a. end-stage renal disease

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 b. comedone d. cheilitis d. carbuncle

a. furuncle

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. a. have you tried to treat the lesions? b. when did the disorder first begin, and where did it first appear? c. do you exercise daily? d. has the problem spread? e. where are the lesions located?

a. have you tried to treat the lesions? b. when did the disorder first begin, and where did it first appear? d. has the problem spread? e. where are the lesions located?

A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition? a. infection b. diet c. hygiene d. unknown

a. infection

A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis? a. preventing infection b. assessing for hemorrhage c. hydrating to prevent renal failure d. limiting protein to limit liver failure

a. preventing infection

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? a. scabies b. dermatophytosis c. impetigo d. contact dermatitis

a. scabies

With repeated reactions of contact dermatitis, which of the following can occur? a. secondary bacterial infection b. pain along the sensory nerve c. sepsis d. hemorrhage

a. secondary bacterial infection

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

b. "All family members need to be treated."

A client asks the nurse what psoriasis is. What is the best answer? a. A cure is possible with prompt treatment. b. It is characterized by patches of redness covered with silvery scales. c. The onset typically occurs in young children. d. It is a chronic, infectious inflammatory disease.

b. It is characterized by patches of redness covered with silvery scales. psoriasis has no cure, chronic non-infectious inflammatory disease

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

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

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? a. homograft b. autograft c. heterograft d. allograft

b. autograft

During the course of a health interview, Mrs. Young tells the nurse that she has been using a new perfume because she wants to smell good. She explains that she has had a rash on her arms and neck since she purchased and used the product. What would be an initial diagnosis for Mrs. Young? a. poison ivy b. contact dermatitis c. xerosis d. psoriasis

b. contact dermatitis

The patient is advised to apply a suspension-type lotion to a dermatosis site. The nurse should advise the patient to apply the lotion how often to be effective? a. every hour b. every 3 hours c. every 12 hrs d. every day at the same time

b. every 3 hours

A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: a. hourly to prevent evaporation b. every 3-4 hours for sustained effectiveness c. twice a day to prevent crusting on the skin d. overnight to enhance absorption

b. every 3-4 hours for sustained effectiveness

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? a. apply a continuous current of warm air b. frequently inspect the oral cavity c. use friction when repositioning the client d. limit fluids

b. frequently inspect the oral cavity

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

b. honey-yellow crusted lesions on an erythematous base.

Which drug is an oral retinoid used to treat acne? a. tetracycline b. isotretinoin c. benzoyl peroxide d. estrogen

b. isotretinoin

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? a. povidone-iodine-soaked gauze b. moist sterile saline gauze c. dry sterile dressing d. sterile petroleum gauze

b. moist sterile saline gauze

The nurse is caring for a client with a furuncle. What advice should the nurse give a client with a furuncle to prevent the spread of the infection? a. avoid the use of cosmetics b. never pick or squeeze a furuncle c. keep hair short, clean, and away from the face and forehead d. use tepid (lukewarm) bath water

b. never pick or squeeze a furuncle

The nurse is caring for a client who may have a 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? a. nits are located near the scalp b. nits are difficult to move from hair shafts c. dandruff is throughout the hair d. dandruff looks white and flaky

b. nits are difficult to move from hair shafts nits are lice eggs --> small, yellowish white ovals firmly fixed to hair shaft

A nurse assesses a client with dry, rough, scaly skin without lesions on the legs. The client reports itching in the affected area. What skin assessment would the nurse document? a. seborrhea b. pruritus c. shingles d. candidiasis

b. pruritus

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

b. the infection results from reactivation of the chickenpox virus.

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? a. to prevent skin inflammation b. to prevent evaporation of water from the hydrated epidermis c. to minimize cracking of the dermis d. to make the skin feel soft

b. to prevent evaporation of water from the hydrated epidermis

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? a. syphilis b. allergic reactions c. Kaposi sarcoma d. platelet disorders

c. Kaposi sarcoma: a frequent comorbidity in clients with AIDS.

Which of the following information regarding the transmission of lice would the nurse identify as a myth? a. Lice can be seen without magnification. b. Lice need to be removed from the hair with a fine comb. c. Lice can jump from one individual to another. d. Lice can be spread by sharing of hats, caps, and combs.

c. Lice can jump from one individual to another.

Which assessment finding indicates an increased risk of skin cancer? a. an irregular scar on the client's abdomen b. white irregular patches on the client's arm c. a deep sunburn d. a dark mole on the client's back

c. a deep sunburn

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions? a. corticosteroids b. antipyretics c. antiviral d. analgesics

c. antiviral

Which of the following uses the body's own digestive enzymes to break down necrotic tissues? a. wet to dry dressing b. enzymatic debridement c. autolytic debridement d. wet dressings

c. autolytic debridement

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? a. use a fabric softener b. wear gloves during the day c. avoid cosmetics with fragrance d. wash skin in very hot water

c. avoid cosmetics with fragrance

The nurse is caring for a client prescribed oral griseofulvin for treatment of a fungal toenail infection. Which instruction by the nurse is essential in understanding the treatment plan? a. administer medication daily b. administer a stool softener to offset constipation c. continue medication regimen for several weeks d. take the medication with meals

c. continue medication regimen for several weeks

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: a. excoriated with multiple fissures b. inflamed with weeping and crusting lesions c. erythematous with raised papules d. dry and scaly with flaking skin

c. erythematous with raised papules

Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? a. scabies b. poison ivy c. impetigo d. pediculosis capitis

c. impetigo

Which infecting agent causes scabies? a. bacteria b. parasitic fungi c. itch mite d. reactivated virus

c. itch mite

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? a. Semi-private room with a client who had chickenpox and was admitted with a GI bleed b. isolation room with negative airflow c. private room d. semi-private room with a client diagnosed with pneumonia

c. private room

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

c. psoriasis photochemotherapy is used to treat psoriasis

A nurse is examining a client's scalp for evidence of lice. The nurse should pay particular attention to which part of the scalp? a. middle area b. top of the head c. temporal area d. behind the ears

d. behind the ears

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? a. gymnasium b. shopping mall c. swimming pool d. college dormitory

d. college dormitory

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: a. squamous cell carcinoma b. actinic keratoses c. basal cell carcinoma d. melanoma

d. melanoma

A patient is diagnosed with malignant melanoma that directly invades the adjacent dermis (vertical growth). The nurse knows that this type of melanoma has a poor prognosis. Which of the following is most likely the type of melanoma described in this scenario? a. lentigo-maligna b. acral-lentiginous c. superficial spreading d. nodular melanoma

d. nodular melanoma

Which of the following superficial fungal infections begins in the skin between the toes and spreads to the soles of the feet? a. tinea capitis b. tinea cruris c. tinea corporis d. tinea pedis

d. tinea pedis

Based on the principles of wound care, nurse should proceed in the following order: (5 choices) a. medicate for pain as needed b. practice technique of changing dressing c. select materials d. change dressing based on assessment e. review clinical indications f. use occlusive dressing g. change dressing based on schedule h. reassess dressing materials

e. review clinical indications c. select materials d. change dressing based on assessment h. reassess dressing materials b. practice technique of changing dressing 5 rules of wound care: 1) categorization 2) selection 3) change 4) evolution 5) practice