Med Surg: Chapter 61

The nurse teaches the client who demonstrates herpes zoster (shingles) that 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. once a client has had shingles, they will not have it a second time. no known medications affect the course of shingles.

The infection results from reactivation of the chickenpox virus.

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? Freezes the growth, so the physician can remove it at the next appointment Lasers the growth off Removes the entire growth Through the application of extreme cold, the tissue is destroyed.

Through the application of extreme cold, the tissue is destroyed.

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? Use very warm water to clean the face prior to applying the medication. Avoid using the medication around the eyelids because it may cause cataracts and glaucoma. Wash the face several times a day and reapply the medication. Scrape the scaly patches off prior to applying the medication.

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

Which procedure done for skin cancer conserves the most amount of normal tissue? Surgical excision Cryosurgery Mohs micrographic surgery Electrosurgery

Mohs micrographic surgery

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

Antiviral Explanation: Oral acyclovir (Zovirax), when taken within 48 hours of the appearance of symptoms, reduces their severity, and prevents the development of additional lesions. Corticosteroids, analgesics,, and antipyretics are not used for this purpose.

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

Autograft

The nurse is teaching a client about the correct use of topical concentrated corticosteroids. The nurse includes which statement(s)?

Avoid applying to the face. Avoid prolonged use.

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

College dormitory

The nurse is conducting an admission history and physical examination of a client with a history of contact dermatitis. The nurse assesses whether the client uses which medication classification? Antifungals Antivirals Corticosteroids Saline irrigations

Corticosteroids

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? Uniform light brown color Symmetrical appearance Distinct borders Diameter exceeding 6 mm

Diameter exceeding 6 mm

Which of the following nonsedating antihistamines is appropriate for daytime pruritus?

Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.

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? Apply a continuous current of warm air. Frequently inspect the oral cavity. Use friction when repositioning the client. Limit fluids.

Frequently inspect the oral cavity.

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

Honey crusted lesions on an erythematous base

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

Isotretinoin

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

Isotretinoin (Accutane)

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

Lice can jump from one individual to another.

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? Povidone-iodine-soaked gauze Dry sterile dressing Sterile petroleum gauze Moist sterile saline gauze

Moist sterile saline gauze Sterile saline dressings support wound healing and are cost-effective; however, dry sterile dressings adhere to the wound and debride the tissue when removed. Petroleum supports healing but is expensive. Povidone-iodine is used as an antiseptic cleaning agent; however, it can irritate epithelial cells, and is contraindicated for use on an open wound.

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

Never pick or squeeze a furuncle.

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 looks white and flakey. Dandruff is throughout the hair. Nits are difficult to move from hair shafts.

Nits are difficult to move from hair shafts.

A patient is being treated for chronic venous stasis ulcers of the lower extremities. What medication does the nurse understand will increase peripheral blood flow by decreasing the viscosity of blood and assist with the healing of the ulcers? Pentoxifylline (Trental) Aspirin Warfarin (Coumadin) Heparin

Pentoxifylline (Trental)

A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis? Assessing for hemorrhage Hydrating to prevent renal failure Limiting protein to limit liver failure Preventing infection

Preventing infection

A nurse assesses a client with dry, rough, scaly skin without lesions and the presence of itching on the legs. What skin assessment would the nurse document? Candidiasis Shingles Pruritus Seborrhea

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

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

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. A process of deep-freezing the tumor, thawing and refreezing. The use of radiation therapy. Removal of the tumor, layer by layer.

Removal of the tumor, layer by layer.

A patient is complaining of severe itching that intensifies at night. The nurse decides to assess the skin using a magnifying glass and penlight to look for the "itch mite." What skin condition does the nurse anticipate finding? Tinea corporis Pediculosis Scabies Contact dermatitis

Scabies

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

Secondary bacterial infection

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? "Apply sunscreen even on overcast days." "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." "When at the beach, sit in the shade to prevent sunburn."

Sunscreen should be applied even on overcast days, because the sun's rays are as damaging then as on sunny days. The sun is strongest from 10 a.m. to 2 p.m. (11 a.m. to 3 p.m. daylight saving time) — not from 1 to 4 p.m. Sun exposure should be minimized during these hours. The nurse should recommend sunscreen with a sun protection factor of at least 15. Sitting in the shade when at the beach doesn't guarantee protection against sunburn because sand, concrete, and water can reflect more than half the sun's rays onto the skin.

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]) Fluorouracil (5-fluorouracil, 5-FU [Efudex]) Zinc oxide gelatin Minoxidil (Rogaine) SUBMIT ANSWER

Tretinoin (retinoic acid)

The nurse working at a physician's office is providing teaching to the parent of a child diagnosed with Tinea capitis (ringworm of the head). How often should the nurse instruct the parent to shampoo the child's hair with ketoconazole or a selenium sulfide shampoo? Weekly Daily Twice weekly Once

Twice weekly

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? Move the piercing back and forth during washing. Use an antifungal mouthwash or salt water. Use a soft-bristled toothbrush. Rinse the mouth after eating food.

Use an antifungal mouthwash or salt water. Explanation: The client can substitute an antifungal mouthwash or salt water if a superinfection of candidiasis develops from the antibacterial mouthwash. A soft-bristled toothbrush should be used to avoid additional oral injury, but it is not the recommended solution for this problem. After eating, the client should rinse her mouth for 30 to 60 seconds with an antifungal mouthwash or salt water. Moving the jewelry at the piercing area back and forth during washing helps clean the pierced tract but does not solve the problem.

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

Use shampoo with piperonyl butoxide.

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. Do you exercise daily? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? 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? When did the disorder first begin, and where did it first appear?

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? Potassium hydroxide test Fungal culture Skin biopsy A Wood's light examination

a wood's light examination

Which of the following uses the body's own digestive enzymes to break down necrotic tissues? Enzymatic debridement Wet to dry dressings Wet dressings Autolytic debridement

autolytic debridement

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 pyodermas. lichenification. acantholysis. dermatitis.

lichenification .Explanation: The nurse should note this as being lichenification, also called scaling. Dermatitis is an inflammation of the skin. Acantholysis is a separation of the epidermal cells from each other, and pyodermas is a bacterial skin infection.

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: actinic keratoses. squamous cell carcinoma. basal cell carcinoma. melanoma.

melanoma.