MS 65

A nurse is providing self-care education to a patient who has been receiving treatment for acne vulgaris. What instruction should the nurse provide to the patient?

"Wash your face with water and gentle soap each morning and evening."

Onychomycosis is a fungal dermatophyte infection of the fingernails or toenails. All of the following are factors for promotion of this infection except:

Alternating pairs of shoes daily

The nurse is conducting an admission history and physical examination of a patient with a history of contact dermatitis. The nurse assesses if the patient utilizes which of the following medication classifications?

Corticosteroids

Adam Tillman, a 19-year-old musician, is undergoing diagnostics for injuries sustained at work on his right arm. The physician has ordered an MRI on his arm which also displays a colorful, tattooed "sleeve". During client education, what do you report to Mr. Tillman could be the effect of the pigmenting on his MRI?

Decreased quality

A nurse is assessing a teenage patient with acne vulgaris. The patient's mother states, "I keep telling him that this is what happens when you eat as much chocolate as he does." What aspect of the pathophysiology of acne should inform the nurse's response?

Diet is thought to play a minimal role in the development of acne.

A patient has a diagnosis of seborrhea and has been referred to the dermatology clinic, where the nurse contributes to care. When planning this patient's care, the nurse should include which of the following nursing diagnoses?

Disturbed Body Image Related to Excess Sebum Production

A public health nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?

Educating participants about the early signs and symptoms of skin cancer.

Which of the following factors aggravates the condition caused by acne vulgaris?

Friction

When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of which of the following?

Furuncle

A patient comes to the clinic complaining of a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with herpes zoster?

Grouped vesicles in linear patches along a dermatome

As a nurse on a pediatric unit you spend a significant amount of time teaching parents the correct techniques for medicating their children and family members. What is an important piece of education when applying topical medications?

Apply exactly as directed

As a nurse on a pediatric unit, you spend a significant amount of time teaching parents the correct techniques for medicating their children and family members. What is an important piece of education when applying topical medications?

Apply exactly as directed.

A nurse is providing care for a patient who has psoriasis. The nurse is aware of the sequelae that can result from this health problem. Following the appearance of skin lesions, the nurse should prioritize what assessment?

Assessment of the patient's joints for pain and decreased range of motion

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

The nurse caring for a patient with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which of the following should the nurse include?

Avoid cosmetics with fragrance.

A nurse practitioner is seeing a 16-year-old male patient who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?

Benzoyl peroxide and erythromycin (Benzamycin)

A patient comes to the clinic complaining of a red rash of small, fluid-filled blisters. The patient is suspected of having herpes zoster. What does the nurse know about the distribution of lesions of herpes zoster?

Grouped vesicles in linear patches along a dermatome.

A patient has received a diagnosis of irritant contact dermatitis. What action should the nurse prioritize in the patient's subsequent care?

Helping the patient identify and avoid the offending agent

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?

Private room

A patient with a chronic diabetic wound is being discharged after receiving a skin graft to aid wound healing. What direction should the nurse include in home care instructions?

Protect the graft from direct sunlight and temperature extremes.

A 35-year-old kidney transplant patient comes to the clinic exhibiting new skin lesions. The diagnosis is Kaposi's sarcoma. The nurse caring for this patient recognizes that this is what type of Kaposi's sarcoma?

Immunosuppression-related

When writing a plan of care for a patient with psoriasis, the nurse would know that an appropriate nursing diagnosis for this patient would be what?

Impaired Skin Integrity Related to Scaly Lesions

When writing a plan of care for a patient with psoriasis the nurse would know that an appropriate nursing diagnosis for this patient would be what?

Impaired skin integrity related to scaly lesions

Development of malignant melanoma is associated with which of the following risk factors?

Individuals with a history of severe sunburn

Marianne Smith, a 47-year-old librarian, is being seen at the dermatology group where you practice nursing. She has a history of diabetes mellitus and has recently developed furunculosis. As the number of her carbuncles increase, you discuss strategies to address her condition. What is causing her condition?

Infection

The Nurse Practitioner is seeing a 16-year-old male who has come to the dermatology clinic for treatment of nodular cystic acne. The Nurse Practitioner would know that the treatment would consist of which of the following medications?

Isotretinoin (Accutane)

Which of the following is an oral retinoid used in the treatment of acne?

Isotretinoin (Accutane)

The nurse is conducting a community education program on basal cell carcinoma (BCC). Which of the following statements should the nurse make?

It begins as a small, waxy nodule with rolled translucent, pearly borders.

Which of the following is indicative of a basal cell carcinoma (BCC)?

It begins as a small, waxy nodule with rolled translucent, pearly borders.

Mr. Baldwin was seen in the clinic with a reddened rash of his face. The physician diagnosed rosacea. All of the following are true statements about rosacea except:

It is a form of acne.

Which of the following is accurate regarding isotretinoin (Accutane)?

It is teratogenic in humans.

Which of the following infecting agents is the cause of scabies?

Itch mite

The nurse assesses the patient and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which of the following conditions?

Kaposi's sarcoma

In assessing a scar, you notice an overgrowth of tissue. It is best described as a

Keloid

A patient comes to the dermatology clinic requesting the removal of a port-wine stain on his right cheek. The nurse knows that the procedure especially useful in treating cutaneous vascular lesions such as port-wine stains is what?

Laser treatment

While performing an initial assessment of a patient admitted with appendicitis the nurse observes an elevated blue-black lesion on the patient's ear. The nurse knows that this is indicative of what type of skin cancer?

Malignant melanoma

While performing an initial assessment of a patient admitted with appendicitis, the nurse observes an elevated blue-black lesion on the patient's ear. The nurse knows that this lesion is consistent with what type of skin cancer?

Malignant melanoma

Mary Wilson, age 62 years, has been diagnosed with shingles. Shingles, also known as herpes zoster, is a skin disorder that develops years after an infection with varicella (chickenpox). Which of the following is not an assessment finding with shingles?

Nausea and vomiting

A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?

Nits may have to be manually removed from the child's hair shafts.

A 17-year-old high school student is being treated for acne vulgaris and significant time is spent in client education to develop strategies to try to decrease the severity of his outbreaks. What contributes to follicular irritation?

Overproduction of sebum

Dry, rough, scaly skin with the presence of itching is best described as:

Pruritus

A nurse is caring for a patient whose chemical injury has necessitated a skin graft to his left hand. The nurse enters the room and observes that the patient is performing active range of motion (ROM) exercises with the affected hand. How should the nurse best respond?

Remind the patient of the need to immobilize the graft to facilitate healing.

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?

Scabies

The nurse is instructing the parents of a child with head lice. Which of the following statements should the nurse include?

Shampoo with piperonyl butoxide (RID).

A Public Health Nurse has been asked to speak to the local PTO about contact dermatitis. The nurse explains various causes of irritant contact dermatitis. It is important for the nurse to include what as a potential cause of this skin disorder to prevent repeated cases?

Soap or detergents

A patient diagnosed with basal cell carcinoma asks the nurse how he got cancer. The nurse tells the patient that the most common cause of basal cell carcinoma is what?

Sun exposure.

A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?

Surgical excision

A nurse is caring for a patient whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?

Teach the patient about self-care after treatment.

What is the role of the nurse when caring for a patient who has their skin cancer removed by excision?

Teach the patient about self-care after treatment.

A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants' risks of basal cell carcinoma (BCC)?

Teaching participants to limit their sun exposure

Which term describes a fungal infection of the scalp?

Tinea capitis

A nurse receives a report on a client who has circular lesions on his neck. Which condition is the client most likely to have?

Tinea corporis

Which of the following is also known as "jock itch"?

Tinea cruris

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])

A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating an education plan for the patient. What information should be included in this plan?

Use caution when taking nonprescription medications.

Ryan Romney, a 17-year-old high school student, is being seen by a physician within the dermatology group where you practice nursing. He is being treated for acne vulgaris and significant time is spent in client education to develop strategies to try to decrease the severity of his outbreaks. What warnings must be given to Ryan and his mom regarding the application of benzoyl peroxide?

Use gloves with application.

William McGill, age 73 years, has had a surgical procedure to correct an ingrown toenail. He is being discharged and you have been asked to instruct him about care to prevent recurrences. All of the following apply except:

Use scissors to trim your toenails.

A patient has just been told he has malignant melanoma. The nurse caring for this patient explains that the first and most important treatment for malignant melanoma is what?

Wide excision

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."

A nurse is planning the care of a patient with herpes zoster. What medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?

Acyclovir (Zovirax)

The pharmacology class is learning about herpes zoster and medications that are used to treat this disease process. When planning care for a patient with herpes zoster, what medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?

Acyclovir (Zovirax)

Your 14-year-old son is quite excited about the prospect of getting his body pierced. As he presents his pitch to get his tongue pierced, you begin your parental task of trying to educate him about all the ramifications of that act. What percent of those undergoing piercings suffer complications?

31%

Which assessment finding indicates an increased risk of skin cancer?

A deep sunburn

The nurse teaches the patient who demonstrates herpes zoster (shingles) which of the following?

The infection results from reactivation of the chickenpox virus.

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.

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:

melanoma

The nurse teaches the patient who demonstrates herpes zoster (shingles) that

the infection results from reactivation of the chickenpox virus.

James Norville, age 56 years, has come to the clinic with a complaint of silvery scales on his elbows and knees. The physician has made a diagnosis of plaque psoriasis. What is the probable cause(s) of psoriasis?

• A genetic predisposition exists. • A triggering mechanism usually occurs, such as systemic infection, injury to the skin, vaccination, or injection.

Mary Stanton's 4-year-old daughter came home from day care with lice. She has called the office to find out what she needs to do. Select the following which are appropriate steps in eradication.

• All are correct. • Apply a pediculicide to the hair (detailed directions also accompany this medication). • Comb the hair free of tangles while the hair is damp. • Use a special lice comb that has narrow stainless steel teeth. • Comb through each area of the hair to remove lice. • Repeat combings daily until there is no more evidence of lice or nits.

Alexi Miller, a one-year-old female, is presenting at the pediatric group where you practice nursing. She has a localized rash and is miserably itchy. Her mother indicates she just started to use a new skin cream and developed the rash within twelve hours of her first dose. What treatment would you expect the pediatrician to prescribe? Choose all correct options.

• Remove allergen • Cool baths without soap twice daily

There is an increase in the incidence of skin cancer being reported. A variety of factors seem to predispose to malignant changes in the skin. Select all of the following which have been identified.

• 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.

Dermatophytes (also called tinea) are parasitic fungi that invade the skin, scalp, and nails. How is a diagnosis made for this condition? Choose all that are correct.

• Visual examination • Wood's light