Nursing 183 Test 1

When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of:

10 to 20 mm Hg.

A client is receiving phenylephrine eye drops in preparation for ophthalmoscopy. The client receives the final dose of drops at 10:30 a.m. The nurse informs the client that he will begin to notice the effects of the drug beginning to wear off around what time?

1:30 p.m.

The nurse is teaching health promotion to a class on osteoporosis prevention. The nurse determines that the participants understand the teaching when they identify that the amount of sun exposure needed to synthesize sufficient vitamin D is what?

5 to 30 minutes twice a week

How do you test for melanoma?

A biopsy test will confirm the diagnosis

what preattack symptom may a patient with Meniere's disease report prior to an attack?

A full feeling in the ear

What is a secondary lesion?

A lesion that results from the primary lesion, caused by scratching/trauma/infections

What is a Tzanck smear?

A test used to examine cells from blistering skin conditions such as herpes zoster, varicella, herpes simplex, and all forms of pemphigus

Which type of glaucoma presents an ocular emergency?

Acute angle-closure glaucoma

What are some nursing diagnoses for melanoma?

Acute pain Anxiety Depression Deficient knowledge

What term refers to the absence of the natural lens?

Aphakia

The nurse is demonstrating how to perform punctal occlusion. What activitie does the nurse perform?

Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

When would hyperpigmentation occur?

As a result of a sun injury or as a result of aging

A nurse is caring for a patient scheduled to have angiography of the right eye in 1 hour. What is the highest priority nursing intervention?

Assess blood urea nitrogen (BUN) and creatinine levels.

Using the acronym ABCDE, what do you want to assess for skin cancer?

Asymmetry Border irregularity Color change/variation Diameter (6mm or larger) Evolving (growing or changing in appearance)

When do the apocrine sweat glands become active?

At puberty

What term 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. what should the nurse include?

Avoid cosmetics with fragrance.

What is the most common type of skin cancer?

Basal cell carcinoma (BCC)

During a routine examination of a client's fingernails, the nurse notes a horizontal depression in each nail plate. When documenting this finding, the nurse should use which term?

Beau's line

Transverse depressions know as WHAT in nails, may reflect retarded growth in the nail matrix because of severe illness or local trauma.

Beaus lines

What is the treatment for seborrhea?

Because there is no known cure, therapy is used to control the disorder and allow the skin to repair itself

The nurse is caring for a patient with a suspected malignancy of the skin. The nurse anticipates that the patient will undergo what diagnostic test?

Biopsy

Describe Cyanosis

Bluish discoloration that results from a lack of oxygen in the blood

What brain structure is responsible for equilibrium?

Cerebellum

Which medication classifications increases aqueous fluid outflow in the patient with glaucoma?

Cholinergics

What patient activity indicates to the nurse that a patient understands how to correctly instill ophthalmic medications?

Client pulls the tissue near the cheek downward to instill medication.

What can occur in nails from hypoxia, and is manifested by straightening of the normal nail and softening of the nail bed?

Clubbing

The nurse recommends what type of therapeutic bath for its antipruritic action?

Colloidal (Aveeno, oatmeal)

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?

Contact dermatitis

What are used widely in treating dermatologic conditions to provide anti-inflammatory, antipruritic, and vasoconstrictive effects?

Corticosteroids

What medication classification may be used for contact dermatitis?

Corticosteroids

What medication needs to be withheld for 5 to 7 days prior to cataract surgery?

Coumadin

What sign may be the first manifestation of human immunodeficiency virus (HIV)?

Cutaneous signs

After teaching a group of students about the structure of the skin, the nursing instructor determines that the teaching was successful when the group identifies which of the following as the true skin?

Dermis

What term refers to altered sensation of orientation in space?

Dizziness

Describe hirsutism

Excessive hair growth on the face, chest, shoulders, and pubic area

What is the leading cause of skin cancer?

Exposure to the sun

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone causing what effect?

Facial nerve paralysis

What are some risk factors for sun cancer?

Fair skin type, blue eyes Chronic sun/uv exposure Family history Exposure to tar and chemicals Outdoor occupations or recreational activities Smoking

The nurse is conducting a community education program on malignant melanoma. When the participants identify what risk factor does the nurse know that they understand the teaching?

Family history of pancreatic cancer

Whar nonsedating antihistamines is appropriate for daytime pruritus?

Fexofenadine (Allegra)

When the nurse is assessing the skin of a patient with tinea pedis, a linear crack is noted. This is documented by the nurse as which of the following?

Fissure

What term refers most precisely to a localized skin infection of a single hair follicle?

Furuncle

What action helps the nurse to determine the quality of the skin turgor?

Grasping the skin

The nurse should monitor for what manifestations in a patient who has had LASIK surgery?

Halos and glare

For people with dark skin, what color does healthy skin appear?

Healthy skin has a reddish base or undertone

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color?

Hemangioma

The nurse is assessing the integumentary system of a female patient with Cushing's syndrome. The nurse anticipates what finding?

Hirsutism

What dressing is a polymer with 90-95% water? They require a secondary dressing to keep them in place.

Hydrogel

what sedative medications is effective for treating pruritus?

Hydroxyzine (Atarax)

Production of melanin is controlled by a hormone secreted from which gland?

Hypothalamus

A patient with a history of chronic respiratory illness exhibits nail clubbing. The nurse interprets this finding as indicating what?

Hypoxia

The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states what?

I need to keep my ear canal clean and dry.

what reflects the pathophysiology of cutaneous signs of HIV disease?

Immune function deterioration

A client presents in the emergency department with complaints of cough, headache, and generalized aches and pains. Upon assessment, the nurse documents a temperature of 102.5° F (39.2° C) and redness on the arms, legs, and upper chest. She also notes that the client takes eight different medications each day. What nursing diagnosis is the priority for this client?

Impaired tissue integrity

The nurse notes several very small, round, red and purple macules on a patient's skin. The patient has a history of anticoagulant use. The nurse records this finding as what?

Petechiae

What is associated with bleeding tendencies or emboli to the skin?

Petechiae

What term refers to the progressive hearing loss associated with aging?

Presbycusis

Laurie Sharples, a 45-year-old teacher, is being seen at the ophthalmic group where you practice nursing due to a vision change. She's noticed an inability to read material as she had previously, needing to extend her arms to make the print readable. What is the term used to describe her visual condition?

Presbyopia

A 15-year-old pubescent boy is visiting a primary care group for a sports physical for high school. Findings on the face and body indicate that the client is overproducing sebum, which is consistent with his age. What is the primary function of sebum?

Prevents drying and cracking of the skin and hair

The nurse is reviewing the medical record of a client with glaucoma. What would alert the nurse to suspect that the client was at increased risk for this disorder?

Prolonged use of corticosteroids

What are the functions of the skin?

Protection Sensation Fluid Balance Temp Regulation Vitamin D Production Immune Response Function

What may be the first indication of a systemic internal disease such as diabetes mellitus, blood disorders, or cancer?

Pruritus

Photochemotherapy combines the use of ultraviolet A (UVA) and what medication?

Psoralen

Photochemotherapy involves a combination of psoralen methoxsalen and type A ultraviolet light. The psoralen methoxsalen is taken 1 to 2 hours before exposure to ultraviolet A. What problem is this used to treat?

Psoriasis

Describe Erythema

Redness of the skin caused by the congestion of capillaries

What is an accurate statement regarding refractive surgery?

Refractive surgery is an elective cosmetic surgery performed to reshape the cornea.

What are some goals for pts with melanoma?

Relief of pain and discomfort Reduced anxiety and depression Increased knowledge of early signs of melanoma Absence of complications

What are some nursing interventions for melanoma?

Relieve pain and discomfort Reduce anxiety and depression Monitor and manage potential complications

What surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?

Scleral buckle

What is the scratch itch cycle?

Scratching of a pruritus area causes the inflamed cells and nerve endings to release histamine, which produces more pruritus

What is an excessive production of sebum in areas where sebaceous glands are normally found in large numbers, such as the face, scalp, eyelids, ears, ect.?

Seborrhea

With repeated reactions of contact dermatitis, what can occur?

Secondary bacterial infection

Nursing students are reviewing information about various types of skin lesions. The students demonstrate understanding of the information when they identify what as a vascular lesion?

Spider angioma

What shaped nails can indicate a severe iron deficiency anemia?

Spoon shaped

What provides the most effective barrier to epidermal water loss and penetration of environmental factors such as chemicals, microbes, and insect bites? (Outer layer of the epidermis)

Stratum corneum

What promotes skin mobility, molds body contours, and insulates the body?

Subcutaneous tissue

What is a definition of ossiculoplasty?

Surgical reconstruction of the middle ear bones

What does not occur until the core body temperature exceeds 37*C, regardless of skin temperature?

Sweating

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision

sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

Susan James has come to the clinic for a physical examination. The nurse is examining her hair. What are the characteristics of a normal scalp?

smooth free of lesions intact

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

the infection results from reactivation of the chickenpox virus.

What client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis?

"My eyelids were stuck together this morning."

A patient is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride (Ophthaine 0.5%) per orders to assess visual acuity. The patient requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse?

"Prescriptions of this medication are generally not given because it can cause corneal problems."

A 52-year-old woman comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." What by the nurse would be most appropriate?

"You'll need to use the drops for the rest of your life to control the glaucoma."

A patient comes into the hospital with a Tegaderm dressing in place on his buttocks. The nurse documents this as being which type of dressing?

Passive

A nurse is preparing a patient with a history of allergies for diagnostic testing. What test would the nurse anticipate as being most likely?

Patch testing

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

Myopia

The nurse is assessing an African American patient and notes a streak of pigmentation in the patient's fingernails. The nurse determines that this finding indicates what?

Normal variation

What dressing covers topical medication that is applied to a skin lesion? The area is kept airtight by using a plastic film.

Occlusive dressing

What describes a condition characterized by abnormal spongy bone formation around the stapes?

Otosclerosis

Development of malignant melanoma is associated with what risk factor?

Individuals with a history of severe sunburn

What are some client teachings with seborrhea?

Inform the client to avoid external irritants, excessive heat, and perspiration

When assessing the skin, what do you want to do as a nurse?

Inspect entire body Wear gloves Assess any lesions Note hair distribution

The nurse is caring for a patient with a skin lesion that is oozing. The surrounding skin is acutely inflamed. What type of dressing should the nurse apply?

Interactive

During a routine assessment of a patient, the nurse notes that the nails are concave shaped. What is indicated by this finding?

Iron deficiency anemia

The nurse is conducting a community education program on basal cell carcinoma (BCC). What statement should the nurse make?

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

What does pruritus mean?

Itching

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

Keloid

What surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer?

LASIK

Which type of cell is believed to play a significant role in cutaneous immune system reactions?

Langerhans cells

The nurse caring for a patient notes that the patient'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 being which of the following?

Lichenification

The nurse is instructing unlicensed personnel on gerontologic considerations of the skin. The nurse finds that the participants understand the instructions when they know that the elderly are at a higher risk for shear injuries due to what?

Loss of rete ridges

The nurse is instructing unlicensed personnel on gerontologic considerations of the skin. The nurse finds that the participants understand the instructions when they know that the elderly are at a higher risk for shear injuries due to which of the following?

Loss of rete ridges

What is a factor that causes wrinkles among older adults?

Loss of the subcutaneous tissue

The nurse is preparing to perform a Wood's light examination. What would be the most important thing for the nurse to do?

Make sure that the room is darkened.

What is the most common cause of hair loss?

Male pattern baldness

Marshall Dunbar, a 7-year-old second grader, is being seen by the pediatric ophthalmologist due to recent vision changes. After his examination by the physician, you discuss his diagnosis with his parents. In explaining myopia, what do you indicate is the cause of Marshall's vision change?

Marshall has elongated eyeballs.

Which group of medications causes pupillary constriction?

Miotics

Which dressing is very efficient at removing exudate because of its higher moisture vapor transmission rate? It improves fibrinolysis, reduces pain, fewer infections, and there is less scar tissue.

Moisture Retentive dressings

What is the term for swelling of the optic disc due to increased IOP?

Papilledema

What is a primary skin lesion?

The first evidence of a lesion, characteristic of the disease itself

Where are sweat glands most heavily concentrated on the body?

The palms of the hands and soles of the feet

What is the largest organ in the body?

The skin

What are some normal aging changes of the skin?

Thinning of skin Uneven pigmentation Wrinkling, skin folds, and decreased elasticity Dry skin Diminished hair Increased fragility and increased potential for injury Reduced healing ability

What is the purpose of melanin?

To determine skin color

What is a Wood's light used for?

To differentiate epidermal from dermal lesions and hypopigmented and hyperpigmented lesions from normal skin

What is the goal of treatment for skin cancer?

To eradicate the tumor

When is a patch test used?

To identify substances to which the pt has developed an allergy; involves applying the suspected allergens to normal skin under occlusive patches

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?

To prevent evaporation of water from the hydrated epidermis.

What are some risk factors for malignant melanoma?

UV rays Immunosuppression Exposure to environmental hazards-agent orange Dysplastic nevus (multiple changing moles) Family history of melanoma

What are some basic skin care techniques?

Use a mild, lipid free soap Rinse the area completely and blot it dry with a soft cloth Avoid deodorant soaps and laundry detergents

Acoustic neuromas are benign tumors of which of the following cranial nerves?

VIII

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection?

Viral

What term refers to a condition characterized by destruction of the melanocytes in circumscribed areas of the skin?

Vitiligo

While assessing a patient at the clinic the nurse notes patchy, milky white spots. The nurse knows that this finding is a symptom of what?

Vitiligo

What are yellowish waxy deposits on the upper and lower eyelids?

Xanthelasma

Describe Jaundice

Yellowing of the skin that is first observed in the sclerae and mucous membranes of the eye

The nurse is reading the physician's report of an elderly patient's physical examination. The patient demonstrates xanthelasma, which refers to which of the following symptoms?

Yellowish waxy deposits on upper eyelids

A client is color blind. The nurse understands that this client has a problem with:

cones

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 how?

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