Review Chapter 57 Skin Disorders
2. Which action should a nurse implement to make a patient with atopic dermatitis more comfortable? a. Instruct the patient to wear loose clothing. b. Add alcohol to the bath water. c. Provide a diet low in fat. d. Increase the room temperature between 78 F and 80 F.
A
22. While assessing an obese older patient in a long-term care facility, you notice that the patient has intertrigo in body folds (axilla, beneath the breasts). Which measure is most appropriate to reduce the risk of a recurrence? a. Keep body folds clean and dry b. Reduce bathing to 3 times each week c. Liberally sprinkle cornstarch on body creases d. Scrub affected areas with topical antiseptics
A
4. Which is an appropriate implementation for a patient with severe psoriasis who has an altered self-concept? a. Touching the patient often b. Reassuring the patient of a quick remission c. Reminding the patient to bathe often d. Promptly administering medications as needed
A
6. A family member of an older patient with severe dermatitis says, "I was always so careful to bathe him every day. I guess I just wasn't careful enough." What is the best response by the nurse? a. "Dermatitis is not caused by poor hygiene." b. "Don't worry; we will bathe him thoroughly while he is here." c. "You will have a chance to do better when he is back at home." d. "You shouldn't feel like the skin condition is your fault."
A
19. You are caring for a client who is experiencing severe itching secondary to atopic dermatitis. Which of the following measures should be recommended to help prevent scratching and skin injury? (Select all that apply.) a. Maintain the room temperature around 70°F b. Apply keratolytic agents liberally to affected areas c. Wash new clothing before wearing it d. Take daily hot baths e. Wear loose clothing
ACE
12. A physician asks a nurse to take a smear from herpetic lesions in an older patient's hip to diagnose the disorder. What is the most probable test that will be performed? a. Culture and sensitivity test to a bactericide b. Tzanck test to test for viral culture c. Complete blood count to assess the white blood count for response to a pathogen d. Titration for the strength of the pathogen
B
13. How does cutaneous T-cell lymphoma differ from squamous cell and basal cell carcinomas? a. Does not metastasize. b. Has a cause unrelated to sun exposure. c. Can be treated with radiation. d. Can be treated topically.
B
17. During the first 24 hours after a burn, fluid replacement is the treatment priority. Which assessment should alert the nurse that the fluid protocol is ineffective? a. Rectal temperature of 101F b. Urine output of 20 mL/hr c. Crackles in the lower left lobe d. Significant edema in the burn area
B
26. Characteristics of typical melanomas include which of the following? a. Nodular lesion with a pearly appearance b. Irregular lesion with uneven coloration c. Scaly ulcer with no clear margins d. Painful red, blue, or purple macules
B
3. Which sign or symptom suggests that a patient with skin breakdown is developing a systemic infection? a. Lesion on the patient's leg that is swollen and warm to the touch b. Temperature that has risen to 101 F c. Blood pressure that has risen from 126/84 to 130/86 mm Hg d. Request by the patient for medication for severe itching
B
7. A nurse is caring for an obese patient who has been bedridden for a long time and who has a high risk for infection. Where is the best location for the nurse to assess for the moist red lesions of Candida albicans? a. Scalp, behind the ears b. Abdominal skinfolds c. Shaft of the penis d. Sacrum and bony prominences
B
1. A nurse is caring for a patient with pruritus. Which implementation can the nurse perform without a physician's order? a. Apply topical corticosteroids to affected areas. b. Administer an antihistamine. c. Apply lubricant to unbroken skin. d. Bathe the patient in an oatmeal bath.
C
16. What should a nurse be sure to frequently assess when caring for a burn patient with eschar formation around an entire arm? a. Urine output b. Pain level c. Capillary refill d. Breath sounds
C
24. Which of the following is a drug used to treat HSV-1? a. Hydrocortisone (Cortizone) b. Isotretinoin (Accutane) c. Acyclovir (Zovirax) d. Methoxsalen (Oxsoralen)
C
5. A patient with severe psoriasis who is to be treated with the systemic drug methotrexate sodium anxiously asks, "Is this cancer drug safe? Are there some side effects I need to know about?" What is the best response by the nurse? a. "Yes, methotrexate is used to treat cancer and psoriasis, and it has no severe side effects." b. "No, it is not a cancer drug, but you should ask your physician about concerns regarding your therapy." c. "We use this drug to treat many kinds of patients, including patients with cancer. You will have periodic blood tests." d. "I don't know if it is used with patients with cancer, but the drug can be used when conditions are as severe as yours."
C
8. What information is most essential for a nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane) for acne? a. Usual weight b. Family history of breast cancer c. Current method of birth control d. Drugs previously used
C
9. An excited mother of a teenage boy with severe acne furiously reports to the nurse, "I've told him a thousand times he should bathe more often! I've kept after him about all that junk food he eats. I jump on him when I see him squeezing his zits. I tried to get him to scrub his face three times a day!" Which statement indicates the most likely cause of the boy's acne? a. Poor personal hygiene b. Ingestion of junk food c. Squeezing lesions d. Need for facial scrubs
C
10. A patient who has undergone treatment for herpes simplex virus type 2 (HSV type 2) expresses relief that she is cured. What should the nurse include in her teaching? a. Daily douches of Burow solution are needed. b. HSV is permanently cured by acyclovir (Zovirax). c. Sexual partners are now safe from infection from her. d. HSV lies dormant and can be triggered without any sexual contact.
D
11. An 80-year-old patient comes to the emergency department with extreme pain and itching in the hip and leg and has herpetic vesicular lesions on the left hip. What should the nurse inquire about patient exposure to? a. HSV, type 1 b. HSV, type 2 c. Smallpox d. Chickenpox
D
14. A nurse is caring for an adult patient with extensive burns on the front of the trunk, including the genitalia, and the fronts of both legs. How should the nurse document the burn size using the rule of nines? a. 13% b. 17% c. 25% d. 37%
D
15. Which assessment by an emergency department nurse most indicates that a burn patient might be at risk for respiratory impairment? a. Burns on the face and neck b. Respiration of 18 breaths/min c. Flaring nares d. Sooty sputum
D
20. You are caring for a client who asks you about the causes of contact dermatitis. You understand that contact dermatitis is caused by which of the following? a. Infestations of parasites b. Reactions to drugs c. Excessive skin dryness d. An allergic response
D
23. You are caring for a female patient who is being treated with isotretinoin (Accutane) at the clinic for severe acne after other treatments have failed. All of the following statements should be included in the teaching plan. Which of the following statements is most important? a. "Your skin may become very dry and peel." b. "It may take several months to see improvement." c. "You will sunburn very easily while on this drug." d. "If sexually active, you must use reliable contraception."
D
21. You are giving a lecture to a group of clients who have psoriasis. Your discussion should include which of the following? (Select all that apply.) a. Psoriasis can usually be cured with drug therapy. b. Direct contact with others can transmit psoriasis. c. Anthralin must be kept on the skin continuously. d. Psoriasis can be aggravated by stress. e. Treatment may include methotrexate and ultraviolet light (UVA).
DE
18. A nurse is alert for the expected fluid shift in the patient who was burned 24 hours earlier. _____ (Place the events in the appropriate sequence. Do not separate answers with a space or punctuation. Example: ABCD.) a. Fluid volume deficit occurs. b. Blood is shunted from the kidneys to compensate for a loss of fluid volume. c. Urine output decreases. d. Generalized edema occurs. e. Hypoproteinemia causes fluid to move from the bloodstream to extracellular space
EDABC
25. What is the best way to prevent skin cancer?
avoid excessive sun exposure
