Deck 50: Skin Disorders

Question 1

The implementation that would make a patient with atopic dermatitis more comfortable is to:

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.

Answer 1

Instruct the patient to wear loose clothing.

Question 2

An appropriate implementation for a patient with severe psoriasis who has a nursing diagnosis of "Disturbed body image,related to skin lesions" would be:

A) Touching the patient often
B) Reassuring the patient of a quick remission
C) Reminding the patient to bathe often
D) Prompt administration of medications as needed

Answer 2

Touching the patient often

Question 3

The nurse organizes the nursing care plan on the nursing diagnosis of "Acute pain,related to postherpetic neuralgia." The least appropriate implementation would be to:

A) Give antiviral medication as prescribed.
B) Generously administer pain medication.
C) Offer guided imagery or distraction techniques.
D) Have the patient ambulate several times daily.

Answer 3

Have the patient ambulate several times daily.

Question 4

The daughter of an older adult patient who has just returned from surgery is distressed about her father's pale,cold hands and feet.The nurse covers the patient with an extra blanket and responds:

A) "Don't be concerned. It is quite cold in the operating room. Your dad will be warm in a minute."
B) "Older patients like your dad get a little shocky during surgery."
C) "When patients have blood loss during surgery, superficial vessels close off temporarily, resulting in cold extremities."
D) "We are watching the disturbed circulation in your dad's hands and feet very carefully."

Question 5

Information essential for the nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane)for acne is:

A) Usual weight
B) Family history of breast cancer
C) Current method of birth control
D) Drugs previously used

Question 6

Displaying her hands,a patient asks,"Do you think my liver is OK? Look at all these liver spots!" The most appropriate response would be:

A) "The spots could mean something is wrong; I will make a note of it."
B) "The spots are normal aging changes and have nothing to do with your liver."
C) "Have you recently been exposed to hepatitis?"
D) "Don't worry about them. They will fade during the winter."

Question 7

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?" The nurse's best response would be:

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."

Question 8

When 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,the nurse inquires about the exposure to:

A) HSV, type a
B) HSV, type b
C) Smallpox
D) Chickenpox

Question 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!" The complaint the nurse recognizes as a true statement about the cause of acne is:

A) Poor personal hygiene
B) Ingestion of junk food
C) Squeezing lesions
D) Need for facial scrubs

Question 10

The physician asks the nurse to take a smear from herpetic lesions in an older patient's hip to diagnose the disorder.The nurse recognizes that the probable test that will be performed is a:

A) Culture and sensitivity test to a bactericide
B) Tzanck smear to test for viral culture
C) Complete blood count (CBC) to assess the white blood count for response to a pathogen
D) Titration for the strength of the pathogen

Question 11

In taking the functional assessment of a patient with a skin disorder,the nurse will inquire about:

A) A sore that is slow to heal
B) Unusual hair growth
C) Previous skin disorders
D) Exposure to chemicals or irritants

Question 12

A confused patient who has been restrained because of combativeness and hyperactivity might,because of the restraints,display:

A) Lentigines
B) Senile purpura
C) Senile angiomas
D) Seborrheic keratoses

Question 13

The implementation that the nurse may perform for a patient with pruritus without a physician's order is to:

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.

Question 14

When assessing the capillary refill,the nurse may document as normal a refill time of __________ seconds.

A) 3
B) 6
C) 8
D) 10

Question 15

A nurse screening patients that the plastic surgeon is considering for phototherapy would exclude a:

A) 34-year-old woman with lupus erythematosus
B) 5-year-old child with pneumonia
C) 60-year-old man with a pacemaker
D) 23-year-old woman who is 3 months' pregnant

Question 16

The sign or symptom that suggests that a patient with impaired skin integrity is developing a systemic infection is a:

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

Question 17

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." The nurse's best response would be:

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."

Question 18

The nurse instructs a patient with vitiligo who is receiving phototherapy to:

A) Expose himself to the sun for several hours before treatment to acclimate the skin surface.
B) Wear protective clothing.
C) Wear loose clothing such as sleeveless T-shirts and shorts after the treatment.
D) Leave off sunglasses after treatment so that the eyes can more quickly accommodate.

Question 19

When caring for an obese patient who has been bedridden for a long time and who has a nursing diagnosis of "Risk for infection,related to obesity," the nurse should assess for the moist red lesions of Candida albicans,especially on the:

A) Scalp, behind the ears
B) Abdominal skin folds
C) Shaft of the penis
D) Sacrum and bony prominences

Question 20

A patient who has undergone treatment for herpes simplex virus type 2 (HSV type 2)expresses relief that she is cured.The nurse should include in her teaching that:

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.

Question 21

During the first 24 hours after the burn,fluid replacement is the treatment priority.The assessment that would alert the nurse that the fluid protocol is ineffective is:

A) Rectal temperature of 101° F
B) Urine output of 20 ml/hr
C) Crackles in the lower left lobe
D) Significant edema in the burn area

Question 22

The nurse is alert for the expected fluid shift in the patient who was burned 24 hours earlier.(Place the events in the appropriate sequence.)

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

Question 23

Conditions that can be improved with negative pressure therapy include: (Select all that apply.)

A) Pressure ulcers
B) Skin grafts
C) Burns
D) Dehisced surgical wounds
E) Eczema

Question 24

In a burn patient with eschar formation around an entire arm,the nurse will include frequent assessment of:

A) Urine output
B) Pain level
C) Capillary refill
D) Breath sounds

Question 25

The nurse collecting tissue for a Tzanck smear will: (Select the appropriate interventions and place the steps in sequence.)

A) Open the lesion with a hypodermic needle.
B) Place the specimen in a culture tube, and take to the laboratory.
C) Saturate the sterile swab with exudates.
D) Wash the lesion.
E) Place a pressure dressing on the lesion.

Question 26

In performing a physical assessment on an 80-year-old man,the nurse anticipates that the age-related skin changes will be: (Select all that apply.)

A) Increased nasal hair
B) Flattened nails
C) Small macular lesions at the hairline
D) Increased hair on the helix of the ear
E) Presence of seborrheic keratosis

Question 27

The assessment by the emergency department nurse most indicative that a burn patient might be at risk for respiratory impairment is:

A) Burns on the face and neck
B) Respiration of 18 breaths/min
C) Flaring nares
D) Sooty sputum

Question 28

The 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.Using the rule of nines,the nurse would document that the burn size as:

A) 13%.
B) 17%.
C) 25%.
D) 37%.

Question 29

The nurse explains that the major characteristic that differentiates cutaneous T-cell lymphoma from squamous cell and basal cell carcinomas is that cutaneous T-cell lymphoma:

A) Does not metastasize.
B) Has a cause unrelated to sun exposure.
C) Can be treated with radiation.
D) Can be treated topically.