Deck 3: Care of the Patient With an Integumentary Disorder

Question 1

A patient, age 26, is admitted to the burn unit with partial- and full-thickness burns to 20% of his body surface area as well as smoke-inhalation injury. Carbon monoxide intoxication secondary to smoke inhalation is often fatal because carbon monoxide

A) binds with hemoglobin in place of oxygen.
B) interferes with oxygen intake.
C) is a respiratory depressant.
D) is a toxic agent.

Answer 1

binds with hemoglobin in place of oxygen.

Question 2

A patient has generalized macular-papular skin eruptions and complains of severe pruritus from contact dermatitis. When the nurse administers his therapeutic bath, it is important to remember that

A) using Burow's solution helps promote healing.
B) rubbing the skin briskly decreases pruritus.
C) allowing 20 to 60 minutes to complete the bath will prevent pruritus.
D) sterilizing all equipment used will prevent pruritus.

Answer 2

using Burow's solution helps promote healing.

Question 3

A patient, age 46, reports to his physician's office with urticaria and papules on his hands and arms. He says, "It itches so badly." In assessing the patient, the nurse should gather data regarding recent

A) travel to foreign countries.
B) upper respiratory tract infection.
C) changes in medication.
D) contact with people who have an infectious disease.

Answer 3

changes in medication.

Question 4

A patient, age 29, is diagnosed with genital herpes. She is receiving acyclovir (Zovirax). Which would indicate a therapeutic response?

A) Decrease in pruritus
B) Decrease in pain
C) Increase in WBC count
D) Increase in activity tolerance

Question 5

A patient has been receiving penicillin, acetaminophen with codeine, and hydrochlorothiazide for 4 days. He now has a urinary tract infection. A sulfonamide has been prescribed to be taken three times per day. Several hours after the second dose , he complains of pruritus. The nurse observes a generalized erythema and rash. The most appropriate nursing intervention would be to hold

A) all medications, and notify the physician of the signs and symptoms.
B) the penicillin.
C) the acetaminophen with codeine.
D) the sulfonamide.

Question 6

A patient, age 63, has cancer of the left breast. After a modified radical mastectomy, she has been receiving chemotherapy. Her grandson, who visited a few days ago, now has varicella (chickenpox). The nurse should observe her carefully for signs of

A) herpes zoster.
B) herpes simplex type I.
C) herpes simplex type II.
D) impetigo.

Question 7

The nurse has initiated measures to promote suppuration of a carbuncle. Which assessment would indicate that these measures have been successful?

A) The area is erythematous and scaly.
B) The area has begun to drain exudate.
C) The area is not erythematous or edematous.
D) The area has stopped draining exudate.

Question 8

A patient has acne vulgaris. When the nurse explains this condition, it is most important to

A) stress the importance of strict hygiene.
B) discuss the connection of diet and stress.
C) explore how this condition is affecting his self-image and lifestyle.
D) describe in detail the proper use of prescribed medication.

Question 9

A duodenal ulcer may occur 8 to 14 days after severe burns. Usually, the first symptom is bright red emesis. Which condition matches this description?

A) Curling's ulcer
B) Paralytic ileus
C) Hypoglycemia
D) ICU psychosis syndrome

Question 10

A patient, age 37, sustained partial- and full-thickness burns to 26% of her body surface area. The greatest fluid loss resulting from her burns will usually occur

A) within 12 hours after burn trauma.
B) 24 to 36 hours after burn trauma.
C) 24 to 48 hours after burn trauma.
D) 48 to 72 hours after burn trauma.

Question 11

A 30-year-old African American had surgery 6 months ago. Her incisional site is now raised, indurated, and shiny. This tissue growth is most likely a(n)

A) angioma.
B) keloid.
C) melanoma.
D) nevus.

Question 12

A child has been sent home from school with pruritus and honey-colored crusts on his lower lip and chin. A probable diagnosis would be

A) chickenpox.
B) impetigo.
C) shingles.
D) herpes simplex type I.

Question 13

A patient, age 27, sustained thermal burns to 18% of her body surface area. After the first 72 hours, the nurse will have to observe for the most common cause of burn-related deaths, which is

A) shock.
B) respiratory arrest.
C) hemorrhage.
D) infection.

Question 14

A patient has an erythematous patch of vesicles on her scalp, and she complains of pain and pruritus. A diagnosis of tinea capitis is made. The causative organism is

A) bacterium.
B) virus.
C) worm.
D) fungus.

Question 15

The nurse is caring for a 26-year-old patient who was burned 72 hours ago. He has partial-thickness burns to 24% of his body surface area. He begins to excrete large amounts of urine. The nurse should

A) slow the IV solution and monitor for burn shock.
B) monitor for signs of infection.
C) assess for signs of fluid overload.
D) raise the foot of the bed and apply blankets.

Question 16

A patient, age 20, is admitted with severe eczema. In planning the care for her, the nurse should plan to

A) keep the skin well hydrated.
B) change the dressings every day.
C) keep the skin clean and dry.
D) administer antibiotics for the infection.

Question 17

A nurse is providing the open method of treatment for a patient who is 52 years old with burns to her lower extremities. It would be important for the nurse to

A) change the dressing using good medical asepsis.
B) provide an analgesic immediately after the dressing change.
C) perform circulation checks every 2 to 4 hours.
D) keep the room temperature at 85° F (24.4° C) to prevent chilling.

Question 18

A nurse arrives at an accident scene where the victim has just received an electrical burn. The nurse's primary concern is

A) the extent and depth of the burn.
B) the sites of entry and exit.
C) the likelihood of cardiac arrest.
D) control of bleeding.

Question 19

Most of the deaths from burn trauma in the emergent phase that require a referral to a burn center result from

A) infection.
B) dysrhythmias with cardiac arrest.
C) hypovolemic shock and renal failure.
D) adrenal failure.

Question 20

A patient has herpes zoster (shingles). A local antiviral agent, which is useful in delaying the progression of herpetic diseases, was prescribed. This medication is

A) lorazepam (Ativan).
B) hydroxyzine (Atarax).
C) acyclovir (Zovirax).
D) hydrocortisone (Solu-Cortef).

Question 21

A patient has been admitted to the hospital with burns to his upper chest. The nurse notes singed nasal hairs. It would be important for the nurse to assess this patient frequently for

A) decreased activity.
B) bradycardia.
C) respiratory complications.
D) hypertension.

Question 22

The most deadly skin cancer is ________________.

Question 23

Place the steps in order for the medical treatment during the emergent phase of burn management from the list below. Place a comma between each answer choice (a, b, c, d, etc.).

A) Transport victim to hospital.
B) Cover victim with clean cloth or sheet.
C) Stop, drop, and roll.
D) Remove all now-adherent clothing and jewelry.
E) Provide an open airway.
F) Control any bleeding.

Question 24

A patient developed a severe contact dermatitis of her hands, arms, and lower legs after spending an afternoon picking strawberries. She states that the itching is severe and she cannot keep from scratching. Which instruction by the nurse will be most helpful in managing the pruritus?

A) Use cool, wet dressings and baths to promote vasoconstriction.
B) Trim the fingernails short to prevent skin damage from scratching.
C) Expose the areas to the sun to promote drying and healing of the lesions.
D) Wear cotton gloves and cover all other affected areas with clothing to prevent environmental irritation.

Question 25

Parasitic skin diseases are identified as pediculosis or scabies. The difference between pediculosis and scabies is

A) pediculosis only occurs in poor living conditions.
B) scabies only occurs when there is poor hygiene.
C) scabies is caused by mites that burrow into the skin.
D) lice is caused by mites that attach themselves to bare areas of the skin.

Question 26

A dark-skinned patient has been admitted to the hospital in severe respiratory distress. To determine whether the patient is cyanotic, the nurse uses what knowledge of skin assessment?

A) It is not possible to assess color changes in patients with dark skin.
B) Cyanosis in patients with dark skin can be seen only in the sclera.
C) Cyanosis can be seen in the lips and mucous membranes of patients with dark skin.
D) Cyanosis will blanch out with direct pressure to the soles of the feet in dark-skinned patients.

Question 27

A patient is a 32-year-old woman whose mother recently died from malignant melanoma. She asks the nurse about what she can do to prevent the development of malignant melanoma in herself and her children. The best response by the nurse includes which information regarding risk factors for melanoma?

A) Avoid exposure to the sun and use protective measures when exposure occurs.
B) Have all nevi removed.
C) Watch for changes in moles, especially on the back.
D) There is nothing that prevents malignant melanoma, but it is curable if detected early.

Question 28

A patient has been walking in the woods. He complains of severe pruritus. The nurse notes an erythematous area on his lower legs. The first nursing intervention for dermatitis venenata would be to

A) administer Benadryl, 50 mg IM.
B) wash area with copious amounts of water.
C) apply cool compresses continuously.
D) expose area to heat and air.

Question 29

In addition to medication management of systemic lupus erythematosus, which supportive therapy would help control the disease?

A) Balanced diet and balance between rest and activity
B) Increase in activity to promote mobility
C) Exposure to the sun to increase vitamin D absorption
D) Increased sodium consumption

Question 30

The nurse debriding a wound explains the purpose of debridement is to:

A) increase the effectiveness of the skin graft.
B) prevent infection and promote healing.
C) promote suppuration of the wound.
D) promote movement in the affected area.

Question 31

The three major glands of the skin are __________, ___________, and __________.

Question 32

A common diagnostic criterion for identifying systemic lupus erythematosus (SLE) is: (Select all that apply.)

A) butterfly rash over nose and cheeks
B) photosensitivity.
C) severe abdominal pain.
D) skin ulcers.
E) polyarthralgias and polyarthritis.
F) immobility.

Question 33

During primary survey assessment of a burn patient, the nurse checks for early signs of carbon monoxide poisoning, which include: (Select all that apply.)

A) dizziness.
B) urticaria.
C) vomiting.
D) headache.
E) vertigo.
F) unsteady gait.

Question 34

Major functions of the skin include: (Select all that apply.)

A) excretion of wastes.
B) protection.
C) vitamin D synthesis.
D) temperature regulation.
E) prevention of dehydration.
F) None of the above

Question 35

Cellulitis is a potentially serious infection. In adults Staphylococcus aureus can cause which complications?

A) Sepsis and meningitis
B) Appendicitis and vasculitis
C) Tinea pedis and tinea corporis
D) Urticaria and psoriasis

Question 36

Nursing interventions and patient teaching for the treatment of head lice and scabies include: (Select all that apply.)

A) clothing, linens, and bath articles thoroughly cleaned in hot water.
B) stress nature and transmission of the disease.
C) special carbohydrate diet to promote healing.
D) complete isolation from the public.

Question 37

Nursing interventions for treatment of herpes virus infections are:

A) Keep the lesions moist to prevent pain.
B) Apply cold, moist compresses to lesions.
C) Focus on treating symptoms and preventing spread of virus.
D) Cleanse lesions with alcohol.

Question 38

Which may indicate a malignant melanoma in a nevus on a patient's arm?

A) Even coloring of the mole
B) Decrease in size of the mole
C) Irregular border of the mole
D) Symmetry of the mole

Question 39

Melanocytes give rise to the pigment melanin which is responsible for skin color. The melanocytes can be found in

A) Dermis
B) Superficial fascia
C) Epidermis
D) Loose connective tissue

Question 40

A female patient is seen by the school nurse because of flat lesions that are clear in the center with erythematous borders. In assessing a patient for tinea corporis, the nurse would check

A) soles of the feet.
B) back of the scalp.
C) groin area.
D) anterior abdomen.

Question 41

MATCHING
Match the pathophysiological stage of burns with the greatest concern.

Stage 1

A) Freedom from wound infection
B) Hypovolemia
C) Circulatory overload

Question 42

MATCHING
Match the pathophysiological stage of burns with the greatest concern.

Stage 3

A) Freedom from wound infection
B) Hypovolemia
C) Circulatory overload

Question 43

MATCHING
Match the pathophysiological stage of burns with the greatest concern.

Stage 2

A) Freedom from wound infection
B) Hypovolemia
C) Circulatory overload