Chapter 45Dermatological Dysfunction: Nursing Management My Nursing Test Banks

Chapter 45Dermatological Dysfunction: Nursing Management

MULTIPLE CHOICE

1.A clients wound is being debrided by letting a wet-to-dry dressing that is packed into the wound dry. This type of debridement is called:

1

autolytic debridement.

2

enzymatic debridement.

3

mechanical debridement.

4

sharp debridement.

ANS: 3

Mechanical debridement makes use of gauze dressing to remove necrotic or devitalized tissue from wounds. Autolytic debridement makes use of the normal phagocytic action of the macrophages and leukocytes present in the wound. Enzymatic debridement is accomplished by using a chemical debriding agent. Sharp debridement is cutting away necrotic tissue from the wound.

PTS:1DIF:AnalyzeREFebridement

2.A client is experiencing a circular lesion with an advancing, red, scaly border on the abdomen. The nurse recognizes this lesion as being:

1

tinea capitis.

2

tinea corporis.

3

tinea cruris.

4

tinea pedis.

ANS: 2

Tinea corporis is a fungal infection that involves the face, trunk, and limbs. Tinea pedis is a common infection of the feet. Tinea cruris occurs in the groin and inner thigh, and tinea capitis involves the scalp.

PTS:1DIF:AnalyzeREF:Fungal Infections

3.A client is complaining of pain and drainage coming from an area on his back. The nurse assesses the area and finds a large erythematous, swollen mass with multiple areas of purulent drainage. The nurse suspects the client has a(n):

1

abscess.

2

carbuncle.

3

furuncle.

4

papule.

ANS: 2

Carbuncles are an aggregate of infected follicles originating deep in the dermis and subcutaneous tissue. Carbuncles are many furuncles, and they form an erythematous, swollen, broad, and slowly evolving mass that can ulcerate and drain from multiple openings. A furuncle is a single localized induration that is painful. An abscess is a cavity containing pus, and a papule is a small, raised lesion.

PTS: 1 DIF: Analyze REF: Furuncles and Carbuncles

4.A client has what appears to be a bacterial infection or warts on her fingertips. This can be a sign of:

1

herpes gladiatorum.

2

herpes simplex.

3

herpes zoster.

4

herpetic whitlow.

ANS: 4

Herpetic whitlow usually occurs on the fingertips and can resemble a bacterial infection or warts. Herpes gladiatorum is most frequently found in athletes who participate in contact sports. The appearance of herpes zoster is usually down a single dermatome. Herpes simplex is usually seen orally or on the genitals.

PTS: 1 DIF: Analyze REF: Cutaneous Herpes Simplex

5.A school-age child is experiencing pruritic vesicles around the mouth. The lesions have a honey-colored crust. The nurse realizes that the child is most likely experiencing:

1

candidiasis.

2

herpes simplex.

3

impetigo.

4

tinea corporis.

ANS: 3

Impetigo is a common, superficial skin infection beginning as a focal erythema and progressing to pruritic vesicles, erosions, and honey-colored crusts. Oral herpes simplex would look like a cold sore. Tinea corporis has a circular, red, scaly border, and candidiasis is a proliferation of the normal yeast flora.

PTS: 1 DIF: Analyze REF: Impetigo

6.A client is being treated for lice. Which of the following medications would the nurse expect to see prescribed for this client?

1

Acyclovir

2

Diphenhydramine

3

Mupirocin

4

Permethrin

ANS: 4

Permethrin is applied for treatment of head lice. Diphenhydramine controls the itching but does not treat the infestation. Mupirocin treats impetigo, and acyclovir is for herpes simplex virus.

PTS: 1 DIF: Apply REF: Pediculosis

7.A client is diagnosed with genital herpes simplex virus. The nurse know that symptoms of the primary infection occur:

1

1 to 4 days after exposure.

2

3 to 7 days after exposure.

3

5 to 9 days after exposure.

4

7 to 11 days after exposure.

ANS: 2

Symptoms of the primary herpes simplex infection occur 3 to 7 days after exposure. The other choices do not describe the length of time before symptoms of the primary herpes simplex infection occur.

PTS:1DIF:AnalyzeREF:Herpes Infections

8.A client is demonstrating patches of thick, red skin with silvery scales on the elbows and knees. The nurse suspects that this client is experiencing:

1

psoriasis.

2

rosacea.

3

scabies.

4

stasis dermatitis.

ANS: 1

Psoriasis is characterized by patches of thick, red skin with silvery scales, usually on the scalp, elbows, knees, and lumbosacral areas. Rosacea is a chronic, inflammatory condition characterized by erythema, papules, pustules, and telangiectasis. Scabies is a highly contagious, pruritic skin infection caused by a mite. Stasis dermatitis is a condition that occurs on the lower extremities of patients with venous insufficiency.

PTS: 1 DIF: Analyze REF: Psoriasis

9.A middle-aged construction worker has a raised lesion with a pearly border on his arm that bleeds easily. The nurse realizes that this client most likely is experiencing a(n):

1

actinic keratosis.

2

basal cell carcinoma.

3

malignant melanoma.

4

melanoma in situ.

ANS: 2

Basal cell carcinoma in its nodular form appears as a pearly, translucent bump that bleeds easily. Actinic keratosis is seen or palpated on the face, scalp, arms, and ears. It can have a color from tan to red or have the patients normal skin tone. Malignant melanoma is a lesion that has changed its color and shape, has gotten bigger, or has an irregular border. Melanoma in situ presents with flat or raised lesions with histologic features of melanoma.

PTS: 1 DIF: Analyze REF: Nonmelanoma Skin Cancers

10.A client periodically experiences pseudofolliculitis barbae. Which of the following should the nurse instruct this client?

1

Avoid close shaving.

2

Avoid washing the hair prior to shaving.

3

Apply a topical antibiotic.

4

Contact the physician since the client needs a prescription for an oral antibiotic.

ANS: 1

Pseudofolliculitis barbae is a foreign body reaction to hair in individuals with a genetic inclination for curly, spiral-shaped hair. Prevention requires the client to avoid close shaving. This is what the nurse should instruct this client. This client is to wash the hair prior to shaving. This condition does not need an oral or topical antibiotic.

PTS: 1 DIF: Apply REF: Folliculitis

11.A client is diagnosed with tinea versicolor. Which of the following should the nurse instruct this client regarding the care for this skin condition?

1

Do nothing since there is no treatment.

2

Utilize shampoo with selenium.

3

Utilize an oral antifungal preparation as prescribed.

4

Apply warm compresses to the affected areas.

ANS: 2

Treatment for tinea versicolor includes the use of selenium shampoo. The nurse should not instruct the client to do nothing since treatment does exist for this condition. Oral antifungal preparations are not necessary for this condition. Warm compresses will not help this condition.

PTS:1DIF:ApplyREF:Fungal Infections

12.Which of the following should the nurse instruct a client who is prescribed a topical medication for a skin condition?

1

Apply directly to broken or irritated skin.

2

Apply before bathing.

3

Apply after bathing.

4

Cover the area with an occlusive dressing.

ANS: 3

The client should be instructed to apply the medication to the skin after bathing since hydration of the area will increase absorption of the medication. The medication should not be applied directly to broken or irritated skin. The medication should not be applied before bathing. The area should not be covered with an occlusive dressing.

PTS:1DIF:Apply

REF: Table 45-2 What Every Patient Needs to Know About Topical Medications

13.A client is diagnosed with a dermatologic condition causing pruritis and inflammation. Which of the following should the nurse instruct this client?

1

Use regular perfumed lotion to moisturize the skin.

2

Use scented soap to bathe the skin daily.

3

Apply skin oil daily.

4

Apply a body moisturizer to the skin within 3 to 5 minutes after bathing.

ANS: 4

Regular usage of body moisturizers, particularly within 3 to 5 minutes after bathing or showering, will aid in the prevention of dry, flaking, and itching skin. Perfumed lotions and scented soaps contain alcohol, which will exacerbate pruritis and inflammation. Skin oil does not penetrate into the skin.

PTS: 1 DIF: Apply REF: Moisturizers and Lubricants

MULTIPLE RESPONSE

1.The nurse is assessing a clients skin for signs of normal aging. Which of the following are skin changes seen with aging? (Select all that apply.)

1

Lentigo

2

Loss of subcutaneous tissue

3

Telangiectasias

4

Thickened, wrinkled, yellowish skin

5

Thin, fragile, and inelastic skin

6

Seborrheic keratosis

ANS: 2, 5

Thin, fragile, inelastic skin that has the loss of subcutaneous tissue is the result of normal aging. Skin that has aged as a result of sun damage exhibits a thickened, wrinkled, yellow appearance. It may also have telangiectasias, lentigo, or seborrheic keratosis.

PTS: 1 DIF: Analyze REF: Table 45-3 Normal Aging versus Photoaging Skin

2.A client is diagnosed with severe nodulocystic acne. The nurse should instruct the client on which of the following types of treatments? (Select all that apply.)

1

Oral antibiotics

2

Benzoyl peroxide

3

Sulfur

4

Intralesional injections

5

Soap and water

6

Topical therapy

ANS: 1, 4, 6

Treatment for severe nodulocystic acne includes oral antibiotics, intralesional injections, and topical therapy. Benzoyl peroxide is indicated for mild and moderate acne. Sulfur is indicated for moderate acne. Soap and water is indicated for mild acne.

PTS: 1 DIF: Apply REF: Acne

3.A client is diagnosed with cellulitis. Which of the following will the nurse most likely assess in this client? (Select all that apply.)

1

Heat

2

Redness

3

Swelling

4

Pain

5

Glossy, stretched skin appearance

6

Thirst

ANS: 1, 2, 3, 4, 5

Cardinal signs of cellulitis include heat, redness, swelling, pain, and a glossy, stretched appearance of the skin. Thirst is not associated with cellulitis.

PTS: 1 DIF: Apply REF: Cellulitis

4.A client is diagnosed with rosacea. Which of the following should the nurse instruct the client regarding this condition? (Select all that apply.)

1

Avoid sunlight.

2

Avoid alcohol.

3

Avoid spicy food.

4

Wash the face five times a day.

5

Wash the face with a clean washcloth.

6

Apply medication to affected areas immediately after washing the face.

ANS: 1, 2, 3

Treatment of rosacea includes avoiding sunlight, alcohol, and spicy food. The client should be instructed to not overwash the face. Washcloths should not be used. Medication should be applied to the entire face, waiting 15 to 20 minutes after washing to apply.

PTS: 1 DIF: Apply REF: Rosacea

5.A client is diagnosed with a viral skin infection. The nurse realizes that which of the following medications may be prescribed for this client? (Select all that apply.)

1

Nystatin (Mycostatin)

2

Docosanol (Abreva)

3

Boric acid

4

Penciclovir (Denavir)

5

Hydrogen peroxide

6

Acyclovir (Zovirax)

ANS: 2, 4, 6

Antiviral medications include docosanol (Abreva), penciclovir (Denavir), and acyclovir (Zovirax). Nystatin (Mycostatin) is an antifungal medication. Boric acid is an antipruritic solution. Hydrogen peroxide is an antiseptic solution.

PTS: 1 DIF: Analyze REF: Table 45-1 Agents to Treat Skin Conditions

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