Deck 43: Care of Patients With Integumentary Disorders and Burns

Question 1

The nurse counsels a patient with poison ivy to decrease his discomfort by:

A)bathing in warm water.
B)maintaining an environment of 80° to 85° F.
C)scrubbing skin to break the vesicles.
D)patting skin dry.

Answer 1

patting skin dry.

Question 2

The nurse recommends that the person who suffers with psoriasis can increase his comfort by:

A)using drying solutions such as alcohol to clean psoriasis plaques.
B)using a humidifier to keep psoriasis plaques moist.
C)applying wet dressing to minimize proliferation.
D)taking hot baths to reduce skin discomfort.

Answer 2

using a humidifier to keep psoriasis plaques moist.

Question 3

In caring for a stage IV pressure ulcer,the nurse assesses the purulent drainage as creamy yellow with a necrotic odor.The nurse is aware that this type of exudate is probably caused by:

A)Proteus.
B)Bacteroides.
C)Staphylococcus.
D)Pseudomonas.

Answer 3

Staphylococcus.

Question 4

The nurse is caring for a patient diagnosed with shingles.The patient has been complaining of constant pain along the sciatic nerve.What intervention by the nurse can best help to provide pain relief?

A)Distract the patient with conversation.
B)Massage the area of pain.
C)Move the affected leg through range of motion (ROM).
D)Change the patient's position frequently.

Question 5

An 84-year-old patient who has had a low-grade fever for 2 days complains of pain in the hip that travels down the leg along the sciatic nerve.The nurse assesses small groups of vesicles along the nerve path.These assessments lead the nurse to suspect that the patient is suffering from:

A)herpes simplex.
B)shingles.
C)carbuncles.
D)furuncles.

Question 6

The nurse explains that the primary purpose of the whirlpool bath given to the patient with a stage III pressure ulcer is to:

A)keep the patient clean.
B)stimulate granulation tissue growth.
C)improve circulation in surrounding skin.
D)provide moisture to the ulcer.

Question 7

A patient with psoriasis is placed on PUVA therapy.The nurse clarifies that this therapy involves the combination of:

A)radiation and corticosteroids.
B)x-rays and methotrexate.
C)artificial ultraviolet (UV) rays and a coal tar product.
D)laser treatment and antimetabolites.

Question 8

The nurse would question the order for isotretinoin (Accutane)that was prescribed for a:

A)20-year-old man with nodular acne who is an epileptic.
B)22-year-old woman with severe acne who is pregnant.
C)46-year-old woman with cystic acne who is on oral contraceptive pills.
D)50-year-old man with cystic acne who is on medication for hypertension.

Question 9

The nurse places a catheter drainage bag with a urometer on the catheter of the adult patient with a burn in order to measure hourly urine output.The nurse is aware that a minimum acceptable urine output is _____ mL/hr.

A)10
B)20
C)30
D)40

Question 10

The nurse advises a 20-year-old college sophomore with acne vulgaris to:

A)avoid all chocolate.
B)wash the face gently with mild soap.
C)scrub the face with soft brush.
D)express clogged sebum from the pores.

Question 11

The patient with shingles has been on an antiviral medication since the vesicles appeared.The nurse encourages the patient that such early treatment will probably prevent:

A)postherpetic pain.
B)outbreak of more vesicles.
C)lesions attacking the eye.
D)pain of the disease.

Question 12

The nurse admitting a patient with significant burns to the emergency department notes the presence of symptoms consistent with an inhalation burn.Which finding is the nurse most likely noting?

A)Full-thickness burns to chest
B)Hypotension
C)Agitation
D)Persistent coughing

Question 13

A patient with acne rosacea is sensitive about the facial erythema and telangiectases.The nurse recommends that she:

A)drink 4 ounces of wine a day for vasodilation.
B)cease smoking.
C)avoid direct sunlight.
D)forgo coffee and tea.

Question 14

The home health nurse instructs the family whose child came home from school with lice that the bed linens should be:

A)thrown out in a sealed garbage bag.
B)washed with strong bleach solution.
C)washed and dried on the hottest setting.
D)washed and dried at least through three cycles.

Question 15

While bathing a patient,the nurse assesses a red,unblanchable area on the coccyx.The best dressing for this lesion is a ________ dressing.

A)transparent film
B)hydrocolloid
C)fluffy absorbent
D)wet-to-dry

Question 16

The Parkland fluid resuscitation calculation calls for 8000 mL.The burn occurred at noon.The present time is 2:00 PM.The fluid should be set to deliver _____ mL by _____ PM.

A)2000, 6:00
B)3000, 7:00
C)4000, 8:00
D)7000, 9:00

Question 17

While bathing a patient,the nurse discovers a grayish black,nodular growth that resembles a blackberry in the middle of the patient's back.The nurse should:

A)encourage the patient to seek medical care as the findings are consistent with malignant melanoma.
B)teach the patient how to assess for changes in the growth
C)document finding an actinic keratoses on the back.
D)suggest the patient get treatment for a growth that is consistent with squamous cell carcinoma.

Question 18

The patient with a stage III pressure ulcer that will not heal is horrified about being hooked up to a unit providing voltage stimulus to the wound.The nurse explains that the electrical stimulation will:

A)sterilize the wound.
B)increase blood vessel growth.
C)cause the ulcer to close by scabbing.
D)coagulate the drainage.

Question 19

A 75-year-old patient questions the nurse about the need to consider a vaccine to prevent the development of shingles.What response by the nurse is most appropriate?

A)"The incidence of shingles in people your age is not overly common, making the need for vaccination unnecessary."
B)"The vaccination is still under study so I would not recommend you consider it."
C)"Considering the incidence of shingles in your age group taking the vaccination should be considered."
D)"The vaccination is considered a positive option for your age group and will provide for lifelong immunity."

Question 20

To prevent contractures in the burn patient,the nurse should:

A)assist the patient to ambulate as soon as fluid shift has stabilized.
B)leave the limbs in full extension.
C)stop range-of-motion (ROM) exercises when the patient complains of pain.
D)place the limbs in the flexion position.

Question 21

The nurse read in the patient's chart that the patient has a stage III pressure ulcer.Which assessment findings are consistent with this stage of ulcer?

A)Damage to the subcutaneous tissue
B)Unblanching skin
C)Presence of mottled skin
D)Damage limited to the epidermis

Question 22

The nurse describes common complications that burn patients may experience.Match the burn complication with the description that best fits it.

Inflammatory response causing fluid shift

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 23

The nurse is providing education about dietary selections that will promote wound healing.The selection of which menu options should be included? (Select all that apply.)

A)Tofu
B)Wheat bread
C)Lean beef
D)Citrus fruits
E)Leafy green vegetables

Question 24

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Mast cell-stimulated release of histamine

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 25

An 86-year-old resident struck her forearm on a table,causing a category I L-shaped skin tear 6 cm ´ 2 cm.The nurse should: (Select all that apply.)

A)clean the tear with alcohol.
B)approximate the edges of the tear.
C)secure the skin flap with Steri-Strips.
D)cover with a nonadherent dressing.
E)assess closely for 5 days for signs of infection.

Question 26

The nurse describes common complications that burn patients may experience.Match the burn complication with the description that best fits it.

Potassium released from damaged cells

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 27

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Cell-mediated immunity resulting in inflammatory response

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 28

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Rash associated with poison ivy

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 29

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Lesions may become ulcerated

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 30

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Erythema and pruritus with scaling associated with phlebitis

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 31

An adult male patient enters the emergency department with full- and partial-thickness burns on the entire right leg,front of the right arm,and one half of the front torso.The nurse,using the "rule of nines," assesses the burn as ____%.

Question 32

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Scaly lesions on scalp,ear canals,and eyebrows

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 33

The interventions for a burn patient newly admitted to the emergency department include: (Select all that apply.)

A)covering the burn with sterile saline-saturated towel.
B)removing clothing stuck to burn.
C)taking care not to disturb blisters.
D)removing jewelry from injured limbs.
E)assessing the cause of the burn.

Question 34

Matching
The nurse differentiates the various type of dermatitis.Match each option with the characteristics that best describe it.(Options may be used once, more than once, or not at all.)

Appearance of vesicular lesions following inflammatory response

A)Contact dermatitis
B)Atopic dermatitis
C)Stasis dermatitis
D)Seborrheic dermatitis

Question 35

The nurse describes common complications that burn patients may experience.Match the burn complication with the description that best fits it.

Negative nitrogen balance

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 36

The home health nurse gives instructions to a patient in avoiding recurrence of athlete's foot,which includes: (Select all that apply.)

A)wear clean cotton socks.
B)wear shoes that allow ventilation.
C)use only clean towels.
D)wash and dry feet daily.
E)apply antibacterial medication to feet.

Question 37

Using the Parkland formula,the fluid needed for a person weighing 140 pounds with a 25% burn would be _____ mL.

Question 38

The mother of a 4-year-old child reports concerns about how to completely rid her home of lice.Which response by the patient indicates the need for further instruction?

A)"I will need to treat my bedding and furniture."
B)"A re-treatment will be needed about a week after the first one."
C)"I will need to discard my child's stuffed animals and dolls."
D)"I should avoid using Lindane."

Question 39

The nurse describes common complications that burn patients may experience.Match the burn complication with the description that best fits it.

Increased viscosity of blood slowing blood flow to small vessels

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 40

The nurse describes common complications that burn patients may experience.Match the burn complication with the description that best fits it.

Loss of fluid from vascular space

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 41

The nurse describes several types of burn treatment.Match the burn treatment to the statement that best describes it.

Wound covered with ointment,and additional environmental warmth provided

A)Open technique
B)Closed technique
C)Escharotomy
D)Allograft
E)Xenograft

Question 42

The nurse describes several types of burn treatment.Match the burn treatment to the statement that best describes it.

Biologic dressing obtained from a pig

A)Open technique
B)Closed technique
C)Escharotomy
D)Allograft
E)Xenograft

Question 43

The nurse describes several types of burn treatment.Match the burn treatment to the statement that best describes it.

Incision into subcutaneous tissue to increase circulation

A)Open technique
B)Closed technique
C)Escharotomy
D)Allograft
E)Xenograft

Question 44

The nurse describes several types of burn treatment.Match the burn treatment to the statement that best describes it.

Biologic dressing obtained from a cadaver

A)Open technique
B)Closed technique
C)Escharotomy
D)Allograft
E)Xenograft

Question 45

The nurse describes several types of burn treatment.Match the burn treatment to the statement that best describes it.

Wound covered with ointment,then covered with layers of gauze saturated with topical medication

A)Open technique
B)Closed technique
C)Escharotomy
D)Allograft
E)Xenograft