Deck 53: Integumentary Dysfunction

Question 1

The primary treatment for warts is:

A)Vaccination.
B)Local destruction.
C)Corticosteroids.
D)Specific antibiotic therapy.

Answer 1

Local destruction.

Question 2

The primary clinical manifestation of scabies is:

A)Edema.
B)Redness.
C)Pruritus.
D)Maceration.

Answer 2

Pruritus.

Question 3

Impetigo ordinarily results in:

A)No scarring.
B)Pigmented spots.
C)Slightly depressed scars.
D)Atrophic white scars.

Answer 3

No scarring.

Question 4

Lymphangitis ("streaking") is frequently seen in:

A)Cellulitis.
B)Folliculitis.
C)Impetigo contagiosa.
D)Staphylococcal scalded skin.

Question 5

Warts are caused by:

A)Bacteria.
B)Fungus.
C)Parasite.
D)Virus.

Question 6

The only symptom of pediculosis capitis (head lice) is usually:

A)Itching.
B)Vesicles.
C)Scalp rash.
D)Localized inflammatory response.

Question 7

Ringworm,frequently found in schoolchildren,is caused by:

A)Virus.
B)Fungus.
C)Allergic reaction.
D)Bacterial infection.

Question 8

A child steps on a nail and sustains a puncture wound of the foot. The most appropriate method for cleansing this wound is to:

A)Wash wound thoroughly with chlorhexidine.
B)Wash wound thoroughly with povidone-iodine.
C)Soak foot in warm water and soap.
D)Soak foot in solution of 50% hydrogen peroxide and 50% water.

Question 9

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to:

A)Apply warm compresses.
B)Carefully scrape off the stinger.
C)Take the child to emergency department.
D)Apply a thin layer of corticosteroid cream.

Question 10

Matt's mother tells the nurse that he keeps scratching the areas where he has poison ivy. The nurse's response should be based on knowing that:

A)Poison ivy does not itch and needs further investigation.
B)Scratching the lesions will not cause a problem.
C)Scratching the lesions will cause the poison ivy to spread.
D)Scratching the lesions may cause them to become secondarily infected.

Question 11

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend:

A)Administering antihistamine.
B)Cleansing with soap and water.
C)Keeping the child quiet and coming to emergency department.
D)Removing the stinger and applying cool compresses.

Question 12

Treatment for herpes simplex virus (types 1 or 2) includes:

A)Corticosteroids.
B)Oral griseofulvin.
C)Oral antiviral agent.
D)Topical and/or systemic antibiotic.

Question 13

The management of a child who has just been stung by a bee or wasp should include the application of:

A)Cool compresses.
B)Warm compresses.
C)Antibiotic cream.
D)Corticosteroid cream.

Question 14

The nurse should know that Lyme disease is:

A)Difficult to prevent.
B)Easily treated with oral antibiotics in stages 1,2,and 3.
C)Caused by a spirochete that enters the skin through a tick bite.
D)Common in geographic areas where the soil contains the mycotic spores that cause the disease.

Question 15

An important nursing consideration when caring for a child with impetigo contagiosa is to:

A)Apply topical corticosteroids to decrease inflammation.
B)Carefully remove dressings so as not to dislodge undermined skin,crusts,and debris.
C)Carefully wash hands and maintain cleanliness when caring for an infected child.
D)Examine child under a Wood lamp for possible spread of lesions.

Question 16

A child falls on the playground and has a small laceration on the forearm. What should the school nurse do to cleanse the wound?

A)Slowly pour hydrogen peroxide over wound.
B)Soak arm in warm water and soap for at least 30 minutes.
C)Gently cleanse with sterile pad and a nonstinging povidone-iodine solution.
D)Wash wound gently with mild soap and water for several minutes.

Question 17

Cellulitis is often caused by:

A)Herpes zoster.
B)Candida albicans.
C)Human papillomavirus.
D)Streptococcus or Staphylococcus organisms.

Question 18

Herpes zoster is caused by the varicella virus and has an affinity for:

A)Sympathetic nerve fibers.
B)Parasympathetic nerve fibers.
C)Posterior root ganglia and the posterior horn of the spinal cord.
D)Lateral and dorsal columns of the spinal cord.

Question 19

Rocky Mountain spotted fever is caused by the bite of a:

A)Flea.
B)Tick.
C)Mosquito.
D)Mouse or rat.

Question 20

The nurse is examining 12-month-old Amy,who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by:

A)Impetigo.
B)Candida albicans.
C)Urine and feces.
D)Infrequent diapering.

Question 21

A high-protein diet for the child with major burns is ordered to:

A)Promote growth.
B)Improve appetite.
C)Diminish risks of stress-induced hyperglycemia.
D)Avoid protein breakdown.

Question 22

An important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns is to:

A)Apply topical medication with clean hands.
B)Wash hands and forearms before and after dressing change.
C)If dressings adhere to the wound,soak in hot water before removal.
D)Apply dressing so that movement is limited during the healing process.

Question 23

An effective strategy to reduce the stress of burn dressing procedures is to:

A)Give the child as many choices as possible.
B)Reassure the child that dressing changes are not painful.
C)Explain to the child why analgesics cannot be used.
D)Encourage the child to master stress with controlled passivity.

Question 24

After the acute stage and during the healing process the primary complication from burn injury is:

A)Asphyxia.
B)Shock.
C)Renal shutdown.
D)Infection.

Question 25

A toddler sustains a minor burn on the hand from hot coffee. The first action in treating this burn is to:

A)Apply ice to burned area.
B)Hold the burned area under cool running water.
C)Break any blisters with a sterile needle.
D)Clean the wound with soap and warm water.

Question 26

Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when:

A)Acne has not responded to other treatments.
B)The adolescent is or may become pregnant.
C)The adolescent is unable to give up foods causing acne.
D)Frequent washing with antibacterial soap has been unsuccessful.

Question 27

What explains physiologically the edema formation that occurs with burns?

A)Vasoconstriction
B)Decreased capillary permeability
C)Increased capillary permeability
D)Decreased hydrostatic pressure within capillaries

Question 28

Nursing care of the infant with atopic dermatitis focuses on:

A)Feeding a variety of foods.
B)Keeping lesions dry.
C)Preventing infection.
D)Using fabric softener to avoid rough cloth.

Question 29

A child experiences frostbite of the fingers after prolonged exposure to the cold. Which intervention would the nurse implement first?

A)Rapid rewarming of the fingers by placing in warm water
B)Placing the hand in cool water
C)Slow rewarming by wrapping in warm cloth
D)Using an ice pack to keep cold until medical intervention is possible

Question 30

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. What is important in her immediate care?

A)Wrap her in a blanket until help arrives
B)Encourage her to drink clear liquids
C)Place her in a tub of cool water
D)Remove her burned clothing and jewelry

Question 31

Biologic dressings are applied to a child with partial-thickness burns of both legs. Nursing actions related to this include:

A)Observing wounds for bleeding.
B)Observing wounds for signs of infection.
C)Monitoring closely for signs of shock.
D)Splinting legs to prevent movement.

Question 32

The nurse is teaching a class on preventing diaper rash in newborns to a group of new parents. Which statement made by a parent indicates a correct understanding of the teaching?

A)"I should wash my infant's buttocks with soap and water every time I change the diaper."
B)"I will wash with a mild soap and water and dry thoroughly whenever my infant has a bowel movement."
C)"I should wash my infant's buttocks with soap before applying a thin layer of oil."
D)"I will apply baby oil and powder to the creases in my infant's buttocks."

Question 33

A child with extensive burns requires debridement. The nurse should anticipate that a priority goal related to this procedure is to:

A)Reduce pain.
B)Prevent bleeding.
C)Maintain airway.
D)Restore fluid balance.

Question 34

A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has:

A)A chemical burn.
B)An inhalation injury.
C)An electrical burn.
D)A hot-water scald.

Question 35

What best describes a full-thickness (third-degree) burn?

A)Erythema and pain
B)Skin showing erythema followed by blister formation
C)Destruction of all layers of skin evident with extension into subcutaneous tissue
D)Destruction injury involving underlying structures such as muscle,fascia,and bone

Question 36

One of the first signs of overwhelming sepsis in a child with burn injuries is:

A)Seizures.
B)Bradycardia.
C)Disorientation.
D)Decreased blood pressure.

Question 37

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include:

A)Avoiding use of sunscreen agents.
B)Using cosmetics with lanolin and petrolatum.
C)Explaining that medication should not be applied until at least 20 to 30 minutes after washing.
D)Explaining that erythema and peeling are indications of toxicity.

Question 38

Atopic dermatitis (eczema) in the infant is:

A)Easily cured.
B)Worse in humid climates.
C)Associated with upper respiratory tract infections.
D)Associated with allergy with a hereditary tendency.

Question 39

Fentanyl and midazolam (Versed) are given before debridement of a child's burn wounds. These drugs are important to:

A)Promote healing.
B)Prevent infection.
C)Provide pain relief.
D)Limit amount of debridement that will be necessary.

Question 40

The most immediate threat to life in children with thermal injuries is:

A)Shock.
B)Anemia.
C)Local infection.
D)Systemic sepsis.

Question 41

Where do the lesions of atopic dermatitis most commonly occur in the infant? Choose all that apply.

A)Cheeks.
B)Buttocks.
C)Extensor surfaces of arms and legs.
D)Back.
E)Trunk.
F) Scalp.

Question 42

The nurse is talking to a parent of an infant with severe atopic dermatitis. What should the nurse reinforce with the parent? Choose all that apply.

A)"You can use warm wet compresses to relieve discomfort."
B)"You will need to keep your infant's skin well hydrated by using a mild soap in the bath."
C)"You should bathe your baby in a bubble bath two times a day."
D)"You will need to prevent your baby from scratching the area by using a mild antihistamine."
E)"You can try a fabric softener in the laundry to avoid rough cloth."
F) "You should apply an emollient to the skin immediately after a bath."

Question 43

The family of a 4-month-old infant will be vacationing at the beach. The best recommendation to this family is to:

A)Use sun block on the infant's nose and ear tips.
B)Use a topical sunscreen product with a sun protective factor of 15.
C)The infant can be exposed to the sun for 15-minute increments.
D)Keep the infant in total shade at all times.