Deck 26: Nursing Management Integumentary Problems

Question 1

The nurse is providing care to a client with a squamous cell carcinoma (SCC) that had a Mohs procedure in the dermatology clinic. Which of the following nursing actions would be included in the postoperative plan of care?

A)Describe the use of topical fluorouracil on the incision.
B)Teach how to use sterile technique to clean the suture line.
C)Schedule daily appointments for wet-to-dry dressing changes.
D)Educate about use of cold packs to reduce bruising and swelling.

Answer 1

Educate about use of cold packs to reduce bruising and swelling.

Question 2

The nurse is caring for a client who has basal cell carcinoma (BCC) of the face. Which of the following information should the nurse include when teaching this client?

A)Treatment plans include watchful waiting.
B)Screening for metastasis will be important.
C)Low-dose systemic chemotherapy is used to treat BCC.
D)Minimizing sun exposure will reduce risk for future BCC.

Answer 2

Minimizing sun exposure will reduce risk for future BCC.

Question 3

The nurse is assessing a client's scalp and suspects the presence of pediculosis when which of the following assessment findings are observed?

A)Ringlike rashes with red, scaly borders over the entire scalp
B)Papular, wheal-like lesions with white deposits on the hair shaft
C)Patchy areas of alopecia with small vesicles and excoriated areas
D)Red, hive-like papules and plaques with sharply circumscribed borders

Answer 3

Papular, wheal-like lesions with white deposits on the hair shaft

Question 4

A client with atopic dermatitis has a new prescription for tacrolimus. After teaching the client about the medication, which statement by the client indicates that further teaching is needed?

A)"After I apply the medication, I can go ahead and get dressed as usual."
B)"I will rub the medication gently onto the skin every morning and night."
C)"I will need to minimize my time in the sun while I am using the tacrolimus."
D)"If the medication burns when I apply it, I will wipe it off and call the doctor."

Question 5

After the nurse determines that a client has the following risk factors for melanoma, which risk factor should be the focus of client teaching related to prevention?

A)The client has multiple dysplastic nevi.
B)The client is fair-skinned and has blue eyes.
C)The client's mother died of a malignant melanoma.
D)The client uses a tanning booth throughout the winter.

Question 6

The health care provider diagnoses impetigo for a client who has crusty vesicopustular lesions on the lower face. Which of the following topics would the nurse include in the teaching plan for this client?

A)Avoidance of antibiotic ointments on the lesions
B)How to clean the infected areas with soap and water
C)Use of petroleum jelly (Vaseline) to soften crusty areas
D)Appropriate use of alcohol-based cleansers on the lesions

Question 7

The nurse is caring for a client who has just received a diagnosis of a fungal infection and the client asks the nurse how this will be treated. The nurses' response is based upon knowledge that which of the following bases is the most common for antifungal treatment?

A)Gel
B)Paste
C)Lotion
D)Powder

Question 8

The health care provider prescribes topical 5-fluorouracil (5-FU) for a client with actinic keratosis on the nose. Which of the following information would the nurse include in the client teaching plan?

A)You may develop nausea and anorexia, but good nutrition is important during treatment.
B)You will need to avoid crowds because of the risk for infection caused by chemotherapy.
C)The nose will develop painful, eroded areas that will take weeks before completely healing.
D)5-FU is needed to shrink the lesion so that less scarring occurs once the lesion is excised.

Question 9

The nurse is teaching the client how to use wet compresses at home for treatment of poison ivy. Which of the following instructions would the nurse include in the teaching plan?

A)Use only sterile water as the solution for the dressing.
B)The material for the compress is to be 4-8 layers thick.
C)The compress should meet the edge of the area that is to be treated.
D)Use abdominal pads (gauze sponges) when covering odd-shaped body parts.

Question 10

The nurse is assessing a new client at the outpatient clinic and notes dry, scaly skin; thin hair; and thick, brittle nails. Which of the following actions is best for the nurse to take at this time?

A)Instruct the client about the importance of nutrition in skin heath.
B)Make a referral to a podiatrist so that the nails can be safely trimmed.
C)Consult with the health care provider about the need for further diagnostic testing.
D)Teach the client about using moisturizing creams and lotions to decrease dry skin.

Question 11

The nurse is caring for a client in the dermatology clinic who has a small, slow-growing papule with ulceration and a depression in the centre of the lesion on the right cheek. Which of the following nursing interventions will the nurse anticipate performing for this client?

A)Prepare the client for a biopsy.
B)Teach about the use of corticosteroid creams.
C)Educate the client about use of tretinoin (Retin-A).
D)Discuss the need for topical application of antibiotics.

Question 12

Which of the following information would the nurse include when teaching an older-adult client about skin care?

A)Dry the skin thoroughly before applying lotions.
B)Bathe and shampoo daily with soap and shampoo.
C)Use warm water and a moisturizing soap when bathing.
D)Use antibacterial soaps when bathing to avoid infection.

Question 13

Which of the following actions would the nurse take when applying a wet dressing to an inflamed and pruritic area of skin on a client's ankle?

A)Use a cool solution to wet the dressing.
B)Change the dressing using sterile gloves.
C)Soak the dressing in sterile normal saline.
D)Apply the dressing from the knee to the foot.

Question 14

The nurse is caring for a client with a urinary tract infection and has been prescribed ciprofloxacin. Which of the following information should the nurse include when teaching this client?

A)Use a sunscreen with a high SPF when exposed to the sun.
B)Sun exposure may decrease the effectiveness of the medication.
C)Photosensitivity may result in an artificial-looking tan appearance.
D)Wear sunglasses to avoid eye damage while taking ciprofloxacin.

Question 15

To decrease the risk for sun damage to the skin, which information should the nurse include when teaching clients?

A)Waterproof sunscreens will provide good protection when swimming.
B)Use a sunscreen with an SPF of at least 8-10 for adequate protection.
C)Try to stay out of the sun between the hours of 1 000 and 1 600.
D)Increase sun exposure by no more than 10 minutes a day to avoid skin damage.

Question 16

A client with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. Which of the findings by the nurse indicates a possible adverse effect of the medication?

A)Thinning of the affected skin
B)Alopecia of the affected areas
C)Reddish-brown discoloration of the skin
D)Dryness and scaling in the areas of treatment

Question 17

The nurse is caring for a client who is undergoing psoralen plus ultraviolet A light (PUVA) therapy for treatment of psoriasis. Which of the following actions would the nurse plan to implement to minimize complications from this procedure?

A)Cleanse the skin carefully with an antiseptic soap.
B)Shield any unaffected areas with lead-lined drapes.
C)Have the client use protective eyewear while receiving PUVA.
D)Apply petroleum jelly to the areas surrounding the psoriatic lesions.

Question 18

A client with an enlarging, irregular mole that is 6 mm in diameter is scheduled for outpatient treatment. Which of the following procedures would the nurse include in the teaching plan for this client?

A)Curettage
B)Cryosurgery
C)Punch biopsy
D)Surgical excision

Question 19

The nurse notes darker skin pigmentation in the skin folds of a client who has a body mass index of 40 kg/m2. Which of the following topics would the nurse include in client teaching?

A)Teach the client about the risk for type 2 diabetes.
B)Educate the client about treatment of fungal infection.
C)Discuss the use of drying agents to minimize infection risk.
D)Instruct the client about use of mild soap to clean skin folds.

Question 20

After the nurse has finished teaching a client about application of corticosteroid cream to an area of contact dermatitis on the right leg, which of the following client actions indicates that more teaching is needed?

A)The client spreads the cream using a downward motion.
B)The client takes a tepid bath before applying the cream.
C)The client applies a thick layer of the cream to the affected skin.
D)The client covers the area with a dressing after applying the cream.

Question 21

A client who has severe refractory psoriasis on the face, neck, and extremities has quit working and withdrawn from social activities because of the appearance of the lesions. Which of the following actions should the nurse take first?

A)Discuss the possibility of enrolling in a worker-retraining program.
B)Encourage the client to volunteer to work on community projects.
C)Suggest that the client use cosmetics to cover the psoriatic lesions.
D)Ask the client to describe the impact of psoriasis on quality of life.

Question 22

The nurse is teaching a client about the use of a wet dressing to reduce pruritus. Which of the following time frames would the nurse instruct the client to leave the dressing on for?

A)5-15 minutes
B)10-30 minutes
C)30-45 minutes
D)45-60 minutes

Question 23

The nurse is assessing a client who has just arrived in the postanaesthesia recovery area (PACU) after a blepharoplasty. Which of the following assessment data is a priority?

A)The client complains of incisional pain.
B)The client's heart rate is 110 beats/minute.
C)The client is unable to detect when the eyelids are touched.
D)The skin around the incision is pale and cold when palpated.

Question 24

The nurse is teaching a client with contact dermatitis of the arms and lower legs about ways to decrease pruritus. Which of the following information would the nurse include in the teaching plan? (Select all that apply.)

A)Cool, wet cloths or dressings can be used to reduce itching.
B)Take cool or tepid baths several times daily to decrease itching.
C)Add oil to your bath water to aid in moisturizing the affected skin.
D)Rub yourself dry with a towel after bathing to prevent skin maceration.
E)Use of an over-the-counter (OTC) antihistamine with sedative effects can reduce scratching.