Question 1

What information is most essential for a nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane)for acne?

Accepted Answer

Isotretinoin is a teratogenic drug, meaning it can cause birth defects if taken during pregnancy. Therefore, it is essential for the nurse to gather information about the patient's current method of birth control and ensure that she understands the importance of avoiding pregnancy while taking the medication. Usual weight and family history of breast cancer are not directly related to the use of isotretinoin. While knowing about drugs previously used may be helpful, it is not as crucial as ensuring the patient's understanding of the need for contraception.

Question 2

How does cutaneous T-cell lymphoma differ from squamous cell and basal cell carcinomas?

Accepted Answer

Cutaneous T-cell lymphoma, unlike squamous cell and basal cell carcinomas, is not primarily caused by sun exposure. It is a type of non-Hodgkin lymphoma that affects the skin.

Question 3

A patient who has undergone treatment for herpes simplex virus type 2 (HSV type 2)expresses relief that she is cured.What should the nurse include in her teaching?

Accepted Answer

HSV lies dormant in the body and can be triggered without sexual contact. While antiviral medications such as acyclovir can treat and reduce the frequency of outbreaks, there is currently no cure for HSV. Daily douches with Burow solution are not recommended and can actually be harmful to the vaginal flora. While the risk of transmission may be reduced with treatment, it is still possible for individuals to transmit the virus to their sexual partners. It is important for the patient to discuss safe sex practices with their healthcare provider to reduce the risk of transmission.

Question 4

Which sign or symptom suggests that a patient with skin breakdown is developing a systemic infection?

Accepted Answer

A rise in temperature suggests that the patient may have a systemic infection. Lesions that are swollen and warm to the touch may also indicate infection, but they alone do not confirm the presence of a systemic infection. Blood pressure and itching are not specific signs of a systemic infection.

Question 5

What should a nurse be sure to frequently assess when caring for a burn patient with eschar formation around an entire arm?

Accepted Answer

Capillary refill is crucial to assess in a patient with eschar formation around an entire arm because it can indicate the status of circulation beneath the eschar. Eschar can constrict and reduce blood flow, leading to compartment syndrome, which is a serious condition that requires immediate attention. Assessing capillary refill helps in monitoring for signs of compromised circulation.

Question 6

A physician asks a nurse to take a smear from herpetic lesions in an older patient's hip to diagnose the disorder.What is the most probable test that will be performed?

Accepted Answer

The most probable test to be performed to diagnose a herpetic lesion is the Tzanck test which involves taking a sample of the fluid from the lesion and examining it under a microscope for the presence of viral infected cells. Culture and sensitivity test to a bactericide is not relevant in this case since herpes is caused by a virus, not a bacterium. A complete blood count may not be specific enough to diagnose the disorder, while titration for the strength of the pathogen is not a commonly used test for diagnosing herpes.

Question 7

An 80-year-old patient comes to the emergency department with extreme pain and itching in the hip and leg and has herpetic vesicular lesions on the left hip.What should the nurse inquire about patient exposure to?

Accepted Answer

The symptoms described are indicative of herpes zoster (shingles), which is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox.

Question 8

A nurse is caring for a patient with pruritus.Which implementation can the nurse perform without a physician's order?

Accepted Answer

Applying lubricant to unbroken skin is a basic nursing intervention that can be performed to moisturize the skin and relieve pruritus without needing a physician's order. It is a non-pharmacological measure that falls within the scope of nursing care.

Question 9

Which assessment by an emergency department nurse most indicates that a burn patient might be at risk for respiratory impairment?

Accepted Answer

The answer of Which assessment by an emergency department nurse...

Question 10

A nurse is caring for an obese patient who has been bedridden for a long time and who has a high risk for infection.Where is the best location for the nurse to assess for the moist red lesions of Candida albicans?

Accepted Answer

Moist red lesions of Candida albicans are commonly found in warm, moist areas of the body, such as skinfolds. In this scenario, the patient is obese and bedridden, which increases the likelihood of skinfold irritation and maceration. The other options (scalp, behind the ears, shaft of the penis, sacrum and bony prominences) are not typically associated with Candida albicans infections.

Question 11

A patient with severe psoriasis who is to be treated with the systemic drug methotrexate sodium anxiously asks, "Is this cancer drug safe? Are there some side effects I need to know about?" What is the best response by the nurse?

Accepted Answer

Methotrexate is indeed used for both cancer and non-cancer conditions like psoriasis. The mention of periodic blood tests is important as it addresses the need for monitoring due to potential side effects, such as liver damage and blood cell count changes.

Question 12

A nurse is caring for an adult patient with extensive burns on the front of the trunk, including the genitalia, and the fronts of both legs.How should the nurse document the burn size using the rule of nines?

Accepted Answer

According to the rule of nines, the front trunk equals 9%, the genitalia equals 1%, and both legs each equal 18%, making the total burn size 9% + 1% + 18% + 18% = 46%. However, since the front trunk and genitalia are together, and the burn on the legs is only on the front, we would subtract the overlap of 4% between the trunk and legs, making the final burn size 46% - 4% = 42%. Rounding to the nearest multiple of 5, the burn size would be documented as 37%.

Question 13

During the first 24 hours after a burn, fluid replacement is the treatment priority.Which assessment should alert the nurse that the fluid protocol is ineffective?

Accepted Answer

Adequate fluid replacement should result in a urine output of at least 30-50 mL/hr in an adult. A urine output of 20 mL/hr indicates inadequate fluid resuscitation and possible kidney damage or failure. Rectal temperature, crackles in the lungs, and edema in the burn area are important assessments, but they may not directly indicate the effectiveness of fluid replacement.

Question 14

Which is an appropriate implementation for a patient with severe psoriasis who has an altered self-concept?

Accepted Answer

The answer of Which is an appropriate implementation for a...

Question 15

Which action should a nurse implement to make a patient with atopic dermatitis more comfortable?

Accepted Answer

Instructing the patient to wear loose clothing can help reduce friction and irritation to the skin, which can be beneficial for managing atopic dermatitis symptoms. Adding alcohol to bathwater, providing a low-fat diet, and increasing the room temperature may have little to no impact on a patient's comfort level or management of atopic dermatitis.

Question 16

A family member of an older patient with severe dermatitis says, "I was always so careful to bathe him every day.I guess I just wasn't careful enough." What is the best response by the nurse?

Accepted Answer

It is important for the nurse to provide accurate information to the family member. Dermatitis can be caused by various factors, such as genetics, allergies, and skin irritants, and it is not solely dependent on hygiene. The nurse can educate the family member on proper skin care techniques to help manage the dermatitis in the future.

Question 17

An excited mother of a teenage boy with severe acne furiously reports to the nurse, "I've told him a thousand times he should bathe more often! I've kept after him about all that junk food he eats.I jump on him when I see him squeezing his zits.I tried to get him to scrub his face three times a day!" Which statement indicates the most likely cause of the boy's acne?

Accepted Answer

Acne is primarily caused by hormonal changes and genetic factors, not by poor hygiene or diet. However, squeezing or picking at acne lesions can cause inflammation, infection, and scarring, making the condition worse.

Quiz 57: Skin Disorders

What information is most essential for a nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane) for acne?