Question 1

A patient is recovering from surgery to remove a large skin cancer and has a skin graft in place to cover the wound area. Consider the following menus and select the one that would be most beneficial for this patient's healing. $$\begin{array} {| l | l |} 
\hline \text { Diet } 1 & \text { Diet } 2 \
\text { Baked chicken } & \text { Vegetable soup } \
\text { Sliced orange/spinach salad } & \text { Grilled cheese sandwich } \
\text { Baked beans } & \text { Brownie } \
\hline \text { Strawberries } & \text { Milk } \
\hline \text { Diet } 3 & \text { Diet 4 } \
\text { Sausage pizza } & \text { Macaroni \& cheese } \
\text { Tossed green salad } & \text { Hot dog with bun } \
\text { Pudding } & \text { Cole slaw }\
\hline
\end{array}$$

Accepted Answer

The patient recovering from a surgery to remove a large skin cancer would benefit from a diet that is high in protein for tissue repair and healing, as well as vitamins and antioxidants to boost the immune system. Diet 1 includes a baked chicken which is a good source of protein and essential amino acids needed for wound healing, and an orange/spinach salad which is high in vitamin C and antioxidants that help in tissue repair. Baked beans are also a good source of protein and fiber. Strawberries are high in vitamin C and have anti-inflammatory properties which are beneficial for wound healing. Overall, Diet 1 provides a balance of essential nutrients that would support the patient's recovery. The other diets have less ideal options such as processed or high-fat foods that could potentially prolong the healing process.

Question 2

A patient at risk for the development of skin cancer is discussing sun exposure prevention with the nurse. What information should be included in the discussion?

Accepted Answer

A) Sunscreen with a higher SPF is recommended during peak sun intensity hours (10 a.m. to 3 p.m.) to protect against UV radiation. B) UV rays can penetrate clouds, making sunscreen necessary even on cloudy days. C) A sunscreen with an SPF of 15 or higher is advised to protect against UVB rays, reducing the risk of skin cancer.

Question 3

The nurse is planning care for a patient with herpes zoster. Which problem should the nurse identify as being the priority for this patient?

Accepted Answer

Managing pain should be the priority for a patient with herpes zoster as it can be severe and debilitating. Pain management can improve the patient's quality of life and help them to engage in other self-care activities such as hygiene and avoiding breakouts. Relief from itchiness can also be addressed through pain management techniques.

Question 4

A patient asks the nurse about possible options regarding treatment for a malignant melanoma lesion on her arm. How should the nurse respond to this patient?

Accepted Answer

The preferred method of treatment for malignant melanoma is surgical removal of the lesion. Other treatments may be used in addition to surgery, but surgery is the primary treatment option. Anti-cancer creams, radiation, and chemotherapy may be used as adjuvant therapies, but they are not typically used as first-line treatments.

Question 5

A patient with a history of tinea pedis reports concerns about developing the disorder again. Which suggestion should the nurse make to reduce the likelihood of a reoccurrence?

Accepted Answer

Wearing sandal-style footwear allows for better ventilation and reduces the likelihood of moisture buildup, which can contribute to the growth of fungi that cause tinea pedis. Cotton undergarments, soaking in salted water, and applying lotion to moisturize potentially affected areas may not be effective preventative measures.

Question 6

The nurse is assessing a patient's risk for pressure ulcer development. Which factors should the nurse include in this assessment?

Accepted Answer

Sensory perception, moisture, mobility, and nutrition are all important risk factors for pressure ulcer development. Social interaction is not directly related to pressure ulcer risk.

Question 7

The nurse understands that certain patients are more susceptible to pressure ulcer development. Which patients should the nurse identify as being at an increased risk for this health problem?

Accepted Answer

Patients with restricted activity, decreased sensation, very thin body types, and those with urinary and fecal incontinence are at increased risk for pressure ulcer development. These factors contribute to skin breakdown and impaired healing. Good nutrition, on the other hand, supports skin integrity and wound healing, reducing the risk of pressure ulcers.

Question 8

The mother of a teenage girl voices concerns about her daughter's acne. Which response by the nurse is best?

Accepted Answer

Washing the skin twice a day with mild soap and water is a recommended practice to help control acne by removing excess oil and dead skin cells that can clog pores.

Question 9

A patient diagnosed with scabies asks the nurse how he "caught" the disorder. What information should be provided to the patient?

Accepted Answer

Scabies is a contagious skin condition caused by microscopic mites that burrow into human skin. It is typically spread by prolonged skin-to-skin contact with an infected person or by sharing personal items such as clothing or bedding. Therefore, the correct response is A.

Question 10

A patient scheduled for Mohs surgery for basal cell skin cancer asks how long the procedure will take. How should the nurse respond to this patient?

Accepted Answer

The answer of A patient scheduled for Mohs surgery for...

Question 11

The nurse is counseling a patient who has atopic dermatitis (eczema) and has developed a secondary infection. What should the nurse emphasize so that the patient can prevent this type of infections in the future?

Accepted Answer

The nurse should emphasize methods to prevent itching to prevent further damage to the skin and reducing exposure of the skin to harmful bacteria, which can result in secondary infections. Continuous antibiotic treatment is not necessary for prevention and can lead to antibiotic resistance. Frequent bathing can further dry out the skin, exacerbating eczema symptoms. Allergy testing does not necessarily prevent secondary infections.

Question 12

A patient has had cryosurgery to treat a skin lesion. What instructions should be given to the patient and family on discharge?

Accepted Answer

The answer of A patient has had cryosurgery to treat...

Question 13

The nurse is planning care for a patient at risk for pressure ulcer development. What should the nurse include in this patient's plan of care?

Accepted Answer

Initiating a frequent toileting schedule helps prevent skin breakdown from moisture associated with incontinence, and turning the patient every 2 hours reduces prolonged pressure on any one area, which is a key factor in preventing pressure ulcers. Massaging pressure areas can actually damage capillaries and tissue under the skin, increasing the risk of pressure ulcers. Inflatable donut rings can concentrate pressure on surrounding tissue, worsening the risk. Using hot water can damage sensitive skin, especially in patients at risk for pressure ulcers.

Question 14

The nurse is planning care for a patient who is at risk for pressure ulcer development. Which action should be included in this patient's plan of care?

Accepted Answer

Using pillows to offload pressure, turning the patient at least every 2 hours, and using a mild cleansing agent on the skin are all effective strategies to prevent pressure ulcers. Keeping the patient on bed rest and pulling them up in bed can increase the risk of pressure ulcers.

Question 15

An African American patient has reoccurring folliculitis on the face. What should the nurse instruct the patient to do about this health problem?

Accepted Answer

Recurring folliculitis on the face can often be caused by poor hygiene or bacteria on the skin. Therefore, the best advice would be to instruct the patient to practice good hygiene, such as keeping the face clean and washing it regularly. Shaving could potentially make the problem worse, so it is not recommended as the best solution.

Question 16

Several individuals from a homeless shelter have been diagnosed with pediculosis. The nurse, planning to train staff on the control and prevention of this contagious infection, should include what information?

Accepted Answer

- Pediculosis, or lice infestation, is spread through direct contact with infected personal items like hats and blankets, and is more common in environments where there is a lack of proper facilities for personal hygiene and laundering, which can include settings like homeless shelters. Woolen hats are not specifically associated with pediculosis, it affects people of all ages, not just children, and it is caused by lice, not mites.

Question 17

A patient with a basal cell carcinoma of the nose will be having the lesion removed by curettage and electrodesiccation. The nurse knows that the lesion must meet what criteria for this type of procedure?

Accepted Answer

Curettage and electrodesiccation are typically used for smaller, superficial basal cell carcinomas. Lesions should be less than 2 cm in diameter (A) and superficial (B) for this procedure to be considered appropriate.

Question 18

A patient has a lesion in the left axilla that is deep, painful, and contains pus. It is 3 centimeters in diameter. After the assessment, what type of lesion should the nurse determine that the patient has?

Accepted Answer

A furuncle, also known as a boil, is a deep, painful, pus-filled lesion typically caused by a bacterial infection, often involving a hair follicle. The description matches that of a furuncle.

Question 19

A patient has a small, red, scaling lesion that is sitting on an elevated base on the forehead. The patient states that lesion began several weeks before and will not heal. What type of lesion does the nurse consider the patient is experiencing?

Accepted Answer

The description of a small, red, scaling lesion on an elevated base that does not heal over weeks is suggestive of squamous cell carcinoma, a type of skin cancer that often presents as a non-healing, red, scaly patch.

Question 20

The patient with herpes zoster has pruritus and reports difficulty resting at night. Which intervention will best aid the patient?

Accepted Answer

Encouraging the patient to take prescribed antipruritic agents approximately one hour before bedtime can help to reduce itching and assist the patient in getting a better night's rest. Massaging the irritated skin areas with lotion or applying powder to the lesions may provide temporary relief but is not as effective as medication. Using heavy bed linens to avoid chilling at night is not specific to the symptom of pruritus and may not provide relief.

Quiz 16: Nursing Care of Patients With Integumentary Disorders