Deck 24: Nursing Management: Integumentary Problems

Question 1

A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. Which finding 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

Answer 1

Thinning of the affected skin

Question 2

A patient in the dermatology clinic has a small, slow-growing papule with ulceration and a depression in the center of the lesion on the right cheek. The nurse will anticipate the need to

A) prepare the patient for a biopsy.
B) teach about the use of corticosteroid creams.
C) educate the patient about use of tretinoin ( Retin-A ).
D) discuss the need for topical application of antibiotics.

Answer 2

prepare the patient for a biopsy.

Question 3

After a patient with a squamous cell carcinoma ( SCC ) has a Mohs procedure in the dermatology clinic, which nursing action will 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 3

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

Question 4

A patient is diagnosed with basal cell carcinoma ( BCC ) of the face. Which information should be included in patient teaching?

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.

Question 5

The nurse notes darker skin pigmentation in the skinfolds of a patient who has a body mass index of 40 kg/m². Which action should the nurse take?

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

Question 6

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

A) Waterproof sunscreens will provide good protection when swimming.
B) Use a sunscreen with an SPF of at least 8 to 10 for adequate protection.
C) Try to stay out of the sun between the hours of 10 AM and 2 PM (regular time).
D) Increase sun exposure by no more than 10 minutes a day to avoid skin damage.

Question 7

When examining a patient's oral cavity, the nurse notes the presence of white lesions that resemble milk curds at the back of the throat. Which question by the nurse is appropriate at this time?

A) Do you have a productive cough?
B) How often do you brush your teeth?
C) Are you taking any medications at present?
D) Have you ever had an oral herpes infection?

Question 8

A patient with atopic dermatitis has a new prescription for tacrolimus ( Protopic ). After teaching the patient about the medication, which statement by the patient 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 Protopic."
D) "If the medication burns when I apply it, I will wipe it off and call the doctor."

Question 9

Through interviewing a patient who has a history of contact dermatitis, the nurse obtains this information about over-the-counter ( OTC ) medication use. Which finding indicates a need for patient teaching?

A) The patient applies corticosteroid cream to any pruritic areas.
B) The patient uses Neosporin ointment on minor cuts or abrasions.
C) The patient adds oilated oatmeal ( Aveeno ) to the bath water every day.
D) The patient takes diphenhydramine ( Benadryl ) at night if itching occurs.

Question 10

When assessing a new patient at the outpatient clinic, the nurse notes dry, scaly skin; thin hair; and thick, brittle nails. Which action is best for the nurse to take at this time?

A) Instruct the patient 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 patient about using moisturizing creams and lotions to decrease dry skin.

Question 11

A patient with an enlarging, irregular mole that is 6 mm in diameter is scheduled for outpatient treatment. The nurse should plan on teaching the patient about

A) curettage.
B) cryosurgery.
C) punch biopsy.
D) surgical excision.

Question 12

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

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

Question 13

A patient is undergoing psoralen plus ultraviolet A light ( PUVA ) therapy for treatment of psoriasis. To minimize complications from this procedure, the nurse plans to

A) cleanse the skin carefully with an antiseptic soap.
B) shield any unaffected areas with lead-lined drapes.
C) have the patient use protective eyewear while receiving PUVA.
D) apply petroleum jelly to the areas surrounding the psoriatic lesions.

Question 14

The health care provider prescribes topical 5-FU for a patient with actinic keratosis on the nose. Which information will the nurse include in the patient 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 15

The health care provider diagnoses impetigo for a patient who has crusty vesicopustular lesions on the lower face. Which topic will be included in the teaching plan for this patient?

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 16

Which information should the nurse include when teaching a patient who has just received a prescription for sulfamethoxazole and trimethoprim (Septra, Bactrim) to treat a urinary tract infection?

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 sulfamethoxazole.

Question 17

Which information will the nurse include when teaching a 70-year-old patient 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 18

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

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

Question 19

When examining a patient's scalp, the nurse suspects the presence of pediculosis on finding

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, hivelike papules and plaques with sharply circumscribed borders.

Question 20

Which action will the nurse take when applying a wet dressing to an inflamed and pruritic area of skin on a patient'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 21

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

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

Question 22

Which nursing action should the nurse delegate to nursing assistive personnel (NAP) who are assisting with the care of a patient with furunculosis?

A) Applying antibiotic cream to the groin.
B) Obtaining cultures from ruptured lesions.
C) Evaluating the patient's personal hygiene.
D) Cleaning the skin with antimicrobial soap.

Question 23

A patient 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 action should the nurse take first?

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

Question 24

When teaching a patient with contact dermatitis of the arms and lower legs about ways to decrease pruritis, which information will the nurse include (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.