Deck 26: Nursing Management: Integumentary Problems

Question 1

A patient is diagnosed with a squamous cell carcinoma of the face.What should the nurse explain about this type of tumour?

A) It is the most common and least deadly of the skin cancers.
B) It commonly occurs on the mouths of individuals who smoke.
C) It is the only type of skin cancer that is not associated with sun exposure.
D) It arises from cells that produce melanin and can metastasize to any organ.

Answer 1

It commonly occurs on the mouths of individuals who smoke.

Question 2

The physician prescribes topical fluorouracil (5-FU)for a patient with actinic keratosis.To promote patient compliance with the use of this drug,what is it most important for the nurse to inform the patient about?

A) She will experience transient symptoms of bone marrow depression because 5-FU is a cytotoxic agent.
B) Dermatitis will develop,with painful,eroded areas that will take weeks to heal.
C) The drug will induce nausea and vomiting,which may be relieved by eating small meals and drinking cool liquids.
D) Initially,the size and depth of the lesion will increase,but it will disappear in about 2 weeks.

Answer 2

Dermatitis will develop,with painful,eroded areas that will take weeks to heal.

Question 3

During application of a wet dressing to the skin of a patient with impetigo,what is it most important for the nurse to do?

A) Use cool solutions to debride the lesions.
B) Use clean gloves to prevent the spread of the infection to others.
C) Use sterile gloves and dressings to prevent infection of the lesions.
D) Apply a prescribed topical antibiotic ointment before the application of the dressings.

Answer 3

Use clean gloves to prevent the spread of the infection to others.

Question 4

Which of the following would the nurse recommend to the patient who has vitiligo?

A) Chemical peels
B) Use of warm compresses to decrease pain
C) Rehabilitative cosmetics to camouflage the lesion
D) Injection of botulinum toxins (Botox)

Question 5

After spending an afternoon picking strawberries,a woman developed a severe contact dermatitis of her hands,arms,and lower legs.She states that the itching is severe,and she cannot keep from scratching.To help the patient manage the pruritus,what should the nurse advise her to do?

A) Use cool,wet dressings and baths to promote vasoconstriction.
B) Trim the fingernails short to prevent skin damage from scratching.
C) Expose the areas to the sun to promote drying and healing of the lesions.
D) Wear cotton gloves and cover all other affected areas with clothing to prevent additional irritation.

Question 6

The physician diagnoses impetigo and prescribes penicillin for a 68-year-old patient who has crusty vesiculopustular lesions over the lower face and skin creases in the neck.While planning care instructions for the patient,what does the nurse recognize is the most common risk factor for impetigo?

A) Obesity
B) Exposure to grease or oils
C) Inadequate personal hygiene
D) Deficiency of vitamin A in the diet

Question 7

A 32-year-old woman whose mother recently died from malignant melanoma asks the nurse what she can do to prevent the development of malignant melanoma in herself and her children.What is the best response regarding risk factors for malignant melanoma?

A) Only moles that develop during adulthood are the most likely to become malignant.
B) She does not need to worry because there is no familial tendency to develop malignant melanoma.
C) Excessive exposure to the sun should be avoided,and protection should be used when exposure occurs.
D) Unless she and her children have an abnormal mole pattern known as dysplastic nevi syndrome,the risk of melanoma is small.

Question 8

Which one of the following diseases has a dermatological manifestation of eczematous patches of the nipple and areola area?

A) Primary syphilis
B) Paget's disease
C) Hodgkin's disease
D) Hyperpituitarism

Question 9

A patient with an enlarging,irregular mole is scheduled for diagnosis and treatment.Which of the following procedures should the nurse anticipate will be performed?

A) Curettage
B) Cryosurgery
C) Mohs' micrographic surgery
D) Electrodesiccation and electrocoagulation

Question 10

A patient hospitalized with acute pyelonephritis develops small grouped vesicles on a reddened base on the lips extending to the skin.What does the nurse recognize about the patient?

A) Most likely will require administration of topical acyclovir to prevent scarring of the lips and face
B) Most likely has a recurrence of an oral herpes simplex virus infection due to stress and systemic infection
C) Most likely has a mixed streptococcal or staphylococcal infection that is causing the kidney infection and the lesions on the lips
D) Most likely has an activation of the varicella-zoster virus,which is contagious to those who have not had varicella

Question 11

A patient is undergoing psoralen plus UVA light (PUVA)therapy for treatment of psoriasis.To prevent complications from this procedure,what should the nurse plan to do?

A) Shield unaffected areas with lead-lined drapes.
B) Monitor for accumulation of laser light in adjacent tissue.
C) Apply petroleum jelly to unaffected areas surrounding the lesions.
D) Have the patient use protective eyewear that blocks 100% of UV light.

Question 12

A young woman who is planning a vacation to the beach asks the nurse about precautions she should take to protect her skin while enjoying the sun and water.What is the best response?

A) "You should wear clothing that covers your arms and legs and use a wide-brimmed hat to shade your face."
B) "Apply a waterproof sunscreen with a sun protection factor of 15 to the exposed areas of your skin,reapplying it as the directions indicate."
C) "Gradually increase the time of sun exposure each day,starting with 30 minutes a day and adding 30 minutes each following day."
D) "Sunscreens with a sun protection factor of 40 to 50 are the best protection against both ultraviolet A and ultraviolet B rays and should be applied during all sun exposure."

Question 13

A patient has a small,slow-growing papule with ulceration and depression of the centre of the lesion on the right cheek.The nurse recognizes that this finding is characteristic of which of the following skin conditions?

A) Actinic keratosis
B) Seborrheic keratosis
C) Basal cell carcinoma
D) Squamous cell carcinoma

Question 14

The nurse identifies a nursing diagnosis of "Risk for infection related to skin lesions and presence of environmental pathogens" for a patient with an allergic dermatitis.The nurse recognizes that the teaching regarding prevention of infection has been effective when the patient states which of the following?

A) "I will use measures to keep me from scratching the inflamed areas."
B) "I should use antibiotic solutions to moisten dressings applied to the rash."
C) "I should take my temperature twice a day to detect the onset of any fever."
D) "I should use sterile dressings and towels when applying wet compresses to the rash."

Question 15

A patient is taking azithromycin (Zithromax)-doxycycline prescribed by his physician for acute bronchitis.He tells the nurse that the information provided by his pharmacy indicates that this drug causes photosensitivity,and he asks about what will happen to him if he is exposed to sunlight while taking the drug.What is the nurse's best response?

A) The heat from the sun is more readily absorbed by the body,predisposing him to heatstroke.
B) Sun exposure may cause an exaggerated sunburn with redness,swelling,and blistering on exposed areas.
C) The most common effect of photosensitivity is corneal damage because the drug causes corneal absorption of UV light.
D) The photosensitivity causes abnormal melanocyte activity on exposure to UV light,resulting in splotchy,abnormally dark tanning.

Question 16

What is the most common reason that people undergo a cosmetic procedure?

A) To increase longevity
B) To obtain different employment
C) To improve their body image
D) To improve function of the area that is involved

Question 17

A topical corticosteroid ointment is prescribed for a patient who has atopic dermatitis in her antecubital and popliteal spaces.During a follow-up visit by the patient,the nurse determines that the patient's administration of the drug should be assessed on observing which of the following findings?

A) Atrophy of the skin
B) Alopecia of the affected areas
C) Red-brown coloration of the lesions
D) Lesions covered with small gauze dressings

Question 18

A patient complains of severe itching,especially at night,and the nurse notes the presence of burrows in the flexor surface of his wrists.What does the nurse suspect?

A) Scabies
B) Bedbugs
C) Pediculosis
D) Lyme disease

Question 19

A patient with multiple commonly acquired nevi expresses concern about their presence and the possibility of malignant changes.How should the nurse advise the patient?

A) To consult the physician if the moles develop irregular coloration or borders
B) To request removal of all nevi larger than 4 mm to prevent malignant changes
C) That only moles occurring on the back and chest are likely to become malignant
D) That malignant changes are characterized by scaling,ulceration,and an opaque appearance of the moles

Question 20

An older adult patient is admitted to the hospital with a possible head injury following a fall at home.While examining the patient's scalp,the nurse suspects the presence of pediculosis on finding which of the following?

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 21

Which of the following would the nurse suspect when assessment data revealed six groups of three wheals surrounded by vivid flare with firm urticaria and intense pruritus?

A) Wasp stings
B) Bedbugs
C) Scabies
D) Pediculosis

Question 22

Why is it important to ensure that piercings in the mouth are done with plastic jewellery rather than metal jewellery?

A) The piercing may get dislodged and be swallowed.
B) Plastic will not chip teeth.
C) This eliminates the risk of metal absorption into the bloodstream.
D) Plastic is easier to clean and disinfect than metal.