Deck 16: Nursing Care of Patients with Integumentary Disorders

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 menu that would be most beneficial for this patient's diet. 11ea992e_0a6a_862c_9f38_4367b91e226f

A)Diet 1
B)Diet 2
C)Diet 3
D)Diet 4

Answer 1

Diet 1

Question 2

A patient asks the nurse about possible options regarding treatment for a malignant melanoma lesion on her arm. The best response by the nurse would bewhich of the following?

A)"The preferred method of treatment is to remove all the cancer surgically."
B)"An anti-cancer cream will be used to dissolve the lesion."
C)"You will receive radiation to the skin lesion as a first method of treatment."
D)"You will receive intravenous chemotherapy as a first method of treatment"

Answer 2

"The preferred method of treatment is to remove all the cancer surgically."

Question 3

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

A)Encourage the patient to take prescribed antipruritic agents approximately one hour before bedtime.
B)Massage the irritated skin areas with lotion.
C)Apply powder to the lesions.
D)Use heavy bed linens to avoid chilling at night.

Answer 3

Encourage the patient to take prescribed antipruritic agents approximately one hour before bedtime.

Question 4

The nurse is planning care for a patient who is at risk for pressure ulcer development over high-risk body areas. Which of the following nursing interventions should be included in this patient's plan of care? Select all that apply.

A)Use pillows to offload pressure.
B)Turn at least every two hours.
C)Use a mild cleansing agent on the skin.
D)Keep on bed rest.
E)Pull up in bed every two hours or less.

Question 5

Which of the following factors is included when assessing a patient for the risk of pressure ulcer development? Select all that apply.

A)sensory perception and activity level
B)moisture
C)mobility
D)nutrition
E)social interaction level

Question 6

An African American patient has reoccurring folliculitis on the face. The nurse should instruct the patient to do which of the following?

A)Use an electric razor.
B)Shave daily.
C)Shave very closely.
D)Shave in the opposite direction of hair growth.

Question 7

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? Select all that apply. Select all that apply.

A)A higher-rated sunscreen is needed between 10 am and 3 pm.
B)Sunscreen is needed even on cloudy days.
C)Apply a sunscreen with an SPF of 15 or more.
D)The higher the sunscreen rating, the less the protection provided.
E)When swimming, sunscreen should be reapplied every four hours.

Question 8

A patient with a history of tinea pedis reports concerns about developing the disorder again. Which of the following interventions suggested by the nurse will reduce the likelihood of a reoccurrence?

A)Wear sandal style footwear.
B)Begin to wear cotton undergarments.
C)Soak affected extremities in salted water nightly.
D)Apply lotions to moisturize potential areas of outbreak daily.

Question 9

The mother of a teenaged female experiencing a severe case of acne voices concern about her daughter's hygiene habits. Which of the following responses by the nurse is best?

A)"Your daughter needs to improve her facial hygiene to help in reducing the severity of the acne outbreaks."
B)"The greatest culprit for the acne is dietary habits, not inadequate hygiene."
C)"Are you embarrassed by her appearance?"
D)"What are your concerns about her hygiene practices?"

Question 10

A patient with a basal skin cancer on his cheek is coming into the dermatologist's office for Mohs surgery. He asks how long the procedure will take. The best response by the nurse would include which of the following? Select all that apply.

A)"The procedure occurs in steps and time needed depends on your lesion."
B)"The time depends on how deep the lesion is."
C)"It is difficult to predict how long the procedure will take."
D)"This is a long, complicated procedure and may take all day"
E)"The procedure should be completed in an hour or less."

Question 11

When planning care for the patient newly diagnosed with herpes zoster, which of the following nursing diagnoses has the highest priority?

A)Acute Pain
B)Ineffective Health Maintenance
C)Anxiety
D)Deficient Knowledge

Question 12

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. The nurse recognized this lesion is possibly which of the following?

A)squamous cell carcinoma
B)melanoma
C)psoriasis
D)seborrheic keratosis

Question 13

A patient is experiencing a lesion in the left axilla that is deep, painful, and contains pus. The lesion is three centimeters in diameter and is walled-off. After the assessment, the nurse determines the lesion is which of the following?

A)a furuncle
B)folliculitis
C)a carbuncle
D)herpes varicella

Question 14

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? Select all that apply.

A)measure less than 2 cm in diameter
B)is superficial
C)measure at least 4 cm in diameter
D)is in an area where the dermis is thin
E)extend into the subcutaneous tissue

Question 15

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 which of the following? Select all that apply.

A)Pediculosis is spread by contact with personal items such as hats and blankets.
B)Pediculosis is more common in people with lack of proper facilities for bathing and washing clothes.
C)Pediculosis is associated with wearing woolen hats.
D)Pediculosis affects children only.
E)Pediculosis is infestation by mites.

Question 16

The nurse understands that certain patients are more susceptible to pressure ulcer development. Which of the following patients would be at an increased risk? Select all that apply.

A)patient with restricted activity
B)patient with decreased sensation
C)patient who is very thin
D)patient with urinary and fecal incontinence
E)patient with good nutrition

Question 17

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

A)The disorder is transmitted by contact with infected persons or their possessions.
B)The disorder is transmitted by the feces of infected animals.
C)Scabies is a bacterial infection transmitted by direct contact with infected persons.
D)Scabies is a fungal infection transmitted by contact with infected respiratory secretions.

Question 18

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

A).The effects may not be seen for 24 hours.
B)Apply a topical antibiotic as ordered.
C)Keep the treated areas clean.
D)Healing may take several weeks.
E)Healing should occur in a few days.

Question 19

When planning care for a patient at risk for the development of pressure ulcers, which of the following should be included in the care? Select all that apply.

A)Initiate a frequent toileting schedule.
B)Turn the patient every two hours.
C)Massage pressure areas with lotion every four hours.
D)Use inflatable donut rings to reduce pressure on the sacrum.
E)Use hot water to cleanse the skin immediately after incontinence.

Question 20

The nurse is counseling a patient who has atopic dermatitis (eczema) and has developed a secondary Staphylococcus aureus infection. To prevent this type of infection from reoccurring in the future, the nurse should stress which of the following?

A)methods to prevent itching
B)continuous antibiotic treatment
C)frequent bathing
D)allergy testing

Question 21

When reading the history and physical records of a patient who has alopecia, the nurse should recognize which of the following conditions as a possible cause? Select all that apply.

A)a thyroid disorder
B)systemic lupus erythematosus
C)three months of chemotherapy for cancer
D)androgenic causes
E)an overactive pituitary

Question 22

A patient with a history of pruritis says, "The itching seems to improve when I take my allergy medicine." The nurse realizes that this is most likely because

A)the allergy medication is reducing histamine release.
B)the patient is distracted from the itching because of the allergies.
C)the patient's pruritis is improving.
D)the patient is taking other medication of which the nurse is not aware.

Question 23

A patient is receiving his first ultraviolet light therapy treatment for psoriasis. Which of the following should be included in this patient's teaching?

A)The skin will appear reddened in approximately eight hours after the treatment.
B)The treatment will be the same length every time.
C)There is no anticipated damage to the eyes or mucous membranes.
D)This is the treatment of choice for patients with psoriasis on 10% of the body.

Question 24

A patient has an infection of the cuticle involving several fingernails on both hands causing pain and edema. The condition has been present for several months. The nurse would recognize this condition as being related to the patient's employment as which of the following?

A)dish washer
B)construction worker
C)painter
D)carpenter

Question 25

A patient with skin cancer is recovering from a surgical procedure in which the layers of the lesion were shaved off. The nurse realizes that this patient most likely has had which of the following?

A)Mohs surgery
B)complete surgical excision of the lesion
C)curettage
D)electrodesiccation

Question 26

A female patient is prescribed isotretinoin (Accutane). Which of the following should the nurse instruct the patient about this medication? Select all that apply. Select all that apply.

A)Avoid prolonged exposure to sunlight.
B)Avoid the use of vitamin A supplements.
C)Use caution when driving at night.
D)Ingest pills on an empty stomach to avoid nausea and vomiting.
E)Use a reliable form of contraception one month prior to and during use of the medication.

Question 27

A patient diagnosed with psoriasis is being treated with topical corticosteroids. With which of the following should the nurse instruct the patient regarding the correct way to apply the medication?

A)Apply the medication in a thin layer.
B)Avoid rubbing the medication into the skin.
C)Apply a thick layer of medication.
D)Continue medication even if lesions worsen, because it is only a temporary reaction.

Question 28

The mother of a 12-year-old child states that she is concerned about her daughter's hair. She reports that her daughter frequently scratches her scalp and the hair "is clumpy and smells really bad." Which of the following should the nurse do to assist this mother?

A)Suggest that the daughter be checked for head lice.
B)Suggest that the daughter have a blood glucose level drawn.
C)Suggest that the daughter wash her hair.
D)Suggest that the daughter have a haircut.

Question 29

A female patient comes into the clinic with an itchy reddened area on both hands. Which of the following assessment techniques should the nurse include in the patient's assessment?

A)Ask the patient if she has changed soap or perfume.
B)Ask the patient to remove her shoes and stockings.
C)Listen to the patient's lungs.
D)Assess the patient's hand grasp strength.

Question 30

A 47-year-old female patient with a history of sun exposure is concerned that she has a disease because she says, "There are broken blood vessels on my cheeks." The nurse realizes that this patient is describing which of the following?

A)telangiectases
B)nevus flammeus
C)venus lakes
D)skin tags

Question 31

A female patient comes into the clinic with eyelid redness and edema. Which of the following would be appropriate for the nurse to include in the assessment of this patient?

A)Ask the patient if she has been thoroughly removing all of her eye makeup.
B)Ask if the patient has recently been in a public swimming pool.
C)Ask the patient if she shaves her legs.
D)Ask the patient if she has recently changed her facial soap.

Question 32

A female patient comes into the clinic concerned that while on a recent vacation she noticed several small patches of skin that "just won't tan." The nurse realizes that this patient might be experiencing which of the following?

A)tinea versicolor
B)tinea capitis
C)tinea corporis
D)tinea cruris

Question 33

A patient experiencing intense itching of the scalp and face has pediculosis in the hair and eyebrows. Which of the following should be included in the information provided to the patient?

A)"Apply the medication for at least 30 minutes before washing it off."
B)"You should start washing your hair more often to avoid this condition."
C)"A single treatment will manage the infestation."
D)"Infestations in the eyebrows will be treated by applying a thin layer of permethrin 1% cream (NIX) to the brows."

Question 34

A 57-year-old female patient complains of "strange pimples" over her buttocks region. The nurse realizes that this patient might be experiencing which of the following?

A)acne conglobata
B)contact dermatitis
C)acne vulgaris
D)acne rosacea

Question 35

The nurse is preparing a teaching plan for a group of community teenagers about acne. Which of the following should be included in this teaching plan? Select all that apply.

A)Sun exposure is permitted when protected with sunscreen, but avoid sunburn.
B)Keep hair clean with frequent shampoos.
C)Avoid eating greasy foods.
D)Wash the affected skin area at least six times per day.
E)Squeeze pimples when they occur.

Question 36

A patient is prescribed oral griseofulvin (fulvicin) for a fungal infection of the nails. The nurse instructs the patient to take the medication with food. Which of the following food should the nurse recommend to the patient? Select all that apply.

A)ice cream
B)cheese
C)crackers
D)pretzels
E)alcohol

Question 37

A 35-year-old female patient is diagnosed with advanced malignant melanoma. The nurse realizes that this patient

A)Has an uncertain prognosis.
B)Has a poor prognosis due to her age.
C)Will be completely cured with surgery.
D)Will need chemotherapy and radiation.

Question 38

A 52-year-old male patient of English descent is diagnosed with basal cell cancer on the face and forehead. Which of the following should the nurse include when teaching this patient about his diagnosis?

A)This type of skin cancer tends to reoccur.
B)This is a virulent form of skin cancer.
C)This type of skin cancer should be left alone.
D)This type of skin cancer is rare.

Question 39

A 68-year-old male patient comes into the clinic with a "strange painful rash" located on the left side of his upper chest. The nurse realizes that this patient might be experiencing which of the following?

A)herpes zoster
B)herpes simplex
C)verruca plana
D)condylomata acuminata

Question 40

The nurse instructs a patient with melanoma to "eat foods rich in protein and calories." This intervention is most likely associated with which of the following nursing diagnosis?

A)Impaired Skin Integrity
B)Hopelessness
C)Anxiety
D)Fluid Volume Deficit

Question 41

A patient in a wheelchair has a history of sacral pressure ulcer formation. Which of the following instructions should be included in the patient's teaching?

A)Shift the weight every 15 minutes to one hour.
B)Sit on a donut.
C)Stay in one position as long as possible.
D)Have a family pull the patient up in the wheelchair.

Question 42

A 40-year-old male patient says, "I wish I could have all of these tattoos removed." Which of the following solutions could the nurse suggest to this patient?

A)dermabrasion
B)chemical peeling
C)skin graft
D)blepharoplasty

Question 43

A 55-year-old patient who is recovering from a face lift says, "I think this was a waste of time and money. I look horrible!" Which of the following would be an appropriate nursing response?

A)"It takes a while for the skin to heal."
B)"You could use makeup."
C)"I would complain to the doctor."
D)"What did you expect?"

Question 44

A patient confined to bed has slid to the bottom of the bed. Which of the following should the nurse do to adjust this patient's body position?

A)Lift the patient up in bed.
B)Pull the patient up in bed.
C)Slide the patient up in bed.
D)Do nothing.

Question 45

A patient with a history of basal cell skin cancer asks the nurse what to do to avoid having the cancer recur. Which of the following would be appropriate for the nurse to instruct this patient?

A)Always use a sunscreen of SPF 15 or higher.
B)Avoid the sun at all costs.
C)Sun exposure between the hours of 10:00 am and 3:00 pm is best.
D)Sunscreen is not needed on cloudy days.