Deck 59: Caring for the Patient With Skin Disorders

Question 1

A patient has a small, red, scaling lesion that is sitting on an elevated base on the forehead. The patient states that the lesion appeared several weeks ago and will not heal. The nurse is concerned that the patient has which type of lesion?

A) Squamous cell carcinoma
B) Melanoma
C) Psoriasis
D) Seborrheic keratosis

Answer 1

Squamous cell carcinoma

Question 2

A patient at risk for the development of skin cancer is discussing sun exposure prevention with the nurse. What guidelines should the nurse offer? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Limit the time spent in the sun between 10 a.m. and 3 p.m.
B) Sunglasses should wrap around the face.
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 4 hours.

Answer 2

Limit the time spent in the sun between 10 a.m. and 3 p.m.
Sunglasses should wrap around the face.
Apply a sunscreen with an SPF of 15 or more.

Question 3

Several individuals from a homeless shelter have been diagnosed with pediculosis. The nurse, planning to train staff in the control and prevention of this infection, should include which information? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: 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 who lack the proper facilities for bathing and washing clothes.
C) "Crabs" is another name for pediculosis.
D) Pediculosis affects children only.
E) Pediculosis is infestation by mites.

Answer 3

Pediculosis is spread by contact with personal items such as hats and blankets.
Pediculosis is more common in people who lack the proper facilities for bathing and washing clothes.
"Crabs" is another name for pediculosis.

Question 4

An African American male patient has recurring folliculitis on the face. Which information should the nurse provide about shaving?

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

Question 5

The nurse is planning care for a patient recently diagnosed with herpes zoster. Which nursing diagnosis will the nurse give highest priority?

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

Question 6

A patient has a lesion in the left axilla that is deep, painful, and contains pus. The lesion is three centimeters in diameter and is walled off. The nurse anticipates treatment to be initiated for which condition?

A) A furuncle
B) Folliculitis
C) A carbuncle
D) Herpes zoster

Question 7

A female patient comes to the clinic with an itchy, reddened area on both hands. What nursing assessment is indicated?

A) Ask the patient if she has changed soap or perfume.
B) Ask the patient if she might be pregnant.
C) Auscultate the patient's lungs for rhonchi or wheezes.
D) Assess the patient's hand grasp strength.

Question 8

The nurse is preparing a teaching plan for a group of community teenagers about acne. Which information should be included in this teaching plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Avoid wearing makeup to reduce acne outbreak.
B) Keep hair clean with frequent shampoos.
C) Avoid eating chocolate.
D) Wearing a cap or hat may increase acne on the forehead.
E) Open pimples when they develop.

Question 9

A patient diagnosed with psoriasis is being treated with topical corticosteroids. How should the nurse instruct the patient to apply the medication?

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

Question 10

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 recurring in the future, the nurse should recommend which action?

A) Apply an emollient to the area at least once daily.
B) Take antibiotics for 3 weeks of each month.
C) Take a warm shower each morning and again before bedtime.
D) Have allergy testing performed.

Question 11

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

A) This type of skin cancer usually occurs on the head and neck.
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 12

A patient with a history of tinea pedis is concerned about developing the disorder again. Which intervention can the nurse suggest to reduce the likelihood of a recurrence?

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

Question 13

A patient has paronychia involving several fingers on one hand. The patient reports having the condition for several months. Which treatment would the nurse recommend in addition to prescribed antibiotics?

A) Application of vitamin E oil
B) Hot compresses
C) Increasing dietary protein intake
D) Soaking the hands in cool water two or three times daily

Question 14

A patient is receiving the first ultraviolet light therapy treatment for psoriasis. What should the nurse include in this patient's teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The skin will appear red after the treatment.
B) The patient will have one treatment a week for 6 months.
C) Clearing of lesions may take 7 weeks or more.
D) This is the treatment of choice for patients with psoriasis on 10% of the body.
E) A photosensitizing medication may be given before the treatment.

Question 15

A patient asks the nurse about possible options regarding treatment for a malignant melanoma lesion on the arm. Which response by the nurse would be most accurate?

A) "The preferred method of treatment is to remove all the cancer surgically."
B) "An anticancer cream will be used to dissolve the lesion."
C) "Radiation to the skin lesion will be the first method of treatment."
D) "Intravenous chemotherapy will be the initial method of treatment."

Question 16

A patient diagnosed with scabies asks the nurse how she "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 via 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 17

A 68-year-old male patient comes into the clinic with a "strange painful rash" on the left side of his upper chest. The nurse would conduct additional assessment for which condition?

A) Herpes zoster
B) Herpes simplex
C) Verruca plana
D) Condylomata acuminata

Question 18

A female patient is prescribed isotretinoin Accutane). Which information should the nurse provide when teaching about the medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Avoid prolonged exposure to sunlight.
B) Avoid the use of vitamin A supplements.
C) The medication may cause intolerance to contact lenses.
D) Take the pills on an empty stomach to avoid nausea and vomiting.
E) Pregnancy prevention is essential.

Question 19

When reviewing the history and physical records of a patient who has alopecia, the nurse should recognize which conditions as a possible cause? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) A thyroid disorder
B) Solar lentigo
C) Three months of chemotherapy for cancer
D) Cushing's syndrome
E) Hypoglycemia

Question 20

The mother of a teenaged female with a severe case of acne expresses concern about her daughter's hygiene habits. Which response by the nurse is most helpful?

A) "Improving facial hygiene is the best way to treat your daughter's acne."
B) "The most important causative factor for acne is poor diet, not inadequate hygiene."
C) "Do you think your daughter is embarrassed by her appearance?"
D) "What are your concerns about her hygiene practices?"

Question 21

A patient has been diagnosed with cellulitis from an insect bite on the hand. In addition to taking the prescribed antibiotic, the nurse would recommend which treatments? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Get plenty of rest with the hand elevated on a pillow.
B) Soak the hand in cool Burrow's solution.
C) Report any pain in the hand.
D) Wrap the hand and arm in warm towels.
E) Protect the blisters from rupture if possible.

Question 22

A 55-year-old patient who is recovering from a face-lift performed 2 days ago says, "I think this was a waste of time and money. I look horrible!" How should the nurse respond?

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 23

A child has been admitted for treatment of Stevens-Johnson syndrome SJS). The nurse assuming care for this patient would expect which assessment findings? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Blue-tinged target lesions
B) Positive Nikolsky's sign
C) Lesions on the face, neck, and extremities
D) Initial involvement of less than 20% of total body surface area
E) Involvement of at least two mucous membranes

Question 24

The parent of a newborn is concerned because the baby has a quarter-sized, raised, and reddened hemangioma on the lower abdomen. What information should the nurse provide?

A) Surgery will be required to remove this lesion.
B) Because of their bright red color, these lesions are called raspberry hemangiomas.
C) Chances are good that this hemangioma will go away on its own by the time the child reaches age 9.
D) This hemangioma is caused by birth trauma and will clear up in the same time period as a bruise heals.

Question 25

A 40-year-old male patient says, "I wish I could have all of these tattoos removed." The nurse would provide information about which method of tattoo removal?

A) Dermabrasion
B) Rhytidectomy
C) Skin graft
D) Blepharoplasty

Question 26

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

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

Question 27

A patient has an infection in a piercing of the upper ear cartilage. Which information should the nurse provide?

A) "Cleanse the area with hydrogen peroxide three times a day."
B) "Keep the area covered with ointment."
C) "This infection will clear after a course of oral antibiotics."
D) "Cartilage infections can cause changes to the shape of your ear."

Question 28

A 3-year-old is diagnosed with impetigo. Which instructions should the nurse provide this child's caregiver? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The crusts can be softened with warm tap water.
B) Use a gentle antibacterial soap to cleanse the area of crusts.
C) Bring the child back to the clinic for another infusion of intravenous antibiotic in 2 days.
D) Do not allow any other family members to use the same towels as this child.
E) Use an emollient lotion on the area until healing occurs.

Question 29

The nurse is concerned that a patient may be developing necrotizing fasciitis NF). Which assessment findings would the nurse evaluate as increasing the patient's risk for this condition? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The patient is 78 years old.
B) The patient has diabetes.
C) The patient is hypertensive.
D) The patient has fair skin and blue eyes.
E) The patient is an alcoholic.

Question 30

A 35-year-old female patient is diagnosed with malignant melanoma. The nurse considers which information when planning care for this patient?

A) Prognosis is uncertain.
B) Prognosis is poor due to the patient's age.
C) The patient will likely be cured with surgery.
D) The patient will need chemotherapy and radiation.

Question 31

A patient sustained an injury to the arm 2 days ago. The patient presents today concerned that the wound is not healing. Which findings would the nurse immediately communicate to the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The skin over the area is tight and red.
B) The pain from the wound seems out of proportion to the injury.
C) The wound edges have separated.
D) Crepitus is present around the wound.
E) The patient reports flulike symptoms.

Question 32

A child has been diagnosed with atopic dermatitis. How should the nurse describe the disorder to the parents? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) This disorder is also called eczema.
B) There may be others in the family with this disorder.
C) A course of antibiotics will cure this disorder.
D) Children often outgrow this disorder.
E) Something in the child's environment may be causing this skin reaction.

Question 33

Inspection of a patient's skin reveals the presence of an irregularly shaped brown patch covered with hair. The patch is palm-sized and is located on the patient's shoulder. The nurse anticipates which diagnosis of this finding?

A) Intradermal nevus
B) Halo nevus
C) Becker's nevus
D) Junctional nevus

Question 34

A veterinarian comes to the urgent care clinic and says, "I think I was bitten on the hand by something earlier in the week and the area isn't healing." Assessment reveals a painless lesion with a black center. Axillary lymph nodes are enlarged. The nurse suspects cutaneous anthrax. Which actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Immediately contact the clinic health care provider with this assessment.
B) Prepare to obtain a culture.
C) Isolate the patient from others in the clinic.
D) Ask the patient about allergy to antibiotics.
E) Ask the patient if any strangers were in the veterinary clinic last week.