Deck 30: Integumentary Alterations

Question 1

In addition to protecting people from the harmful effects of ultraviolet light, what else do melanocytes within the epidermis do?

A) help with assimilation of vitamins
B) are determinant of skin pigmentation
C) play a role in skin lubrication
D) assist in walling off foreign protein

Answer 1

are determinant of skin pigmentation

Question 2

A student tells the school nurse that she knows that ultraviolet light is always harmful to a person. The nurse shares with the student that ultraviolet light has some positive effects as well. Which of the following effects is the most positive effect of ultraviolet light?

A) Absorption of ultraviolet light is necessary for the conversion of substances to vitamin D.
B) Ultraviolet light can help tan a person's body.
C) Ultraviolet light has a major influence on mood and can counteract the effects of major depression.
D) Ultraviolet light helps crops grow at a more even growth rate over time.

Answer 2

Absorption of ultraviolet light is necessary for the conversion of substances to vitamin D.

Question 3

Why is the newborn's skin more susceptible to infection during the first week of life?

A) It is much more porous than it will be at any other time in life.
B) The newborn's skin is very thin, thinner than at any other time in life.
C) The sweat gland system is underdeveloped in the first week.
D) The pH of the newborn's skin is relatively alkaline in the first week of life.

Answer 3

The pH of the newborn's skin is relatively alkaline in the first week of life.

Question 4

What is the classic sign of impetigo, which is typically used to diagnose this condition?

A) red rash on the trunk
B) honey-colored crusts on the skin
C) tracks under the skin
D) scratch marks near insect bites

Question 5

Which of the following organisms are the ones that almost always cause bullous impetigo?

A) Staphylococcus aureus
B) Escherichia coli
C) streptococcus
D) pneumococcus

Question 6

The nurse working with the family of a child with impetigo will teach the family which of the following things?

A) how to cover the skin to prevent the transfer of infection to others
B) isolation techniques such as masking, gowning, and gloving
C) handwashing techniques using antibacterial soap and not sharing towels and personal items
D) how to apply the tincture of benzoin to the lesions

Question 7

The nurse is working with a client who has a diagnosis of cellulitis. The spouse asks the nurse: "Just what is cellulitis anyway?" Which of the following would be the nurse's best answer?

A) an infection in the intracellular spaces, which forces fluids into extracellular space
B) a reaction to an intravenous injection of fluid or medication that has extravasated into the tissue
C) a severe inflammation of cells in any area of the body that will almost always respond to anti-inflammatory drugs
D) inflammation and infection in the loose connective tissue, which extends into the dermis; it often occurs following minor trauma

Question 8

The nurse assessing a child with cellulitis will most often find which of the following classic symptoms?

A) skin breakdown and areas of ulceration resulting from inflammation of cells
B) complaint of burning and tightness in the area of the cellulitis
C) erythema, swelling, warmth, pain, and diffuse borders of the infected area
D) no visible signs but the child will complain of varying types of pain

Question 9

The nurse working with a child who has cellulitis anticipates doctor's orders for which of the following usual treatment regimens?

A) whirlpool, meperidine (Demerol) or morphine sulfate, and wet to dry dressings
B) oral antibiotics, warm compresses, immobilization, elevation of the extremity, and analgesics
C) debridement of the wounds, antibiotic creams, dressings, and an Ace bandage
D) incision and drainage with antibiotics placed in the wound, done as a minor surgical procedure in day surgery

Question 10

The nurse is aware that children with facial cellulitis caused by Haemophilus influenza type B are at risk of developing:

A) the flu
B) an upper respiratory infection
C) meningitis
D) few problems

Question 11

The nurse assessing a baby finds that the baby has creamy-white plaques on the buccal mucosa and lateral borders of the tongue. What method will the nurse normally use to see if this is thrush or residual milk curds?

A) Send a sample of the plaques to the lab for a thrush test.
B) Scrape a sample of the plaques, and look at it under the microscope.
C) Give the baby something acidic to drink such as sweetened lemonade.
D) Do a simple scraping; milk curds will scrape away and thrush will not.

Question 12

The nurse will most often find intertrigo in which of the following places?

A) the upper back and the abdominal areas
B) the waist and any fat folds on the body
C) the axillae, interdigital spaces, and the gluteal cleft
D) the elbows and the hairline

Question 13

When a breastfeeding baby is found to have thrush, which of the following should be done?

A) Stop the breastfeeding immediately, and start on the bottle.
B) Evaluate the mother for candidiasis of the nipple.
C) Pump the breast, and use this milk in a bottle.
D) Paint the baby's mouth and the mother's nipples with gentian violet.

Question 14

When a baby has a diagnosis of thrush, the nurse anticipates an order for which of the following substances to treat the thrush?

A) gentian violet
B) penicillin
C) fluconazole (Diflucan)
D) oral nystatin (Mycostatin)

Question 15

The nurse working with the mother of an infant who has candidal diaper dermatitis will teach the mother which of the following supportive measures to take, in addition to medication, to clear up the condition?

A) Keep the affected area dry and exposed to air then feasible.
B) Use a diaper cream all the time, applying it several times a day.
C) Powder the area well after all voidings, and use cloth diapers.
D) Apply baby lotion to the diaper area several times a day.

Question 16

Which of the following causes tinea infections?

A) fomites
B) mites
C) dermatophytes
D) bacterium

Question 17

The nurse is working with a child who has a tinea capitis infection and is taking griseofulvin. The nurse will teach the parents that this medication is best absorbed:

A) then taken on an empty stomach
B) then taken with a full glass of water
C) then taken with foods high in fat
D) then taken with the meal

Question 18

The highest incidence of warts occurs in which of the following age groups?

A) children and adolescents
B) young adults
C) middle age
D) elderly

Question 19

The nurse is talking to parents about a wart on their child's hand. The wart does not appear to be bothering the child. The parents want to know if it should be surgically removed. Which of the following is the nurse's best response?

A) "Yes, because children's warts often spread and are hard to control."
B) "Two-thirds of warts will go away spontaneously within 2 years."
C) "Surgery is the first line of therapy, but this wart may disappear by itself."
D) "It is better to freeze the wart first before cutting it off. You can talk to the doctor about this."

Question 20

The nurse is working with the family of a child who is bothered by a wart and tends to pick at it. The family has been trying to remove the wart with a nonprescription product. The nurse assesses to see if the family is using the correct technique with a topical agent such as Duofilm, Mediplast, or Trans-plantar to treat the wart. Which of the following statements by the family would indicate correct technique?

A) "We used an emery board to sand the wart, soaked it in warm water, applied the medication, and then dry, reapplied it to cover the whole wart."
B) "We put the topical agent on the wart and covered it with an Elastoplast bandage wrapped with an Ace bandage to prevent picking."
C) "We cut the wart off, applied the medication, and left it open to the air."
D) "We applied a strong vinegar solution and then applied the medication."

Question 21

What percentage of children less than 5 years of age are estimated to have herpes simplex virus type I (HSV-1) antibodies?

A) 5%
B) 9%
C) 10%-19%
D) 20%-50%

Question 22

The nurse is doing some teaching with the parents of a child with herpes simplex virus type I (HSV-1) virus. The nurse will teach that 20%-40% of those with HSV-1 infections will have recurrent infections precipitated by:

A) alcohol or caffeine
B) sunlight, wind, injury, or stress
C) contact with someone else with the virus
D) exposure to allergens

Question 23

The nurse is preparing to take a viral culture of a lesion suspected of being herpes simplex virus type I (HSV-1) infection. How will the nurse take the culture?

A) Swab the base of the newest lesion or the vesicular fluid, doing so within 7 days of the appearance of new lesions and within 2 days of the appearance of recurrent ones.
B) Scrape a small amount of the lesion tissue with a tongue blade, and apply it to a slide.
C) Use a swab to collect fluid from the center of a lesion that is still weeping, and apply this to a slide.
D) Spray the lesion with ether, collect a specimen, and place it in a collection tube containing ether.

Question 24

Head lice are most common in which of the following groups of children?

A) African-American children
B) children from Central and South America
C) Caucasian school-aged boys
D) Caucasian school-aged girls

Question 25

The National Pediculosis Association (2004) recommends that the nurse examining children's hair for lice and nits should:

A) Wear gloves at all times, and change the gloves for each new examination.
B) Use wooden tongue depressors, discarded after each examination, to examine the child's hair.
C) Use ungloved hands, and wash the hands carefully with soap after the examination.
D) Use a comb to part the hair, and do not touch the hair itself with anything other than the comb.

Question 26

The nurse examining a 1-year-old child finds some nits and lice. The nurse is aware that children of this age should be treated for nits and lice in which of the following ways?

A) weight dosed for permethrin (Nix)
B) lice shampoo diluted with water
C) manual removal of nits and lice
D) wash the hair several times a day

Question 27

Which of the following is the most important message the nurse can give the parents of a child with head lice?

A) "Any child from any home can get pediculosis (head lice)."
B) "You will have to wash the child's hair more often."
C) "Shaving the child's head would make it easier to get rid of the lice."
D) "You should not have any children over to play until you get rid of the lice."

Question 28

The nurse assessing a child finds the classic symptoms of scabies, which are:

A) Track-like raised red areas, which burn and hurt but do not itch at all
B) constant itching and secondary infections from itching, in addition to primary dry scaly lesions on the arms and trunk
C) daytime itching and vesicles containing fluid in a Track-like pattern
D) nighttime itching and minute grayish-brown, threadlike burrow tracks with a black dot at the end of the track

Question 29

The nurse will recommend to the family of a child with scabies that every member be treated prophylactically for scabies for which of the following reasons?

A) The incubation period is 2 to 6 weeks.
B) Scabies is highly contagious for months.
C) It is difficult to kill scabies.
D) Psychologically they will feel better.

Question 30

The nurse working in pediatrics will find that the majority of cases of atopic dermatitis or eczema occur in which of the following age groups?

A) infants and young children
B) school-aged children
C) latency age
D) adolescents and young adults

Question 31

When developing a nursing care plan for a child with atopic dermatitis who has a nursing diagnosis of risk for infection (secondary to scratching of lesions), the nurse will most likely select which of the following interventions?

A) Keep the environment warm.
B) Dress the child in clothing that is light, clean, and loose.
C) Teach the family to use antibacterial hand soap.
D) Avoid lotions and creams.

Question 32

Which of the following events is most often necessary to start the process of developing impetigo? Select all that apply.

A) a scratch
B) underlying skin disease
C) contact with a mite
D) an insect bite