Chapter 61 Management of Patients with Dermatologic Exam 4

A nurse practitioner is seeing a 16-year-old male patient who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?
A) Acyclovir (Zovirax)
B) Benzo

Ans: B
Feedback:
Benzamycin gel is among the topical treatments available for acne. Zovirax is used in the treatment of herpes zoster as an oral antiviral agent. Benadryl is an oral antihistamine used in the treatment of pruritus. Intralesional injections

2. A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating an education plan for the patient. What information should be included in this plan?
A) Use caution when taking nonprescription medications.
B) Avoid public pl

Ans: A
Feedback:
The patient should be cautioned about taking nonprescription medications because some may aggravate mild psoriasis. Psoriasis is not contagious. Many patients need reassurance that the condition is not infectious, not a reflection of poor

3. A nurse is planning the care of a patient with herpes zoster. What medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?
A) Prednisone (Deltasone)
B) Azanthioprine (Imuran)
C) Triamcinolone (Kenalog)
D

Ans: D
Feedback:
Acyclovir, if started early, is effective in significantly reducing the pain and halting the progression of the disease. There is evidence that infection is arrested if oral antiviral agents are administered within the first 24 hours. Pre

4. A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?
A) Chemotherapy
B) Radiation therapy
C) Surgical

Ans: C
Feedback:
The primary goal of surgical management of squamous cell carcinoma is to remove the tumor entirely. Radiation therapy is reserved for older patients, because x-ray changes may be seen after 5 to 10 years, and malignant changes in scars ma

5. When writing a plan of care for a patient with psoriasis, the nurse would know that an appropriate nursing diagnosis for this patient would be what?
A) Impaired Skin Integrity Related to Scaly Lesions
B) Acute Pain Related to Blistering and Erosions of

Ans: A
Feedback:
An appropriate diagnosis for a patient with psoriasis would include Impaired Skin Integrity as it relates to scaly lesions. Psoriasis causes pain but does not normally affect the oral cavity. Similarly, tissue integrity is impaired, but n

A patient who has sustained third-degree facial burns and a facial fracture is undergoing reconstructive surgery and implantation of a prosthesis. The nurse has identified a nursing diagnosis of Disturbed Body Image Related to Disfigurement. What would be

Ans: D
Feedback:
The process of facial reconstruction is often slow and tedious. Because a persons facial appearance affects self-esteem so greatly, this type of reconstruction is often a very emotional experience for the patient. Reinforcement of the pat

While performing an initial assessment of a patient admitted with appendicitis, the nurse observes an elevated blue-black lesion on the patients ear. The nurse knows that this lesion is consistent with what type of skin cancer?
A) Basal cell carcinoma
B)

Ans: D
Feedback:
A malignant melanoma presents itself as a superficial spreading melanoma which may appear in a combination of colors, with hues of tan, brown, and black mixed with gray, blue-black, or white. The lesion tends to be circular, with irregula

A patient requires a full-thickness graft to cover a chronic wound. How is the donor site selected?
A) The largest area of the body without hair is selected.
B) Any area that is not normally visible can be used.
C) An area matching the color and texture o

Ans: C
The site where the intact skin is harvested is called the donor site. Selection of the donor site is made to match the color and texture of skin at the surgical site and to leave as little scarring as possible.

A patient has just been told that he has malignant melanoma. The nurse caring for this patient should anticipate that the patient will undergo what treatment?
A) Chemotherapy
B) Immunotherapy
C) Wide excision
D) Radiation therapy

Ans: C
Feedback:
Wide excision is the primary treatment for malignant melanoma, which removes the entire lesion and determines the level and staging. Chemotherapy may be used after the melanoma is excised. Immunotherapy is experimental and radiation thera

A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants risks of basal cell carcinoma (BCC)?
A) Teaching participants to improve their overall health through nutrition
B) Enco

Ans: C
Feedback:
Sun exposure is the best known and most common cause of BCC. BCC is not commonly linked to general health debilitation, family history, or radiation exposure

A patient comes to the clinic complaining of a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with herpes zoster?
A) Grouped vesicles occurring on lips and oral mucous membranes
B) G

Ans: D
Feedback:
Herpes zoster, or shingles, is an acute inflammation of the dorsal root ganglia, causing localized, vesicular skin lesions following a dermatome. Herpes simplex type 1 is a viral infection affecting the skin and mucous membranes, usually

4. A patient with a chronic diabetic wound is being discharged after receiving a skin graft to aid wound healing. What direction should the nurse include in home care instructions?
A) Gently massage the graft site daily to promote perfusion.
B) Protect th

Ans: B
Feedback:
Both the donor site and the grafted area must be protected from exposure to extremes in temperature, external trauma, and sunlight because these areas are sensitive, especially to thermal injuries. Antibiotic ointments are not typically p

A nurse is providing care for a patient who has psoriasis. The nurse is aware of the sequelae that can result from this health problem. Following the appearance of skin lesions, the nurse should prioritize what assessment?
A) Assessment of the patients st

Ans: C
Asymmetric rheumatoid factornegative arthritis of multiple joints occurs in up to 30% of people with psoriasis, most typically after the skin lesions appear. The most typical joints affected include those in the hands or feet, although sometimes la

A nurse is caring for a patient whose chemical injury has necessitated a skin graft to his left hand. The nurse enters the room and observes that the patient is performing active range of motion (ROM) exercises with the affected hand. How should the nurse

Ans: D
Feedback:
The nurse should instruct the patient to keep the affected part immobilized as much as possible in order to facilitate healing. Passive ROM exercises can be equally as damaging as active ROM.

A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?
A) The childs scalp should be monitored for 48 to 72 hours before starti

Ans: B
Feedback:
Treatment for head lice should begin promptly and may require manual removal of nits following medicating shampoo. Head lice are not related to a lack of hygiene. Treatment is necessary because the condition will not likely resolve sponta

A patient has just been diagnosed with psoriasis and frequently has lesions around his right eye. What should the nurse teach the patient about topical corticosteroid use on these lesions?
A) Cataract development is possible.
B) The ointment is likely to

Ans: A
Feedback:
Patients using topical corticosteroid preparations repeatedly on the face and around the eyes should be aware that cataract development is possible. Weeping and glaucoma are less likely. There is no consequent risk of glaucoma

A patients blistering disorder has resulted in the formation of multiple lesions in the patients mouth. What intervention should be included in the patients plan of care?
A) Provide chlorhexidine solution for rinsing the patients mouth.
B) Avoid providing

Ans: A
Feedback:
Frequent rinsing of the mouth with chlorhexidine solution is prescribed to rid the mouth of debris and to soothe ulcerated areas. A hypertonic solution would be likely to cause pain and further skin disruption. Meticulous mouth care shoul

A nurse is assessing a teenage patient with acne vulgaris. The patients mother states, I keep telling him that this is what happens when you eat as much chocolate as he does. What aspect of the pathophysiology of acne should inform the nurses response?
A)

Ans: D
Feedback:
Diet is not believed to play a major role in acne therapy. A change in diet is not known to exacerbate symptoms.

A nurse is providing self-care education to a patient who has been receiving treatment for acne vulgaris. What instruction should the nurse provide to the patient?
A) Wash your face with water and gentle soap each morning and evening.
B) Before bedtime, c

Ans: A
Feedback:
The nurse should inform the patient to wash the face and other affected areas with mild soap and water twice each day to remove surface oils and prevent obstruction of the oil glands. Cleansing with rubbing alcohol is not recommended and

A nurse is caring for a patient whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?
A) Teach the patient about early signs of secondary blistering diseases.
B) Teach the patient about self-care afte

Ans: B
Feedback:
Because many skin cancers are removed by excision, patients are usually treated in outpatient surgical units. The role of the nurse is to teach the patient about prevention of skin cancer and about self-care after treatment. Assessing the

A patient has just undergone surgery for malignant melanoma. Which of the following nursing actions should be prioritized?
A) Maintain the patient on bed rest for the first 24 hours postoperative.
B) Apply distraction techniques to relieve pain.
C) Provid

Ans: D
Feedback:
Nursing interventions after surgery for a malignant melanoma center on promoting comfort, because wide excision surgery may be necessary. Anticipating the need for and administering appropriate analgesic medications are important. Distrac

A patient has recently been diagnosed with advanced malignant melanoma and is scheduled for a wide excision of the tumor on her chest. In writing the plan of care for this patient, what major nursing diagnosis should the nurse include?
A) Deficient Knowle

Ans: A
Feedback:
The fact that the patients disease was not reported until an advanced stage suggests that the patient lacked knowledge about skin lesions. Excision does not result in chronic pain. Reconstructive surgery is not a certainty, and will not n

A public health nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?
A) Educating participants about the relatio

Ans: C
Feedback:
The best hope of decreasing the incidence of skin cancer lies in educating patients about the early signs. There is a relationship between general health and skin cancer, but teaching individuals to identify the early signs and symptoms i

An older adult resident of a long-term care facility has been experiencing generalized pruritus that has become more severe in recent weeks. What intervention should the nurse add to this residents plan of care?
A) Avoid the application of skin emollients

Ans: C
Feedback:
If baths have been prescribed, the patient is reminded to use tepid (not hot) water and to shake off the excess water and blot between intertriginous areas (body folds) with a towel. Skin emollients should be applied to reduce pruritus. A

A nurse is working with a family whose 5 year-old daughter has been diagnosed with impetigo. What educational intervention should the nurse include in this familys care?
A)
Ensuring that the family knows that impetigo is not contagious
B) Teaching about t

Ans: C
Feedback:
Impetigo is associated with unhygienic conditions; educational interventions to address this are appropriate. The disease is contagious, thus vesicles should not be manually burst. Because of the bacterial etiology, corticosteroids are in