Deck 49: Management of Clients with Integumentary Disorders

Question 1

A client asks about the nature of the underlying problem in skin that leads to the development of atopic dermatitis. The nurse's response would include that the problem is caused by

A) a decrease in natural oils.
B) decreased resistance to skin infections.
C) decreased water content.
D) increased sensitivity to histamines.

Answer 1

decreased water content.

Question 2

In the care of a client diagnosed with cutaneous T-cell lymphoma, the nurse's priority focus would be

A) control of pruritus.
B) pain management.
C) prevention of metastasis.
D) removal of the tumors.

Answer 2

control of pruritus.

Question 3

In teaching a client about sun protection, the nurse would make an accurate suggestion with the statement

A) "Sitting in the shade will protect you from sun exposure."
B) "Use sunscreen, even on overcast days."
C) "Use a sunscreen with the lowest SPF number."
D) "Wear light-colored, loosely woven clothes."

Answer 3

"Use sunscreen, even on overcast days."

Question 4

A nurse is conducting community education classes on skin cancer. One participant says to the nurse: "I have read there are now vaccines to protect you from getting a melanoma." The nurse's most helpful response would be

A) "No, there is no vaccination for melanoma."
B) "The vaccines were so ineffective they were withdrawn."
C) "Vaccines are being developed against melanoma."
D) "Yes the vaccine is available, but it is very expensive."

Question 5

To help decrease the threat of a melanoma in a client at risk, the nurse would suggest that the client's diet should include

A) fish oil capsules.
B) lemon grass tea.
C) oatmeal.
D) red meat.

Question 6

After blepharoplasty the client complains of itching of the eyes. The nurse would

A) administer prescribed analgesia.
B) apply cold wet dressings.
C) irrigate the eyes with normal saline.
D) notify the physician immediately.

Question 7

A client is to have a basal cell carcinoma removed with Mohs' surgery. During preoperative teaching, it would be important for the nurse to explain that

A) liquid nitrogen will be applied to the lesion.
B) no dressing will be necessary.
C) scarring is rare.
D) the procedure may be long.

Question 8

When caring for a client after rhytidectomy, the nurse notes that the left side of the client's face is drooping. The nurse would

A) apply cold compresses.
B) call the surgeon immediately.
C) perform a neurosensory assessment.
D) raise the head of the bed.

Question 9

Discharge teaching for a client following rhytidectomy would include the instruction to

A) sleep in the prone position only.
B) practice coughing and deep breathing.
C) maintain a liquid diet for 1 week.
D) exercise the facial muscles daily.

Question 10

Nursing care for a client with atopic dermatitis would focus primarily on

A) decreasing pain.
B) decreasing pruritus.
C) preventing infection.
D) promoting drying of lesions.

Question 11

A client has severe cellulitis on the arm. The nurse would anticipate orders to administer medications to eradicate

A) Candida albicans.
B) group A beta-hemolytic streptococci.
C) Staphylococcus aureus.
D) Streptococcus pyogenes.

Question 12

The statement by a client with psoriasis vulgaris that would indicate to the nurse the need for further teaching regarding the client's illness is

A) "I could develop arthritis because of this disease."
B) "I will always have psoriasis."
C) "Psoriasis is caused by an infection."
D) "Stress can cause psoriasis to worsen."

Question 13

When providing topical treatment of lesions for a client with intertrigo, the nurse would avoid the use of

A) Burrow's solution.
B) cornstarch.
C) talc-containing powder.
D) topical steroids.

Question 14

The physician ordered colloidal oatmeal baths followed by application of an occlusive ointment for a client with pruritus. The nurse's teaching plan would include explaining the need to

A) apply the ointment to damp skin.
B) bathe several times a day.
C) soak for at least 30 minutes.
D) use hot water in the bath.

Question 15

Before a client has blepharoplasty, the nurse would assess the client for

A) ability to close eyes completely.
B) extraocular movement in each eye.
C) facial symmetry and muscle strength.
D) near and distant vision in each eye.

Question 16

The client is to apply topical 5-fluorouracil to a lesion diagnosed as actinic keratosis. The nurse would explain that the client should expect the skin to develop

A) desquamation.
B) dryness.
C) erosion and necrosis.
D) itching.

Question 17

Methotrexate is prescribed for a female client with psoriasis. When teaching the client about this medication, the nurse would explain that the client should avoid

A) aged cheese.
B) alcohol.
C) birth control pills.
D) milk products.

Question 18

Before initiation of photochemotherapy (PUVA), the nurse instructs a client suspected of having lupus erythematosus about the diagnostic study that will be performed first, which is a(n)

A) antinuclear antibody test.
B) chest x-ray study.
C) complete blood cell count.
D) platelet count.

Question 19

A nurse would instruct a client who experienced widespread first-degree sunburn to

A) apply a water-based emollient after bathing.
B) avoid the use of aspirin or ibuprofen.
C) soak in cold baths for 20 minutes at a time.
D) use over-the-counter local anesthetics.

Question 20

A client had a nodule removed from his face that was diagnosed as basal cell carcinoma. In teaching this client, the nurse should include information on the need for future

A) chemotherapy.
B) frequent examinations.
C) further assessment.
D) radiation therapy.

Question 21

A client is returning to the nursing unit after an intermaxillary wiring to treat a facial fracture. What equipment is vital for the nurse to have at the bedside? (Select all that apply)

A) Scale
B) Suction set-up
C) Thermometer
D) Wire cutters

Question 22

The nurse would record the assessment of a nonblanching reddened area on an older client's sacrum as

A) atopic dermatitis.
B) intertrigo.
C) stage 1 pressure ulcer.
D) xerotic eczema.

Question 23

Activities related to skin care the registered nurse can delegate to an unlicensed assistive personnel (UAP) include which of the following? (Select all that apply.)

A) Applying over-the-counter lotions to skin that is not broken
B) Assisting the client with frequent turning to prevent pressure ulcers
C) Covering the client who complains of being cold with more blankets
D) Placing a sterile gauze pad over broken skin to contain drainage
E) Treating a new rash with topical antihistamines if ordered

Question 24

A nurse is working with a client suffering from chronic pruritus. The client is angry and frustrated. The nurse should incorporate actions into the care plan that acknowledge

A) multiple treatments may be tried before finding one that works.
B) the lack of any effective treatments for pruritus.
C) the major impact pruritus has on quality of life.
D) that pruritus is very expensive to treat.

Question 25

When teaching a client with intermaxillary wiring, the nurse would instruct the client to avoid

A) carbonated beverages.
B) thick drinks.
C) using a water irrigation device.
D) vitamin supplements.

Question 26

Oral antiviral therapy is prescribed for a client with herpes zoster. The nurse would explain to the client that the medication is used to decrease (Select all that apply)

A) itching.
B) pain.
C) postherpetic neuralgia.
D) recurrence.
E) spreading.

Question 27

Before plastic surgery, the nurse would help the client develop (Select all that apply)

A) a good body image.
B) a positive attitude.
C) plans for payment.
D) realistic expectations.
E) satisfactory motivation.

Question 28

The nurse would reinforce to a client who is about to undergo liposuction for removal of excess fatty tissue that

A) bed rest is required for 24 hours after suction lipectomy.
B) final results may take up to 6 months to appear.
C) only small amounts of tissue can be removed at one time.
D) the client cannot receive analgesics after liposuction for several days.

Question 29

The nurse would counsel a client with eczema that the condition that might preclude the use of PUVA, or at least would require extra precautions, is

A) age over 60.
B) cataracts in development.
C) long-term cortisone therapy.
D) presence of open lesions.

Question 30

The nurse would explain to a client that effective treatments for severe pruritus include (Select all that apply)

A) oral corticosteroids.
B) sealing emollients.
C) tricyclic antidepressants.
D) topical antihistamines.
E) topical corticosteroids.

Question 31

A nurse is caring for a client who had a musculocutaneous flap reconstruction. The nurse assesses the flap to be cool with dark dermal blood on lancing. The most appropriate action by the nurse is to

A) document the findings and continue care.
B) elevate the affected body part if possible.
C) notify the surgeon immediately.
D) rewrap the pressure dressing.

Question 32

When caring for a client after a chemical peel procedure to the face, the nurse would

A) apply skin moisturizer.
B) cleanse the client's face with an astringent.
C) maintain the client in a head-down position.
D) use abrasive cleaning agents.

Question 33

A client is expressing great disappointment that the plastic surgery did not turn out as well as expected. The client is distressed over visible scarring and lingering edema. The most appropriate nursing diagnosis for this client is

A) Altered Coping
B) Disturbed Body Image
C) Fear
D) Situational Low Self Esteem

Question 34

The nursing care for a client after rhinoplasty would include

A) administering aspirin to decrease inflammation.
B) changing nasal packing daily to prevent infection.
C) maintaining the client flat in bed to reduce edema.
D) observing for excessive swallowing to assess for bleeding.

Question 35

To prevent pressure ulcers in a frail elderly client, the nurse would (Select all that apply)

A) bathe and dry the skin vigorously to stimulate circulation.
B) keep the head of the bed elevated 30 degrees.
C) offer nutritional supplements and frequent snacks.
D) turn the client at least every 2 hours.

Question 36

The nurse working with a UAP can delegate all of the following activities related to care of the client with a pressure ulcer except

A) assessing the client's skin using a standardized tool.
B) turning and repositioning the client according to a schedule.
C) keeping the client's skin clean and dry.
D) reporting any red areas that do not disappear after pressure relief.

Question 37

A nurse is working with a client who has a disfigured face and who is undergoing a series of reconstructive operations. The nurse has formulated the diagnosis: Disturbed Body Image related to perceived disfigurement as a primary problem. The least helpful intervention by the nurse would be to

A) present reality in a kind and compassionate manner.
B) refer the client to a licensed aesthetician to help with makeup.
C) say "I know how you feel" while sitting with the client.
D) tell the client s/he has to look in a mirror to get used to the facial appearance.

Question 38

After abdominoplasty, the nurse would place the client in the

A) low-Fowler position.
B) mid-Fowler position with knees bent.
C) side-lying position.
D) supine position with knees bent.