Question 1

The nurse counsels a patient with poison ivy to decrease his discomfort by:

Accepted Answer

Patting the skin dry will decrease irritation and will not break vesicles.The patient should bathe in tepid water and avoid getting hot as heat exacerbates the itching.

Question 2

The nurse recommends that the person who suffers with psoriasis can increase his comfort by:

Accepted Answer

Humidification increases comfort.Heat and drying increase discomfort of psoriasis.

Question 3

In caring for a stage IV pressure ulcer,the nurse assesses the purulent drainage as creamy yellow with a necrotic odor.The nurse is aware that this type of exudate is probably caused by:

Accepted Answer

Creamy yellow drainage is usually caused by Staphylococcus infections.Proteus is associated with a beige discharge having a fishy odor.Brown discharge having a fecal odor is seen in Bacteroides.Pseudomonas-containing wounds produce a green-blue discharge with a fruity odor.

Question 4

The nurse is caring for a patient diagnosed with shingles.The patient has been complaining of constant pain along the sciatic nerve.What intervention by the nurse can best help to provide pain relief?

Accepted Answer

Distraction,guided imagery,and deep muscle relaxation may help reduce pain.Massage to the affected area will result in disruption in the vesicles of the disease.This disruption will delay healing and cause further discomfort.ROM and changing of positions are needed for patients with shingles in the event they are not mobile,but these actions will not reduce the discomfort.

Question 5

An 84-year-old patient who has had a low-grade fever for 2 days complains of pain in the hip that travels down the leg along the sciatic nerve.The nurse assesses small groups of vesicles along the nerve path.These assessments lead the nurse to suspect that the patient is suffering from:

Accepted Answer

Herpes zoster (shingles)begins with vague symptoms of chills and low-grade fever and possibly some gastrointestinal disturbance.There may be only aching or discomfort along the nerve pathway with or without erythema.About 3 to 5 days after onset,small groups of vesicles appear on the skin.They usually are found on the trunk and spread halfway around the body,following the nerve pathways leading from the spinal nerve to the skin.

Question 6

The nurse explains that the primary purpose of the whirlpool bath given to the patient with a stage III pressure ulcer is to:

Accepted Answer

The whirlpool acts as a type of débridement.It gets rid of the necrotic debris and stimulates granulation tissue growth.

Question 7

A patient with psoriasis is placed on PUVA therapy.The nurse clarifies that this therapy involves the combination of:

Accepted Answer

PUVA is a combination of artificial UV rays and psoralen,a coal tar product.

Question 8

The nurse would question the order for isotretinoin (Accutane)that was prescribed for a:

Accepted Answer

Accutane is considered a teratogen and can cause fetal malformations.Patients of childbearing age must be on a contraceptive.

Question 9

The nurse places a catheter drainage bag with a urometer on the catheter of the adult patient with a burn in order to measure hourly urine output.The nurse is aware that a minimum acceptable urine output is _____ mL/hr.

Accepted Answer

The minimum acceptable urine output for an adult is 30 mL/hr.

Question 10

The nurse advises a 20-year-old college sophomore with acne vulgaris to:

Accepted Answer

Keeping the face clean and dry by washing with mild soap and not scrubbing is helpful to clear up clogged pores.Pustules should not be squeezed as this could lead to infection.Strict diet restrictions of the past are no longer observed as strenuously.

Question 11

The patient with shingles has been on an antiviral medication since the vesicles appeared.The nurse encourages the patient that such early treatment will probably prevent:

Accepted Answer

Early treatment may avoid postherpetic pain syndrome,but it cannot assure that there will not be more vesicles or that the disease will not attack the eye.Pain with shingles is very hard to control.

Question 12

The nurse admitting a patient with significant burns to the emergency department notes the presence of symptoms consistent with an inhalation burn.Which finding is the nurse most likely noting?

Accepted Answer

Persistent coughing,particularly if black mucus is coughed up,is an indicator of an inhalation burn.

Question 13

A patient with acne rosacea is sensitive about the facial erythema and telangiectases.The nurse recommends that she:

Accepted Answer

Avoiding direct sunlight will reduce the symptoms.

Question 14

The home health nurse instructs the family whose child came home from school with lice that the bed linens should be:

Accepted Answer

Washing in hot water with ordinary detergent and drying on the hottest cycle will kill lice.There is no need to completely discard the linens.Bleach is not needed.Multiple wash cycles will not be necessary.

Question 15

While bathing a patient,the nurse assesses a red,unblanchable area on the coccyx.The best dressing for this lesion is a ________ dressing.

Accepted Answer

A transparent film for a stage I pressure ulcer will protect it from shearing injury and will retain moisture.A hydrocolloid dressing would be appropriate for a larger,more advanced pressure ulcer.There is no discharge in a stage I pressure ulcer,making absorbent and wet-to-dry dressing options inappropriate.

Question 16

The Parkland fluid resuscitation calculation calls for 8000 mL.The burn occurred at noon.The present time is 2:00 PM.The fluid should be set to deliver _____ mL by _____ PM.

Accepted Answer

According to the Parkland formula,one half of the fluid resuscitation load should be infused within 8 hours from the time of the burn.The burn occurred at noon,so by 8:00 PM,4000 mL should have been infused of the 8000 mL calculated.

Question 17

While bathing a patient,the nurse discovers a grayish black,nodular growth that resembles a blackberry in the middle of the patient's back.The nurse should:

Accepted Answer

These findings are consistent with a nodular malignant melanoma.It should be evaluated by the physician and removed immediately once the diagnosis is confirmed.Actinic keratoses occur very frequently on the skin of the elderly.They appear on fair-skinned people as a small,scaly,red or grayish papule particularly on areas of skin that are often exposed to the sun.Squamous cell carcinoma appears as a nodule that later becomes ulcerated.

Question 18

The patient with a stage III pressure ulcer that will not heal is horrified about being hooked up to a unit providing voltage stimulus to the wound.The nurse explains that the electrical stimulation will:

Accepted Answer

The electrical stimulation will increase blood supply by stimulating vessel growth.The voltage unit will not cleanse the wound,cause scabbing,or coagulation of drainage.

Question 19

A 75-year-old patient questions the nurse about the need to consider a vaccine to prevent the development of shingles.What response by the nurse is most appropriate?

Accepted Answer

The vaccination should be considered by high-risk populations.About 50% of individuals over age 80 years will have the disease.The vaccination has been approved for use.The immunity provided is anticipated to last for 6 years.

Question 20

To prevent contractures in the burn patient,the nurse should:

Accepted Answer

Unless other injuries prevent it,the patient should be ambulated as soon as the fluid shift has stabilized in order to prevent contractures.Limbs should not be in static positions and should be put through ROM even when painful.

Quiz 43: Care of Patients With Integumentary Disorders and Burns