Question 1

The nurse is cleansing a patient's infected pressure ulcer.What type of equipment should the nurse use?

Accepted Answer

A)   A needleless 30-mL syringe
B)   A needleless 60-mL syringe
C)   A 10-mL syringe with a 24-gauge needle
D)   A 30-mL syringe with an 18-gauge needle D

Question 2

The nurse notes that a patient has a honey-colored crust over a thin-walled vesicle.For which infectious skin disorder should the nurse plan care?

Accepted Answer

A)   Scabies
B)   Carbuncle
C)   Pediculosis
D)   Impetigo contagiosa D

Question 3

The nurse is monitoring a patient's stage 3 pressure ulcer for healing during treatment.Which finding indicates that the nursing interventions have been effective?

Accepted Answer

A)   There is a hard crust over the wound.
B)   The patient states that pain is minimal.
C)   The wound drainage is serosanguinous.
D)   The wound has a grainy, spongy texture. D

Question 4

The nurse is assisting a patient with psoriasis apply coal tar to the skin.What action should the nurse anticipate providing after the tar is applied to the patient?

Accepted Answer

A)   Expose the patient UV light.
B)   Application of occlusive dressings.
C)   Have the patient sit in a warm environment.
D)   Provide the patient with 16 ounces of warm fluids.

Question 5

The nurse is caring for a patient with impetigo contagiosa.For which complication should the nurse monitor when caring for this patient?

Accepted Answer

A)   Psoriasis
B)   Glomerulonephritis
C)   Respiratory infection
D)   Basal cell carcinoma

Question 6

The nurse is caring for a patient with lesions on the skin.Which assessment finding should cause the nurse to suspect scabies?

Accepted Answer

A)   Large, fluid-filled blisters
B)   Short, wavy, brownish black lines
C)   Reddish brown dots at the base of hairs
D)   Gray blue macules on the thighs and axillae

Question 7

A patient is prescribed vitamin A acid (Retin-A)as treatment of acne vulgaris.What should the nurse instruct the patient about the purpose of this medication? (Select all that apply.)

Accepted Answer

A)   It decreases scarring.
B)   It loosens pore plugs.
C)   It kills bacteria in follicles.
D)   It stabilizes hormone levels.
E)   It stimulates the immune system.F)  It prevents occurrence of comedomes.

Question 8

A patient with a wound is prescribed wet-to-dry dressings.What should the nurse do prior to performing a dressing change for this patient?

Accepted Answer

A)   Assist the patient to void
B)   Medicate the patient for pain
C)   Wash hands and apply sterile gloves
D)   Moisten the dressing before removing

Question 9

The nurse is caring for a patient who has a stage 4 pressure ulcer that is 2 cm in diameter and 2 cm deep.Bone is visible in the wound.Which patient assessment finding should be communicated to the registered nurse (RN)immediately?

Accepted Answer

A)   Patient report of pain
B)   Yellow wound drainage
C)   A reddened area adjacent to the ulcer
D)   Pink grainy appearance at wound edges

Question 10

A patient with a carbuncle is prescribed oral antibiotics,daily dressing changes with topical antibiotic ointment,and acetaminophen with codeine for pain.Which patient statement indicates that further teaching about the care of this skin condition is necessary?

Accepted Answer

A)   "Once the swelling and redness are gone, I can stop taking the antibiotics."
B)   "I should wash the area gently with antibacterial soap before applying a new dressing."
C)   "Covering my pillow with plastic and cleaning it every day will help prevent additional infection."
D)   "I will need to increase my fluid and fiber intake to prevent constipation while I'm taking the pain medication."

Question 11

The nurse is care for a patient with shingles.Which statement should the nurse include in patient teaching?

Accepted Answer

A)   "Herpes simplex 2 causes shingles."
B)   "Shingles is caused by herpes simplex 1 virus."
C)   "Varicella zoster is the virus responsible for shingles."
D)   "Herpes zoster is a virus that is common in older patients."

Question 12

The nurse is teaching a patient skin care to prevent cancer.Which time of day should the patient instruct to avoid the sun?

Accepted Answer

A)   7 to 9 a.m.
B)   9 to 10 a.m.
C)   10 a.m. to 4 p.m.
D)   2 to 4 p.m.

Question 13

The nurse is assessing a patient with pemphigus.What skin manifestations should the nurse expect to observe?

Accepted Answer

A)   Rash
B)   Bullae
C)   Wheals
D)   Vesicles

Question 14

A patient's pressure ulcer is 3 cm in diameter and 1 cm deep and has tunneling on the left side.The ulcer holds 17 mL of normal saline and has no visible fascia or bone in the ulcer.What pressure ulcer stage should the nurse document?

Accepted Answer

A)   Stage 1
B)   Stage 2
C)   Stage 3
D)   Stage 4

Question 15

The nurse is planning care for a patient with dermatitis.What interventions should be included in this patient's plan of care? (Select all that apply.)

Accepted Answer

A)   Pat the skin dry after bathing
B)   Apply cool moist compresses
C)   Encourage a high-protein diet
D)   Provide skin care first thing in the morning
E)   Keep fingernails short to prevent scratching

Question 16

A patient has a pressure ulcer that has purulent drainage,areas if black material,foul smelling,and painful.What should the nurse do first for healing to occur?

Accepted Answer

A)   Wound culture
B)   Wound débridement
C)   Topical antibiotic administration
D)   Intravenous antibiotic administration

Question 17

The nurse is completing the Braden scale to predict pressure ulcer development risk for a patient on bedrest.Which findings should the nurse score as increasing this patient's risk? (Select all that apply.)

Accepted Answer

A)   Eats half of offered foods
B)   Patient responds only to painful stimuli
C)   Linen must be changed at least once per shift
D)   Makes body position changes with assistance only
E)   Walks independently outside of the room twice a day

Question 18

A patient admitted to the hospital from a nursing home has a stage 3 pressure ulcer.What is the best way for the nurse to initially document the appearance of the wound?

Accepted Answer

A)   Use objective terminology.
B)   Take a photograph of the wound.
C)   Use a ruler to accurately measure wound size.
D)   Use a clock analogy to describe wound location.

Question 19

The nurses are reviewing actions to reduce the incidence of infectious skin disorders in patients admitted to the care area.What action should the nurses identify as being the most important to prevent infectious skin disorders?

Accepted Answer

A)   Use antibacterial soap.
B)   Wash hands frequently.
C)   Use isolation precautions.
D)   Sterilize all contaminated objects.

Question 20

The nurse is preparing a patient with a history of psoriasis for ultraviolet light therapy with psoralen (PUVA).What is important for the nurse to teach the patient prior to initiating therapy?

Accepted Answer

A)   "You will need to return in 1 week for blood tests for liver function."
B)   "It is expected that you will experience pain and burning at the treatment sites."
C)   "You will need to take your psoralen tablets for 1 week following the treatment."
D)   "Plan to wear dark glasses during the treatment, and for the whole day following treatment."

Exam 54: Nursing Care of Patients With Skin Disorders