Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
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Chapter 23: Integumentary Problems
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Use a sunscreen with an SPF of at least 10 for adequate protection. |
| b. | Try to stay out of the direct sun between the hours of 10 AM and 2 PM. |
| c. | Water resistant sunscreens will provide good protection when swimming. |
| d. | Increase sun exposure by no more than 10 minutes a day to avoid skin damage. |
ANS: B
The risk for skin damage from the sun is highest with exposure between 10 AM and 2 PM. No sunscreen is completely water resistant. Sunscreens classified as water resistant still need to be reapplied after swimming. Sunscreen with an SPF of at least 15 is recommended for people at normal risk for skin cancer. Although gradually increasing sun exposure may decrease the risk for burning, the risk for skin cancer is not decreased.
DIF: Cognitive Level: Apply (application) REF: 408
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
| a. | Use a sunscreen with a high SPF when exposed to the sun. |
| b. | Sun exposure may decrease the effectiveness of the medication. |
| c. | Photosensitivity may result in an artificial-looking tan appearance. |
| d. | Wear sunglasses to avoid eye damage while taking this medication. |
ANS: A
The patient should stay out of the sun. If that is not possible, teach the patient to wear sunscreen when taking medications that can cause photosensitivity. The other statements are not accurate.
DIF: Cognitive Level: Apply (application) REF: 408
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
| a. | Treatment plans include watchful waiting. |
| b. | Screening for metastasis will be important. |
| c. | Minimizing sun exposure reduces risk for future BCC. |
| d. | Low dose systemic chemotherapy is used to treat BCC. |
ANS: C
BCC is frequently associated with sun exposure, and preventive measures should be taken for future sun exposure. BCC spreads locally, and does not metastasize to distant tissues. Because BCC can cause local tissue destruction, treatment is indicated. Local (not systemic) chemotherapy may be used to treat BCC.
DIF: Cognitive Level: Apply (application) REF: 411
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
| a. | Prepare the patient for a skin biopsy. |
| b. | Teach the use of corticosteroid cream. |
| c. | Explain how to apply tretinoin (Retin-A) to the face. |
| d. | Discuss the need for topical application of antibiotics. |
ANS: A
Because the appearance of the lesion is suggestive of actinic keratosis or possible squamous cell carcinoma, the appropriate treatment would be excision and biopsy. Over-the-counter corticosteroids, topical antibiotics, and Retin-A would not be used for this lesion.
DIF: Cognitive Level: Apply (application) REF: 412
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
| a. | The patient has multiple dysplastic nevi. |
| b. | The patient uses a tanning booth weekly. |
| c. | The patient is fair-skinned and has blue eyes. |
| d. | The patient’s mother died of a malignant melanoma. |
ANS: B
Because the only risk factor that the patient can change is the use of a tanning booth, the nurse should focus teaching about melanoma prevention on this factor. The other factors also will contribute to increased risk for melanoma.
DIF: Cognitive Level: Analyze (analysis) REF: 410
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
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