Chapter 3: Care of the Patient with an Integumentary Disorder

Chapter 3: Care of the Patient with an Integumentary Disorder

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. What should the nurse do when administering a therapeutic bath to a patient who has severe pruritus?

a.	Use Burow’s solution to help promote healing
b.	Rub the skin briskly to decrease pruritus
c.	Limit bathing to 3 times a week
d.	Ensure that bath area is at least 85 degrees and dehumidified

 

 

ANS:  A

Pruritus is responsible for most of the discomfort. Wet dressings and using Burow’s solution help promote the healing process. A cool environment with increased humidity decreases the pruritus. Give daily baths with an application to cleanse the skin.

 

DIF:    Cognitive Level: Application           REF:   Page 80          OBJ:   14

TOP:   Pruritus          KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

2. A frail, older adult home health patient who had chickenpox as a child has been exposed to varicella (chickenpox) several days ago. What should the nurse do?

a.	Assess frequently for herpes zoster
b.	Be aware of the patient’s immunity to chickenpox
c.	Encourage the patient to have a pneumonia vaccine
d.	Arrange for the patient to receive gamma globulin

 

 

ANS:  A

Herpes zoster is caused by the same virus that causes chickenpox (Herpes varicella). The greatest risk occurs to patients who have a lowered resistance to infection, such as those on chemotherapy, aging, or receiving large doses of prednisone, in whom the disease could be fatal because of the patient’s compromised immune system.

 

DIF:    Cognitive Level: Application           REF:   Page 72          OBJ:   5

TOP:   Shingles         KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

 

3. A patient has herpes zoster (shingles) and is being treated with acyclovir (Zovirax). What should the nurse do when administering this drug?

a.	Apply lightly, being careful not to completely cover the lesion
b.	After application, wrap in warm wet dressings
c.	Use gloves
d.	Rub medication into lesions

 

 

ANS:  C

The topical application requires that the nurse uses gloves, completely covers the lesion gently, then leaves it open to the air.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 70, Table 3-3

OBJ:   5                    TOP:   Anti-infective

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Physiological Integrity

 

4. A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower lip and chin. The nurse believes these lesions most likely are:

a.	chickenpox.
b.	impetigo.
c.	shingles.
d.	herpes simplex type I.

 

 

ANS:  B

Impetigo is seen at all ages, but is particularly common in children. The crust is honey-colored and easily removed and is associated with pruritus. The disease is highly contagious and spreads by contact.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 76          OBJ:   6

TOP:   Infection        KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

 

5. A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and complains of pain and pruritus. Why would the nurse use a Woods lamp?

a.	To dry out the lesions
b.	To reduce the pruritus
c.	To kill the fungus
d.	To cause fluorescence of the infected hairs

 

 

ANS:  D

Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn a brilliant blue green.

 

DIF:    Cognitive Level: Knowledge            REF:   Page 79, Figure 3-7

OBJ:   6                    TOP:   Infection        KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity