Chapter 03 Care of the Patient with an Integumentary Disorder

Chapter 03  Care of the Patient with an Integumentary Disorder

MULTIPLE CHOICE

1. A patient has generalized macular-papular skin eruptions and complains of severe pruritus from contact dermatitis. When the nurse administers his therapeutic bath, it is important to remember that

1. using Burow’s solution helps promote healing.
2. rubbing the skin briskly decreases pruritus.
3. allowing 20 to 60 minutes to complete the bath will prevent pruritus.
4. sterilizing all equipment used will prevent pruritus.

ANS: A
Pruritus is responsible for most of the discomfort. Wet dressings, using Burow’s solution, help promote the healing process. A cool environment with increased humidity decreases the pruritus.

DIF: Cognitive Level: Application REF: Page 79 OBJ: 7 TOP: Pruritus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. A patient, age 63, has cancer of the left breast. After a modified radical mastectomy, she has been receiving chemotherapy. Her grandson, who visited a few days ago, now has varicella (chickenpox). The nurse should observe her carefully for signs of

1. herpes zoster.
2. herpes simplex type I.
3. herpes simplex type II.
4. impetigo.

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 or large doses of prednisone, in whom the disease could be fatal because of the patient’s compromised immune system.

DIF: Cognitive Level: Analysis REF: Pages 72, 74 OBJ: 9 TOP: Chemotherapy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

3. A patient has herpes zoster (shingles). A local antiviral agent, which is useful in delaying the progression of herpetic diseases, was prescribed. This medication is a. lorazepam (Ativan).

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 3-2

2. hydroxyzine (Atarax).
3. acyclovir (Zovirax).
4. hydrocortisone (Solu-Cortef).

ANS: C
Oral and intravenous acyclovir (Zovirax), when administered early, reduces the pain and duration of the virus.

DIF: Cognitive Level: Comprehension REF: Page 72 OBJ: 9
TOP: Anti-infective KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

4. A child has been sent home from school with pruritus and honey-colored crusts on his lower lip and chin. A probable diagnosis would be

1. chickenpox.
2. impetigo.
3. shingles.
4. 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.

DIF: Cognitive Level: Comprehension REF: Page 76 OBJ: 10 TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

5. A patient has an erythematous patch of vesicles on her scalp, and she complains of pain and pruritus. A diagnosis of tinea capitis is made. The causative organism is a. bacterium.
b. virus.

c. worm. d. fungus.

ANS: D
Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen.

DIF: Cognitive Level: Knowledge REF: Page 78 OBJ: 10 TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

6. A patient, age 46, reports to his physician’s office with urticaria and papules on his hands and arms. He says, “It itches so badly.” In assessing the patient, the nurse should gather data regarding recent

1. travel to foreign countries.
2. upper respiratory tract infection.
3. changes in medication.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 3-3

d. contact with people who have an infectious disease.

ANS: C
Urticaria is the term applied to the presence of wheals or hives in an allergic reaction commonly caused by drugs, food, insect bites, inhalants, emotional stress, or exposure to heat or cold.

DIF: Cognitive Level: Analysis REF: Page 81 OBJ: 8 TOP: Urticaria KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity