Chapter 56 Management of Patients With Dermatologic Problems

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Chapter 56  Management of Patients With Dermatologic Problems

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The Nurse Practitioner is seeing a 16-year-old male who has come to the dermatology clinic for treatment of nodular cystic acne. The Nurse Practitioner would know that the treatment would consist of which of the following medications?
A) Acyclovir (Zovirax)

B) Isotretinoin (Accutane)
C) Diphenhydramine (Benadryl) D) Triamcinolone (Kenalog)

Ans: B
Chapter: 56
Client Needs: D-2
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 1
Page and Header: 1686, Acne Vulgaris

Feedback: Accutane is an oral retinoid that has shown dramatic results in patients with nodular cystic acne unresponsive to conventional therapy. Zovirax is used in the treatment of herpes zoster as an oral antiviral agent. Benadryl is an oral antihistamine used in the treatment of

pruritus. Intralesional injections of Kenalog have been utilized in the treatment of psoriasis.

2. The nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating a teaching plan for the patient. What information should be included in the plan? A) Caution when taking nonprescription medications
B) Explain that contact with others should be avoided

C) Frequently wash skin to prevent infection
D) Liberally apply corticosteroids as often as needed

Ans: A
Chapter: 56
Client Needs: A-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2
Page and Header: 1697, Psoriasis

Feedback: The patient should be cautioned about taking nonprescription medications because some may aggravate mild psoriasis. Psoriasis is not contagious. Many patients need reassurance that the condition is not infectious, not a reflection of poor personal hygiene, and not skin cancer. Too-frequent washing of skin produces more soreness and scaling. Overuse of topical corticosteroids can result in skin atrophy, striae, and medication resistance.

3. The pharmacology class is learning about herpes zoster and medications that are used to treat this disease process. When planning care for a patient with herpes zoster, what medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?
A) Deltasone (Prednisone)

B) Azanthioprine (Imuran) C) Triamcinolone (Kenalog) D) Acyclovir (Zovirax)

Ans: D
Chapter: 56
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 1689, Viral Skin Infections

Feedback: Intravenous acyclovir, if started early, is effective in significantly reducing the pain and halting the progression of the disease. There is evidence that infection is arrested if oral antiviral agents are administered within the first 24 hours. Prednisone is an anti-inflammatory agent used in a variety of skin disorders. Imuran is an immunosuppressive agent used in the treatment of pemphigus. Kenalog is utilized in the treatment of psoriasis.

4. A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse knows that the primary method of treatment in this type of cancer is what?
A) Chemotherapy
B) Radiation therapy

C) Surgical excision
D) Biopsy of sample tissue

Ans: C
Chapter: 56
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 6
Page and Header: 1707, Basal Cell and Squamous Cell Carcinoma

Feedback: The primary goal of surgical management of squamous cell carcinoma is to remove the tumor entirely. Radiation therapy is reserved for older patients, because x-ray changes may be seen after 5 to 10 years, and malignant changes in scars may be induced by irradiation 15 to 30 years later. Obtaining a biopsy would not be a goal of treatment; it may be an intervention. Squamous cell carcinoma is an invasive carcinoma, metastasizing by the blood or lymphatic system. Chemotherapy would not be the treatment goal.

5. When writing a plan of care for a patient with psoriasis the nurse would know that an appropriate nursing diagnosis for this patient would be what?
A) Impaired skin integrity related to scaly lesions
B) Acute pain of skin and oral cavity related to blistering and erosions

C) Impaired tissue integrity related to epidermal shedding D) Anxiety and depression related to disfigurement

Ans: A
Chapter: 56 Client Needs: A-1

Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3

Page and Header: 1694, Psoriasis

Feedback: The nursing assessment focuses on the appearance of the normal skin, the appearance of the skin lesions, and how the patient is coping with the psoriatic skin condition. An appropriate diagnosis for a patient with psoriasis would include Impaired skin integrity as it relates to scaly lesions. Acute pain of the skin and oral cavity relates to the diagnosis of pemphigus. Impaired tissue integrity related to epidermal shedding would be an important nursing diagnosis for the disorder of toxic epidermal necrolysis (TEN). Anxiety and depression related to disfigurement may be seen in the plan of care for a patient undergoing reconstructive surgery.

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