Chapter 61 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 61  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A nurse practitioner is seeing a 16-year-old male patient who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?

  1. A)  Acyclovir (Zovirax)
  2. B)  Benzoyl peroxide and erythromycin (Benzamycin)
  3. C)  Diphenhydramine (Benadryl)
  4. D)  Triamcinolone (Kenalog)

Ans: B


Benzamycin gel is among the topical treatments available for acne. 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. A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating an education plan for the patient. What information should be included in this plan?

  1. A)  Use caution when taking nonprescription medications.
  2. B)  Avoid public places until symptoms subside.
  3. C)  Wash skin frequently to prevent infection.
  4. D)  Liberally apply corticosteroids as needed.

Ans: A


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. Excessively frequent washing of skin produces more soreness and scaling. Overuse of topical corticosteroids can result in skin atrophy, striae, and medication resistance.

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3. A nurse is planning the care of a patient with herpes zoster. What medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?

  1. A)  Prednisone (Deltasone)
  2. B)  Azanthioprine (Imuran)
  3. C)  Triamcinolone (Kenalog)
  4. D)  Acyclovir (Zovirax)

Ans: D


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, but not in the treatment of herpes. Azanthioprine is an immunosuppressive agent used in the treatment of pemphigus. Triamcinolone is utilized in the treatment of psoriasis.

4. A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?

  1. A)  Chemotherapy
  2. B)  Radiation therapy
  3. C)  Surgical excision
  4. D)  Biopsy of sample tissue

Ans: C


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 assessment. Chemotherapy and radiation therapy are generally reserved for patients who are not surgical candidates.

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?

  1. A)  Impaired Skin Integrity Related to Scaly Lesions
  2. B)  Acute Pain Related to Blistering and Erosions of the Oral Cavity
  3. C)  Impaired Tissue Integrity Related to Epidermal Shedding
  4. D)  Anxiety Related to Risk for Melanoma

Ans: A


An appropriate diagnosis for a patient with psoriasis would include Impaired Skin Integrity as it relates to scaly lesions. Psoriasis causes pain but does not normally affect the oral cavity. Similarly, tissue integrity is impaired, but not through the process of epidermal shedding. Psoriasis is not related to an increased risk for melanoma.

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