Integumentary

Question 0

Explain the KOH Test.

What is it used to detect? How is this test performed?

Answer 0

It is Potassium Hydroxide Prep test. Hair, nail and skin specimen is collected and/or scraped, placed on a glass with KOH.

It is used to diagnose presence of a possible fungal infection

Question 1

Why is it important to stop antihistamines before a patch test?

When should antihistamines be stopped?

Answer 1

Because they can suppress the response to the allergans on the patches.

They should be stopped 2-5 days before application of the patch.

Question 2

What type of drugs are stopped before a biopsy? Why?

Answer 2

Anticoagulants and aspirin are stopped prior to this procedure because of risk of bleeding.

Question 3

Explain the Tzanck Smear. How is the test performed? What is it used to detect?

Answer 3

It is performed if viral infection (herpes) is suspected.

Fluid and cells are collected from blisters and placed on a slide and stained.

Question 4

What is the Wood’s Lamp examination?

What is it used for?

Answer 4

It is a handheld ultraviolet light. Exposed skin surfaces identify infection. Fungal infection will appear bluish or greenish.

The exam is performed in a darkened room.

Question 5

Burke Book - Chapter 44

What diagnostic test should the nurse anticipate to identify a fungal infection?

A. Skin biopsy
B. Skin scraping
C. Patch testing
D. Tzanck test

Answer 5

B. Skin scraping

Question 6

Maternity Book - Chapter 24

Which of the following nursing interventions is recommended for a child with impetigo?

A. Apply nystatin to open lesions.
B. Elevate extremities that have lesions.
C. Place toys in a plastic bag for 2 weeks.
D. Soak and remove crust on lesions several times a day.

Answer 6

D. Soak and remove crust on lesions several times a day.

Question 7

Burke Workbook - Chapter 45

Discharge instructions for a client diagnosed with cellulitis should include:

A. apply cool compresses t.i.d.
B. discontinue the medication when the symptoms disappear
C. cover draining lesions with a sterile dressing
D. keep skin moist at all times.

Answer 7

C. cover draining lesions with a sterile dressing

Question 8

Burke Workbook - Chapter 45

Mr. Williams is admitted to the hospital for treatment of acute cellulitis caused by a spider bite. He asks the nurse to explain what the term means. The nurse plans to base a response on the understanding that cellulitis is a(n):

A. skin infection that extends into the subcutaneous tissue.
B. acute superficial infection.
C. inflammation of the epidermis
D. epidermal infection caused by staphylococcus.

Answer 8

A. skin infection that extends into the subcutaneous tissue.

Question 9

NCLEX-PN Review - Chapter 40

446. A nurse prepares to help a physician examine the client’s skin with a Wood’s light. Which of the following would be included in the plan for this procedure?

A. Prepare a local anesthetic.
B. Obtain an informed consent.
C. Darken the room for the examination.
D. Shave the skin and scrub it with a providone-iodine (Betadine) solution.

Answer 9

C. Darken the room for the examination.

Question 10

NCLEX-PN Review - Chapter 40

449. A client is being admitted to the hospital for the treatment of acute cellulitis of the lower left leg. The client asks the nurse to explain what cellulitis means. The nurse bases the response on the understanding that the characteristics of cellulitis include:

A. An acute superficial infection
B. An inflammation of the lymphatics
C. A superficial infection caused by Staphylococcus.
D. A skin infection into the deep dermis and subcutaneous fat.

Answer 10

D. A skin infection into the deep dermis and subcutaneous fat.

Question 11

NCLEX-PN Review - Chapter 40

450. A nurse prepares to care for a client with acute cellulitis of the lower leg. Which of the following would the nurse anticipate being prescribed for the client?

A. Cold compresses to the affected area.
B. Warm compresses to the affected area.
C. Alternating hot and cold compresses continuously.
D. Intermittent heat-lamp treatments four times per day.

Answer 11

B. Warm compresses to the affected area.

Rationale:
Warm compresses may be used to decreased discomfort, erythema, and edema. After tissue and blood cultures are obtained, antibiotics are initiated. Heat lamps can cause more disruption of tissue that is already inflamed. Continuous cold and hot compresses are not the best measures.

Question 12

Burke Book - Chapter 45

The nurse recognizes that which factors in a client’s history are most likely to be related to a diagnosis of herpes zoster? (Select all that apply.)

A. Cervical cancer.
B. Kidney transplant.
C. Childhood infection of chickenpox.
D. Measles at the age of 20
E. Client receiving chemotherapy
F. Menstruating female.

Answer 12

B. Kidney transplant.
C. Childhood infection of chickenpox.
E. Client receiving chemotherapy

Question 13

Burke Workbook - Chapter 45

Shingles is a viral infection also known as:

A. herpes simplex 1.
B. herpes simplex 2.
C. herpes zoster.
D. herpes simplex 4.

Answer 13

C. herpes zoster.

Question 14

NCLEX-PN Review - Chapter 40

428. A nurse is assigned to care for a client with herpes zoster. Which of the following characteristics would the nurse expect to note when assessing the lesions of this infection?

A. Clustered skin vesicles
B. A generalized body rash
C. Small blue-white spots with red bases.
D. A fiery red edematous rash on the cheeks.

Answer 14

A. Clustered skin vesicles

Question 15

NCLEX-PN Review - Chapter 40

428. A nurse who is employed in a long0term care facility is planning the clinical assignments for the day. The nurse avoids assigning which staff member to the client with a diagnosis of herpes zoster?

A. A staff member who has never had roseola
B. A staff member who has never had mumps
C. A nursing assistant who has never had German measles.
D. An experienced nursing assistant who has never had chickenpox.

Answer 15

D. An experienced nursing assistant who has never had chickenpox.

Question 16

NCLEX-PN Review - Chapter 40

451. A nurse notes that the physician has documented a diagnosis of herpes zoster in the client’s chart. On the basis of an understanding of the cause of this disorder, the nurse would determine that this diagnosis was made after the use of which diagnostic test?

A. Patch test
B. Skin biopsy
C. Culture of the lesion
D. Wood’s light examination

Answer 16

C. Culture of the lesion

Question 17

NCLEX-PN Review - Chapter 40

456. A client is diagnosed with herpes simplex. The physician tells the nurse that a topical medication for treatment with be prescribed. The nurse expects that which of the following medications will be prescribed?

A. Triple antibiotic
B. Acyclovir (Zovirax)
C. Masoprocol (Actinex)
D. Mupirocin (Bactroban)

Answer 17

B. Acyclovir (Zovirax)

Question 18

NCLEX-PN Review - Chapter 35

381. A school nurse prepares a list of home-care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which is include in the list?

A. Use anti-lice sprays on all bedding and furniture.
B. Boil combs and brushes in hot water for 2 hours.
C. Take all bedding and linens to the cleaners to be dry cleaned.
D. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.

Answer 18

D. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.

Question 19

NCLEX-PN Review - Chapter 35

383. A nurse is providing home-care instructions to an adolescent who has been diagnosed with tinea pedis. Which statement by the adolescent indicates the need for further instruction?

A. “I need to wear clean socks.”
B. “I need to wear shoes that are well ventilated.”
C. “I should wear plastic shoes as much as possible.”
D. “I need to dry my feet carefully, especially between the toes.”

Answer 19

C. “I should wear plastic shoes as much as possible.”

Question 20

NCLEX-PN Review - Chapter 35

383. A nurse assists with providing an instructional session to parents regarding impetigo. Which statement by a parent indicates a need for further instruction?

A. “It is extremely contagious.”
B. “It is common during humid weather.”
C. “Lesions are most often located on the arms and chest.”
D. “It begins in an area of broken skin, such as an insect bite.”

Answer 20

C. “Lesions are most often located on the arms and chest.”

Rationale:
Lesions are usually located around the mouth and nose, but they may be present on the extremities.

Question 21

NCLEX-PN Review - Chapter 35

383. A nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is accurate?

A. Ten days after using the antibiotic ointment
B. One week after using the antibiotic ointment
C. Forty-eight hours after using the antibiotic ointment
D. Twenty-four hours after using the antibiotic ointment

Answer 21

C. Forty-eight hours after using the antibiotic ointment

Rationale:
The child should not attend school for 24 to 48 hours after the initiation of systemic antibiotics or for 48 hours after the use of the antibiotic ointment. The school should be notified of the diagnosis.

Question 22

Burke Workbook - Chapter 45

A neighbor calls during the evening and asks you to look at her child’s head. When you ask about the problem, the neighbor says that “rice grains” are stuck to the roots of the hair. From your knowledge of lice, you would anticipate that the physician will diagnose:

A. Scabies
B. Pediculosis corporis
C. Pediculosis capititis
D. tinea pedis

Answer 22

C. Pediculosis capititis