Online Nursing Practice Test about Skin (Integumentary Disorder 11-15)


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11. The clinic nurse inspects the skin of a client suspected of having scabies. Which assessment finding would the nurse note if this disorder was present?

a) patchy hair loss and round red macules with scales
b) the presence of white patches scattered about the trunk
c) multiple straight or wavy, thread-like lines beneath the skin
d) the appearance of vesicles or pustules with a thick honey-colored crust

12. The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third degree circumferential arm burn. The nurse understands that the anticipated therapeutic outcome of the escharotomy is:

a) return of distal pulses
b) brisk bleeding from the site
c) decreasing edema formation
d) formation of granulation tissue



13. Salicylic acid is prescribed for a client with psoriasis. Then nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

a) tinnitus
b) diarrhea
c) constipation
d) decreased respirations

14. The client is diagnosed with herpes simplex type 1. The physician prescribes a topical medication for treatment. The nurse anticipates that which of the following medications will be prescribed?

a) salicylic acid
b) gentamycin sulfate
c) acyclovir (Zorivax)
d) mupirocin calcium (Bactroban)

15. The physician has prescribed coal tar treatments for the client with psoriasis, and the nurse provides information to the client about the treatments. Which statement made by the client indicates a lack of understanding about the treatments?

a) the medication has an unpleasant odor
b) the medication can cause phototoxicity
c) the medication can stain the skin and hair
d) the medication always causes systemic toxicity




ANSWERS AND RATIONALE

11) C
- Scabies can be identified by the multiple straight or wavy, thread-like lines noted beneath the skin. The skin lesions are caused by the female mite, which burrows beneath the skin and lays her eggs. The eggs hatch in a few days, and the baby mites find their way to the skin surface, where they mate and complete the life cycle. Options A, B, and D are not characteristics of scabies.

12) A
- Escharotomies are performed to relieve the compartment syndrome that can occur when edema forms under nondistensible eschar in a circumferential third-degree burn. Escharotomies are performed through avascular eschar to subcutaneous fat. Although bleeding may occur from the site, it is considered a complication rather than an anticipated therapeutic outcome. Usually, direct pressure with a bulky dressing and elevation will control the bleeding, but occasionally an artery is damaged and may require ligation. Formation of granulation tissue is not the intent of an escharotomy. Escharotomy will not affect the formation of edema.

13) A
- Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.

14) C
- Acyclovir is a topical antiviral agent that inhibits DNA replication in the virus. Acyclovir has activity against herpes simplex virus types 1 and 2, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus. Gentamicin sulfate is an antibacterial and would not be effective in treating herpesvirus. Mupirocin calcium is a topical antibacterial active against Staphylococcus aureus, beta-hemolytic streptococci, or Streptococcus pyogenes. Salicylic acid is a keratolytic.

15) D
- Coal tar is used to treat psoriasis and other chronic disorders of the skin. Coal tar suppresses DNA synthesis, mitotic activity, and cell proliferation. Coal tar has an unpleasant odor, frequently stains the skin and hair, and can cause phototoxicity. Systemic toxicity does not occur.


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