Chapter 61 Managements of Patients with Dermatologic Problems

Chapter 61: Managements of Patients with Dermatologic Problems 1. A nurse practitioner is seeing a 16-year-old male patient who has come to the dermatole treatment of acne. The nurse practitioner would know that the treatment may consist of following medications? A) Acyclovir (Zovirax) B) Benzoyl peroxide and Derythromycin (Benzamycin) C) Diphenhydramine (Benadryl) D) Triamcinolone (Kenalog) Ans: B Feedback: Benzamycin gelis among the topical treatments available for acne. Zovirax is used int herpes zoster Das an oral antiviral agent. Benadryl is an oral antihistamine used in the t pruritus. Intralesional injections of Kenalog have been utilized in the treatment of psorias 2. A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is cr plan for the patient. What information should be included in this plan? A) Use caution when taking nonprescription medications. B) Avoid public places until symptoms subside. C) Wash skin frequently to prevent infection. D) Liberally apply corticosteroids Das needed. Ans: Feedback: The patient should be cautioned about taking nonprescription medications because somem mild psoriasis. Psoriasis is not contagious. Many patients need reassurance that the condi infectious, not a reflection of poor personal hygiene, and not skin cancer. Excessively fr of skin produces more soreness and scaling. Overuse of topical corticosteroids can result striae, Cand medication resistance. 3. A nurse is planning the care of a patient with herpes zoster. What medication, if first 24 hours of the initial eruption, can arrest herpes zoster? A) Prednisone (Deltasone) B) Azanthioprine (Imuran) C) Triamcinolone (Kenalog) D) Acyclovir (Zovirax) Ans: D Feedback: Acyclovir, Difustarted Dearly, is Deffective in significantly reducing the pain and halting the the disease. There is evidence that infection is arrested if oral antiviral agents are admi first 24 hours.Prednisone is an anti-inflammatory agent used in a variety of skin disor treatment of herpes. Azanthioprine is an immunosuppressive Dagent used in the treatment Triamcinolone Dis utilized in the treatment of psoriasis. 4. A patient with squamous cell carcinoma has been scheduled for treatment of this maligna should anticipate that treatment for this type of cancer will primarily consist of what in A) Chemotherapy B) Radiation therapy C) SurgicalDexcision D) Biopsy of sample tissue Ans: C Feedback: The primary goal of surgical management of squamous cell carcinoma is to remove the Radiation therapy is reserved for older patients, because x-ray changes may be seen afte and malignant changes in scars may be induced by irradiation 15 to 30 years later. Ot would not be a goal of treatment; it may be an assessment. Chemotherapy and radiation 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 ar nursing diagnosis for this patient would be what? A) Impaired Skin Integrity Related to Scaly Lesions Ans: A,B,CC,DD Feedback: Blistering diseases disrupt skin integrity and DareDassociated with pain and a risk for infi the visibility of blisters, body image is often affected. The patient faces a risk for hyp hyperthermia. 24. A patients blistering disorder has resulted in the formation of multiple lesions in the pat What intervention should be included in the patients plan of care? A) Provide chlorhexidine solution for rinsing the patients mouth. B) Avoid providing regular mouth care until the patients lesions heal. C) Liaise with the primary care provider to arrange for parenteral nutrition. D) Encourage the patient to gargle with a hypertonic solution after each meal. A Ans: Feedback: Frequent rinsing of the mouth with chlorhexidine solution Dis prescribed to rid the mouth soothe ulcerated areas. A hypertonic solution would be likely to cause pain and further Meticulous mouth care should be provided and there is no reason to provide nutrition 25. When caring for a patient with toxic epidermal necrolysis (TEN), the critical care nurse frequently for high fever, tachycardia, and extreme weakness and fatigue. The nurse is a findings are potential indicators of what? Select all that apply. A) Possible malignancy B) Epidermal necrosis C) Neurologic involvement D) Increased metabolic needs E) Possible gastrointestinal mucosal sloughing Ans: B,OD,DE Feedback: Assessment for high fever, tachycardia, and Dextreme weakness and fatigue is essential be factors indicate the process of epidermal necrosis, increased metabolic needs, and possible gastrointestinal Dand respiratory mucosal sloughing. These factors are less likely to suggest neurologic involvement, as these are not .common.complications of TEN, 26. A nurse is assessing a teenage patient with acne vulgaris. The patients mother states, I that this is what happens when you eat as much chocolate as he does. What aspect o pathophysiology of acne should inform the nurses response? A) A sudden change in patients diet may exacerbate, rather than alleviate, the patients: B) Chocolate is not among the foods that are known to cause acne. C) Elimination of chocolate from the patients diet will likely lead to resolution within D) Diet is thought to play a minimal role in the development of acne. Ans: D Feedback: Diet is not believed to play a major role in acne therapy. A change in diet is not k symptoms. 27. A nurse is providing self-care education to a patient who has been receiving treatment fi What instruction should the nurse provide to the patient? A) Wash your face with water and gentle soap each morning and Devening. B) Before bedtime, clean your face with rubbing alcohol on a cotton pad. C) Gently burst new pimples before they forma visible head. D) Set aside time each day to squeeze blackheads and remove the plug. Ans: A Feedback: The nurse should inform the patient to wash the face and other affected areas with mi twice each day to remove surface oils and prevent obstruction of the oil glands. Cleans alcohol is not recommended and all forms of manipulation should be avoided. 28. A nurse is caring for a patient whose skin cancer will soon be removed by excision. following actions should the nurse perform?