Ch16 Full Test Bank Nursing Care Of Patients With - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 16 Nursing Care of Patients with Integumentary Disorders
1) The parent of an adolescent voices concerns about the child's acne. Which response by the nurse is best?
1. "The skin needs to be washed at least twice a day with mild soap and water to remove surface oil."
2. "The greatest culprit for acne is dietary habits, not inadequate hygiene."
3. "Are you embarrassed by her appearance?"
4. "What are your concerns about her hygiene practices?"
Page Ref: 491
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Self-Care
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; Environmental health; health promotion/disease prevention (e.g., transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with integumentary disorders.
2) A patient has a 3 cm in diameter lesion in the left axilla that is deep, painful, and contains pus. Which type of lesion should the nurse document in the patient's medical record?
1. Furuncle
2. Folliculitis
3. Carbuncle
4. Herpes varicella
Page Ref: 478
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; Environmental health; health promotion/disease prevention (e.g., transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
3) An African American patient has reoccurring folliculitis on the face. What should the nurse instruct the patient to do about this health problem?
1. Practice good hygiene.
2. Shave daily.
3. Shave very closely.
4. Shave in the opposite direction of hair growth.
Page Ref: 479
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; Environmental health; health promotion/disease prevention (e.g., transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with integumentary disorders.
4) A patient has atopic dermatitis (eczema) with a secondary infection. What should the nurse emphasize when teaching to prevent this type of infection in the future?
1. Methods to prevent itching
2. Continuous antibiotic treatment
3. Frequent bathing
4. Allergy testing
Page Ref: 487
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Knowledge; Environmental health; health promotion/disease prevention (e.g., transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
5) A patient who has a small, red, scaling lesion that is sitting on an elevated base on the forehead states the lesion began several weeks before and will not heal. What type of lesion does the nurse consider the patient is experiencing?
1. Squamous cell carcinoma
2. Melanoma
3. Psoriasis
4. Seborrheic keratosis
Page Ref: 495
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
6) A patient diagnosed with scabies asks how the disorder was "caught." What information should be provided to the patient?
1. The disorder is transmitted by contact with infected persons or their possessions.
2. The disorder is transmitted by the feces of infected animals.
3. Scabies is a bacterial infection transmitted by direct contact with infected persons.
4. Scabies is a fungal infection transmitted by contact with infected respiratory secretions.
Page Ref: 483
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
7) The nurse is planning care for a patient with herpes zoster. Which problem should the nurse identify as being the priority for this patient?
1. Managing pain
2. Avoiding breakouts
3. Relieving itchiness
4. Improving hygiene
Page Ref: 484
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
8) A patient with herpes zoster has pruritus and reports difficulty resting at night. Which intervention will best help the patient?
1. Encourage to take prescribed antipruritic agents approximately one hour before bedtime.
2. Massage the irritated skin areas with lotion.
3. Apply powder to the lesions.
4. Use heavy bed linens to avoid chilling at night.
Page Ref: 485
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
9) The nurse is planning care for a patient at risk for a pressure injury. What should the nurse include in this patient's plan of care? Select all that apply.
1. Initiate a frequent toileting schedule.
2. Turn the patient every 2 hours.
3. Massage pressure areas with lotion every 4 hours.
4. Use inflatable doughnut rings to reduce pressure on the sacrum.
5. Use hot water to cleanse the skin immediately after incontinence.
Page Ref: 507
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with integumentary disorders.
10) The nurse is preparing a teaching tool to reduce the incidence of pressure injuries. Which patient characteristic should the nurse identify as being at an increased risk for this health problem? Select all that apply.
1. Restricted activity
2. Decreased sensation
3. Very thin
4. Urinary and fecal incontinence
5. Good nutrition
Page Ref: 503-504
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
11) The nurse is assessing a patient's risk for a pressure injury. Which factors should the nurse include in this assessment? Select all that apply.
1. Sensory perception
2. Moisture
3. Mobility
4. Nutrition
5. Social interaction
Page Ref: 504
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
12) The nurse is planning care for a patient who is at risk for a pressure injury. Which action should be included in this patient's plan of care? Select all that apply.
1. Use pillows to offload pressure.
2. Turn at least every 2 hours.
3. Use a mild cleansing agent on the skin.
4. Keep on bed rest.
5. Pull up in bed every 2 hours or less.
Page Ref: 506-507
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
13) A patient asks about options to treat a malignant melanoma lesion on her arm. How should the nurse respond to this patient?
1. "The preferred method of treatment is to remove all the cancer surgically."
2. "An anti-cancer cream will be used to dissolve the lesion."
3. "You will receive radiation to the skin lesion as a first method of treatment."
4. "You will receive intravenous chemotherapy as a first method of treatment"
Page Ref: 498
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
14) A patient with a basal cell carcinoma of the nose is scheduled for curettage and electrodesiccation to remove the lesion. Which criteria were used to select this procedure? Select all that apply.
1. The lesion must measure less than 2 cm in diameter.
2. The lesion must be superficial.
3. The lesion must measure at least 4 cm in diameter.
4. The lesion must be in an area where the dermis is thin.
5. The lesion must extend into the subcutaneous tissue.
Page Ref: 496
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
15) A patient scheduled for Mohs surgery for basal cell skin cancer asks how long the procedure will take. How should the nurse respond to this patient? Select all that apply.
1. "The procedure occurs in steps, and time needed depends on your lesion."
2. "The time depends on how deep the lesion is."
3. "It is difficult to predict how long the procedure will take."
4. "This is a long, complicated procedure and may take all day."
5. "The procedure should be completed in an hour or less."
Page Ref: 496
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
16) A patient has had cryosurgery to treat a skin lesion. What instructions should be given to the patient and family on discharge? Select all that apply.
1. The effects may not be seen for 24 hours.
2. Apply a topical antibiotic as ordered.
3. Keep the treated areas clean.
4. Healing may take several weeks.
5. Healing should occur in a few days.
Page Ref: 509
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
17) A patient with a history of tinea pedis reports concerns about developing the disorder again. Which suggestion should the nurse make to reduce the likelihood of a reoccurrence?
1. Wear sandal-style footwear.
2. Begin to wear cotton undergarments.
3. Soak affected extremities in salted water nightly.
4. Apply lotions to moisturize potential areas of outbreak daily.
Page Ref: 31
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
18) Several individuals from a homeless shelter have been diagnosed with pediculosis. What should the nurse include when training the staff on the control and prevention of this infestation? Select all that apply.
1. Pediculosis is spread by contact with personal items such as hats and blankets.
2. Pediculosis is more common in people with lack of proper facilities for bathing and washing clothes.
3. Pediculosis is associated with wearing woolen hats.
4. Pediculosis affects children only.
5. Pediculosis is infestation by mites.
Page Ref: 482
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.7 Describe the pathophysiology and manifestations of disorders of the hair and nails, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
19) The nurse is reviewing the health history of a patient with alopecia. What should the nurse recognize as a possible cause for this disorder? Select all that apply.
1. Thyroid disorder
2. Systemic lupus erythematosus
3. Three months of chemotherapy for cancer
4. Androgenic causes
5. An overactive pituitary
Page Ref: 513
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.7 Describe the pathophysiology and manifestations of disorders of the hair and nails, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
20) For several months a patient has been experiencing an infection of the cuticle involving several fingernails on both hands. Which type of employment should the nurse suspect is causing this patient's health problem?
1. Dish washer
2. Construction worker
3. Painter
4. Carpenter
Page Ref: 514
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.7 Describe the pathophysiology and manifestations of disorders of the hair and nails, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
21) A female patient is prescribed tretinoin (Retin-A). What should the nurse instruct the patient about this medication? Select all that apply.
1. Wear protective clothing when out of doors.
2. Avoid the use of vitamin A supplements.
3. Use caution when driving at night.
4. Apply to clean, dry skin.
5. Use a reliable form of contraception one month prior to and during use of the medication.
Page Ref: 491
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.3 Describe the pathophysiology and manifestations of inflammatory disorders of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
22) A patient with psoriasis is being treated with topical corticosteroids. What should the nurse instruct the patient about the use of this medication?
1. Apply in a thin layer.
2. Avoid rubbing into the skin.
3. Apply a thick layer.
4. Continue medication even if lesions worsen.
Page Ref: 489
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
23) The nurse instructs a patient who is prescribed oral griseofulvin for a fungal infection of the nails to take the medication with food. Which foods should the nurse recommend to the patient? Select all that apply.
1. Ice cream
2. Cheese
3. Crackers
4. Pretzels
5. Alcohol
Page Ref: 482
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
24) A patient with a history of pruritis reports less itching when allergy medicine is used. Which should the nurse consider as the reason for the improvement in symptoms?
1. The allergy medication is reducing histamine release.
2. The patient is distracted from the itching because of the allergies.
3. The patient's pruritis is improving.
4. The patient is taking other medication the nurse is not aware of.
Page Ref: 489
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16.3 Describe the pathophysiology and manifestations of inflammatory disorders of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
25) A patient with a history of sun exposure is concerned about broken blood vessels on the cheeks. What should the nurse realize this patient is describing?
1. Telangiectases
2. Nevus flammeus
3. Venus lakes
4. Skin tags
Page Ref: 473
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
26) A patient is receiving the first ultraviolet light therapy treatment for psoriasis. What should be included in this patient's teaching?
1. The skin will appear reddened approximately eight hours after the treatment.
2. The treatment will be the same length every time.
3. There is no anticipated damage to the eyes or mucous membranes.
4. This is the treatment of choice for patients with psoriasis on 10% of the body.
Page Ref: 475
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
27) A female is experiencing eyelid redness and edema. What would be appropriate for the nurse to include in the assessment of this patient?
1. Ask if eye makeup is thoroughly removed.
2. Ask if swimming in a public pool has recently occurred.
3. Ask the patient if legs are routinely shaved.
4. Ask if facial soap has recently been changed.
Page Ref: 477
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with integumentary disorders.
28) A school-age child is reported to frequently scratch the scalp and the hair "is clumpy and smells really bad." What should the nurse instruct the parent to do?
1. Suggest that the patient be checked for head lice.
2. Suggest that the patient have a blood glucose level drawn.
3. Suggest that the patient wash the hair.
4. Suggest that the patient have a haircut.
Page Ref: 482
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
29) An older patient seeks medical attention for a "strange painful rash" located on the left side of the upper chest. Which health problem should the nurse suspect this patient is experiencing?
1. Herpes zoster
2. Herpes simplex
3. Verruca plana
4. Condylomata acuminata
Page Ref: 484
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
30) A female patient seeks medical attention for an itchy reddened area on both hands. Which technique should the nurse use when assessing this patient?
1. Ask if soap or perfume have been recently changed.
2. Ask to remove both shoes and stockings.
3. Auscultate lung sounds.
4. Assess hand grasp strength.
Page Ref: 488
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Techniques of Physical Assessment
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
31) A middle-aged female patient reports "strange pimples" over the buttocks region. Which health problem should the nurse suspect this patient is experiencing?
1. Acne conglobata
2. Contact dermatitis
3. Acne vulgaris
4. Acne rosacea
Page Ref: 490
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
32) The nurse is preparing a teaching plan about acne for a group of adolescents. What should be included in this teaching plan? Select all that apply.
1. Sun exposure is permitted when protected with sunscreen, but avoid sunburn.
2. Keep hair clean with frequent shampoos.
3. Avoid eating greasy foods.
4. Wash the affected skin area at least six times per day.
5. Squeeze pimples when they occur.
Page Ref: 491
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
33) A patient with fair skin and blond hair is diagnosed with basal cell cancer on the face and forehead. What should the nurse include when teaching this patient about the diagnosis?
1. This type of skin cancer tends to reoccur.
2. This is a virulent form of skin cancer.
3. This type of skin cancer should be left alone.
4. This type of skin cancer is rare.
Page Ref: 494
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
34) A patient with skin cancer is recovering from a surgical procedure in which the layers of the lesion were shaved off. For which procedure should the nurse prepare teaching for this patient?
1. Mohs surgery
2. Complete surgical excision of the lesion
3. Curettage
4. Electrodesiccation
Page Ref: 496
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
35) A patient is diagnosed with advanced malignant melanoma. What should the nurse consider when planning care for this patient?
1. The prognosis is uncertain.
2. Age of the patient has no impact on the prognosis.
3. The disease will be completely cured with surgery.
4. The patient will need chemotherapy and radiation.
Page Ref: 497
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
36) The nurse instructs a patient with melanoma to "eat foods rich in protein and calories." For which health problem is this action most likely being directed?
1. Changes in skin integrity
2. Insufficient blood flow
3. Altered oxygen to blood tissues
4. Insufficient body fluid
Page Ref: 500
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.5 Describe the risk factors for and pathophysiology and manifestations of malignant skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
37) A patient confined to bed has slid to the bottom of the bed. What should the nurse do to adjust this patient's body position?
1. Lift the patient up in bed.
2. Pull the patient up in bed.
3. Slide the patient up in bed.
4. Do nothing.
Page Ref: 507
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
38) A patient in a wheelchair has a history of sacral pressure injuries. What instruction should be included in the patient's teaching?
1. Shift the weight every 15 minutes to 1 hour.
2. Sit on a doughnut.
3. Stay in one position as long as possible.
4. Have a family pull the patient up in the wheelchair.
Page Ref: 507
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
39) A middle-aged male patient says, "I wish I could have all of these tattoos removed." What solution should the nurse suggest to this patient?
1. Dermabrasion
2. Chemical peeling
3. Skin graft
4. Blepharoplasty
Page Ref: 510
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Lifestyle Choices
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
40) A middle-aged patient recovering from a facelift says, "I think this was a waste of time and money. I look horrible!" How should the nurse respond to this patient?
1. "It takes a while for the skin to heal."
2. "You could use makeup."
3. "I would complain to the doctor."
4. "What did you expect?"
Page Ref: 512
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
41) A patient with a skin disorder is prescribed a therapeutic bath to be used at home. What should the nurse include when teaching the patient about this treatment? Select all that apply.
1. Place a bath mat in the tub.
2. Stay in the tub bath for 1 hour.
3. Keep the bathroom well-ventilated.
4. Rub the skin vigorously with a dry towel.
5. Expect the skin to be itchy after the bath.
Page Ref: 472
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with integumentary disorders.
42) A patient with psoriasis is prescribed photochemotherapy treatments. What should the nurse teach the patient about future health risks caused by this treatment? Select all that apply.
1. It can accelerate aging.
2. It can exacerbate psoriasis.
3. It can alter immune functions.
4. It can induce cataract development.
5. It can increase the risk of melanoma.
Page Ref: 475
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 16.1 Describe the pathophysiology and manifestations of common skin problems and lesions, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
43) A patient with a skin infection is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA). What medication should the nurse expect to be prescribed for this patient? Select all that apply.
1. Penicillin (Pen-V-K)
2. Clindamycin (Cleocin)
3. Minocycline (Minocin)
4. Doxycycline (Vibramycin)
5. Trimethoprim-sulfamethoxazole (Bactrim)
Page Ref: 479
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.2 Describe the pathophysiology and manifestations of infections and infestations of the skin, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
44) A patient who was stranded during a snowstorm is admitted for frostbite of the fingers and toes. Which action should the nurse expect to perform for this patient? Select all that apply.
1. Elevate the feet and hands.
2. Provide pain medication as prescribed.
3. Apply elastic compression bandages to the feet and hands.
4. Massage the fingers and toes for 10 minutes after warming.
5. Warm the digits with circulating water for 20 to 30 minutes.
Page Ref: 509
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16.6 Describe the pathophysiology and manifestations of skin trauma, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
45) During a health assessment a patient reports a family member having a severe skin reaction after receiving an antibiotic that required care in a burn unit for several weeks. Which additional risk factors for Stevens-Johnson syndrome should the nurse assess this patient? Select all that apply.
1. Nation of origin
2. Previous organ transplantation
3. History of an autoimmune disease
4. Medications prescribed for fluid balance
5. History of human immunodeficiency virus (HIV)
Page Ref: 492
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.4 Describe the risk factors for and pathophysiology and manifestations of acute skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with integumentary disorders.
46) The nurse is collecting data to be used to complete the SCORTEN scale for a patient with Stevens-Johnson syndrome. Which information should the nurse have prepared to calculate the score for this patient? Select all that apply.
1. Patient age
2. Serum urea level
3. Current heart rate
4. Oxygen saturation
5. Serum glucose level
Page Ref: 492
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 16.4 Describe the risk factors for and pathophysiology and manifestations of acute skin disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with integumentary disorders.
Document Information
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