Ch 43: Care of the Patient with an
Integumentary Disorder
1. A patient has generalized macular-papular skin eruptions and complains of
severe pruritus from contact dermatitis. When the nurse administers his
therapeutic bath, it is important to remember that
a. using Burow's solution helps promote healing.
b. rubbing the skin briskly decreases pruritus.
c. allowing 20 to 60 minutes to complete the bath will prevent pruritus.
d. sterilizing all equipment used will prevent pruritus.
ANS: A
Pruritus is responsible for most of the discomfort. Wet dressings, using
Burow's solution, help promote the healing process. A cool environment with
increased humidity decreases the pruritus.
REF: Page 1315 TOP: Pruritus
2. A patient, age 63, has cancer of the left breast. After a modified radical
mastectomy, she has been receiving chemotherapy. Her grandson, who
visited a few days ago, now has varicella (chickenpox). The nurse should
observe her carefully for signs of
a. herpes zoster.
b. herpes simplex type I.
c. herpes simplex type II.
d. impetigo.
ANS: A
Herpes zoster is caused by the same virus that causes chickenpox (Herpes
varicella). The greatest risk occurs to patients who have a lowered resistance
to infection, such as those on chemotherapy or large doses of prednisone, in
whom the disease could be fatal because of the patient's compromised
immune system.
REF: Pages 1308, 1310 TOP: Chemotherapy
3. A patient has herpes zoster (shingles). A local antiviral agent, which is
useful in delaying the progression of herpetic diseases, was prescribed. This
medication is
,a. lorazepam (Ativan).
b. hydroxyzine (Atarax).
c. acyclovir (Zovirax).
d. hydrocortisone (Solu-Cortef).
ANS: C
Oral and intravenous acyclovir (Zovirax), when administered early, reduces
the pain and duration of the virus.
REF: Page 1308
TOP: Anti-infective Step: Planning
4. A child has been sent home from school with pruritus and honey-colored
crusts on his lower lip and chin. A probable diagnosis would be
a. chickenpox.
b. impetigo.
c. shingles.
d. herpes simplex type I.
ANS: B
Impetigo is seen at all ages, but is particularly common in children. The crust
is honey-colored and easily removed.
REF: Page 1312 TOP: Infection
5. A patient has an erythematous patch of vesicles on her scalp, and she
complains of pain and pruritus. A diagnosis of tinea capitis is made. The
causative organism is
a. bacterium.
b. virus.
c. worm.
d. fungus.
ANS: D
Tinea capitis is commonly known as ringworm of the scalp. Microsporum
audouinii is the major fungal pathogen.
REF: Page 1314 TOP: Infection
, 6. A patient, age 46, reports to his physician's office with urticaria and papules
on his hands and arms. He says, "It itches so badly." In assessing the patient,
the nurse should gather data regarding recent
a. travel to foreign countries.
b. upper respiratory tract infection.
c. changes in medication.
d. contact with people who have an infectious disease.
ANS: C
Urticaria is the term applied to the presence of wheals or hives in an allergic
reaction commonly caused by drugs, food, insect bites, inhalants, emotional
stress, or exposure to heat or cold.
REF: Page 1317 TOP: Urticaria
7. A patient has been receiving penicillin, acetaminophen with codeine, and
hydrochlorothiazide for 4 days. He now has a urinary tract infection. A
sulfonamide has been prescribed to be taken three times per day. Several
hours after the second dose , he complains of pruritus. The nurse observes a
generalized erythema and rash. The most appropriate nursing intervention
would be to hold
a. all medications, and notify the physician of the signs and symptoms.
b. the penicillin.
c. the acetaminophen with codeine.
d. the sulfonamide.
ANS: A
If a patient develops wheals or hives in an allergic reaction to drugs (urticaria),
then all medications should be held.
REF: Page 1316 TOP: Medication
8. A patient has acne vulgaris. When the nurse explains this condition, it is
most important to
a. stress the importance of strict hygiene.
b. discuss the connection of diet and stress.
c. explore how this condition is affecting his self-image and lifestyle.
d. describe in detail the proper use of prescribed medication.
ANS: C
Integumentary Disorder
1. A patient has generalized macular-papular skin eruptions and complains of
severe pruritus from contact dermatitis. When the nurse administers his
therapeutic bath, it is important to remember that
a. using Burow's solution helps promote healing.
b. rubbing the skin briskly decreases pruritus.
c. allowing 20 to 60 minutes to complete the bath will prevent pruritus.
d. sterilizing all equipment used will prevent pruritus.
ANS: A
Pruritus is responsible for most of the discomfort. Wet dressings, using
Burow's solution, help promote the healing process. A cool environment with
increased humidity decreases the pruritus.
REF: Page 1315 TOP: Pruritus
2. A patient, age 63, has cancer of the left breast. After a modified radical
mastectomy, she has been receiving chemotherapy. Her grandson, who
visited a few days ago, now has varicella (chickenpox). The nurse should
observe her carefully for signs of
a. herpes zoster.
b. herpes simplex type I.
c. herpes simplex type II.
d. impetigo.
ANS: A
Herpes zoster is caused by the same virus that causes chickenpox (Herpes
varicella). The greatest risk occurs to patients who have a lowered resistance
to infection, such as those on chemotherapy or large doses of prednisone, in
whom the disease could be fatal because of the patient's compromised
immune system.
REF: Pages 1308, 1310 TOP: Chemotherapy
3. A patient has herpes zoster (shingles). A local antiviral agent, which is
useful in delaying the progression of herpetic diseases, was prescribed. This
medication is
,a. lorazepam (Ativan).
b. hydroxyzine (Atarax).
c. acyclovir (Zovirax).
d. hydrocortisone (Solu-Cortef).
ANS: C
Oral and intravenous acyclovir (Zovirax), when administered early, reduces
the pain and duration of the virus.
REF: Page 1308
TOP: Anti-infective Step: Planning
4. A child has been sent home from school with pruritus and honey-colored
crusts on his lower lip and chin. A probable diagnosis would be
a. chickenpox.
b. impetigo.
c. shingles.
d. herpes simplex type I.
ANS: B
Impetigo is seen at all ages, but is particularly common in children. The crust
is honey-colored and easily removed.
REF: Page 1312 TOP: Infection
5. A patient has an erythematous patch of vesicles on her scalp, and she
complains of pain and pruritus. A diagnosis of tinea capitis is made. The
causative organism is
a. bacterium.
b. virus.
c. worm.
d. fungus.
ANS: D
Tinea capitis is commonly known as ringworm of the scalp. Microsporum
audouinii is the major fungal pathogen.
REF: Page 1314 TOP: Infection
, 6. A patient, age 46, reports to his physician's office with urticaria and papules
on his hands and arms. He says, "It itches so badly." In assessing the patient,
the nurse should gather data regarding recent
a. travel to foreign countries.
b. upper respiratory tract infection.
c. changes in medication.
d. contact with people who have an infectious disease.
ANS: C
Urticaria is the term applied to the presence of wheals or hives in an allergic
reaction commonly caused by drugs, food, insect bites, inhalants, emotional
stress, or exposure to heat or cold.
REF: Page 1317 TOP: Urticaria
7. A patient has been receiving penicillin, acetaminophen with codeine, and
hydrochlorothiazide for 4 days. He now has a urinary tract infection. A
sulfonamide has been prescribed to be taken three times per day. Several
hours after the second dose , he complains of pruritus. The nurse observes a
generalized erythema and rash. The most appropriate nursing intervention
would be to hold
a. all medications, and notify the physician of the signs and symptoms.
b. the penicillin.
c. the acetaminophen with codeine.
d. the sulfonamide.
ANS: A
If a patient develops wheals or hives in an allergic reaction to drugs (urticaria),
then all medications should be held.
REF: Page 1316 TOP: Medication
8. A patient has acne vulgaris. When the nurse explains this condition, it is
most important to
a. stress the importance of strict hygiene.
b. discuss the connection of diet and stress.
c. explore how this condition is affecting his self-image and lifestyle.
d. describe in detail the proper use of prescribed medication.
ANS: C
