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Chapter 22: Dermatological Diseases

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Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A 15-month-old toddler has a strange rash on his nose and mouth. It contains papules and vesicles and has a honeylike, glazed look. The toddler has a history of eczema, but the nurse differentiates the features of the presenting rash and explains that he has developed a secondary infection. What is the treatment of choice for this type of dermatological disease? a. Bathe the skin daily with hydrogen peroxide. b. Apply Caladryl lotion to dry the lesions. c. Use an antiviral lotion as ordered for 7 to 10 days. d. Administer topical antibiotics as ordered until the skin is clear. ANS: D Chapter: Chapter 22 Dermatological Diseases Chapter Learning Objective: 4. Explain diagnostic and laboratory studies used for skin conditions. Page: 548 Heading: Bacterial Infections Impetigo Nursing Interventions Integrated Processes: Nursing Process Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies Cognitive Level: Analysis [Analyzing] Concept: Infection Difficulty: Moderate Feedback A. This is incorrect. Bathing with hydrogen peroxide is not recommended. B. This is incorrect. Caladryl is used to relieve the pruritus of contact dermatitis such as poison ivy. C. This is incorrect. The superimposed infection is not viral. D. This is correct. A topical antibiotic is the treatment of choice for impetigo. In severe cases, an oral antibiotic will be given in addition to the ointment. S. aureus or group A beta-hemolytic streptococcus are causative factors for impetigo. PTS: 1 CON: Infection 2. An adolescent is brought to the health-care provider’s office for evaluation of scaly rashes and erythema on the scalp. The patient also has some patches of hair loss. The nurse should anticipate which test will most likely be ordered? a. Potassium hydroxide (KOH) stain b. Blood cultures c. Comprehensive metabolic panel (CMP) d. Skin biopsy ANS: A Chapter: Chapter 22 Dermatological Diseases Chapter Learning Objective: 4. Explain diagnostic and laboratory studies used for skin conditions. Page: 551 Heading: Tinea (Fungal) Infections Diagnostic Testing Integrated Processes: Nursing Process Client Need: Physiological Integrity: Basic Care and Comfort Cognitive Level: Analysis [Analyzing] Concept: Infection Difficulty: Moderate Feedback A. This is correct. The health-care provider would most likely order a KOH stain. The lesion is scraped, and the tissue mixed with KOH before examining under a microscope. B. This is incorrect. Blood cultures may be ordered if a patient presents with a fever and systemic signs and symptoms. It is not indicated in this situation. C. This is incorrect. A CMP is used to assess a person’s metabolism and chemical balance. It would not be useful in this scenario. D. This is incorrect. A skin biopsy provides information about the cellular growth of skin cells. It is not indicated in this situation. PTS: 1 CON: Infection 3. A teenager is being cared for in the emergency department after being trapped in a garage fire at her home. Partial-thickness burns are present on the side of the face, as well as on both arms. Which nursing action is the highest priority? a. Apply cool, sterile compresses to the burns. b. Remove all clothing from the patient. c. Give pain medication as ordered. d. Give 100% humidified oxygen.

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Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. A 15-month-old toddler has a strange rash on his nose and mouth. It contains papules and
vesicles and has a honeylike, glazed look. The toddler has a history of eczema, but the
nurse differentiates the features of the presenting rash and explains that he has developed
a secondary infection. What is the treatment of choice for this type of dermatological
disease?
a. Bathe the skin daily with hydrogen peroxide.
b. Apply Caladryl lotion to dry the lesions.
c. Use an antiviral lotion as ordered for 7 to 10 days.
d. Administer topical antibiotics as ordered until the skin is clear.

ANS: D
Chapter: Chapter 22 Dermatological Diseases
Chapter Learning Objective: 4. Explain diagnostic and laboratory studies used for
skin conditions.
Page: 548
Heading: Bacterial Infections > Impetigo > Nursing Interventions
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Infection
Difficulty: Moderate

Feedback
A. This is incorrect. Bathing with hydrogen peroxide is not recommended.
B. This is incorrect. Caladryl is used to relieve the pruritus of contact dermatitis
such as poison ivy.
C. This is incorrect. The superimposed infection is not viral.
D. This is correct. A topical antibiotic is the treatment of choice for impetigo. In
severe cases, an oral antibiotic will be given in addition to the ointment. S. aureus
or group A beta-hemolytic streptococcus are causative factors for impetigo.

PTS: 1 CON: Infection

2. An adolescent is brought to the health-care provider’s office for evaluation of scaly rashes
and erythema on the scalp. The patient also has some patches of hair loss. The nurse
should anticipate which test will most likely be ordered?
a. Potassium hydroxide (KOH) stain

, b. Blood cultures
c. Comprehensive metabolic panel (CMP)
d. Skin biopsy

ANS: A
Chapter: Chapter 22 Dermatological Diseases
Chapter Learning Objective: 4. Explain diagnostic and laboratory studies used for
skin conditions.
Page: 551
Heading: Tinea (Fungal) Infections > Diagnostic Testing
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Analysis [Analyzing]
Concept: Infection
Difficulty: Moderate

Feedback
A. This is correct. The health-care provider would most likely order a KOH stain.
The lesion is scraped, and the tissue mixed with KOH before examining under a
microscope.
B. This is incorrect. Blood cultures may be ordered if a patient presents with a fever
and systemic signs and symptoms. It is not indicated in this situation.
C. This is incorrect. A CMP is used to assess a person’s metabolism and chemical
balance. It would not be useful in this scenario.
D. This is incorrect. A skin biopsy provides information about the cellular growth of
skin cells. It is not indicated in this situation.

PTS: 1 CON: Infection

3. A teenager is being cared for in the emergency department after being trapped in a garage
fire at her home. Partial-thickness burns are present on the side of the face, as well as on
both arms. Which nursing action is the highest priority?
a. Apply cool, sterile compresses to the burns.
b. Remove all clothing from the patient.
c. Give pain medication as ordered.
d. Give 100% humidified oxygen.

ANS: D
Chapter: Chapter 22 Dermatological Diseases
Chapter Learning Objective: 5. Describe emergency care given for acute infections,
bites, and burns to the skin.
Page: 558
Heading: Disorders Related to Injuries > Minor and Major Burns > Nursing
Interventions > Emergency Care

, Client Need: Safe and Effective Care Management: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Tissue Integrity
Difficulty: Moderate

Feedback
A. This is incorrect. Applying cool, sterile, normal saline compresses to cool and
protect the skin is done after airway, breathing (oxygen), and circulation is
established.
B. This is incorrect. Although it is important to remove clothing that is burned, hot
in temperature, or contaminated with chemicals, this is not the highest priority.
C. This is incorrect. Although pain medication should be administered as needed,
this is not the priority action.
D. This is correct. The priority action is establishing airway, breathing (oxygen), and
circulation. The nurse should give 100% oxygen if the individual has been
burned severely or if the fire was in a confined space. A pulse oximeter is used to
monitor oxygen saturation levels.

PTS: 1 CON: Tissue Integrity

4. A nurse is caring for a 12-year-old child who fell off a bicycle and sustained a laceration
to the leg. What is the nurse’s priority intervention?
a. Clean the laceration with normal saline.
b. Use gauze to apply pressure to the laceration.
c. Ascertain whether the child’s tetanus immunization is up to date.
d. Apply antibiotic ointment such as bacitracin to the laceration.

ANS: B
Chapter: Chapter 22 Dermatological Diseases
Chapter Learning Objective: 9. Develop a teaching plan for caregivers of children or
adolescents with skin conditions or injuries to the skin.
Page: 556
Heading: Disorders Related to Injuries > Lacerations > Nursing Interventions
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Tissue Integrity
Difficulty: Moderate

Feedback
A. This is incorrect. Cleaning the laceration to prevent infection is important, but
there is a more important action for the nurse to take.
B. This is correct. Applying pressure to the laceration will stop the bleeding, which
is priority. (Think airway, breathing, circulation.)

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