Integumentary Disorders NCLEX Practice Quiz (80 Questions)

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Question-02-001

The clinic nurse notes that the physician has documented a diagnosis of herpes zoster (shingles) in the male client’s chart. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made following which diagnostic test?

• A. Patch test
• B. Skin biopsy
• C. Culture of the lesion
• D. Wood’s light examination

Correct Answer: C. Culture of the lesion

With the classic presentation of herpes zoster, the clinical examination is diagnostic. A viral culture of the lesion provides the definitive diagnosis. Herpes zoster (shingles) is caused by a reactivation of the varicella-zoster virus, the virus that causes chickenpox.

• Option A: A patch test is a skin test that involves the administration of an allergen to the surface of the skin to identify specific allergies. 
• Option B: A biopsy would provide a cytological examination of tissue. 
• Option D: In a Wood’s light examination, the skin is viewed under ultraviolet light to identify superficial infections of the skin.

Question-02-002

The nurse is assigned to care for a female client with herpes zoster (Shingles). Which of the following characteristics would the nurse expect to note when assessing the lesions of this infection?

• A. Clustered skin vesicles
• B. A generalized body rash
• C. Small blue-white spots with a red base
• D. Cutaneous lesions on the hands, feet, and buttocks

Correct Answer: A. Clustered skin vesicles

The primary lesion of herpes zoster is a vesicle. The classic presentation is grouped vesicles on an erythematous base along a dermatome. Because the lesions follow nerve pathways, they do not cross the midline of the body. 

• Option B: Generalized rashes are normally the result of skin inflammation that is observed in eczema and atopic dermatitis.
• Option C: Small blue-white spot with a red base is a characteristic of a Koplik spot that is seen in measles.
• Option D: Cutaneous lesions on the hands, feet, and buttocks are signs of Hand-foot-and-mouth disease (HFMD).

Question-02-003

When assessing a lesion diagnosed as malignant melanoma, the nurse in-charge most likely expects to note which of the following?

• A. An irregular shaped lesion
• B. A small papule with a dry, rough scale
• C. A firm, nodular lesion topped with crust
• D. A pearly papule with a central crater and a waxy border

Correct Answer: A. An irregular shaped lesion

Melanoma is an irregularly shaped pigmented papule or plaque with a red-, white-, or blue-toned color.

• Option B: Actinic keratosis, a premalignant lesion, appears as a small macule or papule with a dry, rough, adherent yellow or brown scale.
• Option C: Squamous cell carcinoma is a firm, nodular lesion topped with a crust or a central area of ulceration.
• Option D: Basal cell carcinoma appears as a pearly papule with a central crater and rolled waxy border.

Question-02-004

The nurse prepares discharge instructions for a male client following cryosurgery for the treatment of a malignant skin lesion. Which of the following should the nurse include in the instruction?

• A. Avoid showering for 7 to 10 days
• B. Apply ice to the site to prevent discomfort
• C. Apply alcohol-soaked dressing twice a day
• D. Clean the site with hydrogen peroxide to prevent infection

Correct Answer: D. Clean the site with hydrogen peroxide to prevent infection

Cryosurgery involves the local application of liquid nitrogen to isolated lesions and causes cell death and tissue destruction. The nurse informs the client that swelling and increased tenderness of the treated area can occur when the skin thaws. Tissue freezing is followed by hemorrhagic blister formation in 1 to 2 days. The nurse instructs the client to clean the treatment site with hydrogen peroxide to prevent secondary infection. A topical antibiotic also may be prescribed. 

• Option A: The client does not need to avoid showering.  
• Option B: Application of a warm, damp washcloth intermittently to the site will provide relief from any discomfort. 
• Option C: Alcohol-soaked dressings will cause irritation. 

Question-02-005

Nurse Kevin reviews the client’s chart and notes that the physician has documented a diagnosis of paronychia. Based on this diagnosis, which of the following would the nurse expect to note during the assessment?

• A. Dry, rough patches and bumps around the hair follicles on the upper arms, legs, and buttocks
• B. Red shiny skin around the nail bed
• C. White silvery patches on the elbows
• D. Swelling of the skin near the parotid gland

Correct Answer: B. Red shiny skin around the nail bed

Paronychia, or infection around the nail, is characterized by red, shiny skin, often associated with painful swelling. These infections frequently result from trauma, picking at the nail, or disorders such as dermatitis. Often, these become secondarily infected with bacteria or fungus, which later involves the nail. Warm soaks three or four times a day may reduce pain and pressure; however, incision and drainage of the inflamed site frequently are required. 

• Option A: A skin disorder that causes small, dry, rough patches and bumps around the hair follicles on the upper arms, legs, and buttocks is called keratosis pilaris.
• Option C: Silvery white patches that are seen on elbows, knees, and lower back is a characteristic of Plaque psoriasis, a common form of psoriasis. 
• Option D: Swelling of the skin near the parotid gland is observed in patients with mumps.

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Question-02-006

A male client arrives at the emergency room and has experienced frostbites to the right hand. Which of the following would the nurse note on assessment of the client’s hand?

• A. A pink, edematous hand
• B. A fiery red skin with edema in the nail beds
• C. Black fingertips surrounded by an erythematous rash
• D. A white color to the skin, which is insensitive to touch

Correct Answer: D. A white color to the skin, which is insensitive to touch

Assessment findings in frostbite include a white or blue color; the skin will be hard, cold, and insensitive to touch. As thawing occurs, flushing of the skin, the development of blisters or blebs, or tissue edema appears. 

• Option A: Client may complain of heaviness in an exposed extremity as numbness progresses. 
• Option B: During the late stages of frostbite, affected areas may become dark or purplish in color due to poor vascular tone and pooling of blood.
• Option C: Deep, full-thickness frostbite will become hemorrhagic with rewarming and may become gangrenous.

Question-02-007

The evening nurse reviews the nursing documentation in the male client’s chart and notes that the day nurse has documented that the client has a stage II pressure ulcer in the sacral area. Which of the following would the nurse expect to note on assessment of the client’s sacral area?

• A. Intact skin
• B. Full-thickness skin loss
• C. Exposed bone, tendon, or muscle
• D. Partial-thickness skin loss of the dermis

Correct Answer: D. Partial-thickness skin loss of the dermis

In a stage II pressure ulcer, the skin is not intact. Partial-thickness skin loss of the dermis has occurred. It presents as a shallow open ulcer with a red-pink wound bed, without slough. It may also present as an intact, open or ruptured, serum-filled blister. 

• Option A: The skin is intact in stage I. 
• Option B: Full-thickness skin loss occurs in stage 3.
• Option C: Exposed bone, tendon, or muscle is present in stage 4.

Question-02-008

Nurse Imee is implementing a teaching plan to a group of adolescents regarding the causes of acne. Which of the following is an appropriate nursing statement regarding the cause of this disorder?

• A. “Acne is caused by oily skin”
• B. “The actual cause is not known”
• C. “Acne is caused by eating chocolate”
• D. “Acne is caused as a result of exposure to heat and humidity”

Correct Answer: B. “The actual cause is not known”

There are a lot of theories regarding the causes of acne. Some of these ideas are scientifically explained, but many aren’t. For example, people sometimes say that not washing properly contributes to acne or makes it worse. There is no scientific proof that this is true. But claims like this can make teenagers feel guilty because they believe they are to blame for their acne.

• Options A & C: Oily skin or the consumption of foods such as chocolate, nuts, or fatty foods are not causes of acne.
• Option D: Exacerbations that coincide with the menstrual cycle result from hormonal activity. Heat, humidity, and excessive perspiration may play a role in exacerbating acne but do not cause it.

Question-02-009

The nurse is reviewing the healthcare record of a male client scheduled to be seen at the health care clinic. The nurse determines that which of the following individuals is at the greatest risk for the development of an integumentary disorder?

• A. An adolescent
• B. An older female
• C. A physical education teacher
• D. An outdoor construction worker

Correct Answer: D. An outdoor construction worker

Prolonged exposure to the sun, unusual cold, or other conditions can damage the skin. The outdoor construction worker would fit into a high-risk category for the development of an integumentary disorder. 

• Option A: An adolescent may be prone to the development of acne, but this does not occur in all adolescents. 
• Option B: Immobility and lack of nutrition would increase the older person’s risk but the older client is not at as high a risk as the outdoor construction worker. 
• Option C: The physical education teacher is at low or no risk of developing an integumentary problem.

Question-02-010

A male client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. The appropriate response by the nurse is:

• A. “There is no pain associated with this procedure”
• B. “The local anesthetic may cause a burning or stinging sensation”
• C. A preoperative medication will be given so you will be sleeping and will not feel any pain”
• D. “There is some pain, but the physician will prescribe an opioid analgesic following the procedure”

Correct Answer: B. “The local anesthetic may cause a burning or stinging sensation”

Depending on the size and location of the lesion, a biopsy is usually a quick and almost painless procedure. The most common source of pain is the initial local anesthetic, which can produce a burning or stinging sensation.

• Option A: A mild pain is experienced during the procedure and the application of a local anesthetic prior to the biopsy normally causes a mild stinging sensation lasting a few seconds.
• Option C: Preoperative medication is not necessary with this procedure.
• Option D: Opioid analgesics are not recommended for relief of postoperative pain since it can cause respiratory depression. Tylenol (acetaminophen) and application of ice to the area for 10 minutes are some of the pain-relieving measures after a skin biopsy

Question-02-011

The nurse is teaching a female client with a leg ulcer about tissue repair and wound healing. Which of the following statements by the client indicates effective teaching?

• A. “I’ll limit my intake of protein.”
• B. “I’ll make sure that the bandage is wrapped tightly.”
• C. “My foot should feel cold.”
• D. “I’ll eat plenty of fruits and vegetables.”

Correct Answer: D. “I’ll eat plenty of fruits and vegetables.”

For effective tissue healing, adequate intake of protein, vitamin A, B complex, C, D, E, and K are needed. Therefore, the client should eat a high protein diet with plenty of fruits and vegetables to provide these nutrients.

• Option A: The wound healing process further exacerbates protein loss, therefore during recovery, a high protein diet helps the body in repairing damaged tissues.
• Option B: The bandage should be secure but not too tight to impede circulation to the area (needed for tissue repair).
• Option C: If the client’s foot feels cold, circulation is impaired, thus inhibiting wound healing.

Question-02-012

Following a full-thickness (third-degree) burn of his left arm, a male client is treated with artificial skin. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict:

• A. Range of motion
• B. Protein intake
• C. Going outdoors
• D. Fluid ingestion

Correct Answer: A. Range of motion

To prevent disruption of the artificial skin’s adherence to the wound bed, the client should restrict range of motion of the involved limb. 

• Options B & D: Protein intake and fluid intake are important for healing and regeneration and shouldn’t be restricted. 
• Option C: Going outdoors is acceptable as long as the left arm is protected from direct sunlight.

Question-02-013

Following a small-bowel resection, a male client develops fever and anemia. The surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:

• A. Erythema
• B. Leukocytosis
• C. Pressure-like pain
• D. Swelling

Correct Answer: C. Pressure-like pain.

Severe pressure like pain out of proportion to visible signs distinguishes necrotizing fasciitis from cellulitis. 

• Options A, B, & D: Erythema, leukocytosis, and swelling are present in both cellulitis and necrotizing fasciitis. 

Question-02-014

While in a skilled nursing facility, a female client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughter’s home, where six other persons are living. During her visit to the clinic, she asks a staff nurse, “What should my family do?” The most accurate response from the nurse is:

• A. “All family members will need to be treated.”
• B. “If someone develops symptoms, tell him to see a physician right away.”
• C. “Just be careful not to share linens and towels with family members.”
• D. “After you’re treated, family members won’t be at risk for contracting scabies.”

Correct Answer: A. “All family members will need to be treated.”

When someone in a group of persons sharing a home contracts scabies, each individual in the home needs prompt treatment whether he’s symptomatic or not. 

• Options B, C, & D: Towels and linens should be washed in hot water. Scabies can be transmitted from one person to another before symptoms develop.

Question-02-015

The nurse is assessing a male client admitted with second- and third-degree burns on the face, arms, and chest. Which finding indicates a potential problem?

• A. Partial pressure of arterial oxygen (PaO2) value of 80 mm Hg
• B. Urine output of 20 ml/hour
• C. White pulmonary secretions
• D. Rectal temperature of 100.6° F (38° C)

Correct Answer: B. Urine output of 20 ml/hour

A urine output of less than 40 ml/hour in a client with burns indicates a fluid volume deficit. 

• Option A: This client’s PaO2 value falls within the normal range (80 to 100 mm Hg). 
• Option C: White pulmonary secretions also are normal. 
• Option D: The client’s rectal temperature isn’t significantly elevated and probably results from the fluid volume deficit.

Question-02-016

A female client exhibits purplish bruises to the skin after a fall. The nurse would document this finding most accurately using which of the following terms?

• A. Purpura
• B. Petechiae
• C. Ecchymosis
• D. Erythema

Correct Answer:  C. Ecchymosis

Ecchymosis is a type of purpuric lesion and also is known as a bruise. It happens when blood leaks out of the vessels into the underlying subcutaneous tissues.

• Option A: Purpura is an umbrella term that incorporates ecchymoses and petechiae.
• Option B:  Petechiae are pinpoint hemorrhages and are another form of purpura. 
• Option D: Erythema is an area of redness on the skin.

Question-02-017

An older client’s physical examination reveals the presence of a number of bright red-colored lesions scattered on the trunk and tights. The nurse interprets that this indicates which of the following lesions due to alterations in blood vessels of the skin?

• A. Cherry angioma
• B. Spider angioma
• C. Venous star
• D. Purpura

Correct Answer:  A. Cherry angioma

Cherry angioma occurs with increasing age and has no clinical significance. It appears as a small, round, bright red–colored lesion on the trunk or extremities. 

• Option A: Spider angiomas have a bright red center with legs that radiate outward. These lesions commonly are seen in liver disease and vitamin B deficiency, although they occasionally can occur without underlying pathology. 
• Option C: A venous star results from increased pressure in veins, usually in the lower legs, and has an irregularly shaped bluish center with radiating branches. 
• Option D: Purpura results from hemorrhage into the skin.

Question-02-018

A nurse is reviewing the medical record of a male client to be admitted to the nursing unit and notes documentation of reticular skin lesions. The nurse expects that these lesions will appear to be:

• A. Ring-shaped
• B. Linear
• C. Shaped like an arc
• D. Net-like appearance

Correct Answer: D. Net-like appearance

Reticular skin lesions resemble a net in appearance. 

• Option A: Annular lesions are ring-shaped.
• Option B: Linear lesions appear in a straight line. 
• Option C: Arciform lesions are shaped like an arc.

Question-02-019

A male client seen in an ambulatory clinic has a butterfly rash across the nose. The nurse interprets that this finding is consistent with early manifestations of which of the following disorders?

• A. Hyperthyroidism
• B. Pernicious anemia
• C. Cardiopulmonary disorders
• D. Systemic lupus erythematosus (SLE)

Correct Answer: D. Systemic lupus erythematosus (SLE)

An early sign of SLE is the appearance of a butterfly rash across the nose. 

• Option A: Hyperthyroidism often leads to moist skin and increased perspiration. 
• Option B: Pernicious anemia would be manifested by pallor of the skin. 
• Option C: Cardiopulmonary disorders may lead to clubbing of the fingers.

Question-02-020

A female client with cellulitis of the lower leg has had cultures done on the affected area. The nurse reading the culture report understands that which of the following organisms is not part of the normal flora of the skin?

• A. Staphylococcus epidermidis
• B. Staphylococcus aureus
• C. Escherichia coli (E. coli)
• D. Candida albicans

Correct Answer: C. Escherichia coli (E. coli)

E. coli normally is found in the intestines and constitutes a common source of infection of wounds and the urinary system. The other microbes listed are part of the normal flora of the skin.

• Option A: Staphylococcus epidermidis is a major inhabitant of the skin, and in some areas it makes up more than 90 percent of the resident aerobic flora.
• Option B: Staphylococcus aureus can be found in different body areas such as the skin, rectum, vagina, axilla, and nose.
• Option D: Candida albicans is usually seen in warm, moist, creased areas such as the groin and armpits. most often it occurs in warm, moist, creased areas such as the armpits and groin. 

Question-02-021

JT being the charge nurse for today is providing orientation to Nurse Brad, a newly hired employee. Which of the following action by Nurse Brad requires the most immediate action?

• A. Educating a newly admitted burn client regarding the use of pressure garments.
• B. Obtaining an anaerobic culture specimen from a superficial burn wound.
• C. Administering tetracycline with a glass of milk to a client with cellulitis.
• D. Discussing the use of herpes zoster vaccine with a 20-year-old client.

Correct Answer: C. Administering tetracycline with a glass of milk to a client with cellulitis.

Tetracyclines should never be taken with milk or milk products since dairy products prevent the absorption of tetracycline.

• Option A: Pressure garments may be used after graft wounds heal and during the rehabilitation period after a burn injury, but this should be discussed when the client is ready for rehabilitation, now when the client is admitted.
• Option B: Anaerobic bacteria would not be likely to grow in a superficial wound.
• Option D: The herpes zoster vaccine is recommended for clients who are 60 years or older.

Question-02-022

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Nurse Sierra is assessing the skin of a client suffering from psoriasis. She understands that which characteristic is associated with this skin disorder?

• A. Red-purplish scaly lesions.
• B. Silvery-white scaly patches on the scalp, elbows, knees, and sacral regions.
• C. Clear, thin nail beds.
• D. Oily skin and absence of pruritus.

Correct Answer: B. Silvery-white scaly patches on the scalp, elbows, knees, and sacral regions.

Psoriatic patches are covered with silvery white scales. Affected areas include the scalp, elbows, knees, shins, sacral area, and trunk.

• Option A: The lesions in psoriasis are not red-purplish scaly lesions.
• Option C: Thickening, pitting, and discoloration of the nails occurs.
• Option D: Pruritus may occur.

Question-02-023

Which assessment finding calls for the most immediate further assessment or interventions?

• A. Bilateral erythema of the face and neck.
• B. Bluish color around the earlobes and lips.
• C. Dark brown spotting on the back and chest.
• D. Yellow color of the skin and sclera.

Correct Answer: B. Bluish color around the earlobes and lips.

A blue color or cyanosis may indicate that the client has significant problems with circulation or ventilation. More detailed assessments are needed immediately.

• Options A, C, and D: The other data may also indicate health problems in major body systems, but potential respiratory or circulatory abnormalities are the priority.

Question-02-024

Nurse Keith is conducting a session about the principles of first aid and is discussing the interventions for a snakebite to an extremity. He should inform those attending the session that the first priority intervention in the event of this occurrence is which of the following?

• A. Remove jewelry and constricting clothing from the victim.
• B. Move the victim to a safe area away from the snake and encourage the victim to rest.
• C. Immobilize the affected extremity.
• D. Place the extremity in a position so that it is below the level of the heart.

Correct Answer: B. Move the victim to a safe area away from the snake and encourage the victim to rest.

The first priority in case of a snakebite is to move the victim to a safe area away from the snake and encourage the client to rest to decrease venom circulation.

• Option A: Removing jewelry or constricting clothing from the victim right away, before any swelling begins, but moving the victim safely away from the snake is  a more priority action.
• Options C & D: Immobilize the affected extremity and keep it below the level of the heart. Immobilization is done to slow the movement of venom through the lymphatic system. And prevent it from spreading.

Question-02-025

Nurse Luis is caring for a client who has just had a squamous cell carcinoma removed from the face. Which activities can you delegate to an experienced nursing LPN/LVN?

• A. Monitoring the surgical site for swelling, bleeding or pain.
• B. Teaching the client about risk factors for squamous cell carcinoma.
• C. Discussing the reasons for avoiding aspirin use for a week after surgery.
• D. Showing the client how to take care for the surgical site at home.

Correct Answer: A. Monitoring the surgical site for swelling, bleeding or pain.

An LPN/LVN who is experienced with postoperative clients will know how to monitor for swelling, bleeding, or pain and will notify the supervising RN.

• Options B, C, & D: Teaching about risk factors, discussing medication use, and performing education with the client about the plan of care is within the scope of practice of a registered nurse.

Question-02-026 

When assessing a lesion diagnosed as malignant melanoma, the nurse most likely expects to note which of the following?

• A. A firm, nodular lesion topped with crust.
• B. A pearly papule with a central crater and a waxy border.
• C. An irregularly shaped lesion.
• D. A small papule with a dry, rough scale.

Correct Answer: C. An irregularly shaped lesion.

Melanoma is an irregularly shaped pigmented papule or plaque with a red, white, or blue-toned color.

• Option A: Squamous cell carcinoma is a firm, nodular lesion topped with a crust or a central area of ulceration.
• Option B: Basal cell carcinoma appeared as a pearly papule with a central crater and rolled waxy border.
• Option D: Actinic keratosis, a premalignant lesion, appears as a small macule or papule with a dry, rough, adherent yellow or brown scale.

Question-02-027

Nurse Chael is performing a skin assessment on a new resident in a long-term care facility. Which finding is of most concern?

• A. All the toenails are thickened and yellow.
• B. Silver scaling is present on the elbows and knees.
• C. An irregular border is seen on a black mole on the scalp.
• D. Numerous striae are noted across the abdomen and buttocks.

Correct Answer: C. An irregular border is seen on a black mole on the scalp.

Irregular borders and a black mole or variegated color are characteristics associated with malignant skin lesions.

• Options A and D: Striae and toenail thickening are common with elderly individuals.
• Option B: Silver scaling is associated with psoriasis, which may need treatment but is not as urgent a concern as the appearance of the mole.

Question-02-028

A client calls the emergency department and tells the nurse that he had been cleaning a wooden area in the backyard and came directly into contact with poison ivy shrubs. The client tells the nurse that he cannot see anything on the skin and ask the nurse what to do. Which of the following is the appropriate nursing response?

• A. “Apply calamine lotion immediately to the exposed skin areas.”
• B. “It is not necessary to do anything if you cannot see anything on your skin.”
• C. “Come to the emergency department.”
• D. “Take a shower immediately, lathering, and rinsing several times.”

Correct Answer: D. “Take a shower immediately, lathering, and rinsing several times.”

When an individual comes in contact with a poison ivy plant, the sap from the plants forms an invisible film on the human skin. The client should be instructed to cleanse the area with alcohol and then shower immediately and to lather the skin several times and rinse each time in running water.

• Option A: Calamine lotion is recommended for use if dermatitis occurs.
• Option B: The sap that is released from a poison ivy triggers an allergic reaction when it comes into contact with the skin, resulting in an itchy rash that may appear within hours of exposure or up to several days later so it is important to observe and treat it immediately.
• Option C: It is not yet necessary to be at the emergency unit at this time.

Question-02-029

A client returns to the clinic for follow-up treatment following a skin biopsy of a suspicious lesion performed one (1) week ago. The biopsy report indicates that the lesion is melanoma. The nurse understands that which of the following describes a characteristic of this type of lesion?

• A. Melanoma is characterized by local invasion.
• B. Melanoma is highly metastatic.
• C. Metastasis is rare.
• D. Melanoma is encapsulated.

Correct Answer: B. Melanoma is highly metastatic.

Melanomas are pigmented malignant lesions originating in the melanin-producing cells of the epidermis. This cancer is highly metastatic, and prognosis depends on early diagnosis and treatment.

Question-02-030

A 30-year old woman who has been taking isotretinoin (Accutane) to treat severe cystic acne make all these statements while being seen for a follow-up examination. Which statement is of most concern?

• A. “Sometimes I get nauseated after taking the medication.”
• B. “My husband and I are thinking of starting a family soon.”
• C. “I have been having problems driving when it gets dark.”
• D. “I don’t think there has been much improvement in my skin.”

Correct Answer: B. “My husband and I are thinking of starting a family soon.”

Isotretinoin (Accutane) is associated with a high incidence of birth defects, it is important that the client stops using the medication at least a month before attempting to become pregnant.

• Options A and C: Poor night vision and nausea are possible adverse effects of isotretinoin that would require further assessment but are not as urgent as discussing but are not as urgent as discussing the fetal risks associated with this medication.
• Option D: The client’s concern about the effectiveness of the medication should be addressed, but this is a low-priority intervention.

Question-02-031

A client has been taking prednisone (Deltasone) 20 mg once a day to treat severe seborrheic dermatitis. Which of the following assessment findings is of most concern?

• A. Complaints of epigastric pain.
• B. Blood pressure 145/90 mm Hg.
• C. Blood glucose level 129 mg/dL.
• D. Complaints of increase appetite.

Correct Answer: A. Complaints of epigastric pain.

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Complaints of epigastric pain indicate that the client might be suffering from peptic ulcers, which require the addition of the use of antacid such as proton pump inhibitor (Nexium).

• Options B, C, and D: These are symptoms related to the use of prednisone but are not clinically significant when steroids are used for limited periods and do not require treatment.

Question-02-032

A client is being admitted for the treatment of acute cellulitis of the thigh. The client asks the admitting nurse to explain what cellulitis means. The nurse bases the response on the understanding that the characteristics of cellulitis include:

• A. An epidermal and lymphatic infection caused by Staphylococcus.
• B. An inflammation of the epidermis only.
• C. A skin infection into the subcutaneous tissue and dermis.
• D. An acute superficial infection of the lymphatics and dermis.

Correct Answer: C. A skin infection into the subcutaneous tissue and dermis.

Cellulitis is an infection into deeper dermal and subcutaneous tissue that results in a deep red erythema without sharp borders and spreads widely throughout tissue spaces.

• Option D: Erysipelas is an acute, superficial, rapidly spreading inflammation of the dermis and lymphatics.

Question-02-033

The nurse manager is planning the clinical assignments for the day. Which staff members can be assigned to care for a client with herpes zoster? Select all that apply

• A. The nurse who never had German Measles.
• B. The nurse who never received the varicella zoster vaccine.
• C. The nurse who never had mumps.
• D. The nurse who never had roseola.
• E. The nurse who never had chicken pox.

Correct Answer: A, C, & D

Herpes zoster (shingles) is caused by a reactivation of the varicella-zoster virus, the causative virus for chicken pox. Individuals who have not been exposed to the varicella-zoster virus or who did not receive the varicella-zoster vaccine are susceptible to chickenpox. Health workers who are unsure of their immune status should have varicella titers done before exposure to a person with herpes zoster.

Question-02-034

A female client went to the emergency department states that she is having burning and intense itching on the skin. A further assessment made by the nurse notes that the client is having red and white patches in the mouth. Based on this, the nurse understand that the client is most likely is suffering from?

• A. Shingles
• B. Erysipelas
• C. Eczema
• D. Candidiasis

Correct Answer: D. Candidiasis

Candidiasis is a superficial fungal infection of the skin and mucous membranes caused by a yeast called Candida. Assessment of this disorder includes red and irritated skin appearances that itches and burns & red and whitish patches on the mucous membranes of the mouth.

• Option A: Shingles appears as unilateral clustered skin vesicles.
• Option B: Erysipelas is characterized by a tender, intensely erythematous, indurated plaque with a sharply demarcated border.
• Option C: Eczema is a skin condition where patches of skin become inflamed, itchy, red, cracked, and rough.

Question-02-035

A nurse is developing a care plan for a client suffering from shingles. Which of the following cranial nerves should the nurse assess as part of the client’s care?

• A. Cranial nerve number I
• B. Cranial nerve number IV
• C. Cranial nerve number VII
• D. Cranial nerve number XI

Correct Answer: C. Cranial nerve number VII

A potential complication of shingles is Bell’s palsy which can be assessed by the seventh cranial nerve function.

Question-02-036

Nurse Jeff is performing skin assessment on a client with a facial lesion. It appears as a well-defined, red, scaling, thickened bump. This type of skin lesion refers to?

• A. Kaposi’s Sarcoma
• B. Melanoma
• C. Squamous cell carcinoma
• D. Basal cell carcinoma

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Correct Answer: C. Squamous cell carcinoma

A squamous cell carcinoma is characterized by a well-defined, red, scaling, thickened bump on the sun-exposed skin such as the face, ears, neck, lips, and backs of the hands.

• Option A: A client with Kaposi’s sarcoma has reddish to purplish non-blanching, slightly raised, or nodular lesions of the skin or on the mucosal surfaces.
• Option B: A client with melanoma has smooth, dark brown or black colored smooth lesions that become irregular as it grows.
• Option D: A client with basal cell carcinoma has red patches, shiny bumps, scars, or growth with slightly raised, rolled edges.

Question-02-037

The nurse is teaching a female client with a leg ulcer about tissue repair and wound healing. Which of the following statements by the client indicates effective teaching?

• A. “To make the bandage tightly wrapped .”
• B. “My foot should feel cold.”
• C. “I’ll include fruits and vegetables in my meal plan.”
• D. “I’ll restrict my intake of protein.”

Correct Answer: C. “I’ll include fruits and vegetables in my meal plan.”

The beneficial nutrients found in fruits and vegetables are essential in the wound healing process.

• Option A: The bandage should be secure but not too tight to impede circulation to the area (needed for tissue repair).
• Option B: If the client’s foot feels cold, circulation is impaired, thus inhibiting wound healing.
• Option D: For effective tissue healing, adequate intake of protein is needed.

Question-02-038

A client with a severe cellulitis on the left hand was ordered to have cultures done on the affected area. After a few days, the culture report was released. The nurse understands that which of the following organisms is not part of the normal flora of the skin?

• A. Corynebacterium
• B. Brevibacterium
• C. Campylobacter jejuni
• D. Malasezzia

Correct Answer: C. Campylobacter jejuni.

Campylobacter jejuni is found in the intestines and is one of the most common causes of diarrheal illness.

• Options A, B, & D: These microorganisms are seen in the upper portion of the epidermis and congregated in and around the hair follicles.

Question-02-039

Sonny, an African American noticed an appearance of a dark spot under a toenail. This is a typical presentation of what kind of melanoma?

• A. Lentigo maligna 
• B. Nodular melanoma
• C. Amelanotic melanoma
• D. Acral lentiginous melanoma

Correct Answer: D. Acral lentiginous melanoma

Acral lentiginous melanoma, the most common form of melanoma seen in people of color, usually appears in hard-to-spot places such as under the fingernails or toenails, on the palms of the hands, or soles of the feet.

• Option A: Lentino maligna typically occurs on sun-damaged skin on the face, ears, arms, or upper torso.
• Option B: Nodular melanoma will have a tumor that grows rapidly deeper into the skin than any other type and is most frequently found on the torso, legs, and arms, as well as the scalp in older men.
• Option C: Amelanotic melanoma is a type of melanoma where the cancer cells do not produce melanin or pigment. It usually appears as a pink or red spot on the skin.

Question-02-040

Actinic keratosis typically progresses into which type of skin cancer? 

• A.  Cutaneous T-cell lymphoma 
• B.  Squamous cell carcinoma
• C.  Merkel cell cancer
• D.  Sebaceous carcinoma

Correct Answer: B.  Squamous cell carcinoma

Actinic keratosis, also known as solar keratosis, is a dry scaly patch found on sun-damaged skin. It is a precancerous form of cutaneous squamous cell carcinoma.Options A, C, & D: Actinic keratosis is not related to the development of these types of skin cancer.