Med Surg, Integumentary System Study
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Chapter 22
1. When the nurse is assessing a 42-year-old woman, the patient states that she is
using topical fluorouracil (Efudex, Fluoroplex) to treat actinic keratoses on her
face. Which additional information will be most important for the nurse to obtain?
a.
Method of birth control the patient is using
b.
History of extensive sun exposure by the patient
c.
Length of time the patient has used the medication
d.
Appearance of the treated areas on the patients face - ANSWER✔✔ANS: A
Since fluorouracil is teratogenic, it is essential that the patient use a reliable
method of birth control. The other information also will be obtained by the nurse,
but lack of reliable birth control has the most potential for serious adverse
medication effects.
2. Which assessment information documented in a patients chart indicates that the
nurse may need to continue to monitor the skin condition of an 82-year-old patient
admitted with bacterial pneumonia?
a.
Scattered macular brown areas on extremities
b.
Skin brown and wrinkled, skin tenting on forearm
,c.
Longitudinal nail bed ridges noted, sparse scalp hair
d.
Skin moist and intact; states history of allergic rashes - ANSWER✔✔ANS: D
Because the patient will be receiving antibiotics, the nurse should monitor the
patient for the presence of an allergic rash. The assessment data in the other
response would be normal for an elderly patient.
3. A patient has a circular, flat, reddened lesion about 5 cm in diameter on his
ankle. To determine whether the lesion is related to blood vessel dilation, the nurse
will
a.
elevate the patients leg.
b.
press firmly on the lesion.
c.
check the temperature of the skin around the lesion.
d.
palpate the dorsalis pedis and posterior tibial pulses. - ANSWER✔✔ANS: B
If the lesion is caused by blood vessel dilation, blanching will occur with direct
pressure. The other assessments will assess circulation to the leg, but will not be
helpful in determining the etiology of the lesion.
4. When examining a homebound patient, the home health nurse notes a musky,
sour body odor. Based on this assessment, the most appropriate nursing action is to
a.
teach the patient to apply a moisturizing body lotion daily.
, b.
ask about use of over-the-counter (OTC) skin medications.
c.
ask the health care provider about a prescription for a topical antifungal.
d.
schedule nursing assistive personnel to help with bathing several times weekly. -
ANSWER✔✔ANS: D
The skin odor indicates that the patients hygiene is poor and that assistance with
bathing is needed. Although elderly patients may need moisturizing lotions and
should be asked about use of skin medications, the assessment data do not indicate
that these are the most appropriate actions. An antifungal would be indicated if the
nurse noticed a yeast odor.
5. A dark-skinned patient has been admitted to the hospital in severe respiratory
distress. To determine whether the patient is cyanotic, the nurse will
a.
assess the skin color of the earlobes.
b.
apply pressure to the palms of the hands.
c.
check the lips and oral mucous membranes.
d.
examine capillary refill time of the nail beds. - ANSWER✔✔ANS: C
Cyanosis in dark-skinned individuals is more easily seen in the mucous
membranes. Earlobe color may change in light-skinned individuals, but this change
in skin color is difficult to detect on darker skin. Application of pressure to the
palms of the hands and nail bed assessment would check for adequate circulation,
but not for skin color.
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