Chapter 23: Concepts of Care for Patients
with Skin Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A client contacts the clinic to report a life-long mole has developed a crust with
occasional bleeding. What instruction by the nurse is most appropriate?
a. “Take monthly photographs of it so you can document any changes.”
b. “Wash daily with warm water and gentle soap to prevent infection.”
c. “Keep the lesion covered with a bandage and triple antibiotic ointment.”
d. “Please make an appointment to be seen here as soon as possible.”
ANS: D
A lesion demonstrating a change in characteristics, such as oozing, crusting, bleeding,
or scaling, is suspicious for skin cancer. The nurse would instruct the client to come in
for evaluation. Monthly photographs are a good way to document skin changes, but
the client needs an assessment for skin cancer. The lesion can be washed and covered
with a bandage and ointment, but again, the client needs an evaluation for skin cancer.
DIF: Applying TOP: Integrated Process: Nursing Process: Implementation
KEY: Skin cancer MSC: Client Needs Category: Physiological
Integrity: Reduction of Risk Potential
2. A nurse is teaching a client who has itchy, raised red patches covered with a silvery
white scale how to care for this disorder. What statement by the client shows a need
for further information?
, a. “At the next family reunion, I’m going to ask my relatives if they have
anything similar.”
b. “I have to make sure I keep my lesions covered, so I do not spread this to
others.”
c. “I must avoid large crowds and sick people while I am taking adalimumab.”
d. “I will buy a good quality emollient to put on my skin each day.”
ANS: B
This client has plaque psoriasis which is not a contagious disorder. The client does not
have to worry about spreading the condition to others. It is a condition that has
hereditary links so it would be correct for the client to inquire about other family
members who are affects. Adalimumab is a drug used to treat psoriasis and it has a
black box warning about serious infection risk and cancer risk, so the client needs to
take precautions to avoid infectious individuals. Emollients help keep the plaques soft
and reduce itching.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Skin disorders, Psoriasis MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse performs a skin screening for a client who has numerous skin lesions. Which
lesion does the nurse evaluate first?
a. Beige freckles on the backs of both hands.
b. Irregular mole with multiple colors on the leg.
c. Large cluster of pustules in the right axilla.
d. Thick, reddened papules covered by white scales.
ANS: B
This mole fits two of the criteria for being cancerous or precancerous: variation of
color within one lesion, and an indistinct or irregular border. Freckles are a benign
condition. Pustules could mean an infection, but it is more important to assess the
, potentially cancerous lesion first. Psoriasis vulgaris manifests as thick reddened
papules covered by white scales. This is a chronic disorder and is not the priority.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Skin cancer, Nursing assessment MSC: Client Needs
Category: Physiological Integrity: Physiological Adaptation
4. A nurse assesses a young female client who is prescribed tazarotene. Which question
should the nurse ask prior to starting this therapy?
a. “Do you spend a great deal of time in the sun?”
b. “Have you or any family members ever had skin cancer?”
c. “Which method of contraception are you using?”
d. “Do you drink alcoholic beverages?”
ANS: C
Tazarotene has many side effects. It is a known teratogen and can cause severe birth
defects. Strict birth control measures must be used during therapy. The other
questions are not directly related to this medication.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Skin disorders, Medications MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
5. A nurse is assessing clients with pressure injuries. Which wound description is
correctly matched to its description?
a. Suspected deep tissue injury: nonblanchable deep purple or maroon.
b. Stage 2: may have visible adipose tissue and slough.
c. Stage 3: may have a pink or red wound bed.
d. Stage 4: wound bed is obscured with eschar or slough.
ANS: A
with Skin Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A client contacts the clinic to report a life-long mole has developed a crust with
occasional bleeding. What instruction by the nurse is most appropriate?
a. “Take monthly photographs of it so you can document any changes.”
b. “Wash daily with warm water and gentle soap to prevent infection.”
c. “Keep the lesion covered with a bandage and triple antibiotic ointment.”
d. “Please make an appointment to be seen here as soon as possible.”
ANS: D
A lesion demonstrating a change in characteristics, such as oozing, crusting, bleeding,
or scaling, is suspicious for skin cancer. The nurse would instruct the client to come in
for evaluation. Monthly photographs are a good way to document skin changes, but
the client needs an assessment for skin cancer. The lesion can be washed and covered
with a bandage and ointment, but again, the client needs an evaluation for skin cancer.
DIF: Applying TOP: Integrated Process: Nursing Process: Implementation
KEY: Skin cancer MSC: Client Needs Category: Physiological
Integrity: Reduction of Risk Potential
2. A nurse is teaching a client who has itchy, raised red patches covered with a silvery
white scale how to care for this disorder. What statement by the client shows a need
for further information?
, a. “At the next family reunion, I’m going to ask my relatives if they have
anything similar.”
b. “I have to make sure I keep my lesions covered, so I do not spread this to
others.”
c. “I must avoid large crowds and sick people while I am taking adalimumab.”
d. “I will buy a good quality emollient to put on my skin each day.”
ANS: B
This client has plaque psoriasis which is not a contagious disorder. The client does not
have to worry about spreading the condition to others. It is a condition that has
hereditary links so it would be correct for the client to inquire about other family
members who are affects. Adalimumab is a drug used to treat psoriasis and it has a
black box warning about serious infection risk and cancer risk, so the client needs to
take precautions to avoid infectious individuals. Emollients help keep the plaques soft
and reduce itching.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Skin disorders, Psoriasis MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A nurse performs a skin screening for a client who has numerous skin lesions. Which
lesion does the nurse evaluate first?
a. Beige freckles on the backs of both hands.
b. Irregular mole with multiple colors on the leg.
c. Large cluster of pustules in the right axilla.
d. Thick, reddened papules covered by white scales.
ANS: B
This mole fits two of the criteria for being cancerous or precancerous: variation of
color within one lesion, and an indistinct or irregular border. Freckles are a benign
condition. Pustules could mean an infection, but it is more important to assess the
, potentially cancerous lesion first. Psoriasis vulgaris manifests as thick reddened
papules covered by white scales. This is a chronic disorder and is not the priority.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Skin cancer, Nursing assessment MSC: Client Needs
Category: Physiological Integrity: Physiological Adaptation
4. A nurse assesses a young female client who is prescribed tazarotene. Which question
should the nurse ask prior to starting this therapy?
a. “Do you spend a great deal of time in the sun?”
b. “Have you or any family members ever had skin cancer?”
c. “Which method of contraception are you using?”
d. “Do you drink alcoholic beverages?”
ANS: C
Tazarotene has many side effects. It is a known teratogen and can cause severe birth
defects. Strict birth control measures must be used during therapy. The other
questions are not directly related to this medication.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Skin disorders, Medications MSC: Client Needs Category:
Physiological Integrity: Pharmacological and Parenteral Therapies
5. A nurse is assessing clients with pressure injuries. Which wound description is
correctly matched to its description?
a. Suspected deep tissue injury: nonblanchable deep purple or maroon.
b. Stage 2: may have visible adipose tissue and slough.
c. Stage 3: may have a pink or red wound bed.
d. Stage 4: wound bed is obscured with eschar or slough.
ANS: A
