Chapter 3: Care of the Patient with an Integumentary Disorder
MULTIPLE CHOICE
1. What should the nurse do when administering a therapeutic bath to a patient who has severe
pruritus?
a. Use Burow’s solution to help promote healing
b. Rub the skin briskly to decrease pruritus
c. Limit bathing to 3 times a week
d. Ensure that bath area is at least 85 degrees and dehumidified
ANS: A
Pruritus is responsible for most of the discomfort. Wet dressings and using Burow’s solution
help promote the healing process. A cool environment with increased humidity decreases the
pruritus. Give daily baths with an application to cleanse the skin.
DIF: Cognitive Level: Application REF: Page 80 OBJ: 14
TOP: Pruritus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. A frail, older adult home health patient who had chickenpox as a child has been exposed to
varicella (chickenpox) several days ago. What should the nurse do?
a. Assess frequently for herpes zoster
b. Be aware of the patient’s immunity to chickenpox
c. Encourage the patient to have a pneumonia vaccine
d. Arrange for the patient to receive gamma globulin
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, aging, or receiving large doses of prednisone, in whom the disease could be
fatal because of the patient’s compromised immune system.
DIF: Cognitive Level: Application REF: Page 72 OBJ: 5
TOP: Shingles KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. A patient has herpes zoster (shingles) and is being treated with acyclovir (Zovirax). What
should the nurse do when administering this drug?
a. Apply lightly, being careful not to completely cover the lesion
b. After application, wrap in warm wet dressings
c. Use gloves
d. Rub medication into lesions
ANS: C
The topical application requires that the nurse uses gloves, completely covers the lesion
gently, then leaves it open to the air.
DIF: Cognitive Level: Comprehension REF: Page 70, Table 3-3
OBJ: 5 TOP: Anti-infective
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
, 4. A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower
lip and chin. The nurse believes these lesions most likely are:
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 and is associated with pruritus. The disease is highly contagious and
spreads by contact.
DIF: Cognitive Level: Comprehension REF: Page 76 OBJ: 6
TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. A school nurse assesses a child who has an erythematous circular patch of vesicles on her
scalp with alopecia and complains of pain and pruritus. Why would the nurse use a Woods
lamp?
a. To dry out the lesions
b. To reduce the pruritus
c. To kill the fungus
d. To cause fluorescence of the infected hairs
ANS: D
Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the
major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn
a brilliant blue green.
DIF: Cognitive Level: Knowledge REF: Page 79, Figure 3-7
OBJ: 6 TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
6. A patient, age 46, reports to his physician’s office with urticaria with elevated lesions that are
white in the center with a pale red border on hands and arms. He says, “It itches like crazy.”
Which type of lesion would the nurse include in her documentation?
a. Macules
b. Plaques
c. Wheals
d. Vesicles
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. The lesions are elevated with a white center and a pale red border.
DIF: Cognitive Level: Analysis REF: Page 82, Table 3-1
OBJ: 6 TOP: Urticaria KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
MULTIPLE CHOICE
1. What should the nurse do when administering a therapeutic bath to a patient who has severe
pruritus?
a. Use Burow’s solution to help promote healing
b. Rub the skin briskly to decrease pruritus
c. Limit bathing to 3 times a week
d. Ensure that bath area is at least 85 degrees and dehumidified
ANS: A
Pruritus is responsible for most of the discomfort. Wet dressings and using Burow’s solution
help promote the healing process. A cool environment with increased humidity decreases the
pruritus. Give daily baths with an application to cleanse the skin.
DIF: Cognitive Level: Application REF: Page 80 OBJ: 14
TOP: Pruritus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. A frail, older adult home health patient who had chickenpox as a child has been exposed to
varicella (chickenpox) several days ago. What should the nurse do?
a. Assess frequently for herpes zoster
b. Be aware of the patient’s immunity to chickenpox
c. Encourage the patient to have a pneumonia vaccine
d. Arrange for the patient to receive gamma globulin
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, aging, or receiving large doses of prednisone, in whom the disease could be
fatal because of the patient’s compromised immune system.
DIF: Cognitive Level: Application REF: Page 72 OBJ: 5
TOP: Shingles KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. A patient has herpes zoster (shingles) and is being treated with acyclovir (Zovirax). What
should the nurse do when administering this drug?
a. Apply lightly, being careful not to completely cover the lesion
b. After application, wrap in warm wet dressings
c. Use gloves
d. Rub medication into lesions
ANS: C
The topical application requires that the nurse uses gloves, completely covers the lesion
gently, then leaves it open to the air.
DIF: Cognitive Level: Comprehension REF: Page 70, Table 3-3
OBJ: 5 TOP: Anti-infective
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
, 4. A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower
lip and chin. The nurse believes these lesions most likely are:
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 and is associated with pruritus. The disease is highly contagious and
spreads by contact.
DIF: Cognitive Level: Comprehension REF: Page 76 OBJ: 6
TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. A school nurse assesses a child who has an erythematous circular patch of vesicles on her
scalp with alopecia and complains of pain and pruritus. Why would the nurse use a Woods
lamp?
a. To dry out the lesions
b. To reduce the pruritus
c. To kill the fungus
d. To cause fluorescence of the infected hairs
ANS: D
Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the
major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn
a brilliant blue green.
DIF: Cognitive Level: Knowledge REF: Page 79, Figure 3-7
OBJ: 6 TOP: Infection KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
6. A patient, age 46, reports to his physician’s office with urticaria with elevated lesions that are
white in the center with a pale red border on hands and arms. He says, “It itches like crazy.”
Which type of lesion would the nurse include in her documentation?
a. Macules
b. Plaques
c. Wheals
d. Vesicles
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. The lesions are elevated with a white center and a pale red border.
DIF: Cognitive Level: Analysis REF: Page 82, Table 3-1
OBJ: 6 TOP: Urticaria KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
