ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 65 : Caring for Clients With Skin, Hair, and Nail Disorders Questions
Question 1 of 5
The nurse is caring for a client with a new tattoo. Which nursing diagnosis is of highest priority?
Correct Answer: B
Rationale: The trauma created by a tattoo is similar to a minor burn, thus, skin integrity, pain, and tissue perfusion are not the highest priority. Infection risk is the highest priority due to the injection of ink in the dermis. The priority of care is preventing infection.
Question 2 of 5
The nurse is preparing to care for a client's new tattoo. Which action would the nurse take first?
Correct Answer: B
Rationale: As with any wound care, the nurse performs hand hygiene prior to donning gloves. The nurse is then ready to care for the newly tattooed skin. Antibiotic ointment is applied each day for 5 days. A sterile dressing is used to cover the tattoo for the first 12 hours. Sunscreen is good protection for the tattoo but not as part of a new tattoo treatment regimen.
Question 3 of 5
A client enters the walk-in clinic stating that there is an itchy, red, warm, raised rash on the left forearm. The nurse documents when the rash developed and what the client was doing when it appeared. Allergic dermatitis is diagnosed. Which instruction is most important to prevent further problems?
Correct Answer: C
Rationale: It is important to instruct on the use of topical ointment, if prescribed, and to keep the area clean and dry. It is also important to advise against scratching the rash. By scratching the itchy rash, the client can open the skin and develop an infection. Staphylococcus aureus is the most common skin infection.
To prevent further problems, the client must avoid further exposure to the allergen.
Question 4 of 5
The nurse is caring for a client experiencing rosacea. Which is the earliest symptom of the disease process?
Correct Answer: A
Rationale: The nurse is correct to identify the earliest symptom of rosacea as being a flushed appearance across the nose, forehead, cheeks, and chin. Other symptoms include a sunburn appearance to the skin, solid papules or pustules, large facial pores, and an orange peel texture to the skin. Large facial pores and orange peel skin texture are found in the later stages as the disease progresses.
Question 5 of 5
The nurse is assessing a client experiencing an exacerbation of plaque psoriasis. The nurse assesses the area and documents a proliferation of which cell type?
Correct Answer: B
Rationale: The nurse is correct to document that the proliferation of skin cells occurs in the first layer of skin cells, the epidermis. In the epidermal layer, there is rapid turnover of the cells. The dermis is under the epidermis. Endothelial is the layer on the inside such as the interior of the blood vessel. Epithelial are on the outside or coating of walls.