A male client with psoriasis visits the dermatology clinic. When inspecting the affected areas, the nurse expects to see which type of secondary lesion?

Correct Answer: A

Rationale: The correct answer is A: Scale. In psoriasis, scales are a common secondary lesion due to the rapid turnover of skin cells. The scaling appears as silvery-white plaques on red, inflamed skin. Scales are formed by the accumulation of dead skin cells on the skin surface. Crust (B) forms from dried serum, blood, or pus and is not typically associated with psoriasis. Fissure (C) is a linear crack in the skin that may occur in psoriasis but is not a primary characteristic. Ulcer (D) is a full-thickness loss of skin tissue and is not a typical secondary lesion in psoriasis.

Correct Answer: B

Rationale: The correct answer is B. Leaving the lotion on until the next day and giving a bath is incorrect as per the treatment guidelines for scabies. The rationale is that permethrin lotion should be applied on dry skin and left on for 8-14 hours before washing off. This allows the medication to work effectively. Giving a bath right after applying the lotion can wash off the medication prematurely, reducing its efficacy. A: This statement is correct as it describes the correct application of Elimite from the nape of the neck to the toes, except on the genitals. C: This statement is correct as scabies treatment often requires a second application one week after the first to ensure all mites are eradicated. D: This statement is correct as it is recommended to give a warm soapy bath before applying the lotion to clean the skin.

Correct Answer: D

Rationale: The correct answer is D: Ulcers. Secondary skin lesions are modifications or changes that result from primary skin lesions or external factors. Ulcers are a type of secondary skin lesion that involves loss of skin tissue, often due to underlying conditions like infections or vascular issues. Crusts (A), scales (B), and scars (C) are examples of primary skin lesions, not secondary. Crusts are dried blood or exudate on the skin surface, scales are flakes of skin, and scars are areas of fibrous tissue formed during the healing process. Ulcers are the only correct example of a secondary skin lesion in this context.

Correct Answer: A

Rationale: The correct answer is A. Silver sulfadiazine can cause kidney damage due to its effect on renal function. Encouraging the client to drink 3,000 mL of water helps prevent kidney damage by promoting adequate hydration and maintaining kidney function. B: While protein is important for wound healing, it is not directly related to the medication. C: Testing urine for ketones is not necessary unless the client is at risk for diabetic ketoacidosis, which is not related to silver sulfadiazine. D: Changing the dressing twice a day is important for wound care but not specifically related to the medication's side effects.

Correct Answer: B

Rationale: The correct answer is B because a dose pack of prednisone is designed to provide a tapering dose regimen. Prednisone should not be abruptly stopped to prevent adrenal insufficiency. Tapering the dose gradually allows the body to adjust and minimize withdrawal symptoms. Choice A is incorrect because prednisone helps reduce inflammation, not decrease it. Choice C is incorrect as the dose pack typically starts with a higher dose then tapers down. Choice D is incorrect because while prednisone may reduce redness, the main purpose of the dose pack is to taper the medication.