A patient who has severe refractory psoriasis on the face, neck, and extremities is socially withdrawn because of the appearance of the lesions. Which action should the nurse take first?

Correct Answer: D

Rationale: The correct answer is D: Ask the patient to describe the impact of psoriasis on quality of life. This is the first action the nurse should take to understand the patient's perspective, feelings, and how psoriasis is affecting their daily life. By doing so, the nurse can assess the severity of the social withdrawal and emotional impact, which can guide further interventions. Choice A is incorrect because enrolling in a worker-retraining program does not address the immediate social withdrawal and emotional impact due to psoriasis. Choice B is incorrect as encouraging the patient to volunteer for community projects may not be suitable or effective in addressing the patient's current emotional distress. Choice C is incorrect because suggesting cosmetics to cover the lesions only focuses on the physical appearance and does not address the underlying emotional and social issues.

Correct Answer: B

Rationale: The correct answer is B: Maintain a cool environment. This is the most appropriate intervention for a client with acute pain and itching from bacterial skin lesions. Cooling the environment helps alleviate discomfort by reducing inflammation and itching. Keeping humidity low (choice A) may exacerbate dryness and itching. Using mild soap (choice C) is important for skin care but does not directly address pain and itching from bacterial lesions. Applying skin lotion (choice D) may provide temporary relief but does not address the root cause of the symptoms. Maintaining a cool environment is the most effective intervention to provide immediate comfort and promote healing for the client.

Correct Answer: A

Rationale: The correct answer is A because asking when the client first noticed the skin problem helps determine the onset and progression of the condition. This information is crucial for diagnosis and treatment planning. Choice B is incorrect as it focuses on external factors rather than the client's symptoms. Choice C is irrelevant unless the client presents with specific sensory issues. Choice D is unrelated to the client's skin concern and does not aid in assessing the skin problem.

Correct Answer: A

Rationale: The correct answer is A. Atopic dermatitis is a condition characterized by dry, itchy skin. Using hydrating lotions and minimal soap helps to keep the skin moisturized and prevent further irritation. This promotes skin barrier function and reduces flare-ups. Choice B is incorrect because treating secondary infections should be addressed by a healthcare provider, not the client. Choice C is incorrect as prolonged use of topical corticosteroids can lead to adverse effects such as skin thinning and increased risk of infection. Choice D is incorrect because inhaled allergens can trigger exacerbations, but it is not the primary focus of teaching for atopic dermatitis.

Correct Answer: C

Rationale: The correct answer is C: The nurse who never had chickenpox. Herpes zoster, also known as shingles, is caused by the reactivation of the varicella-zoster virus, which causes chickenpox. Once someone has had chickenpox, the virus remains dormant in the body and can reactivate later in life as shingles. Therefore, the nurse who never had chickenpox may be at risk of contracting the virus from the client with herpes zoster. A, B, and D are incorrect choices because having had roseola, mumps, or German measles does not increase the risk of contracting herpes zoster. These conditions are caused by different viruses and do not confer immunity against varicella-zoster virus.