Nokea
A new patient has come to the dermatology clinic to be assessed for a reddened rash on his abdomen. What diagnostic test would most likely be ordered to identify the causative allergen?
- A. Skin scrapings
- B. Skin biopsy
- C. Patch testing
- D. Tzanck smear
Correct Answer: C
Rationale: Patch testing identifies allergens causing contact dermatitis. Skin scrapings are for fungal infections, biopsies rule out malignancy, and Tzanck smears diagnose blistering conditions.
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A nurse is aware that the outer layer of the skin consists of dead cells that contain large amounts of keratin. The physiologic functions of keratin include which of the following? Select all that apply.
- A. Producing antibodies
- B. Absorbing electrolytes
- C. Maintaining acidbase balance
- D. Physically repelling pathogens
- E. Preventing fluid loss
Correct Answer: D,E
Rationale: The dead cells of the epidermis contain large amounts of keratin, an insoluble, fibrous protein that forms the outer barrier of the skin. Keratin has the capacity to repel pathogens and prevent excessive fluid loss from the body. It does not contribute directly to antibody production, acidbase balance, or electrolyte levels.
A nurse is preparing to perform the physical assessment of a newly admitted patient. During which of the following components of the assessment should the nurse wear gloves? Select all that apply.
- A. Palpation of the patients scalp
- B. Palpation of the patients upper extremities
- C. Palpation of a rash on the patients trunk
- D. Palpation of a lesion on the patients upper back
- E. Palpation of the patients fingers
Correct Answer: C,D
Rationale: Gloves are required when palpating rashes or lesions to prevent contact with potential infectious material. Palpation of scalp, extremities, or fingers does not typically require gloves unless body fluids are present.
A young student comes to the school nurse and shows the nurse a mosquito bite. As the nurse expects, the bite is elevated and has serous fluid contained in the dermis. How would the nurse classify this lesion?
- A. Vesicle
- B. Macule
- C. Nodule
- D. Wheal
Correct Answer: D
Rationale: A wheal is an elevated lesion with serous fluid in the dermis, such as a mosquito bite. Vesicles contain fluid but are circumscribed, macules are flat, and nodules are solid.
A nurse in a dermatology clinic is reading the electronic health record of a new patient. The nurse notes that the patient has a history of a primary skin lesion. What is an example of a primary skin lesion?
- A. Crust
- B. Keloid
- C. Pustule
- D. Ulcer
Correct Answer: C
Rationale: A pustule is a primary skin lesion, arising from previously normal skin. Crusts, keloids, and ulcers are secondary lesions resulting from changes to primary lesions.
A patient with a suspected malignant melanoma is referred to the dermatology clinic. The nurse knows to facilitate what diagnostic test to rule out a skin malignancy?
- A. Tzanck smear
- B. Skin biopsy
- C. Patch testing
- D. Skin scrapings
Correct Answer: B
Rationale: A skin biopsy is used to diagnose or rule out skin malignancies like melanoma. Tzanck smears diagnose blistering conditions, patch testing identifies allergens, and skin scrapings detect fungal infections.