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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.
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Assessment of a patients leg reveals the presence of a 1.5-cm circular region of necrotic tissue that is deeper than the epidermis. The nurse should document the presence of what type of skin lesion?
- A. Keloid
- B. Ulcer
- C. Fissure
- D. Erosion
Correct Answer: B
Rationale: An ulcer involves skin loss past the epidermis with necrotic tissue. Keloids are scar tissue, fissures are linear, and erosions are superficial.
A patients health assessment has resulted in a diagnosis of alopecia areata. What nursing diagnosis should the nurse most likely associate with this health problem?
- A. Chronic Pain
- B. Impaired Skin Integrity
- C. Impaired Tissue Integrity
- D. Disturbed Body Image
Correct Answer: D
Rationale: Alopecia areata, causing patchy hair loss, often leads to disturbed body image due to its cosmetic impact. It does not cause pain or impair skin/tissue integrity.
An 80-year-old patient is brought to the clinic by her son. The son asks the nurse why his mother has gotten so many spots on her skin. What would be an appropriate response by the nurse?
- A. As people age, they normally develop uneven pigmentation in their skin.
- B. These spots are called liver spots or age spots.
- C. Older skin is more apt to break down and tear, causing sores.
- D. These are usually the result of nutritional deficits earlier in life.
Correct Answer: A
Rationale: Uneven pigmentation, such as age spots, is a common age-related skin change. Naming the spots or discussing skin breakdown does not directly address the cause, and nutritional deficits are not typically responsible.
A nurse is reviewing gerontologic considerations relating to the care of patients with dermatologic problems. What vulnerability results from the age-related loss of subcutaneous tissue?
- A. Decreased resistance to ultraviolet radiation
- B. Increased vulnerability to infection
- C. Diminished protection of tissues and organs
- D. Increased risk of skin malignancies
Correct Answer: C
Rationale: Loss of subcutaneous tissue reduces cushioning and insulation for underlying tissues and organs. It does not directly affect UV resistance, infection risk, or malignancy risk.
The nurse is performing an initial assessment of a patient who has a raised, pruritic rash. The patient denies taking any prescription medication and denies any allergies. What would be an appropriate question to ask this patient at this time?
- A. Is anyone in your family allergic to anything?
- B. How long have you had this abrasion?
- C. Do you take any over-the-counter drugs or herbal preparations?
- D. What do you do for a living?
Correct Answer: C
Rationale: Asking about over-the-counter drugs or herbal preparations can identify potential causes of a rash. Family allergy history, occupation, or mislabeling the rash as an abrasion are less immediately relevant.