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A nurse is assessing a teenage patient with acne vulgaris. The patients mother states, I keep telling him that this is what happens when you eat as much chocolate as he does. What aspect of the pathophysiology of acne should inform the nurses response?
- A. A sudden change in patients diet may exacerbate, rather than alleviate, the patients symptoms.
- B. Chocolate is not among the foods that are known to cause acne.
- C. Elimination of chocolate from the patients diet will likely lead to resolution within several months.
- D. Diet is thought to play a minimal role in the development of acne.
Correct Answer: D
Rationale: Diet, including chocolate, plays a minimal role in acne development. Eliminating chocolate or changing diet does not significantly impact acne symptoms.
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A nurse is planning the care of a patient with herpes zoster. What medication, if administered within the first 24 hours of the initial eruption, can arrest herpes zoster?
- A. Prednisone (Deltasone)
- B. Azanthioprine (Imuran)
- C. Triamcinolone (Kenalog)
- D. Acyclovir (Zovirax)
Correct Answer: D
Rationale: Acyclovir, an antiviral, can halt herpes zoster progression if given within 24 hours of eruption. Prednisone, azathioprine, and triamcinolone are not used for herpes zoster treatment.
A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?
- A. Chemotherapy
- B. Radiation therapy
- C. Surgical excision
- D. Biopsy of sample tissue
Correct Answer: C
Rationale: Surgical excision is the primary treatment for squamous cell carcinoma to remove the tumor entirely. Radiation is used for non-surgical candidates, chemotherapy is less common, and biopsy is diagnostic, not therapeutic.
A nurse is caring for a patient whose chemical injury has necessitated a skin graft to his left hand. The nurse enters the room and observes that the patient is performing active range of motion (ROM) exercises with the affected hand. How should the nurse best respond?
- A. Liaise with the physical therapist to ensure that the patient is performing exercises safely.
- B. Validate the patients efforts to increase blood perfusion to the graft site.
- C. Remind the patient that ROM exercises should be passive, not active.
- D. Remind the patient of the need to immobilize the graft to facilitate healing.
Correct Answer: D
Rationale: Immobilization of the graft site is critical to promote healing and prevent damage. Active or passive ROM exercises can disrupt the graft, and perfusion is not enhanced by early movement.
When writing a plan of care for a patient with psoriasis, the nurse would know that an appropriate nursing diagnosis for this patient would be what?
- A. Impaired Skin Integrity Related to Scaly Lesions
- B. Acute Pain Related to Blistering and Erosions of the Oral Cavity
- C. Impaired Tissue Integrity Related to Epidermal Shedding
- D. Anxiety Related to Risk for Melanoma
Correct Answer: A
Rationale: Psoriasis causes scaly lesions, leading to impaired skin integrity. It does not typically affect the oral cavity, cause epidermal shedding, or increase melanoma risk.
A patient requires a full-thickness graft to cover a chronic wound. How is the donor site selected?
- A. The largest area of the body without hair is selected.
- B. Any area that is not normally visible can be used.
- C. An area matching the color and texture of the skin at the surgical site is selected.
- D. An area matching the sensory capability of the skin at the surgical site is selected.
Correct Answer: C
Rationale: Donor site selection for full-thickness grafts prioritizes matching the color and texture of the surgical site to minimize scarring and ensure aesthetic compatibility.