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A nurse prepares to admit a client who has herpes zoster. Which actions should the nurse take? (Select all that apply.)
- A. Prepare a room for reverse isolation.
- B. Assess staff for a history of or vaccination for chickenpox.
- C. Check the admission orders for analgesia.
- D. Choose a roommate who also is immune suppressed.
- E. Ensure that gloves are available in the room.
Correct Answer: B,C,E
Rationale: Herpes zoster (shingles) is caused by reactivation of the varicella zoster virus, and staff without immunity to chickenpox are at risk. Analgesia is necessary due to the painful nature of shingles. Gloves and hand hygiene prevent spread, but reverse isolation is not required. An immune-suppressed roommate should be avoided to prevent infection transmission.
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A nurse assesses a client who has a lesion on the skin that is suspicious for skin cancer. Which diagnostic test should the nurse anticipate being ordered for this client?
- A. Punch skin biopsy
- B. Viral cultures
- C. Wood's lamp examination
- D. Diascopy
Correct Answer: A
Rationale: This lesion is suspicious for skin cancer and a biopsy is needed. A viral culture would not be appropriate. A Wood's lamp examination is used to determine if skin lesions have characteristic color changes. Diascopy eliminates polymorph making skin lesions easier to examine.
A nurse cares for a client who reports pain related to eczematous dermatitis. Which nonpharmacologic comfort measures should the nurse implement? (Select all that apply.)
- A. Cool, moist compresses
- B. Topical corticosteroids
- C. Heating pad
- D. Tepid bath with cornstarch
- E. Back rub with baby oil
Correct Answer: A,D
Rationale: Cool, moist compresses and tepid baths with cornstarch reduce inflammation and help debride crusts in eczematous dermatitis. Topical corticosteroids are pharmacologic, and heating pads or baby oil may increase inflammation and discomfort.
After teaching a client who has psoriasis, a nurse assesses the client's understanding. Which statement indicates the client needs further education?
- A. I'll avoid scratching the patches to prevent worsening.
- B. I'll use moisturizers to keep my skin hydrated.
- C. I'll apply sunscreen to protect my skin from UV damage.
- D. I'll take hot baths daily to soothe the lesions.
Correct Answer: D
Rationale: Hot baths can exacerbate psoriasis by drying out the skin and increasing irritation. The other statements reflect appropriate self-care measures for managing psoriasis, such as avoiding scratching, using moisturizers, and protecting skin from UV damage.
When transferring a client into a chair, a nurse notices that the pressure-relieving mattress overlay has deep imprints of the clients buttocks, heels, and scapulae. Which action should the nurse take next?
- A. Turn the mattress overlay to the opposite side.
- B. Do nothing because this is an expected occurrence.
- C. Apply a different pressure-relieving device.
- D. Reinforce the overlay with extra cushions.
Correct Answer: C
Rationale: Bottoming out, as evidenced by deep imprints in the mattress overlay, indicates that this device is not appropriate for this client, and a different device or strategy should be implemented to prevent pressure ulcer formation.
A nurse assesses an older client who is scratching and rubbing white ridges on the skin between the fingers. Which condition should the nurse suspect?
- A. Scabies
- B. Psoriasis
- C. Eczema
- D. Contact dermatitis
Correct Answer: A
Rationale: White ridges on the skin between the fingers, especially with scratching and rubbing, are characteristic of scabies, a parasitic infestation caused by mites. Psoriasis typically presents with scaly, red patches, eczema with inflamed, itchy skin, and contact dermatitis with localized redness from an allergen or irritant. Scabies is the most likely condition based on the description.