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A patient comes to the clinic complaining of a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with herpes zoster?
- A. Grouped vesicles occurring on lips and oral mucous membranes
- B. Grouped vesicles occurring on the genitalia
- C. Rough, fresh, or gray skin protrusions
- D. Grouped vesicles in linear patches along a dermatome
Correct Answer: D
Rationale: Herpes zoster presents as grouped vesicles along a dermatome due to dorsal root ganglia inflammation. Lip vesicles suggest herpes simplex type 1, genital vesicles suggest type 2, and rough protrusions indicate warts.
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A patient who has sustained third-degree facial burns and a facial fracture is undergoing reconstructive surgery and implantation of a prosthesis. The nurse has identified a nursing diagnosis of Disturbed Body Image Related to Disfigurement. What would be an appropriate nursing intervention related to this diagnosis?
- A. Referring the patient to a speech therapist
- B. Gradually adding soft foods to diet
- C. Administering analgesics as prescribed
- D. Teaching the patient how to use and care for the prosthesis
Correct Answer: D
Rationale: Teaching prosthesis care fosters independence and addresses body image concerns by empowering the patient. Speech therapy, diet changes, and analgesics do not directly address disturbed body image.
A nurse is caring for a patient whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?
- A. Teach the patient about early signs of secondary blistering diseases.
- B. Teach the patient about self-care after treatment.
- C. Assess the patients risk for recurrent malignancy.
- D. Assess the patient for adverse effects of radiotherapy.
Correct Answer: B
Rationale: The nurse's role includes teaching self-care after skin cancer excision. Assessing malignancy risk is the physician's role, blistering diseases are unrelated, and radiotherapy is not typically used.
A patient has just been told that he has malignant melanoma. The nurse caring for this patient should anticipate that the patient will undergo what treatment?
- A. Chemotherapy
- B. Immunotherapy
- C. Wide excision
- D. Radiation therapy
Correct Answer: C
Rationale: Wide excision is the primary treatment for malignant melanoma to remove the lesion and assess staging. Chemotherapy, immunotherapy, and radiation are secondary or palliative options.
A patient with a chronic diabetic wound is being discharged after receiving a skin graft to aid wound healing. What direction should the nurse include in home care instructions?
- A. Gently massage the graft site daily to promote perfusion.
- B. Protect the graft from direct sunlight and temperature extremes.
- C. Protect the graft site from any form of moisture for at least 12 weeks.
- D. Apply antibiotic ointment to the graft site and donor site daily.
Correct Answer: B
Rationale: Protecting the graft from sunlight and temperature extremes prevents thermal injury and promotes healing. Massage and antibiotics are not standard, and avoiding all moisture for 12 weeks is impractical.
A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?
- A. The childs scalp should be monitored for 48 to 72 hours before starting treatment.
- B. Nits may have to be manually removed from the childs hair shafts.
- C. The disease is self-limiting and symptoms will abate within 1 week.
- D. Efforts should be made to improve the childs level of hygiene.
Correct Answer: B
Rationale: Manual removal of nits is often necessary after medicated shampoo for pediculosis capitis. The condition is not self-limiting, requires prompt treatment, and is not caused by poor hygiene.