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A resident of an assisted living center reports having sharp pain on one side of the body, with patches of 'blisters'. The nurse notices vesicles on one side of the thorax, which follow a peripheral nerve pathway. Suspecting herpes zoster, the nurse immediately contacts the health care provider. Which is the reason for the prompt notification?
- A. Early recognition is essential to treat the disorder.
- B. Prompt notification prevents sexual transmission.
- C. Oral ulcers could prevent intake of adequate fluids.
- D. Early administration of the varicella vaccine is needed.
Correct Answer: A
Rationale: Early recognition of herpes zoster (shingles) will allow administration of antiviral agents, prevention of secondary infections and pain relief. Acyclovir, when given within 72 hours of the onset of symptoms, reduces pain and the duration of the outbreak. Herpes zoster is not transmitted sexually. Oral lesions are associated with Herpes simplex 1. Varicella vaccine will not be effective against this current outbreak.
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A patient developed a severe contact dermatitis of the hands, arms, and lower legs after spending an afternoon picking strawberries. The patient states that the itching is severe and cannot keep from scratching. Which instruction will be helpful in managing the pruritus?
- A. Use cool, wet dressings and baths to promote vasoconstriction.
- B. Trim the fingernails short to prevent skin damage from scratching.
- C. Expose the areas to the sun to promote drying and healing of the lesions.
- D. Wear cotton gloves and cover all other affected areas with clothing to prevent environmental irritation.
Correct Answer: A
Rationale: Wet dressings and using Burow's solution help promote the healing process. Cold compresses may be applied to decrease circulation to the area (vasoconstriction). Short nails prevent skin damage, but not pruritus. Exposing the areas to the sun will not manage pruritus. Wearing cotton gloves may prevent environmental irritation, but will not help the existing pruritis.
Which is a major function of the skin?
- A. Excretion of wastes
- B. Protection
- C. Vitamin C synthesis
- D. Temperature regulation
- E. Prevention of dehydration
Correct Answer: A,B,D,E
Rationale: Functions of the skin include protection from the environment (pathogenic organisms, foreign substances, natural barrier against infection), temperature regulation, prevention of dehydration, excretion of waste products, and vitamin D synthesis.
A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower lip and chin. The nurse believes these lesions most likely are caused by which condition?
- A. chickenpox.
- B. impetigo.
- C. shingles.
- D. herpes simplex type I.
Correct Answer: B
Rationale: Impetigo is seen at all ages but is particularly common in children. The crust is honey-colored and easily removed and is associated with pruritus. The disease is highly contagious and spreads by contact. Chickenpox and shingles are characterized by vesicles and are not honey-colored. Herpes simplex type I is also known as 'cold sores' or 'fever blisters'. Lesions are generally located around and in the mouth.
A patient who has sustained a burn injury will undergo wound debridement. The nurse includes which explanation when explaining the purpose of burn wound debridement?
- A. To increase the effectiveness of the skin graft.
- B. Prevention of infection and promote healing.
- C. Promoting suppuration of the wound.
- D. Promoting movement in the affected area.
Correct Answer: B
Rationale: Débridement is the removal of damaged tissue and cellular debris from a wound or burn to prevent infection and to promote healing. Debridement does not increase the effectiveness of the skin graft, promote wound suppuration or movement.
Which patient instruction will the nurse reinforce relative to the management of systemic lupus erythematosus (SLE)?
- A. Maintain a balance between rest and activity.
- B. Increase activity to promote mobility.
- C. Increase exposure to the sun to increase vitamin D absorption.
- D. Increase sodium consumption.
Correct Answer: A
Rationale: Balanced rest, activity, and diet will support medication management. It is not necessary to increase activity to promote mobility. Limited sunlight exposure is recommended to prevent photosensitivity. SLE often has kidney involvement, which would require reduction of sodium.