Nokea
After the nurse has finished teaching a patient about application of corticosteroid cream to an area of contact dermatitis on the right leg, which of the following patient actions indicates that more teaching is needed?
- A. The patient spreads the cream using a downward motion.
- B. The patient takes a tepid bath before applying the cream.
- C. The patient applies a thick layer of the cream to the affected skin.
- D. The patient covers the area with a dressing after applying the cream.
Correct Answer: C
Rationale: Creams and ointments should be applied in a thin layer to avoid wasting the medication. The other actions by the patient indicate that the teaching has been successful.
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The nurse notes darker skin pigmentation in the skin folds of a patient who has a body mass index of $40 \mathrm{kg} / \mathrm{m}^2$. Which of the following topics would the nurse include in patient teaching?
- A. Teach the patient about the risk for type 2 diabetes.
- B. Educate the patient about treatment of fungal infection.
- C. Discuss the use of drying agents to minimize infection risk.
- D. Instruct the patient about use of mild soap to clean skin folds.
Correct Answer: A
Rationale: Obesity and the presence of acanthosis nigricans in skin folds suggest an increased risk for type 2 diabetes. The description of the patient's skin does not indicate problems with fungal infection, poor hygiene, or the need to dry the skin folds better.
The health care provider diagnoses impetigo for a patient who has crusty vesicopustular lesions on the lower face. Which of the following topics would the nurse include in the teaching plan for this patient?
- A. Avoidance of antibiotic ointments on the lesions
- B. How to clean the infected areas with soap and water
- C. Use of petroleum jelly (Vaseline) to soften crusty areas
- D. Appropriate use of alcohol-based cleansers on the lesions
Correct Answer: B
Rationale: The treatment for impetigo includes softening of the crusts with warm saline soaks and then soap-and-water removal. Alcohol-based cleansers and use of petroleum jelly are not recommended for impetigo. Antibiotic ointments may be applied to the lesions.
The nurse is caring for a patient who has just received a diagnosis of a fungal infection and the patient asks the nurse how this will be treated. The nurses' response is based upon knowledge that which of the following bases is the most common for antifungal treatment?
- A. Gel
- B. Paste
- C. Lotion
- D. Powder
Correct Answer: D
Rationale: Powder is the most common base for antifungal preparations. Gels are used for acute exudative inflammation. The paste is used when a drying effect is necessary because moisture is absorbed. A lotion is useful in treating subacute pruritic eruptions.
The nurse is providing care to a patient with a squamous cell carcinoma (SCC) that had a Mohs procedure in the dermatology clinic. Which of the following nursing actions would be included in the postoperative plan of care?
- A. Describe the use of topical fluorouracil on the incision.
- B. Teach how to use sterile technique to clean the suture line.
- C. Schedule daily appointments for wet-to-dry dressing changes.
- D. Educate about use of cold packs to reduce bruising and swelling.
Correct Answer: D
Rationale: Application of cold packs to the incision after the surgery will help decrease bruising and swelling at the site. Since the Mohs procedure results in complete excision of the lesion, topical fluorouracil is not needed after surgery. The suture line is cleaned with tap water. No debridement with wet-to-dry dressings is indicated.
A patient with atopic dermatitis has a new prescription for tacrolimus. After teaching the patient about the medication, which statement by the patient indicates that further teaching is needed?
- A. After I apply the medication, I can go ahead and get dressed as usual.
- B. I will rub the medication gently onto the skin every morning and night.
- C. I will need to minimize my time in the sun while I am using the tacrolimus.
- D. If the medication burns when I apply it, I will wipe it off and call the doctor.
Correct Answer: D
Rationale: The patient should be taught that transient burning at the application site is an expected effect of tacrolimus and that the medication should be left in place. The other statements by the patient are accurate and indicate that patient teaching has been effective.