Nokea
The nurse is assessing a patient's scalp and suspects the presence of pediculosis when which of the following assessment findings are observed?
- A. Ringlike rashes with red, scaly borders over the entire scalp
- B. Papular, wheal-like lesions with white deposits on the hair shaft
- C. Patchy areas of alopecia with small vesicles and excorated areas
- D. Red, hive-like papules and plaques with sharply circumscribed borders
Correct Answer: B
Rationale: Pediculosis is characterized by wheal-like lesions with parasites that attach eggs to the base of the hair shaft. The other descriptions are more characteristic of other types of skin disorders.
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Which of the following actions would the nurse take when applying a wet dressing to an inflamed and pruritic area of skin on a patient's ankle?
- A. Use a cool solution to wet the dressing.
- B. Change the dressing using sterile gloves.
- C. Soak the dressing in sterile normal saline.
- D. Apply the dressing from the knee to the foot.
Correct Answer: A
Rationale: Cool solutions are used when wet dressings are applied to inflamed areas. Wet dressings do not require sterile technique; tap water is the most common solution used. To avoid maceration of healthy skin, wet dressings should only be applied over the affected area.
The nurse is teaching a patient about the use of a wet dressing to reduce pruritus. Which of the following time frames would the nurse instruct the patient to leave the dressing on for?
- A. 5-15 minutes
- B. 10-30 minutes
- C. 30-45 minutes
- D. 45-60 minutes
Correct Answer: B
Rationale: Wet dressings can be used effectively to relieve pruritus. Thin cotton sheets or thermal underwear is placed in warm water, wrung out, and placed over the pruritic area. After 10-30 minutes, the dressing is removed and the skin is patted dry (not rubbed) and a lubricant or medication applied. This can be done two to four times per day.
The nurse is teaching the patient how to use wet compresses at home for treatment of poison ivy. Which of the following instructions would the nurse include in the teaching plan?
- A. Use only sterile water as the solution for the dressing.
- B. The material for the compress is to be 4-8 layers thick.
- C. The compress should meet the edge of the area that is to be treated.
- D. Use abdominal pads (gauze sponges) when covering odd-shaped body parts.
Correct Answer: B
Rationale: The material for wet compresses should be 4-8 layers thick and slightly larger than the area that is being treated. Abdominal pads are to be avoided as they hold too much fluid as well as fibres may be left in the wound if the skin is not intact. It is not necessary to use sterile water; tap water at room temperature is acceptable.
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.
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.