Nokea
The nurse is caring for a client experiencing rosacea. Which is the earliest symptom of the disease process?
- A. Flushed facial appearance
- B. Blush pallor of the skin.
- C. Large facial pores.
- D. Orange peel skin texture
Correct Answer: A
Rationale: The nurse is correct to identify the earliest symptom of rosacea as being a flushed appearance across the nose, forehead, cheeks, and chin. Other symptoms include a sunburn appearance to the skin, solid papules or pustules, large facial pores, and an orange peel texture to the skin. Large facial pores and orange peel skin texture are found in the later stages as the disease progresses.
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The nurse is caring for a client with a new tattoo. Which nursing diagnosis is of highest priority?
- A. Altered Skin Integrity
- B. Infection Risk
- C. Acute Pain
- D. Altered Tissue Perfusion
Correct Answer: B
Rationale: The trauma created by a tattoo is similar to a minor burn, thus, skin integrity, pain, and tissue perfusion are not the highest priority. Infection risk is the highest priority due to the injection of ink in the dermis. The priority of care is preventing infection.
The nurse has assessed a client's superficial fungal infection that began in the skin between the toes and has spread to the soles of the feet. How would the nurse document this finding?
- A. Tinea corporis
- B. Tinea capitis
- C. Tinea pedis
- D. Tinea cruris
Correct Answer: C
Rationale: Tinea pedis is an infection that begins in the skin between the toes and spreads to the soles of the feet. Tinea corporis is a skin infection of the body. Tinea capitis invades the hair shaft below the scalp. Tinea cruris is a skin infection of the groin.
The nurse is preparing to care for a client's new tattoo. Which action would the nurse take first?
- A. Cover the new tattoo with antibiotic ointment.
- B. Wash hands prior to gloving.
- C. Place a sterile gauze dressing over the tattoo.
- D. Teach the client to use a sunscreen (SPF 30) while in the sun.
Correct Answer: B
Rationale: As with any wound care, the nurse performs hand hygiene prior to donning gloves. The nurse is then ready to care for the newly tattooed skin. Antibiotic ointment is applied each day for 5 days. A sterile dressing is used to cover the tattoo for the first 12 hours. Sunscreen is good protection for the tattoo but not as part of a new tattoo treatment regimen.
The pediatric nurse is instructing a young athlete and parent regarding tinea pedis. Which nursing advice best decreases frequent attacks?
- A. Provide meticulous nail care.
- B. Avoid being barefoot outside.
- C. Avoid white cotton socks.
- D. Rotate shoe use.
Correct Answer: D
Rationale: The nurse is correct to instruct the client to rotate the use of different shoes allowing the shoes time to evaporate shoe moisture from use. The fungus particularly grows in dark, warm, moist areas. Eliminating the factors decreases the risk of further outbreaks. The other options are not necessary.
The nurse is assessing four clients in the skin clinic for skin cancer. Which client is of highest risk for skin cancer?
- A. The client who tans easily
- B. The client with dark-colored skin
- C. The client with psoriasis
- D. The client with scar tissue
Correct Answer: D
Rationale: The nurse is correct to identify that clients with scar tissue are prone to malignant changes of the skin. Fair-skinned clients or those with decreased melanin are at a higher risk for skin cancer. A client with psoriasis is not at an increased risk for skin cancer.