Nokea
The nurse is caring for a patient in the dermatology clinic who has a small, slow-growing papule with ulceration and a depression in the centre of the lesion on the right cheek. Which of the following nursing interventions will the nurse anticipate performing for this patient?
- A. Prepare the patient for a biopsy.
- B. Teach about the use of corticosteroid creams.
- C. Educate the patient about use of tretinion (Retin-A).
- D. Discuss the need for topical application of antibiotics.
Correct Answer: A
Rationale: Because the appearance of the lesion is consistent with a possible basal cell carcinoma (BCC), the appropriate treatment would be excision and biopsy. Over-the-counter (OTC) corticosteroids, topical antibiotics, and Retin-A would not be used for this lesion unless the biopsy indicated that the lesion was nonmalignant.
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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.
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.
A patient with an enlarging, irregular mole that is $6 \mathrm{mm}$ in diameter is scheduled for outpatient treatment. Which of the following procedures would the nurse include in the teaching plan for this patient?
- A. Curettage
- B. Cryosurgery
- C. Punch biopsy
- D. Surgical excision
Correct Answer: D
Rationale: The description of the mole is consistent with malignancy, so excision and biopsy are indicated. Curettage and cryosurgery are not used if malignancy is suspected. A punch biopsy would not be done for a lesion greater than $5 \mathrm{mm}$ in diameter.