Nokea
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.
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To decrease the risk for sun damage to the skin, which information should the nurse include when teaching patients?
- A. Waterproof sunscreens will provide good protection when swimming.
- B. Use a sunscreen with an SPF of at least 8-10 for adequate protection.
- C. Try to stay out of the sun between the hours of 10:00 and 16:00.
- D. Increase sun exposure by no more than 10 minutes a day to avoid skin damage.
Correct Answer: C
Rationale: The risk for skin damage from the sun is highest with exposure between 10:00 and 15:00 during regular time and 11:00-16:00 during daylight savings time. The term waterproof is misleading; no sunscreen is completely waterproof. Sunscreen with an SPF of at least 15 is recommended for people at normal risk for skin cancer. Although gradually increasing sun exposure may decrease the risk for burning, the risk for skin cancer is not decreased.
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.
A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. Which of the findings by the nurse indicates a possible adverse effect of the medication?
- A. Thinning of the affected skin
- B. Alopecia of the affected areas
- C. Reddish-brown discoloration of the skin
- D. Dryness and scaling in the areas of treatment
Correct Answer: A
Rationale: Thinning of the skin indicates that atrophy, a possible adverse effect of topical corticosteroids, is occurring. The health care provider should be notified so that the medication can be changed or tapered. Alopecia, red-brown discoloration, and dryness or scaling of the skin are not adverse effects of topical corticosteroid use.
The nurse is caring for a patient who is undergoing psoralen plus ultraviolet A light (PUVA) therapy for treatment of psoriasis. Which of the following actions would the nurse plan to implement to minimize complications from this procedure?
- A. Cleanse the skin carefully with an antiseptic soap.
- B. Shield any unaffected areas with lead-lined drapes.
- C. Have the patient use protective eyewear while receiving PUVA.
- D. Apply petroleum jelly to the areas surrounding the psoriatic lesions.
Correct Answer: C
Rationale: The eyes should be shielded from UV light (UVL) during and after PUVA therapy to prevent the development of cataracts. The patient should be taught about the effects of UVL on unaffected skin, but lead-lined drapes, use of antiseptic soap, and petroleum jelly are not used to prevent skin damage.
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.