Chapter 75 Skin Disorders

A client presents at the emergency room with a cut on his hand caused by using a serrated knife to cut a bagel. What is another term for this type of skin alteration?

A) Abrasion

B) Excoriation

C) Laceration

D) Desquamation

C

A client arrives at the healthcare facility with complaints of purplish-blue discoloration of the skin on his arm that developed after an accident. Which of the following terms should the nurse use to document the skin lesion?

A) Purpura

B) Desquamation

C) Laceration

D) Dermatitis

A

The nurse examining the skin of a client notices small fluid-filled blisters around the client's mouth and suspects they are caused by the herpesvirus. What test would be performed to confirm this suspicion?

A) Wood light examination

B) Tzanck's smear

C) Biopsy

D) Scabies scraping

B

The nurse is teaching a patient who has severe skin allergies how to treat and prevent rashes. Which of the following are recommended teaching guidelines? Select all that apply.

A) Take hot baths or showers.

B) Do not use make-up.

C) Wear clothing made of wool.

D) Rinse clothes in clear water.

E) Lightly slap the itching area.

F) Keep fingernails short.

D, E, F

A client is prescribed the antihistamine fexofenadine (Allegra) for severe seasonal allergies. Which of the following teaching points are appropriate for this client? Select all that apply.

A) Warn the client not to drive or work around machinery.

B) Urge the client to avoid using alcohol and other sedatives.

C) Encourage the client to drink only water when taking the medication.

D) Discontinue the antihistamine for 2 weeks before allergy testing.

E) Use sunscreen to avoid photosensitivity reactions.

F) Warn older adults that a larger dose may be required owing to the effects of aging.

A, B, E

The nurse is preparing a therapeutic bath for a patient recovering from third-degree burns. Which of the following is a recommended guideline for this procedure?

A) Give the bath in a standard tub, not a whirlpool tank.

B) Use water that is as hot as the client can tolerate.

C) Use medicated bath oil instead of soap.

D) Rub the client's skin dry after the therapeutic bath.

C

A client with atopic dermatitis has intense pruritus. Which of the following should the nurse explain as an intervention to prevent pruritus?

A) Do not wash new clothes before wearing them.

B) Apply lotion on dry skin.

C) Wear nylon gloves and socks at night.

D) Avoid activities that cause the body to be chilled.

B

The nurse is applying a moist dressing on the arm of a patient with acute dermatitis. Which of the following nursing interventions would be appropriate when performing this procedure?

A) Follow standard procedures.

B) Premoisten the area with alcohol.

C) Use a bed cradle when applying the dressing.

D) Medicate with analgesics following the procedure.

A

The nurse is using wet-to-moist dressing to debride a client's decubitus ulcer. Which of the following types of debridement is the nurse employing?

A) Autolysis

B) Enzymatic debridement

C) Mechanical debridement

D) Surgical debridement

C

Which of the following clients would be the most likely candidate for a pedicle graft?

A) A client with a stage II decubitus ulcer

B) A client with third-degree burns on his hand

C) A client with severe eczema

D) A client with a keloid behind the ear

B

The nurse consults a nutritionist to help plan a diet for a client who has third-degree, full-thickness burns on 30% of his body. Which of the following types of diets would the nutritionist recommend?

A) Low calorie, high carbohydrate

B) High calorie, high carbohydrate

C) Low calorie, high protein

D) High calorie, high protein

D

The nurse performing a physical examination of a client with pruritus suspects the client has urticaria. Which of the following symptoms would the nurse document in this situation?

A) Edematous, raised pink wheals that itch and burn

B) Areas of the skin that are completely lacking in pigmentation

C) Small vesicles with reddened and pruritic skin that is sometimes crusted

D) Small, scaly patches of skin

A

The nurse recognizes the signs and symptoms of angioedema when treating a client in the emergency room and documents "swelling around the eyes and dyspnea (difficulty breathing)." With what condition is angioedema associated?

A) Vitiligo

B) Warts

C) Urticaria

D) Folliculitis

C

A teenage client is diagnosed with psoriasis. Which of the following would be the highest priority observation of the nurse who is caring for this client?

A) Difficulty breathing

B) Low self-esteem

C) Pigment changes

D) Skin infections

B

A client with a skin disorder is undergoing electrodesiccation. For which of the following disorders is this a common treatment?

A) Warts

B) Impetigo

C) Carbuncle

D) Scabies

A

A client with seborrheic dermatitis complains of itching and large white scales over the eyebrows. Which of the following makes the eyebrows a common site for seborrheic dermatitis?

A) Thicker dermal tissue

B) Increased number of pigment cells

C) Large number of hair follicles

D) Large concentration of sebaceous glands

D

The nurse is assessing a client who arrives at the emergency room with burns on her hands from a malfunctioning coffee pot. The client's skin is moist and pinkish with blisters and some blanching. What degree of burns would the nurse document in this situation?

A) First degree: superficial, partial thickness

B) Second degree: superficial, partial thickness

C) Second degree: deep dermal, partial thickness

D) Third degree: full thickness

B

The nurse is providing discharge teaching for a client who suffered minor burns using a steam cleaner. Which of the following are accurate teaching points for this client?

A) Use ice to cool the area for 10 minutes or until the pain diminishes.

B) If blisters occur, puncture the blisters with a sterile needle.

C) Cover the burn loosely with sterile gauze.

D) Do not use over-the-counter NSAIDs for pain; use only prescribed drugs.

C

The school nurse is caring for a teenager who developed sunburn after being out in the sun without sunscreen at a school trip. How would the nurse classify this type of burn?

A) Thermal

B) Electrical

C) Chemical

D) Radiation

D

A client is admitted to a healthcare facility with third-degree burns. Which of the following is the extent of tissue damage seen in third-degree burns?

A) Epidermis with minimal dermis involvement

B) Entire epidermis and a portion of dermis

C) Entire epidermis, dermis, and subcutaneous fat

D) Minimal damage of the epidermis

C

A client is admitted to a healthcare facility with 30% full-thickness burns. What should be the goal when caring for the client with these burns during the resuscitative phase?

A) Achieve physiologic stability.

B) Focus on managing the burn wound.

C) Focus on physical repair of the tissue.

D) Psychological restoration of the individual.

A

A client is brought to the community health clinic after he was rescued from a burning building. The client has minor burns on 20% of his head and neck. What is the priority nursing intervention for this client?

A) Dress the burns with salve.

B) Wrap the burns with sterile bandages.

C) Monitor the client's respiratory status.

D) Insert a feeding tube before edema sets in.

C

The nurse is caring for a client who has third-degree burns on 25% of her body. Which of the following is a goal for this client when managing fluid and electrolyte balance during burn care management?

A) Urinary output of 1 to 1.5 mL/kg/hour

B) Heart rate less than 120 beats per minute

C) Systolic blood pressure greater than 150 mm Hg

D) Decreased sodium levels

B

A nurse is preparing a dressing to be applied to the first-degree burns on a client's face. Which of the following should the nurse use as a topical agent in the dressing?

A) Methotrexate

B) Bacitracin

C) Psoralen

D) Calcipotriene

B

A client with severe burns is undergoing a skin graft made from cadaver skin. What is the term for this type of graft?

A) Homograft

B) Autograft

C) Isograft

D) Xenograft

A

A nurse is caring for a client with full-thickness burns on the entire left side of the body following an accidental oil spill. Which of the following complications can occur during the recovery period from a burn injury?

A) Asthma

B) Hay fever

C) Anemia

D) Leukemia

C

A nurse is providing enteral tube feedings for a client with third-degree burns to prevent the development of Curling's ulcer. Which of the following mechanisms is involved in the development of Curling's ulcer?

A) Depletion of hydrogen ions in the gastric mucosa

B) Occurrence of ischemic changes in the gastric mucosa

C) Effect of medication such as cimetidine on gastric mucosa

D) Proliferation of gastric mucosal cells in excess

B

A client diagnosed with basal cell carcinoma arrives at the healthcare facility along with her 16-year-old daughter. The client is worried that her daughter is also susceptible. The client's daughter asks the nurse if skin cancer is preventable. Which of the following interventions should the nurse emphasize with regard to the prevention of skin cancer?

A) Avoid direct early morning sunlight exposure.

B) Use sunscreen with a sun protective factor (SPF) of 12.

C) Regularly use sunlamps and tanning beds rather than direct sunlight.

D) Consult healthcare provider if changes in moles occur.

D

A nurse is caring for a client with a filiform wart. The nurse understands that filiform warts are nonmalignant. Which of the following is another type of nonmalignant tumor of the skin of which the nurse should be aware?

A) Angioma

B) Varicose veins

C) Ganglion

D) Ecchymosis

A

The American Cancer Society has developed a helpful ABCD rule for evaluating a mole. Which of the following is one of these guidelines?

A) Asymmetry: one-half the mole matches the other half

B) Border: edges are regular and defined

C) Color: color is not uniform and has varying shades

D) Diameter: size is smaller than that of a pencil eraser

C

Displaying her hands, a patient asks, Do you think my liver is OK? Look at all these liver spots! What is the most appropriate nursing response?

a. The spots could mean something is wrong; I will make a note of it.

b. The spots are normal aging changes and have nothing to do with your liver.

c. Have you recently been exposed to hepatitis?

d. Dont worry about them. They will fade during the winter.

B

A confused patient has been restrained because of combativeness and hyperactivity. What skin assessment may occur as a result of the restraints?

a. Lentigines

b. Senile purpura

c. Senile angiomas

d. Seborrheic keratoses

B

What should a nurse ask about when taking the functional assessment of a patient with a skin disorder?

a. A sore that is slow to heal

b. Unusual hair growth

c. Previous skin disorders

d. Exposure to chemicals or irritants

D

A daughter of an older adult patient who has just returned from surgery is distressed about her fathers pale, cold hands and feet. What is the best response by the nurse after covering the patient with an extra blanket?

a. Dont be concerned. It is quite cold in the operating room. Your dad will be warm in a minute.

b. Older patients like your dad get a little shocky during surgery.

c. When patients have blood loss during surgery, superficial vessels close off temporarily, resulting in cold extremities.

d. We are watching the disturbed circulation in your dads hands and feet very carefully.

C

What information should a nurse provide to a patient with vitiligo receiving phototherapy?

a. Expose yourself to the sun for several hours before treatment to acclimate the skin surface.

b. Wear protective clothing.

c. Wear loose clothing such as sleeveless T-shirts and shorts after the treatment.

d. Leave off sunglasses after treatment so your eyes can more quickly accommodate.

B

A nurse is screening patients that the plastic surgeon is considering for phototherapy. Which patient should the nurse exclude?

a. A 34-year-old woman with lupus erythematosus

b. A 5-year-old child with pneumonia

c. A 60-year-old man with a pacemaker

d. A 23-year-old woman who is 3 months pregnant

A

A nurse is caring for a patient with pruritus. Which implementation can the nurse perform without a physicians order?

a. Apply topical corticosteroids to affected areas.

b. Administer an antihistamine.

c. Apply lubricant to unbroken skin.

d. Bathe the patient in an oatmeal bath.

C

Which action should a nurse implement to make a patient with atopic dermatitis more comfortable?

a. Instruct the patient to wear loose clothing.

b. Add alcohol to the bath water.

c. Provide a diet low in fat.

d. Increase the room temperature between 78 F and 80 F.

A

Which sign or symptom suggests that a patient with impaired skin integrity is developing a systemic infection?

a. Lesion on the patients leg that is swollen and warm to the touch

b. Temperature that has risen to 101 F

c. Blood pressure that has risen from 126/84 to 130/86 mm Hg

d. Request by the patient for medication for severe itching

B

Which is an appropriate implementation for a patient with severe psoriasis who has a nursing diagnosis of Disturbed body image, related to skin lesions?

a. Touching the patient often

b. Reassuring the patient of a quick remission

c. Reminding the patient to bathe often

d. Promptly administering medications as needed

A

A patient with severe psoriasis who is to be treated with the systemic drug methotrexate sodium anxiously asks, Is this cancer drug safe? Are there some side effects I need to know about? What is the best response by the nurse?

a. Yes, methotrexate is used to treat cancer and psoriasis, and it has no severe side effects.

b. No, it is not a cancer drug, but you should ask your physician about concerns regarding your therapy.

c. We use this drug to treat many kinds of patients, including patients with cancer. You will have periodic blood tests.

d. I dont know if it is used with patients with cancer, but the drug can be used when conditions are as severe as yours.

C

A family member of an older patient with severe dermatitis says, I was always so careful to bathe him every day. I guess I just wasnt careful enough. What is the best response by the nurse?

a. Dermatitis is not caused by poor hygiene.

b. Dont worry; we will bathe him thoroughly while he is here.

c. You will have a chance to do better when he is back at home.

d. You shouldnt feel like the skin condition is your fault.

A

A nurse is caring for an obese patient who has been bedridden for a long time and who has a nursing diagnosis of Risk for infection, related to obesity. Where is the best location for the nurse to assess for the moist red lesions of Candida albicans?

a. Scalp, behind the ears

b. Abdominal skin folds

c. Shaft of the penis

d. Sacrum and bony prominences

B

What information is most essential for a nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane) for acne?

a. Usual weight

b. Family history of breast cancer

c. Current method of birth control

d. Drugs previously used

C

An excited mother of a teenage boy with severe acne furiously reports to the nurse, Ive told him a thousand times he should bathe more often! Ive kept after him about all that junk food he eats. I jump on him when I see him squeezing his zits. I tried to get him to scrub his face three times a day! Which statement indicates the most likely cause of the boys acne?

a. Poor personal hygiene

b. Ingestion of junk food

c. Squeezing lesions

d. Need for facial scrubs

C

A patient who has undergone treatment for herpes simplex virus type 2 (HSV type 2) expresses relief that she is cured. What should the nurse include in her teaching?

a. Daily douches of Burow solution are needed.

b. HSV is permanently cured by acyclovir (Zovirax).

c. Sexual partners are now safe from infection from her.

d. HSV lies dormant and can be triggered without any sexual contact.

D

An 80-year-old patient comes to the emergency department with extreme pain and itching in the hip and leg and has herpetic vesicular lesions on the left hip. What should the nurse inquire about patient exposure to?

a. HSV, type 1

b. HSV, type 2

c. Smallpox

d. Chickenpox

D

A physician asks a nurse to take a smear from herpetic lesions in an older patients hip to diagnose the disorder. What is the most probable test that will be performed?

a. Culture and sensitivity test to a bactericide

b. Tzanck smear to test for viral culture

c. Complete blood count to assess the white blood count for response to a pathogen

d. Titration for the strength of the pathogen

B

How does cutaneous T-cell lymphoma differ from squamous cell and basal cell carcinomas?

a. Does not metastasize

b. Has a cause unrelated to sun exposure

c. Can be treated with radiation

d. Can be treated topically

B

A nurse is caring for an adult patient with extensive burns on the front of the trunk, including the genitalia, and the fronts of both legs. How should the nurse document the burn size using the rule of nines?

a. 13%

b. 17%

c. 25%

d. 37%

D

Which assessment by an emergency department nurse most indicates that a burn patient might be at risk for respiratory impairment?

a. Burns on the face and neck

b. Respiration of 18 breaths/min

c. Flaring nares

d. Sooty sputum

D

What should a nurse be sure to frequently assess when caring for a burn patient with eschar formation around an entire arm?

a. Urine output

b. Pain level

c. Capillary refill

d. Breath sounds

C

During the first 24 hours after a burn, fluid replacement is the treatment priority. Which assessment should alert the nurse that the fluid protocol is ineffective?

a. Rectal temperature of 101 F

b. Urine output of 20 mL/hr

c. Crackles in the lower left lobe

d. Significant edema in the burn area

B

Which age-related skin changes should a nurse anticipate when performing a physical assessment on an 80-year-old man? (Select all that apply.)

a. Increased nasal hair

b. Flattened nails

c. Small macular lesions at the hairline

d. Increased hair on the helix of the ear

e. Presence of seborrheic keratosis

A, B, D, E

Which conditions can be improved with negative pressure therapy? (Select all that apply.)

a. Pressure ulcers

b. Skin grafts

c. Burns

d. Dehisced surgical wounds

e. Eczema

A, B, D

A nurse is alert for the expected fluid shift in the patient who was burned 24 hours earlier. (Place the events in the appropriate sequence. Separate letters by a comma and space as follows: A, B, C, D.)

a. Fluid volume deficit occurs.

b. Blood is shunted from the kidneys to compensate for a loss of fluid volume.

c. Urine output decreases.

d. Generalized edema occurs.

e. Hypoproteinemia causes fluid to move from the bloodstream to extracellular space

E, D, A, B, C

When assessing the capillary refill, a nurse should document as normal a refill time of __________ seconds.

a. 3

b. 4

c. 5

d. 6

A

A nurse collecting tissue for a Tzanck smear should (Select the appropriate interventions and place the steps in sequence. Separate letters by a comma and space as follows: A, B, C, D. Some letter may not be used.)

A. Open the lesion with a hypodermic needle.

B. Place the specimen in a culture tube and take it to the laboratory.

C. Saturate the sterile swab with exudates.

D. Wash the lesion.

E. Place a pressure dressing on the lesion.

D, A, C, B

A licensed practical nurse (LPN) is contributing to a health history on a patient who is experiencing a skin disorder. What is the FIRST piece of information that the nurse should obtain about the patient?

a. Changes in skin color or pigmentation

b. Occupation and exposure to chemicals

c. Pruritus, skin color changes, and lesions

d. Skin diseases or problems and drug therapy

C

An LPN is caring for a patient who is scheduled to be treated with acitretin (Soriatane). What is the HIGHEST priority instruction that the LPN should give the patient?

a. Liver enzymes and triglycerides should be monitored.

b. Hair loss and skin peeling may occur during treatment.

c. Contraception should be used throughout the treatment.

d. Medication should be taken with meals for the duration of the treatment.

C

An LPN is caring for a patient who is undergoing patch testing. What should be the FIRST step in assisting the patient to undergo this test?

a. Patched areas are examined after 48, 72, and 96 hours.

b. Patched areas are examined after 1 week of being covered.

c. Areas are observed for evidence of redness, swelling, and blistering.

d. Various common irritants are applied to the skin and covered with patches.

D

A patient is scheduled to undergo a biopsy of a skin lesion. What is the HIGHEST priority preprocedural instruction that the LPN should give the patient?

a. Return on a specified date for suture removal.

b. Apply direct pressure if needed to control bleeding.

c. Specify when the expected results are to be available.

d. Avoid aspirin or other nonsteroidal anti Inflammatory drugs (NSAIDs) for 48 hours.

D

An LPN is caring for a patient who is being treated with crotamiton (Eurax). What is the HIGHEST priority instruction that the nurse should give the patient regarding the prevention of reinfection?

a. Treat the clothing and bed linens.

b. Repeat the treatment if recommended.

c. Caution the patient to avoid contact with eyes.

d. Recognize that great improvement occurs with one application.

A

The nurse is determining the presence of jaundice in a dark-skinned patient. Observation of which areas would assist in the visual evaluation?

Select all that apply.

a. Soles of feet

b. Conjunctivae

c. Palms of hands

d. Helix of the ear

e. Oral mucous membranes

f. Absence of seborrheic keratosis

A, B, C, E

An older adult patient is complaining about her wrinkled skin. How could the nurse explain this occurrence to her?

a. "You have less melanin as you age."

b. "This is caused by decreased production of vitamin D."

c. "This is caused by increased dryness of your skin as you age."

d. "This is caused by thinning of the skin and degeneration of elastin fibers."

D

A patient has sustained a burn injury to the arm and chest within the past 4 hours. Which findings would be most prevalent for this patient during the first few hours?

a. Fluid evaporation and increased blood volume

b. Shift in fluids and electrolytes resulting in localized edema and decreased cardiac output

c. Shift in fluids and electrolytes resulting in generalized edema and increased blood volume

d. Laboratory results indicating that excess potassium is escaping from the extracellular compartment.

B

The nurse is caring for a patient who sustained a burn injury 1 week ago and has been transferred to the nursing unit. The patient has a bounding pulse and hypertension. This would signify which condition?

a. Hypoxia

b. Infection

c. Hypovolemia

d. Excess fluid volume

D

A patient had a deep skin biopsy. How should the nurse respond to the patient's concern about postprocedure care?

a. "Be prepared to spend a minimum of 1 night in the hospital."

b. "An appointment will be made for you to return for suture removal."

c. "The area must be examined at intervals beginning 48 hours after the procedure."

d. "No postprocedure care is required, and the results will be available immediately."

B

Patients who are pregnant, malnourished, immunosuppressed, or taking antibiotics are among those who are at risk for which condition?

a. Acne

b. Fissures

c. Psoriasis

d. Candidiasis

D

A patient reveals the use of angelica as an alternative therapy. Which instruction should the nurse provide for this patient?

a. The agent causes skin atrophy.

b. No known side effects have been noted.

c. The agent requires the use of an occlusive dressing.

d. The agent can cause a skin rash if a patient is exposed to sunlight.

D

A patient has received an order for Nizoral. The nurse knows that this medication is used for which purpose?

a. To treat a viral infection

b. To treat a fungal infection

c. To treat a bacterial infection

d. To treat an overgrowth of keratin

B

A woman of childbearing age is to begin taking Soriatane. Which instructions should the patient receive concerning this medication?

a. The medication may increase the risk for lymphomas.

b. Avoid extreme temperatures while taking this medication.

c. Use reliable contraception during therapy and for 3 years after therapy with Soriatane.

d. No reliable drug studies have been completed concerning the use of this medication during pregnancy.

C

Which integumentary assessment data from an older patient admitted with bacterial pneumonia is of most concern for the nurse?

a. Reports a history of allergic rashes

b. Scattered macular brown areas on extremities

c. Skin brown and wrinkled, skin tenting on forearm

d. Longitudinal nail bed ridges noted; sparse scalp hair

A

The nurse assesses a circular, flat, reddened lesion about 5 cm in diameter on a middle-aged patient's ankle. How should the nurse determine if the lesion is related to intradermal bleeding?

a. Elevate the patient's leg.

b. Press firmly on the lesion.

c. Check the temperature of the skin around the lesion.

d. Palpate the dorsalis pedis and posterior tibial pulses.

B

When examining an older patient in the home, the home health nurse notices irregular patterns of bruising at different stages of healing on the patient's body. Which action should the nurse take first?

a. Discourage the use of throw rugs throughout the house.

b. Ensure the patient has a pair of shoes with non-slip soles.

c. Talk with the patient alone and ask about what caused the bruising.

d. Notify the health care provider so that x-rays can be ordered as soon as possible.

C

A dark-skinned patient has been admitted to the hospital with chronic heart failure. How would the nurse best assess this patient for cyanosis?

a. Assess the skin color of the earlobes.

b. Apply pressure to the palms of the hands.

c. Check the lips and oral mucous membranes.

d. Examine capillary refill time of the nail beds.

C

The nurse prepares to obtain a culture from a patient who has a possible fungal infection on the foot. Which items should the nurse gather for this procedure?

a. Sterile gloves

b. Patch test instruments

c. Cotton-tipped applicators

d. Local anesthetic, syringe, and intradermal needle

C

When performing a skin assessment, the nurse notes several angiomas on the chest of an older patient. Which action should the nurse take next?

a. Assess the patient for evidence of liver disease.

b. Discuss the adverse effects of sun exposure on the skin.

c. Teach the patient about possible skin changes with aging.

d. Suggest that the patient make an appointment with a dermatologist.

A

A patient in the dermatology clinic is scheduled for removal of a 15-mm multicolored and irregular mole from the upper back. The nurse should prepare the patient for which type of biopsy?

a. Shave biopsy

b. Punch biopsy

c. Incisional biopsy

d. Excisional biopsy

C

During assessment of the patient's skin, the nurse observes a similar pattern of small, raised lesions on the left and right upper back areas. Which term should the nurse use to document these lesions?

a. Confluent

b. Zosteriform

c. Generalized

d. Symmetric

D

A patient reports chronic itching of the ankles and continuously scratches the area. Which assessment finding will the nurse expect?

a. Hypertrophied scars on both ankles

b. Thickening of the skin around the ankles

c. Yellowish-brown skin around both ankles

d. Complete absence of melanin in both ankles

B

Which abnormality on the skin of an older patient is the priority to discuss immediately with the health care provider?

a. Several dry, scaly patches on the face

b. Numerous varicosities noted on both legs

c. Dilation of small blood vessels on the face

d. Petechiae present on the chest and abdomen

D

Which of the following areas lacks blood vessels and nerves?

a. Epidermis

b. Dermis

c. Subcutaneous tissue

d. Fatty tissue

A

Which of the following is a common effect of a type I hypersensitivity response to an ingested substance?

a. Contact dermatitis

b. Urticaria

c. Discoid lupus erythematosus

d. Psoriasis

B

What change occurs in the skin with psoriasis?

a. Recurrent hypersensitivity reactions

b. Autoimmune response

c. Increased mitosis and shedding of epithelium

d. Basal cell degeneration

C

Which of the following best describes the typical lesion of psoriasis?

a. Purplish papules that can erode and become open ulcers

b. Firm, raised pruritic nodules that can become cancerous

c. Moist red vesicles, which develop into bleeding ulcers

d. Begins as a red papule and develops into silvery plaques

D

Why do secondary infections frequently develop in pruritic lesions?

a. Loss of protective sebum

b. Entry of resident flora while scratching the lesion

c. Blockage of sebaceous glands

d. Increased sweat production

B

Which of the following skin lesions are usually caused by Staphylococcus aureus?

a. Furuncles

b. Verrucae

c. Scabies

d. Tinea

A

Which of the following statements applies to impetigo?

a. Lesions usually appear on the hands and arms

b. The cause is usually a virus

c. The infection is highly contagious

d. Scar tissue is common following infection

C

Plantar warts are caused by:

a. The fungus aspergillus.

b. A parasitic arthropod.

c. Human papillomavirus

d. The bacterium Streptococcus pyogenes.

C

What causes the pruritus associated with scabies?

a. An allergic reaction to the causative microbe due to endotoxins

b. Mites burrowing into the epidermis and reaction to their feces

c. Bleeding and injected toxin from bites of the larvae

d. Neurotoxins secreted by mites on the skin surface

B

How can pediculosis be diagnosed?

a. Pruritus in hairy areas of the body

b. Loss of blood due to lice bites

c. Finding lice in clothing

d. The presence of nits at the base of hair shafts

D

What is the major predisposing factor to squamous cell carcinoma?

a. Viral infection

b. Presence of nevi (moles) on the skin

c. Exposure to ultraviolet light

d. Frequent hypersensitivity reaction

C

All of the following statements apply to malignant melanoma EXCEPT:

a. The malignant cell is a melanocyte.

b. They present as non-pruritic purplish macules.

c. The neoplasm grows rapidly and metastasizes early.

d. The lesion is usually dark or multicolored with an irregular border.

B

Which primary lesion that is Flat, discolored spot on the skin, such as a freckle?

a. Macule

b. Papule

c. Vesicle

d. Pustule

A

Which primary lesions that is solid elevations without fluid with sharp borders, such as mole?

a. Macule

b. Papule

c. Vesicle

d. Pustule

B

Which primary lesion that is small distinct elevation with fluid, such as blister caused by herpes simplex?

a. Macule

b. Papule

c. Vesicle

d. Pustule

C

Which primary lesion that is vesicle or bulla filled with purulent fluid such as acne, carbuncles?

a. Macule

b. Papule

c. Vesicle

d. Pustule

D