0 [{"id":125117,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"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?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Fungal cultures are obtained by swabbing the affected area of the skin with cotton-tipped applicators. Sterile gloves are not needed because it is not a sterile procedure. Local injection is not needed because the swabbing is not usually painful. The patc","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125124,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"Which activities can the nurse working in the outpatient clinic delegate to a licensed practical\/vocational nurse (LPN\/LVN) (select all that apply)?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Skills such as administration of patch testing and sterile dressing technique are included in LPN\/LVN education and scope of practice. Obtaining a health history and patient education require more critical thinking and registered nurse (RN) level educatio","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125114,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"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?","questionTimeSeconds":"0","questionTimeMinutes":"5","questionImagePath":null,"position":null,"explanation":"If the lesion is caused by intradermal or subcutaneous bleeding or a nonvascular cause, the discoloration will remain when direct pressure is applied to the lesion. If the lesion is caused by blood vessel dilation, blanching will occur with direct pressur","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125119,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"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?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"An incisional biopsy would remove the entire mole and the tissue borders. The appearance of the mole indicates that it may be malignant. A shave biopsy would not remove the entire mole. The mole is too large to be removed with punch biopsy. Excisional bio","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125115,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"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?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"The nurse should note irregular patterns of bruising, especially in the shapes of hands or fingers, in different stages of resolution. These may be indications of other health problems or abuse, and should be further investigated. It is important that the","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125120,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"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?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"The description of the lesions indicates that they are grouped. The other terms are inconsistent with the description of the lesions.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125116,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"A dark-skinned patient has been admitted to the hospital with chronic heart failure. How would the nurse best assess this patient for cyanosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Cyanosis in dark-skinned individuals is more easily seen in the mucous membranes. Earlobe color may change in light-skinned individuals, but this change in skin color is difficult to detect on darker skin. Application of pressure to the palms of the hands","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125121,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"A patient reports chronic itching of the ankles and continuously scratches the area. Which assessment finding will the nurse expect?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Lichenification is likely to occur in areas where the patient scratches the skin frequently. Lichenification results in thickening of the skin with accentuated normal skin markings. Vitiligo is the complete absence of melanin in the skin. Keloids are hype","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125122,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"Which abnormality on the skin of an older patient is the priority to discuss immediately with the health care provider?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Petechiae are caused by pinpoint hemorrhages and are associated with a variety of serious disorders such as meningitis and coagulopathies. The nurse should contact the patient?s health care provider about this finding for further diagnostic follow-up. The","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125123,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"When taking the health history of an older adult, the nurse discovers that the patient has worked in the landscaping business for 40 years. The nurse will plan to teach the patient about how to self-assess for which clinical manifestations (select all that apply)?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"A patient who has worked as a landscaper is at risk for skin lesions caused by sun exposure such as erythema and actinic keratosis. Vitiligo, alopecia, and intertrigo are not associated with excessive sun exposure.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125113,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"Which integumentary assessment data from an older patient admitted with bacterial pneumonia is of most concern for the nurse?","questionTimeSeconds":"0","questionTimeMinutes":"4","questionImagePath":null,"position":null,"explanation":"Because the patient will be receiving antibiotics to treat the pneumonia, the nurse should be most concerned about her history of allergic rashes. The nurse needs to do further assessment of possible causes of the allergic rashes and whether she has ever ","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125112,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"A 38-year-old female patient states that she is using topical fluorouracil to treat actinic keratoses on her face. Which additional assessment information will be most important for the nurse to obtain?","questionTimeSeconds":"0","questionTimeMinutes":"5","questionImagePath":null,"position":null,"explanation":"Because fluorouracil is teratogenic, it is essential that the patient use a reliable method of birth control. The other information is also important for the nurse to obtain, but lack of reliable birth control has the most potential for serious adverse me","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":125118,"quiz_id":"8435","answer_id":null,"answerType_id":"0","created_at":"2016-11-13 17:23:43","updated_at":"2016-11-13 17:23:43","questionName":"When performing a skin assessment, the nurse notes several angiomas on the chest of an older patient. Which action should the nurse take next?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":null,"explanation":"Angiomas are a common occurrence as patients get older, but they may occur with systemic problems such as liver disease. The patient may want to see a dermatologist to have the angiomas removed, but this is not the initial action by the nurse. The nurse m","question_score_id":null,"lang":null,"questionAudioPath":null}]

block

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?

Select the correct answer(s).  

(0/0)

Explanation

Fungal cultures are obtained by swabbing the affected area of the skin with cotton-tipped applicators. Sterile gloves are not needed because it is not a sterile procedure. Local injection is not needed because the swabbing is not usually painful. The patc

---

Local anesthetic, syringe, and intradermal needle

Sterile gloves

Cotton-tipped applicators

Patch test instruments

none

Which activities can the nurse working in the outpatient clinic delegate to a licensed practical/vocational nurse (LPN/LVN) (select all that apply)?

Select the correct answer(s).  

(0/0)

Explanation

Skills such as administration of patch testing and sterile dressing technique are included in LPN/LVN education and scope of practice. Obtaining a health history and patient education require more critical thinking and registered nurse (RN) level educatio

---

Explain potassium hydroxide testing to a patient with a superficial skin infection.

Administer patch testing to a patient with allergic dermatitis.

Interview a new patient about chronic health problems and allergies.

Apply a sterile dressing after the health care provider excises a mole.

Teach a patient about site care after a punch biopsy of an upper arm lesion.

none

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?

Select the correct answer(s).  

(0/0)

Explanation

If the lesion is caused by intradermal or subcutaneous bleeding or a nonvascular cause, the discoloration will remain when direct pressure is applied to the lesion. If the lesion is caused by blood vessel dilation, blanching will occur with direct pressur

---

Press firmly on the lesion.

Elevate the patient?s leg.

Palpate the dorsalis pedis and posterior tibial pulses.

Check the temperature of the skin around the lesion.

none

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?

Select the correct answer(s).  

(0/0)

Explanation

An incisional biopsy would remove the entire mole and the tissue borders. The appearance of the mole indicates that it may be malignant. A shave biopsy would not remove the entire mole. The mole is too large to be removed with punch biopsy. Excisional bio

---

Incisional biopsy

Excisional biopsy

Shave biopsy

Punch biopsy

none

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?

Select the correct answer(s).  

(0/0)

Explanation

The nurse should note irregular patterns of bruising, especially in the shapes of hands or fingers, in different stages of resolution. These may be indications of other health problems or abuse, and should be further investigated. It is important that the

---

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

Discourage the use of throw rugs throughout the house.

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

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

none

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?

Select the correct answer(s).  

(0/0)

Explanation

The description of the lesions indicates that they are grouped. The other terms are inconsistent with the description of the lesions.

---

Zosteriform

Confluent

Generalized

Symmetric

none

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

Select the correct answer(s).  

(0/0)

Explanation

Cyanosis in dark-skinned individuals is more easily seen in the mucous membranes. Earlobe color may change in light-skinned individuals, but this change in skin color is difficult to detect on darker skin. Application of pressure to the palms of the hands

---

Apply pressure to the palms of the hands.

Check the lips and oral mucous membranes.

Examine capillary refill time of the nail beds.

Assess the skin color of the earlobes.

none

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

Select the correct answer(s).  

(0/0)

Explanation

Lichenification is likely to occur in areas where the patient scratches the skin frequently. Lichenification results in thickening of the skin with accentuated normal skin markings. Vitiligo is the complete absence of melanin in the skin. Keloids are hype

---

Hypertrophied scars on both ankles

Yellowish-brown skin around both ankles

Thickening of the skin around the ankles

Complete absence of melanin in both ankles

none

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

Select the correct answer(s).  

(0/0)

Explanation

Petechiae are caused by pinpoint hemorrhages and are associated with a variety of serious disorders such as meningitis and coagulopathies. The nurse should contact the patient?s health care provider about this finding for further diagnostic follow-up. The

---

Petechiae present on the chest and abdomen

Numerous varicosities noted on both legs

Dilation of small blood vessels on the face

Several dry, scaly patches on the face

none

When taking the health history of an older adult, the nurse discovers that the patient has worked in the landscaping business for 40 years. The nurse will plan to teach the patient about how to self-assess for which clinical manifestations (select all that apply)?

Select the correct answer(s).  

(0/0)

Explanation

A patient who has worked as a landscaper is at risk for skin lesions caused by sun exposure such as erythema and actinic keratosis. Vitiligo, alopecia, and intertrigo are not associated with excessive sun exposure.

---

Erythema

Intertrigo

Alopecia

Vitiligo

Actinic keratosis

none

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

Select the correct answer(s).  

(0/0)

Explanation

Because the patient will be receiving antibiotics to treat the pneumonia, the nurse should be most concerned about her history of allergic rashes. The nurse needs to do further assessment of possible causes of the allergic rashes and whether she has ever

---

Scattered macular brown areas on extremities

Skin brown and wrinkled, skin tenting on forearm

Longitudinal nail bed ridges noted; sparse scalp hair

Reports a history of allergic rashes

none

A 38-year-old female patient states that she is using topical fluorouracil to treat actinic keratoses on her face. Which additional assessment information will be most important for the nurse to obtain?

Select the correct answer(s).  

(0/0)

Explanation

Because fluorouracil is teratogenic, it is essential that the patient use a reliable method of birth control. The other information is also important for the nurse to obtain, but lack of reliable birth control has the most potential for serious adverse me

---

History of sun exposure by the patient

Appearance of the treated areas on the patient?s face

Length of time the patient has used fluorouracil

Method of birth control used by the patient

none

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

Select the correct answer(s).  

(0/0)

Explanation

Angiomas are a common occurrence as patients get older, but they may occur with systemic problems such as liver disease. The patient may want to see a dermatologist to have the angiomas removed, but this is not the initial action by the nurse. The nurse m

---

Teach the patient about possible skin changes with aging.

Suggest that the patient make an appointment with a dermatologist.

Assess the patient for evidence of liver disease.

Discuss the adverse effects of sun exposure on the skin.