NCLEX Integumentary Questions (1-5)

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1. A home care nurse is performing an admission assessment of a client. When performing the skin assessment, the nurse suspects the presence of herpes zoster. Which of the following assessment findings would be noted as characteristic of this disorder?

a) a generalized red body rash that causes pruritus
b) small blue-white spots with a red base noted on the extremities
c) a fiery edematous rash on the cheeks and neck
d) clustered and grouped skin vesicles

2. A client returns to the clinic for follow-up treatment after a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicates that the lesion is a squamous cell carcinoma. The nurse plans care for the client, knowing that this type of lesion:

a) never metastasizes
b) does not metastasize
c) is characterized by local invasion
d) is encapsulated

3. NCLEX Integumentary Questions about a nurse who reviews the record of a client scheduled for removal of a skin lesion. The record indicates that the lesion is a irregularly shaped pigmented papule with a blue tone. The nurse interprets that this description of the lesion is characteristic of:

a)  malignant melanoma
b) basal cell carcinoma
c) squamous cell carcinoma
d) actinic keratosis

4. The emergency service team brings a client to the emergency department. The client was found lying in an alley near a Dumpster by a policeman, who reports that the client is a homeless victim. An assessment is performed, and the client is suspected of having frostbite of the hands. Which of the following findings would the nurse note in this condition?

a) a white appearance to the skin that is insensitive to touch
b) a pink edematous hand
c) black fingertips surrounded by an erythematous rash
d) res skin with edema in the nail beds

5. An emergency department nurse prepares to treat a client who has frostbite of the toes from prolonged exposure during an ice-fishing trip. Which of the following would the nurse anticipate to be prescribed for this condition?

a) rapid rewarming of the toes in hot water
b) rapid and continuous rewarming  of the toes in a warm water bath until flushing of the skin occurs
c) rapid and continuous alternating cold and hot soaks of the toes
d) rapid rewarming of the toes by soaking in cold water for 45 minutes





NCLEX Integumentary Questions
Answers and Rationale

1) D
- The primary lesion of herpes zoster is a vesicle. The classic presentation consists of grouped vesicles on an erythematous base along a dermatome. Because they follow nerve pathways, the lesions do not cross the body's midline. Options A, B, and C are not characteristics of herpes zoster.

2) C
- Squamous cell carcinomas are malignant neoplasms of the epidermis. They are characterized by local invasion and have a potential for metastasis. Melanomas are pigmented malignant lesions originating in the melanin-producing cells of the epidermis. This type of skin cancer is highly metastatic, and a person's survival depends on early diagnosis and treatment. Basal cell carcinomas arise in the basal cell layer of the epidermis. Early malignant basal cell lesions often go unnoticed, and although metastasis is rare, underlying tissue destruction can progress to include vital structures.

3) A
- NCLEX Integumentary Questions Rationale: A melanoma is an irregularly shaped pigmented papule or plaque with a red, white, or blue tone. Basal cell carcinoma appears as a pearly papule with a central crater and rolled waxy border. Squamous cell carcinoma is a firm, nodular lesion topped with a crust or a central area of ulceration. Actinic keratosis, a premalignant lesion, appears as a small macule or papule with a dry rough adherent yellow or brown scale.

4) A
- Assessment findings in frostbite include a white or blue appearance, and the skin will be hard, cold, and insensitive to touch. As thawing occurs, the skin becomes flushed, blisters or blebs develop, or tissue edema appears. Gangrene develops in 9 to 15 days.

5) B
- Acute frostbite is ideally treated with rapid and continuous rewarming of the tissue in a water bath for 15 to 20 minutes or until flushing of the skin occurs. Slow thawing or interrupted periods of warmth are avoided because this can contribute to increased cellular damage. Thawing can cause considerable pain, and the nurse would administer analgesics as prescribed.


  
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

NCLEX Integumentary Questions (6-10)

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