NCLEX Ques(Psoriasis)
Psoriasis is best described as:
A contagious bacterial skin infection - Psoriasis is not caused by bacteria, and it is not contagious.
B An autoimmune skin disorder characterized by red, scaly patches.
C. A fungal infection causing itching and rash.
D. A viral skin condition resulting in fluid-filled blisters
Answer: Psoriasis is an autoimmune skin disorder where the immune system mistakenly attacks healthy skin cells, leading to the rapid buildup of skin cells and the formation of red, scaly patches on the skin's surface.
What is the most common early sign of a pressure ulcer?
Answer: The most common early sign of a pressure ulcer is redness (erythema) on the skin that does not blanch when pressed.
Rationale: Redness that does not blanch indicates impaired blood flow and tissue ischemia, an early warning sign of pressure ulcer development.
What is one of the most basic nursing interventions to prevent pressure ulcers?
Answer: Regularly repositioning the patient every 2 hours to relieve pressure on vulnerable areas.
Rationale: Frequent repositioning reduces prolonged pressure on bony prominences, improving circulation and preventing tissue ischemia.
You're developing a plan of care for a patient who is at risk for pressure injury development. The patient is 75 years old and weighs 95 lbs. The patient is confused and has right and left leg contractures. In addition, the patient has a urinary tract infection and is incontinent of urine. The patient is on aspiration precautions and is ordered a honey thick liquid diet with pureed foods. Select all the nursing intervention you will include in the patient's plan of care to prevent a pressure injury:
A. When feeding the patient keep the head of bed elevated at 45' degree and avoid elevating the foot of the bed.
B. Apply barrier cream as needed to the skin daily.
C. Turn the patient every 4 hours.
D. Keep linens and gowns dry and wrinkle free.
E. Use a wedge pillow for the right and left legs daily.
The answers are B, D, and E. Option A is wrong because when the patient is sitting up you want to prevent them from sliding down in the bed. This can cause friction and shear, which can lead to a pressure injury. Raising the foot of the bed when the HOB is elevated will help prevent the patient from sliding down. Option C is wrong because you will need to turn the patient every 2 hours NOT every 4 hours. Option E is beneficial for the leg contractures to prevent a pressure injury to the knees and ankles
The main cause of psoriasis is:
A. Poor hygiene and lack of skin care
B Exposure to environmental toxins
C Genetic and immune system factors
D Excessive sun exposure
Answer:
Psoriasis is believed to have a genetic component, and it is considered an autoimmune disorder where the immune system mistakenly attacks healthy skin cells, leading to the characteristic skin changes.
What are the most common areas of the body affected by psoriasis?
Answer: Psoriasis most commonly affects the scalp, elbows, knees, lower back, and nails.
Rationale: These areas are prone to plaque formation due to mechanical stress and friction, which can trigger skin cell proliferation.
What is the primary goal of nursing interventions in managing psoriasis?
Answer: The primary goal is to reduce inflammation, prevent exacerbations, and manage symptoms like itching and scaling.
Rationale: Psoriasis is a chronic condition, so interventions focus on symptom management and improving the patient’s quality of life.
You're working on a medical surgical floor. You have the following patients below. Select all the patients below that are at risk for a pressure injury:
A. A 19 year old female who is a quadriplegic.
B. A 35 year old male with a BMI of 13.6 that is incontinent of stool and has a right leg splint.
C. A 55 year old female who has controlled diabetes and is ambulating three times a day.
D. A 76 year old male with an elevated ammonia level and is excessively sweaty.
E. A 45 year old with a Braden Scale score of 7.
The answer are A, B, D, and E. The only patient not at risk for a pressure injury is the patient in option B. Remember altered sensory perception, any type of moisture issue (incontinence, sweating etc.), immobility, poor nutrition, altered mental status (high ammonia level can cause confusion and drowsiness), Braden scale score less than 9 are all risk factors for a pressure injury.
How does genetic predisposition contribute to the development of psoriasis?
A Genetic factors increase skin sensitivity to environmental irritants
B Genetic factors cause an allergic reaction to certain foods
C Genetic factors lead to abnormal immune system functioning
D Genetic factors impair the skin's barrier function
Answer: Genetic predisposition in psoriasis contributes to the development of the condition by causing abnormal functioning of the immune system. Certain genes involved in the immune response are associated with psoriasis, leading to an overactive immune system that triggers inflammation and skin cell overproduction.
Which body areas are most prone to developing pressure ulcers?
Answer: The sacrum, heels, elbows, and hips are the most prone areas.
Rationale: These areas are bony prominences where prolonged pressure compresses blood vessels, leading to tissue damage.
Why is a high-protein diet recommended for patients with pressure ulcers?
Answer: A high-protein diet supports wound healing by providing essential nutrients for tissue repair.
Rationale: Protein is crucial for collagen synthesis, immune function, and cellular regeneration, which are all necessary for ulcer healing.
An 86 year old female patient is immobile and is in the right lateral recumbent position. As the nurse you know which sites below are at most risk for pressure injury in this position?*
A. Sacral
B. Patella
C. Ankle
D. Ear
E. Elbow
F. Hip
G. Heel
H. Shoulder
The answers are: B, C, D, F, and H. The right lateral recumbent position is where the patient is positioned on their right side. Therefore, the ankle, ear, hip, knee, and shoulders are sites where a pressure injury can occur.
Which of the following clinical manifestations is characteristic of psoriasis?
A Painful, deep ulcers on the skin
B Itchy, raised, red patches with silvery scales
C Small, fluid-filled blisters on the palms and soles
D Thickened, hardened skin with deep cracks
Answer: Psoriasis is characterized by the presence of itchy, raised, red patches on the skin with silvery scales. These patches are known as plaques and are a hallmark feature of psoriasis.
What are two common signs of infection in a pressure ulcer?
Answer: Two common signs are purulent discharge and increased redness and warmth around the wound.
Rationale: Infected pressure ulcers exhibit local inflammatory responses, such as drainage, erythema, warmth, and sometimes systemic signs like fever.
What is the role of topical treatments like corticosteroids in nursing care for psoriasis?
Answer: Topical corticosteroids are used to reduce inflammation and suppress overactive skin cell production.
Rationale: These medications are a first-line treatment in managing mild-to-moderate psoriasis and help alleviate symptoms such as redness and scaling.
You're educating a group of nursing students about the different stages of a pressure injury. Which statement is correct about a stage 3 pressure injury?
A. There is full loss of skin tissue that can extend to the muscle, bone, or tendon.
B. A hallmark of a stage 3 pressure injury is that the skin will be intact but it not blanch.
C. The skin will not be intact and there will be full loss of skin tissue that can extend to the subcutaneous tissue.
D. The wound edges will never roll away (epibole) as with a stage 2 pressure injury?
The answer is C. This is the only correct statement about a stage 3 pressure injury.
Which of the following diagnostic criteria is essential for confirming the diagnosis of psoriasis?
A Positive skin biopsy showing eosinophils infiltration
B Family history of autoimmune diseases
C Presence of at least 3 typical psoriasis plaques on the body
D Elevated erythrocyte sedimentation rate (ESR) on blood test.
Answer: The presence of at least 3 typical psoriasis plaques on the body is one of the essential diagnostic criteria for confirming psoriasis. These plaques are characterized by well-defined, erythematous (red), raised lesions with silvery-white scales
What is the Koebner phenomenon, and how does it relate to psoriasis?
Answer: The Koebner phenomenon is when psoriasis lesions develop at the site of skin injury or trauma.
Rationale: This response occurs due to immune activation in damaged skin, which triggers the inflammatory pathways involved in psoriasis.
Why is it important to keep the skin clean and dry in patients at risk for pressure ulcers?
Answer: Keeping the skin clean and dry prevents skin breakdown caused by moisture, such as sweat or incontinence.
Rationale: Excess moisture macerates the skin, making it more susceptible to injury and ulceration.
While performing a skin assessment on a patient who is immobile, you note a purplish black area on the patient's left heel. The skin is intact. On palpation the site feels heavy and spongy. You suspect this may be?
A. Stage 1 pressure injury
B. Deep-tissue injury
C. Stage 4 pressure injury
D. Stage 2 pressure injury
The answer is B. Deep-tissue injuries present as purplish or blackish areas over skin that is intact. The fatty tissue below is injured. Also, they may look like a black blistered area and may feel heavy or squishy.