A patient has a rash on her left elbow and a small amount on both knees.

The rash is patchy, red, and has thick, silvery scales.

What type of rash is this most likely

Eczema.

Psoriasis.

Scabies.

Seborrheic dermatitis.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Eczema, or atopic dermatitis, is a chronic inflammatory skin condition characterized by itchy, red, and swollen skin. While it can be patchy, it typically presents with weeping, crusting, and scaling, but not the thick, silvery scales characteristic of the described rash. Eczema often occurs in skin folds and flexural surfaces, distinguishing it from the patient's presentation.

Choice B rationale

Psoriasis is a chronic autoimmune condition causing an accelerated turnover of skin cells. This rapid proliferation leads to the formation of thick, red patches covered with characteristic silvery scales. The typical locations are the elbows, knees, and scalp, which perfectly matches the patient's presentation, making this the most likely diagnosis.

Choice C rationale

Scabies is a contagious infestation of the skin by the human itch mite. It presents as an intensely itchy rash, often with small, raised red bumps and burrows, typically found in skin folds, between fingers, and on the wrists. It does not produce the thick, silvery scales seen in the patient's rash, making this choice incorrect.

Choice D rationale

Seborrheic dermatitis is a common skin condition that mainly affects the scalp, causing flaky scales and red skin, and is commonly known as dandruff. While it can occur in other oily areas of the body, it does not typically present with the thick, silvery scales on the elbows and knees that are highly indicative of psoriasis. *.

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Correct Answer is C

Explanation

Choice A rationale

A patient with diarrhea may have a communicable disease, such as C. difficile or Norovirus. The patient with Stevens-Johnson syndrome has compromised skin integrity, making them highly susceptible to opportunistic infections. Placing them with a patient who has a potential infection poses a significant risk of cross-contamination and sepsis, which is a life-threatening complication for this vulnerable patient.

Choice B rationale

A patient with methicillin-resistant Staphylococcus aureus (MRSA) has a colonization or infection with a resistant bacteria. Stevens-Johnson syndrome involves extensive epidermal detachment, creating large areas of open, denuded skin, similar to a burn injury. This makes the patient extremely vulnerable to infection from resistant organisms like MRSA, which could lead to severe systemic infection and sepsis.

Choice C rationale

A patient with atrial fibrillation is not contagious and does not pose an infectious risk. Atrial fibrillation is a cardiac arrhythmia caused by an electrical conduction abnormality in the heart, with no risk of transmission. This roommate choice is the safest because it minimizes the risk of infection for the patient with Stevens-Johnson syndrome, whose compromised skin barrier makes them highly susceptible.

Choice D rationale

A fever of unknown origin (FUO) suggests an underlying infectious process that has not yet been identified. This poses a high risk of cross-contamination to the patient with Stevens-Johnson syndrome. The patient with compromised skin integrity is at an extreme risk of contracting a new infection from an undiagnosed and potentially contagious pathogen, which could lead to a severe and rapid decline in their condition.

A. Hypotension. B. Cyanosis. C. Hypoxia. D. Bradycardia. E. Moist mucous membranes.

Correct Answer is ["B","C"]

Explanation

Choice A rationale

Hypotension, while a possible consequence of severe oxygenation alterations, is not a primary or direct clinical manifestation. It often results from the systemic effects of prolonged hypoxemia, such as myocardial depression or severe acidosis leading to vasodilation. The initial physiological response to hypoxemia is typically tachycardia and hypertension as a compensatory mechanism to increase oxygen delivery, with hypotension occurring later as a sign of decompensation.

Choice B rationale

Cyanosis is a direct clinical manifestation resulting from a high concentration of deoxygenated hemoglobin in the blood. It becomes visible when the deoxygenated hemoglobin level exceeds 5 g/dL. Central cyanosis, seen in the lips and mucous membranes, indicates systemic hypoxemia, while peripheral cyanosis, in the extremities, suggests local impaired circulation or vasoconstriction. It is a key sign of inadequate oxygenation.

Choice C rationale

Hypoxia, defined as a deficiency in the amount of oxygen reaching the tissues, is a fundamental alteration in oxygenation. While not a visible sign, it is the underlying pathological condition that drives other clinical manifestations. The body's cells and organs require a constant supply of oxygen for aerobic metabolism. When this supply is insufficient, cellular function is impaired, leading to the clinical signs and symptoms.

Choice D rationale

Bradycardia is generally not a common initial manifestation of altered oxygenation. The body's primary compensatory mechanism for hypoxemia is to increase heart rate and cardiac output to enhance oxygen delivery, leading to tachycardia. Bradycardia may occur as a late, ominous sign of severe, prolonged, and decompensated hypoxia, particularly in infants and children, and often precedes cardiac arrest.

Choice E rationale

Moist mucous membranes are a sign of adequate hydration and perfusion. In patients with significant alterations in oxygenation, especially in conditions leading to mouth breathing or tachypnea, mucous membranes are more likely to become dry due to increased insensible water loss. Therefore, moist mucous membranes are not a common clinical manifestation of impaired oxygenation. *.

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A patient has a rash on her left elbow and a small amount on both knees. The rash is patchy, red, and has thick, silvery scales. What type of rash is this most likely

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is caring for a patient admitted to the hospital with alterations in oxygenation. The nurse understands that which of the following are common clinical manifestations in patients with alterations in oxygenation? Select all that apply.

Correct Answer is ["B","C"]

Explanation

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A nurse is caring for a patient who has a pneumothorax and whose vitals show low blood pressure.

A patient has a rash on her left elbow and a small amount on both knees.

The rash is patchy, red, and has thick, silvery scales.

What type of rash is this most likely