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.
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. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Hypertension is not a typical finding in a patient with a pulmonary embolism. The body's response to a significant blockage in the pulmonary arteries is often a decrease in cardiac output due to increased right ventricular afterload. This can lead to a compensatory drop in systemic blood pressure, resulting in hypotension rather than hypertension. Hypertension is a less common finding and usually occurs only with very small emboli.
Choice B rationale
Tachycardia is a very common and expected manifestation of a pulmonary embolism. The embolism causes a ventilation-perfusion mismatch and hypoxemia. The body compensates for the reduced oxygenation by increasing the heart rate to improve cardiac output and oxygen delivery to the tissues. Additionally, the release of inflammatory mediators and catecholamines in response to the physiological stress also contributes to an elevated heart rate.
Choice C rationale
Petechiae are small, pinpoint hemorrhages under the skin. They are typically associated with disorders of platelet function, such as thrombocytopenia, or small vessel vasculitis. They are not a direct manifestation of a pulmonary embolism. A pulmonary embolism is a thrombotic event within the pulmonary arteries and does not cause a systemic microvascular hemorrhage that would present as petechiae on the skin.
Choice D rationale
Bradypnea, or an abnormally slow respiratory rate, is not an expected finding in a patient with a pulmonary embolism. The hypoxemia and physiological stress caused by the embolism trigger a compensatory increase in the respiratory rate to improve oxygen intake. The patient will likely present with tachypnea, a rapid respiratory rate (normal range is 12-20 breaths/min), as they struggle to overcome the respiratory compromise and ventilate adequately. ---.
Correct Answer is C
Explanation
Choice A rationale
While obtaining a complete history is important for diagnosis, it is not the immediate priority. The patient's altered mental status, chest pain, and chills suggest a serious infectious or cardiopulmonary process like pneumonia, which can rapidly progress. Delaying the assessment of vital signs and oxygen saturation to gather a detailed history could be detrimental, as the patient's condition may worsen during that time.
Choice B rationale
Providing a pneumococcal vaccine is a prophylactic measure for pneumonia prevention. While potentially relevant for a patient at risk for or diagnosed with pneumonia, it is not an immediate life-saving intervention. The priority is to assess and stabilize the patient's current condition, not to prevent a future illness. Vaccination is a secondary intervention once the patient is stabilized.
Choice C rationale
The nursing priority in this situation is to obtain baseline vital signs and oxygen saturation. The patient's symptoms of altered mental status, chest pain, and chills are red flags for a serious cardiopulmonary condition like pneumonia. Assessing vital signs, including oxygen saturation, provides crucial data to determine the severity of the illness and guide immediate interventions to stabilize the patient's condition. Normal oxygen saturation is 95-100%.
Choice D rationale
Obtaining a sputum culture is a diagnostic procedure used to identify the causative organism of a respiratory infection. While an important step for guiding targeted antibiotic therapy, it is not the nursing priority. Sputum collection can be time-consuming, and the results are not immediately available. The priority is to assess the patient's current physiological status and provide supportive care, such as oxygen, if needed, based on the vital signs
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