Unit 3: Alterations in Tissue Integrity - NSG 3280 Exam 2 Mastery Guide
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Course: Pathophysiology I (NSG 3280) | Exam 2 Prep Material Content:
Complete question set with all rationales included.
1. A client presents with a unilateral, painful vesicular rash along the T4
dermatome. Which physiological mechanism explains this condition?
○ Initial exposure to the rickettsia bacteria via a tick bite.
○ Massive collagen deposition leading to fibrosis of the dermal layer.
○ Hypersensitivity reaction to urushiol oil from a plant.
DETAILED RATIONALES
Initial exposure to the rickettsia bacteria via a tick bite.: Rickettsia causes Rocky Mountain Spotted Fever,
which presents with a petechial rash rather than a dermatomal vesicular rash.
Reactivation of the latent varicella-zoster virus in the dorsal root ganglia.: Herpes Zoster (Shingles) results
from the reactivation of the chickenpox virus that has remained dormant in the sensory nerves.
Massive collagen deposition leading to fibrosis of the dermal layer.: This mechanism describes Scleroderma, which
results in skin hardening rather than an acute vesicular rash.
Hypersensitivity reaction to urushiol oil from a plant.: Contact dermatitis (Rhus) is an inflammatory response to
plant oils, typically presenting in a linear pattern.
https://www.stuvia.com/user/geniusexpert
,2. The nurse is assessing a client with a history of HIV who has multiple purple,
maculopapular lesions on the lower extremities. Which diagnostic test is the
priority to confirm the suspected diagnosis?
○ Tzanck smear of a lesion.
○ Enzyme-linked immunosorbent assay (ELISA).
○ Wood's lamp examination.
DETAILED RATIONALES
Tzanck smear of a lesion.: A Tzanck smear is used to identify viral infections like HSV, not malignant tumors.
Biopsy of the skin lesion.: Biopsy is the definitive diagnostic tool for Kaposi Sarcoma, a malignancy arising
from reticulocytes.
Enzyme-linked immunosorbent assay (ELISA).: ELISA is a screening tool for antibodies, but it does not
diagnose a specific tissue malignancy.
Wood's lamp examination.: Wood's lamp is used to detect certain fungal infections, which do not present as
purple malignant lesions.
https://www.stuvia.com/user/geniusexpert
,3. Which statement by a parent of a child with impetigo indicates a need for further
teaching?
○ I need to wash my hands thoroughly after touching my child's skin.
○ I will soak the honey-colored crusts in warm water to help remove them.
○ We should use separate towels and washcloths for each family member.
DETAILED RATIONALES
I should keep my child home from school until the sores are gone.: Children can return to school 24 hours
after starting effective antibiotic therapy, even if sores are still present.
I need to wash my hands thoroughly after touching my child's skin.: Hand hygiene is crucial because
impetigo is a highly contagious bacterial infection.
I will soak the honey-colored crusts in warm water to help remove them.: Soaking helps soften the crusts,
which is an appropriate step before applying topical antibiotics.
We should use separate towels and washcloths for each family member.: Preventing the sharing of linens
reduces the risk of transmission.
, 4. The nurse is caring for a client with diffuse scleroderma. Which new assessment finding
requires immediate notification of the healthcare provider?
○ Violet-colored macules on the forearm.
○ Hardening of the skin on the fingers.
○ Report of Raynaud's phenomenon when cold.
DETAILED RATIONALES
Violet-colored macules on the forearm.: Violet macules are expected in localized scleroderma and are not
typically an acute emergency.
New-onset crackles in the lung bases.: Crackles may indicate pulmonary fibrosis or heart failure, both of
which are serious systemic complications.
Hardening of the skin on the fingers.: Sclerodactyly (skin hardening) is a chronic and expected finding of the
disease.
Report of Raynaud's phenomenon when cold.: Raynaud's is a common vascular manifestation and is
manageable, not an immediate crisis.
Premium with Questions and Answers with detailed rationales | New Update 2026 || 100%
Guaranteed Pass || complete A+ Guide
Course: Pathophysiology I (NSG 3280) | Exam 2 Prep Material Content:
Complete question set with all rationales included.
1. A client presents with a unilateral, painful vesicular rash along the T4
dermatome. Which physiological mechanism explains this condition?
○ Initial exposure to the rickettsia bacteria via a tick bite.
○ Massive collagen deposition leading to fibrosis of the dermal layer.
○ Hypersensitivity reaction to urushiol oil from a plant.
DETAILED RATIONALES
Initial exposure to the rickettsia bacteria via a tick bite.: Rickettsia causes Rocky Mountain Spotted Fever,
which presents with a petechial rash rather than a dermatomal vesicular rash.
Reactivation of the latent varicella-zoster virus in the dorsal root ganglia.: Herpes Zoster (Shingles) results
from the reactivation of the chickenpox virus that has remained dormant in the sensory nerves.
Massive collagen deposition leading to fibrosis of the dermal layer.: This mechanism describes Scleroderma, which
results in skin hardening rather than an acute vesicular rash.
Hypersensitivity reaction to urushiol oil from a plant.: Contact dermatitis (Rhus) is an inflammatory response to
plant oils, typically presenting in a linear pattern.
https://www.stuvia.com/user/geniusexpert
,2. The nurse is assessing a client with a history of HIV who has multiple purple,
maculopapular lesions on the lower extremities. Which diagnostic test is the
priority to confirm the suspected diagnosis?
○ Tzanck smear of a lesion.
○ Enzyme-linked immunosorbent assay (ELISA).
○ Wood's lamp examination.
DETAILED RATIONALES
Tzanck smear of a lesion.: A Tzanck smear is used to identify viral infections like HSV, not malignant tumors.
Biopsy of the skin lesion.: Biopsy is the definitive diagnostic tool for Kaposi Sarcoma, a malignancy arising
from reticulocytes.
Enzyme-linked immunosorbent assay (ELISA).: ELISA is a screening tool for antibodies, but it does not
diagnose a specific tissue malignancy.
Wood's lamp examination.: Wood's lamp is used to detect certain fungal infections, which do not present as
purple malignant lesions.
https://www.stuvia.com/user/geniusexpert
,3. Which statement by a parent of a child with impetigo indicates a need for further
teaching?
○ I need to wash my hands thoroughly after touching my child's skin.
○ I will soak the honey-colored crusts in warm water to help remove them.
○ We should use separate towels and washcloths for each family member.
DETAILED RATIONALES
I should keep my child home from school until the sores are gone.: Children can return to school 24 hours
after starting effective antibiotic therapy, even if sores are still present.
I need to wash my hands thoroughly after touching my child's skin.: Hand hygiene is crucial because
impetigo is a highly contagious bacterial infection.
I will soak the honey-colored crusts in warm water to help remove them.: Soaking helps soften the crusts,
which is an appropriate step before applying topical antibiotics.
We should use separate towels and washcloths for each family member.: Preventing the sharing of linens
reduces the risk of transmission.
, 4. The nurse is caring for a client with diffuse scleroderma. Which new assessment finding
requires immediate notification of the healthcare provider?
○ Violet-colored macules on the forearm.
○ Hardening of the skin on the fingers.
○ Report of Raynaud's phenomenon when cold.
DETAILED RATIONALES
Violet-colored macules on the forearm.: Violet macules are expected in localized scleroderma and are not
typically an acute emergency.
New-onset crackles in the lung bases.: Crackles may indicate pulmonary fibrosis or heart failure, both of
which are serious systemic complications.
Hardening of the skin on the fingers.: Sclerodactyly (skin hardening) is a chronic and expected finding of the
disease.
Report of Raynaud's phenomenon when cold.: Raynaud's is a common vascular manifestation and is
manageable, not an immediate crisis.
