Chapter 43: Bullous Pemphigoid Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid (BP) lesions, what will the practitioner do?

a. Avoid contact with the infected lesions.

b. Elicit a positive Nikolsky sign to confirm the diagnosis.

c. Perform direct immunofluorescence microscopy.

d. Prevent spread of the lesions to other areas of the skin.

ANS: C a. Osteoporosis b. Pruritis c. Depression d. Weight gain

Direct immunofluorescence microscopy is the gold standard for diagnosis of BP. The lesions are not infected. The Nikolsky sign will be negative in patients with BP. The lesions do not spread by this manner.

2. An older adult patient diagnosed with bullous pemphigoid (BP). Which comorbid condition is of concern for this patient?

ANS: C

Living with chronic BP can lead to isolation, anxiety, and depression. None of the other options are directly associated with this disorder.

NURSINGTB.COM a. Bone marrow suppression b. Developing systemic lesions c Secondary infection d. Spread of disease to others

3. A patient is newly diagnosed with bullous pemphigoid and has moderate to severe itching. The provider orders a topical corticosteroid will discuss which potential complication with this patient?

ANS: C

Topical corticosteroids and excessive rubbing and trauma to skin increase the risk of secondary infections. Bone marrow suppression is a side effect of immunosuppressive therapy. Systemic lesions are not likely; patients may develop systemic infection if secondary infection occurs. The disease is not contagious.