Chapter 22 - Integumentary System

Which activities can the nurse working in the outpatient clinic delegate to a licensed practical/vocational nurse (LPN/VN)? (Select all that apply.) A. Administer patch testing to a patient with allergic dermatitis. B. Interview a new patient about chronic health problems and allergies. C. Apply a sterile dressing after the health care provider excises a mole. D. Explain potassium hydroxide testing to a patient with a skin infection. E. Teach a patient about site care after a punch biopsy of an upper arm lesion.

A. Administer patch testing to a patient with allergic dermatitis. C. Apply a sterile dressing after the health care provider excises a mole.

When performing a skin assessment, the nurse notes angiomas on the chest of an older patient. Which action should the nurse take next? A. Suggest an appointment with a dermatologist. B. Assess the patient for evidence of liver disease. C. Teach the patient about skin changes with aging. D. Discuss the use of sunscreen to prevent skin cancers.

B. Assess the patient for evidence of liver disease.

The nurse assesses a circular, flat, reddened lesion about 5 cm in diameter on a middle-aged patient's ankle. How should the nurse determine if the lesion is related to intradermal bleeding? A. Elevate the patient's leg. B. Press firmly on the lesion. C. Check the temperature of the skin around the lesion. D. Palpate the dorsalis pedis and posterior tibial pulses.

B. Press firmly on the lesion.

Which integumentary assessment data from an older patient admitted with bacterial pneumonia should be of concern to the nurse? A. Brown macules on extremities B. Reports a history of allergic rashes C. Skin wrinkled with tenting on both hands D. Longitudinal nail ridges and sparse scalp hair

B. Reports a history of allergic rashes

During assessment of the patient's skin, the nurse observes a similar pattern of discrete, small, raised lesions on the left and right upper back areas. Which term should the nurse use to document the distribution of these lesions? A. Confluent B. Symmetric C. Zosteriform D. Generalized

B. Symmetric

A patient who reports chronic itching of the ankles continuously scratches the area. Which assessment finding should the nurse expect? A. Hypertrophied scars on both ankles B. Thickening of the skin around the ankles C. Yellowish-brown skin around both ankles D. Complete absence of melanin in both ankles

B. Thickening of the skin around the ankles

Which abnormality on the skin of an older patient is the priority for the nurse to discuss with the health care provider? A. Dry, scaly patches on the face B. Numerous varicosities on both legs C. Petechiae on the chest and abdomen D. Small dilated blood vessels on the face

C. Petechiae on the chest and abdomen

A patient with dark skin has been admitted to the hospital with acute decompensated heart failure. How would the nurse assess this patient for cyanosis? A. Assess the skin color of the earlobes. B. Apply pressure to the palms of the hands. C. Check the lips and oral mucous membranes. D. Examine capillary refill time of the nail beds.

C. Check the lips and oral mucous membranes.

When assessing a new patient at the outpatient clinic, the nurse notes dry, scaly skin; thin hair; and thick, brittle nails. What is the nurse's most important action? A. Instruct the patient about the importance of nutrition for skin health. B. Make a referral to a podiatrist so that the nails can be safely trimmed. C. Consult with the health care provider about the need for further diagnostic testing. D. Teach the patient about using moisturizing creams and lotions to decrease dry skin.

C. Consult with the health care provider about the need for further diagnostic testing.

The nurse prepares to obtain a culture from a patient who has a possible fungal infection on the foot. Which items should the nurse gather for this procedure? A. Sterile gloves B. Patch test instruments C. Cotton-tipped applicators D. Syringe and intradermal needle

C. Cotton-tipped applicators

A patient in the dermatology clinic is scheduled for removal of a 15-mm multicolored and irregular mole from the upper back. The nurse should prepare the patient for which type of biopsy? A. Shave biopsy B. Punch biopsy C. Incisional biopsy D. Excisional biopsy

C. Incisional biopsy

The home health nurse notices irregular patterns of bruising at different stages of healing on an older patient's body. Which action should the nurse take first? A. Ensure the patient wears shoes with nonslip soles. B. Discourage using throw rugs throughout the house. C. Talk with the patient alone and ask about the bruising. D. Suggest that the health care provider prescribe radiographs.

C. Talk with the patient alone and ask about the bruising.

The nurse notes darker skin pigmentation in the skinfolds of a middle-aged patient who has a body mass index of 40 kg/m2. What is the nurse's appropriate action? A. Discuss the use of drying agents to minimize infection risk. B. Instruct the patient about the use of mild soap to clean skinfolds. C. Teach the patient about treating fungal infections in the skinfolds. D. Ask the patient about a personal or family history of type 2 diabetes.

D. Ask the patient about a personal or family history of type 2 diabetes.

The nurse is developing a health promotion plan for an older adult who worked in the landscaping business for 40 years. The nurse will plan to teach the patient about how to self-assess for which clinical manifestations? (Select all that apply.) A. Vitiligo B. Alopecia C. Intertrigo D. Erythema E. Actinic keratosis

D. Erythema E. Actinic keratosis