Exam 1 Questions 1-30

Which of the following causes odor in perspiration?

Correct response: Bacteria on the skin Explanation: Perspiration is odorless. An odor develops when perspiration mixes with bacteria on the skin. Sunlight, air pollutants, and a cloudy environment do not cause odor in perspiration.

Which diagnostic test would be used if a malignancy is suspected?

Correct response: Biopsy Explanation: Biopsies are performed on skin nodules, plaques, blisters, and other lesions to rule out malignancy and to establish an exact diagnosis. Skin scrapings are used to diagnose spores and hyphae. A Tzanck smear is a test used to examine cells from blistering skin conditions such as herpes zoster. A patch test is used to identify substances to which the client has developed an allergy.

Which instruction does the nurse give a client when antibiotic, antiviral, or antifungal agents are prescribed?

Correct response: Complete the entire course of the drug, even if the conditions clear. Explanation: The nurse should instruct clients taking antibiotic, antiviral, or antifungal agents to complete the entire prescription, even if the condition clears before the client finishes all the medication. It is not necessary to keep medications locked in a cupboard and to mix the drug in food. It is also not necessary to avoid exposure to sunlight.

The nurse is applying a cold towel to a patient's neck to reduce body heat. How does the nurse understand that the heat is reduced?

Correct response: Conduction Explanation: Three major physical processes are involved in loss of heat from the body to the environment. The first process—radiation—is the transfer of heat to another object of lower temperature situated at a distance. The second process—conduction—is the transfer of heat from the body to a cooler object in contact with it. The third process—convection, which consists of movement of warm air molecules away from the body—is the transfer of heat by conduction to the air surrounding the body.

Which type of heat loss is caused by a cool breeze that blows across the body surface?

Correct response: Convection Explanation: Convection is the transfer of heat by means of currents of liquids or gases in which warm air molecules move away from the body. Conduction is the transfer of heat through direct contact. Radiation is the transfer of surface heat in the environment. Evaporation is the loss of moisture or water.

A client on a prescribed medication for a skin disorder visits the clinic complaining of a skin rash. Which of the following would explain the client's condition?

Correct response: Drug allergy Explanation: The nurse suspects a drug allergy whenever a client has a skin rash. Hormone change, suntan, and heat stroke do not cause skin rash.

Which medications are used to soothe, protect, and soften the skin?

Correct response: Emollients Explanation: Emollients soothe, protect, and soften the skin. Antiseptics are used to reduce bacteria on the skin. Antiseborrheic agents are used to control dandruff. Keratolytics cause softening and swelling of an area, facilitating lesion removal.

Which condition is the cause of thickening of the nail?

Correct response: Fungal infection Explanation: Long-standing poor circulation leads to nail thickening, especially of the lower extremities. Nails thicken when there is a fungal infection and poor circulation. Clubbing of the nails suggests a long-standing cardiopulmonary disease. Concave-shaped nails are a sign of iron deficiency anemia. Myocardial infarction does not cause thickening of nails.

Which of the following is a true statement regarding cryosurgery?

Correct response: Healing takes place in 4 to 6 weeks. Explanation: Crysosurgery is the application of extreme cold to destroy tissue. Healing takes place in 4 to 6 weeks. The other statements are false.

A 57-year-old homeless man arrives confused, disoriented and in severe need of hygiene measures. The results of his diagnostic laboratory tests reveal out-of-control diabetes mellitus and malnutrition. As you perform overall hygiene before sending him up to the unit where he'll be admitted, you perform a head-to-toe skin assessment. Which of the following options would you expect to find in a "within normal limit" skin assessment? Choose all correct options.

Correct response: Intact Warm Dry Explanation: A typical "within normal limit" skin assessment includes descriptions such as dry, etc.

During a routine assessment of a client, the nurse notes that the client's nails are concave. Which condition is indicated by this finding?

Correct response: Iron deficiency anemia Explanation: The concave shape of the nails, referred to as spooning, is a sign of iron deficiency anemia. Clubbing of the nails, at greater than a 160-degree angle, suggests long-standing cardiopulmonary disease. Nails thicken when there is a fungal infection and poor circulation.

A client has been diagnosed with liver disease. The nurse would expect which skin variation?

Correct response: Jaundice Explanation: Jaundice occurs in liver or kidney disease. Cyanosis may occur with low oxygenation of the tissues. Ecchymosis occurs when there is trauma to the tissues. Pallor occur with anemia.

Which is the principal hardening ingredient of the hair and nails?

Correct response: Keratin Explanation: Keratin an insoluble, fibrous protein that forms the outer barrier of the skin and has the capacity to repel pathogens and prevent excessive fluid loss from the body. Melanin is the substance responsible for the coloration of the skin. Merkel cells are located in the epidermis and play a role in the transmission of sensory messages. A sebaceous gland secretes sebum to keep the skin soft and pliable.

Which factor causes wrinkles among older adults?

Correct response: Loss of subcutaneous tissue Explanation: The loss of subcutaneous tissue causes wrinkles in older adults. A decrease in melanin results in a change of hair color to gray. The decrease in the production of estrogen and sebum do not cause wrinkles in older adults.

Which of the following could be a possible cause of cyanosis?

Correct response: Low tissue oxygenation Explanation: A possible cause of cyanosis includes a low tissue oxygenation. A red appearance to the skin may be indicative of carbon monoxide poisoning. A pink color to the skin may be indicative of a fever or hypertension. Pallor occurs in anemia.

Which of the following pigments influences hair color?

Correct response: Melanin Explanation: Melanin, produced by the melanocytes in the hair roots, influences hair color. Pheromones are hormone-like chemicals that communicate reproductive and social information among the lower animal species. Sebum is a lubricant that prevents drying and cracking of the skin and hair. Keratin is a tough protective protein.

Which of the following is a method to treat psoriasis that uses ultraviolet light?

Correct response: Photochemotherapy Explanation: Photochemotherapy involves a combination of psoralen methoxsalen and type A ultraviolet light. Electrodesiccation is the use of electrical energy converted to heat which destroys the tissue. Radiation therapy is used to treat malignant skin lesions. Cryosurgery is the application of extreme cold to destroy tissue.

A nurse is aware that the outer layer of the skin consists of dead cells that contain large amounts of keratin. The physiologic functions of keratin include which of the following? Select all that apply.

Correct response: Physically repelling pathogens Preventing fluid loss Explanation: The dead cells of the epidermis contain large amounts of keratin, an insoluble, fibrous protein that forms the outer barrier of the skin. Keratin has the capacity to repel pathogens and prevent excessive fluid loss from the body. It does not contribute directly to antibody production, acid-base balance, or electrolyte levels.

The most important principle of psoriasis treatment is which of the following?

Correct response: Gentle removal of scales Explanation: The most important principle of psoriasis treatment is gentle removal of scales. This can be accomplished with baths. After bathing, the application of emollient creams containing alpha-hydroxy acids or salicylic acid continues to soften thick scales. The patient and family should be encouraged to establish a regular skin care routine that can be maintained even when the psoriasis is not in an acute stage. Although dressing changes may be done in the treatment of psoriasis, it is not the most important principle of treatment.

Inspection of the skin is an important part of nursing assessment. Interpretation of abnormalities is based on an understanding of structure and function. The nurse is aware that the epidermis, especially the stratum cornea, has many vital functions. What are some of these functions? Select all that apply.

Correct response: Provides an effective barrier to water loss Contains lipids that resist penetration by microbes Produces keratin, the hardening ingredient of the nails Explanation: The incorrect choices refer to functions of the dermis. The stratum corneum, the outer layer of the epidermis provides the most effective barrier to epidermal water loss, maintains a homeostatic environment, and prevents the penetration of environmental factors such as chemicals, microbes, and insect bites. Various lipids are synthesized in the stratum corneum and are the basis for the barrier function of this layer, especially keratin, the principal hardening ingredient of the hair and nails.

An older adult client's skin has become dry and flaked. Which of the following is the cause of this condition?

Correct response: Reduction in sebum production Explanation: The sebum is a lubricant that prevents the drying and the cracking of the skin and hair. Due to aging, the skin becomes dry and flaked as sebum production is reduced. Loss of elasticity of the skin causes wrinkles among older adults. Reduction in melanin results in gray hair. Facial hair and sometimes chest hair appear in postmenopausal women as a result of the decreased production of estrogen.

Which portion of the skin is primarily composed of connective tissue and fat cells?

Correct response: Subcutaneous tissue Explanation: The subcutaneous tissue is the layer of skin attached to muscle and bone and is composed primarily of connective tissue and fat cells. The epidermis is the outermost layer of skin. The dermis lies below the epidermis. Keratin is a protective protein on the skin.

Students are reviewing information about the glands of the skin. The students demonstrate understanding of the material when they state which of the following?

Correct response: The apocrine glands become active at puberty. Explanation: The apocrine glands, a type of sweat gland, become active at puberty. The sebaceous glands are responsible for lubricating the hair and rendering the skin soft and pliable. The sweat glands are responsible for sweat secretion. The apocrine glands are located in the axillae, anal region, scrotum, and labia majora.

28s A dermatologist has asked the nurse to assist with examination of a client's skin using a Wood light. This test will allow the health care provider to assess for which of the following?

Correct response: Unusual patterns of pigmentation on the client's skin Explanation: Wood light makes it possible to differentiate epidermal from dermal lesions and hypopigmented and hyperpigmented lesions from normal skin.

The nurse examines a patient and notices a herpes simplex/zoster skin lesion. How does the nurse document this lesion?

Correct response: Vesicle Explanation: A vesicle is a circumscribed, elevated, palpable mass containing serous fluid less than 0.5 cm. Examples include herpes simplex/zoster, varicella, poison ivy, and 2nd-degree burn (blister).

A client comes to the dermatology clinic with numerous skin lesions. Inspection reveals that the lesions are elevated, sharply defined, less than 0.5 cm in diameter, and filled with serous fluid. When documenting these findings, the nurse should use which term to describe the client's lesions?

Correct response: Vesicles Explanation: Vesicles are elevated, sharply defined lesions that are usually less than 0.5 cm in diameter and contain serous fluid. Common examples of vesicles include blisters and the lesions caused by chickenpox and herpes simplex. Bullae are elevated, fluid-filled lesions greater than 0.5 cm in diameter; an example is a 0.5 blister. Cysts, such as sebaceous cysts, are elevated, thick-walled lesions containing fluid or semisolid matter. Pustules are elevated lesions less than 1 cm in diameter containing purulent material; examples include impetigo and acne lesions.

The diagnosis of a skin disorder is made chiefly by which of the following?

Correct response: Visual inspection Explanation: The diagnosis of a skin disorder is made chiefly by visual inspection. Some disorders may involve additional inspection with other diagnostic procedures.

The nurse notes that the client demonstrates generalized pallor and recognizes that this finding may be indicative of

Correct response: anemia. Explanation: In light-skinned individuals, generalized pallor is a manifestation of anemia. In brown- and black-skinned individuals, anemia is demonstrated as a dull skin appearance. Albinism is a condition of total absence of pigment in which the skin appears whitish pink. Vitiligo is a condition characterized by the destruction of melanocytes in circumscribed areas of skin, resulting in patchy, milky-white spots. Local arterial insufficiency is characterized by marked localized pallor

A client is undergoing diagnostics for an injury to the right arm. The physician has ordered an MRI on the arm, which has a colorful tattooed "sleeve." What effect could the MRI have on the client's skin?

Correct response: edema Explanation: Some people have experienced swelling or burning in the area of the tattoo when undergoing an MRI.

The school nurse is instructing a group of high school students on the considerations with tattooing and body piercing. Which instruction would be included in the discussion? Select all that apply.

Correct response: -Cosmetic pigment is approved by the Federal Food, Drug, and Cosmetic Act. -Infection is a potential complication of tattoos and piercings. -Tattoo is injected into the dermal layer of the skin. Explanation: Tattoos and body piercings are becoming more popular. The school nurse is a valuable resource in discussing some of the considerations prior to obtaining a tattoo or body piercing. Tattoo ink is approved by the Federal Food, Drug, and Cosmetic Act; however, none are approved for injection into the skin. Some tattoo artists are members of the Alliance for Professional Tattooists. Infection is a concern as the ink is injected into the dermal layer of the skin. Tattoos, called micropigmentation, can be used as an adjunct to a medical procedure. Hepatitis B and C can be transmitted as a blood-borne infectious disease.