Integumentary Prep U Questions

The nurse notes multiple elevated masses with irregular transient borders that are superficial, raised, and erythematous in a client who complains of an "itching rash." Which question would be most important for the nurse to ask? a) "Have you ever had a rash like this before?" b) "What have you been doing to control the itching?" c) "Are you allergic to foods, medications, or other substances?" d) "Does anyone else in your family have a rash like this?"

"Are you allergic to foods, medications, or other substances?" Reason: the rash could be urticaria (hives)

Question: Pressure ulcers are staged as I through IV. Put the following in order from stage I through stage IV. 1 2 3 4 intact, firm skin with redness ulceration involving the dermis full-thickness skin loss necrosis with damage to underlying muscle

1. intact, firm skin with redness 2. ulceration involving the dermis 3. full-thickness skin loss 4. necrosis w/ damage to underlying muscle

A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on a ventilator for 3 weeks. The nurse is completing an initial assessment and evaluating the client's skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter with damage to the subcutaneous tissue. The underlying muscle is not affected. What is the stage of this pressure ulcer? a) 2 b) 4 c) 3 d) 1

3

The nurse is speaking to a group of seniors about health promotion and is preparing to discuss the ABCDEs of melanoma. Which of the following descriptions is correct for the ABCDEs? a) a = actinic; b = basal cell; c = color changes, esp. blue; d = diameter > 6 mm; e = evolution b) a = asymmetry; b = irregular borders; c = color changes, esp. blue; d = diameter > 6 mm; e = evolution c) a = actinic, b = irregular borders, c = keratoses, d = dystrophic nails, e = evolution d) a = asymmetry; b = regular borders; c = color changes, especially orange; d = diameter > 6 mm; e = evolution

A=asymmetry B=irregular borders C=color changes, esp. blue D=diameter >6mm E=evolution

A woman and her teenager have come to the clinic. The teenager has acne lesions and says that the lesions are not well controlled. The mother asks the nurse what causes acne. What would be the nurse's best response? a) Acne is caused by decreased activity of the sebaceous glands b) Acne is caused by the apocrine glands c) Acne is caused by enlarged epocrine glands d) Acne is caused by the impedance of sebum secretion onto the skin's surface

Acne is caused by the impedance of sebum secretion onto the skin's surface

Assessment of a client's nails reveals Beau's lines. The nurse interprets this finding as indicating which of the following? a) Oxygen deficiency b) Acute illness c) Psoriasis d) Trauma

Acute illness Reason: Beau's lines happen after an acute illness and eventually grow out; clubbing indicates an oxygen deficiency; pitting denotes psoriasis; splinter hemorrhages indicate trauma

Which of the following terms is used to describe the arrangement of skin lesions? a) Generalized b) Localized c) Exposed d) Annular

Annular Reason: annular is a shape of a lesion, so that means that it's arranged in that shape

A client asks a nurse to look at a raised lesion on the skin that has been present for about 5 years. Which is an "ABCD" characteristic of malignant melanoma? a) Asymmetrical shape b) Borders well demarcated c) Color is uniform d) Diameter less than 6mm

Asymmetrical shape

What is the rationale for asking the client whether he or she has noticed any new or changed moles? a) Transition from pustules to moles can indicate psoriasis b) The appearance of new moles is a sign of vitamin D deficiency. c) Excessive eccrine sweat gland production can cause the emergence of a new mole. d) Changes in existing moles or the appearance of new moles can indicate melanoma.

Changes in existing moles or the appearance of new moles can indicate melanoma

Which layer of the skin contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands? a) Dermis b) Connective layer c) Subcutaneous layer d) Epidermis

Dermis

The terms "generalized," "exposed surfaces," "upper arm," and "skin folds" are used to describe which major characteristic of skin lesions? a) Type b) Colour c) Distribution d) Arrangement

Distribution

The nurse notes a large keloid on the pierced ear of an adolescent. The client asks what caused this finding. Which of the following would the nurse incorporate into the response as the most likely cause? a) Inadequate circulation b) Decreased subcutaneous tissue c) Continuous trauma d) Excessive collagen formation

Excessive collagen formation

A nurse receives report from the shift nurse that a client has new onset of peripheral cyanosis. Where should the nurse focus the assessment of the skin to detect the presence of this condition? a) Nose and earlobes b) Around the mouth and lips c) Chest and abdomen d) Fingers and toes

Fingers and toes

When assessing your new patient, you note that he has no hair on his legs. What might this indicate about the patient? a) He has a hormonal imbalance b) He has peripheral artery disease c) He has hyperthyroidism d) He has hypothyroidism

He has peripheral artery disease

A client tells the nurse about a raised lesion on the client's leg. What is the nurse's first nursing action? a) Inspect the area b) Move on to next body system c) Ask further questions d) Document the statement

Inspect the area

Which of the following assessment findings most likely constitutes a secondary skin lesion? a) Facial lesions associated with herpes simplex b) Facial acne c) Keloid formation at the site of an old incision d) Psoriasis

Keloid formation at the site of an old incision Reason: secondary means that it's a lesion formed on a previously existing lesion

A burn victim of a house fire is brought to the emergency department. The burn is classified as dermal. The nurse knows that the structures destroyed by the burn are what? (Select all that apply.) a) Vernix b) Blood vessels c) Lymphatic vessels d) Sweat glands e) Connective tissue

Lymphatic Vessels Blood Vessels Sweat glands

The nurse would pursue additional assessment and evaluation of an older adult client with diabetes upon assessing which of the following? a) Cutaneous horn b) Seborrheic keratosis c) Pressure ulcer d) Cherry angioma

Pressure ulcer Reason: an older client's skin is more fragile so it can be broken down more easily; cherry angioma isn't significant; cutaneous horns and seborrheic keratosis are considered normal skin variations

When educating a patient about the risks of malignant melanoma, what would you know to include? (Mark all that apply.) a) Freckles b) Age older than 60 c) Female gender d) Red or light hair e) Immunosuppression

Red or light hair immunosuppression freckles

When asked to assess an area of broken skin on an older adult client in a long-term care facility, the nurse notes a break in the skin erythema and a small amount of serosanguineous drainage over the sacrum. The area appears blister-like. The nurse would interpret this finding as indicating which stage of pressure ulcer? a) Stage III b) Stage I c) Stage II d) Stage IV

Stage 2

Which of the following is an important function of the skin? a) Synthesis of vitamin D b) Maintenance of acid-base balance c) Production of carotene d) Protection against melanin deposits

Synthesis of Vitamin D

An elderly client comes to the clinic for evaluation. During the skin assessment, the nurse notes considerable skin tenting. Why does this finding require further assessment? a) Tenting indicates dehydration b) Tenting indicates vitamin B12 deficiency c) Tenting indicates dramatic weight loss d) Tenting indicates malnutrition

Tenting indicates dehydration

An adult client is having his skin assessed. The client tells the nurse he has been a heavy smoker for the last 40 years. The client has clubbing of the fingernails. What does this finding tell the nurse? a) The client has melanoma b) The client has chronic hypoxia c) The client has asthma d) The client has COPD

The client has chronic hypoxia

Which of the following statements most accurately conveys an aspect of the anatomy and physiology of the skin? a) The skin plays a central role in the synthesis of vitamin A. b) Migration from the inner layer to the top of the epidermis takes approximately 1 year. c) The colour of normal skin is primarily a consequence of the character and quantity of hemoglobin. d) The skin is composed of an epidermis, dermis, and subcutaneous tissue.

The skin is composed of an epidermis, dermis and subcutaneous tissue

A decrease in oxyhemoglobin will result in documentation of pallor. a) True b) False

True

A patient admitted with dehydration would typically have a decrease in skin turgor. a) False b) True

True

What is the most important focus area for the integumentary system? a) Moles with defined borders smaller than 6 mm b) Washing the face and hands c) Chemical exposure d) UV radiation exposure

UV Radiation exposure

Mrs. Anderson presents with an itchy raised rash that appears and disappears in various locations. Each lesion lasts for many minutes. Which most likely accounts for this rash? a) Insect bites b) Psoriasis c) Urticaria or hives d) Purpura

Urticaria or hives Reason: rash moves place to place

The nurse in the dermatology clinic is assessing an adult who has presented at the clinic with a lesion on the left inner thigh. The client tells the nurse that the lesion was discovered one month ago and no changes in the color or size of the lesion have been noted. What would be the most appropriate teaching subject for this client? a) Skin self-examination b) Signs and symptoms of melanoma c) Recognizing different types of lesions d) Protection from sun damage

signs and symptoms of melanoma

When examining a fair-skinned white woman with red hair and freckled skin, the nurse should focus health education on measures related to which condition? a) Fungal infections b) Dry skin c) Sun exposure d) Easy bruising

sun exposure