Patho Final - Ch 51
A nurse is assessing a client's apocrine sweat glands. Which locations should be looked at? Select all that apply.
Axillae, Anal area, Genitals
The nurse is assessing a client with darker skin. The nurse is aware that:
It will be difficult to observe - Erythema will be difficult to observe - Verbal histories are important in skin assessment
A client has dry skin, and scratching the dry regions causes some skin flakes to become dislodged. Which cell type makes up the dry skin?
Keratinocytes
When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin?
Tyrosinase
A nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the epidermis based on which statement?
"Keratinized epithelial cells formed in the deepest layer of the epidermis migrate to the skin surface to replace cells that are lost during normal skin shedding"
A nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the Langerhans cells based on which statement?
"Langerhans cells are the immunologic cells responsible for recognizing foreign antigens that are harmful to the body"
A young child asks, "How does our skin get nourished so it does not die and fall off?" The best response by the nurse would be which statement?
"Like the rest of our cells, capillaries, arteries, and veins bring nutrients to the top layer of the skin"
A client shows the nurse an area on his arm where he has repeatedly been giving insulin injections to himself. The nurse feels the area and the skin appears to be thin. The nurse feels a "valley" or indentation in the area. What would the nurse tell the client?
"This is an area of atrophy"
A skin care consultant informs the client that he needs to bathe and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that:
A basal cell is mitotically active and pushes older dead cells to the skin's surface
Which term is correctly linked with its definition?
A corn is a keratinous thickening of skin
A man's primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching to avoid lichenization. What is the most likely categorization of the man's skin lesion?
A rash
Most of the body's hair follicles are paired with which anatomical part?
A sebaceous gland
A teenager is interested in determining the cause of his acne. Which factors contribute to an increase in sebum production that can lead to acne? Select all that apply.
Adolescence - Enlargement of sebaceous glands - Rise in androgen hormone levels - Inflammation of the sebaceous glands
Which statement about the structure of the skin is correct?
All five layers of the epidermis lack a blood supply
Which structure would likely be present in a hair follicle in a man's groin but not in a follicle on his face?
Apocrine gland
Which statement about temperature regulation and skin is accurate?
Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation
The nurse has completed an assessment of a client and noted a hyperkeratotic plaque of skin that resulted from chronic pressure or friction. The nurse would document this as:
Callus
An industrial laborer uses his hands every day when he lifts and transfers heavy materials. Which integumentary adaptation to his work is normal?
Calluses
When trying to explain the advantages of using an emollient over other products to a client suffering from dry skin, the nurse will emphasize that emollients:
Can replenish the oils on the skin surface because they contain fatty acids
A 70-year-old client has needed to reduce the frequency of bathing due to dry skin. Which factor has resulted in this age-related change in skin function?
Change in composition of sebaceous secretions
A client accidentally cuts his hand at work and comes to the clinic for stitches. The nurse understands that the client's immune system will be initially activated by which cells found in the dermis?
Dermal macrophages
A child with strep throat is given a prescription for penicillin. After the first dose, the parents call to report the development of a skin rash. Which skin lesion description leads the provider to discontinue the medication and encourage them to seek help if the child has trouble breathing?
Elevated, irregular mass of varying sizes
Which layer of the skin contains cells responsible for skin color, tanning, and protection from the sun's ultraviolet radiation?
Epidermis
Which stratum layer of the epidermis has cells working to lose cytoplasm and DNA while synthesizing keratin?
Granulosum
Age-related melanin deficiency leads to which manifestation?
Graying hair
Which factor is genetically determined and primarily responsible for dark skin tone?
High production of melanin
A parent calls the health care provider reporting the child has red sores on the face, especially around the nose and mouth that have pus/fluid inside and when the sores burst, they develop a honey-colored crust. The parent is asking whether to make an appointment. Which contagious skin lesion does the provider think the child has developed?
Impetigo pustule
A nurse is teaching individuals at a community health fair about the effects of photoaging due to sun exposure. Which group of people are best protected from these effects?
Individuals with dark skin
What is a physiologic basis for albinism?
Lack of tyrosinase
A student with a rash goes to the school nurse for evaluation. The nurse suspects the student has contact dermatitis. The primary cell responsible for this delayed-type hypersensitivity reaction is:
Langerhans cells
Among the skin's protective functions is the fact that it serves as an immunologic barrier. What cells are responsible for detecting foreign antigens?
Langerhans cells
Which type of cells form a network to bind and process antigens in the epidermis?
Langerhans cells
During finals week, a college student notices an increase in the amount of acne on the face. Which physiological principal is responsible for this acne during times of added stress?
Langerhans cells are innervated by sympathetic nerve fibers, which may explain why the skin's immune system is altered under stress
Which immune cells are found in the dermis? Select all that apply.
Macrophages, T cells, Mast cells, Fibroblasts
A client expresses concern to the nurse about an area of skin on the chest that has recently turned white and was diagnosed as vitiligo. Which principle best explains the cause of vitiligo to the client?
Melanocytes are destroyed, leading to a complete absence of melanin pigment
A client has sought care for a serious sunburn that resulted from falling asleep at the beach. What physiologic process was involved in the client's overexposure to ultraviolet radiation?
Melanocytes were unable to sufficiently protect that client
Select the cells of the epidermis that are responsible for providing sensory information.
Merkel cells
Which are the sparsest cells in the epidermis?
Merkel cells
The nurse should rely on verbal history when assessing for which condition in clients with dark skin color? Select all that apply.
Pallor, cyanosis, erythema
A nurse is teaching a client about psoriasis. The nurse knows that teaching is effective when the client correctly identifies which lesions as being associated with psoriasis? Select all that apply.
Plaques, scales
A boy has arrived home after experiencing his first outdoor camping trip with his Boy Scout troop. Upon arrival at home, he is very uncomfortable and scratches a rash. It appears that he has poison ivy and that it has spread to many areas on his body. The nurse in the clinic will likely prescribe which treatment for this child? Select all that apply.
Prescription for corticosteroids - Cool showers, especially right before bedtime - Over-the-counter antihistamines
The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. This particular vascular structure allows a client to:
Regulate body temperature
Which cells are characterized by a complex meshwork of dense collagen bundles interconnected with large elastic fibers and a viscid gel that is rich in mucopolysaccharides?
Reticular cells
Select the layer of dermis characterized by a complex meshwork of three-dimensional collagen bundles interconnected with large elastic fibers.
Reticular dermis
Sebaceous glands excrete a mixture of lipids that lubricates the hair and skin. What is this mixture called?
Sebum
Select the statement that best describes skin disorders.
Skin color may influence the appearance of the skin disorder
Pruritis, or the itch sensation, is a by-product of almost all skin disorders. However, we can itch without having a skin disorder. Itch then can be local or central in our bodies. Where is it postulated that a central "itch center" exists?
Somatosensory cortex
A nurse educator is teaching students about the layers of the skin. Which layer is commonly referred to as prickle cells?
Stratum spinosum
Most of the skin's blood vessels are innervated by which component of the nervous system?
Sympathetic nervous system
Which are considered functions of the skin? Select all that apply.
Synthesis of Vitamin D - Protection from an invasion of microbes - Protection against physical injury
A biology class is discussing blood flow directions and the role of arteries and veins. The professor says, "The skin is the only place where there is a direct anastomosis between an artery and a vein." What is the purpose for this type of blood flow in the skin?
Temperature regulation
Fingernails and toenails, unlike hair, grow continuously. The nail plate itself is nearly transparent and acts as a window for viewing:
The amount of oxygen in the blood
A nurse educator is preparing an education module on the dermis layer of the skin for the nursing staff. Which statements should be included in the module? Select all that apply.
The dermis is the connective tissue layer - The pink color of light skin results primarily from blood in the vessels of the dermis - The glandular structures are embedded in this layer
Which statement about nevi (common moles) is true?
They are an elevated, palpable, solid mass with a circumscribed border
The pars reticularis is characterized by what?
Three-dimensional collagen bundles
Why do sebaceous glands secrete sebum?
To lubricate skin and hair
A client with pale skin, white hair, and pink eyes comes to the clinic for a routine physical exam. Based on the client's appearance, the nurse knows this client has a genetic lack of which enzyme?
Tyrosinase
A nurse is preparing for a certification course in wound care and needs to be able to identify various lesions that may be identified when assessing the skin. Which definitions are correctly identified with their skin lesion? Select all that apply.
Vesicle: A circumscribed, elevated palpable mass containing serous fluid, <0/5ml - Nodule: Solid, elevated, hard or soft, larger than 0.5cm circumscribed
A 22-year-old male college student goes to clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the provider notes the lesions are between 2 and 4 mm in diameter and filled with serous fluid. Which term will the clinician document in the record?
Vesicles
Which skin disorder is likely to result from the localized lack of melanin production by melanocytes?
Vitiligo
