Chapter 51 Study Guide

A nurse is assessing a client's apocrine sweat glands. Which locations should be looked at? Select all that apply.

Axillae Anal area Genitals

An individual has developed blisters on the palms of her hands after gardening for several hours. What physiologic process has contributed to the client's blisters?

Intercellular junctions have separated, allowing the accumulation of fluid.

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

Which statement might the nurse tell a client with pruritus? Select all that apply.

"Assess the area for dry skin and apply moisturizing lotion." "Take cool showers before bedtime." "Maintain cool temperatures in the home." "Maintain humidification of the home."

Following laparoscopic gall bladder surgery, a client has a 2-in (5-cm) incision that is elevated, irregular, and a different color from the normal skin. The client asks, "What is wrong with this incision? It's been 2 years and I expected no visible sign of this surgery since it was laparoscopic." How will the nurse explain this condition?

"Your body formed excessive collagen during the healing process."

A high school athlete has developed a fungal infection between the toes where it is red, sore, and cracked into the dermis. Which term is the most accurate for the nurse to document in the client's record?

A fissure

Which clients would experience an accelerated rate of cell division in the stratum germinativum layer?

A motorcycle accident client with large abrasions on the lower limbs

The nurse is caring for a client with an infection and fever. The client reports feeling chilled and having "goose bumps." The nurse will anticipate what change in the client's assessment findings as a result of this physiologic reaction?

An increase in body temperature

A frustrated 26-year-old female has sought a referral to a dermatologist in an effort to resolve her sweating and body odor which persist despite good hygiene. Which facts would underlie the explanation that her health care provider provides about her problem?

Apocrine sweat glands produce a substance that is more oily than sweat from other sources.

A nurse is assessing a client with a 2-cm second-degree burn on the arm. This burn is characterized by the presence of:

Bullae

While breaking in a new pair of shoes, a client develops a large (1 cm) lesion filled with clear fluid. Which term will the health care provider document in the client's chart?

Bullae

An older adult client asks the nurse why her skin is so dry. Which response is best for the nurse to give to this client? Select all that apply.

Changes occur in the sebaceous gland. A decrease in skin capillaries occurs. Flattening of the dermal rete ridges occurs.

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 nurse assesses the skin of a client for xerosis based on the fact that it may occur in a susceptible person as a consequence of which case?

Diabetes

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

A client is diagnosed as having a bullous pemphigoid. The nurse teaches the client that the blisters are occurring in which layer of the skin?

Epidermis

After falling off his bicycle, an 8-year-old boy has a large abrasion on his posterior thigh that has removed the epidermis in the region but left the dermis largely intact. Which change in integumentary system would be expected in the area of his wound?

Fewer Merkel and Langerhans cells in the region

Clinical investigation of a 40-year-old female client with diverse dermatologic signs and symptoms has focused on the woman's basement membrane. Which skin function would a clinician most likely attribute to a region of the integument other than the basement membrane?

Lack of sensory nerve impulse conduction

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

A nurse educator is instructing students on the importance of a skin assessment to help identify underlying systemic disease. Which assessments are correctly correlated to the identified disease? Select all that apply.

Malar rash associated with systemic lupus erythematosus Bronze skin associated with Addison disease Jaundice associated with liver disease

With eyes closed, an object is placed in a student's hand. The instructor asks the student to identify the object. When he does so correctly, this is primarily the responsibility of:

Meissner corpuscles

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

The nurse caring for a client with extreme xerosis applies which type of agent to minimize the loss of water from the skin?

Occlusives

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 person with severe lymphedema is asking the nurse where specifically the lymph vessels are located in the skin layers. What would the nurse would respond?

Papillary dermis layer

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 first-line treatment for dry skin is moisturizing agents. How do these agents work?

Repairing the skin barrier

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather, which then helps conserve body heat?" The best answer is:

Sebum, secreted by the sebaceous gland

A nurse educator is instructing individuals at a health fair about the body's natural defenses. Which potentially harmful environmental agent does the skin provide defense against on a daily basis? Select all that apply.

Sunlight Microorganisms Cigarette smoke

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 best conveys an aspect of the process of keratinization?

The stratum germinativum continuously produces new keratinocytes to replace losses.

A client of Asian descent requests treatment suggestions for the darkened macules on the face. Which treatment measures for melasma should be recommended? Select all that apply.

Try to limit amount of time in the sun Use sunscreen regularly Consult a health care provider about using a bleaching agent

An older adult client has noticeable dry skin that is rough and scaly. The client is frequently scratching, resulting in cracking and other skin problems. Which intervention(s) would the nurse consider important to discuss with this client? Select all that apply.

Use occlusive, petroleum-based creams every morning and night Use room humidifiers, especially in bed room Apply emollients to the skin surface, applying frequently

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, <0.5 cm Nodule: Solid, elevated, hard or soft, larger than 0.5 cm 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

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.

The nurse is assessing a client with darker skin. The nurse is aware that: Select all that apply.

it will be difficult to assess skin pallor. erythema will be difficult to observe. verbal histories are important in skin assessment.