Patho- Quiz 1- Ch. 51

Which type of cells form a network to bind and process antigens in the epidermis?

Langerhans cells

Nursing assessment documents that a client has pruritus. Which plan of care is most appropriate for this client?

Smoothing the skin to minimize the itching sensation

A client with a parathyroid tumor has elevated calcium levels and low vitamin D levels. The provider suggests that the client get 15 to 20 minutes of unprotected sunlight per day, if possible. How will the provider explain why this intervention will help raise vitamin D levels for this client?

"A substance called 7-dehydrocholesterol is converted to an inactive form of vitamin D by UV rays from the sun."

An adolescent, who is an athlete, asks the health care provider, "Why do I now have such awful body odor? What has changed in my body?" Which response is the best reply?

"Apocrine sweat glands open through a hair follicle and secrete an oily substance that mixes with bacteria on the skin, producing body odor."

Which statement is the nurse's best description of a wheal?

"It is an elevated mass with irregular borders."

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.

The health care provider has recommended that a client with unusually dry skin buy an over-the-counter lotion that contains alpha-hydroxy acids. While educating the client about this, what is the nurse's best statement on the subject?

"Look for a lotion that has an abundance of fruit additives as an ingredient."

A client arrives with a very large blister on the heel from "new shoes" and fear having "damaged" the structures (ligaments and tendons) beyond repair and want to know "what caused this blister?" Which nursing response is best in this situation?

"This blister is caused by mechanical friction from repeated rubbing on this area. The fluid is in the basement membrane between the epidermis and dermis."

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."

The nurse is assessing a newborn who has been diagnosed with albinism. The newborn's parent asks what leads to albinism. Which response by the nurse is most accurate?

"Your baby was born with the inability to produce an enzyme called tyrosinase, leading to a lack of melanin."

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."

The parent of an infant recently diagnosed with albinism asks, "Why did this happen to my infant?" Which response by the nurse is most appropriate?

"Your infant is not producing the enzyme tyrosinase, which is needed to synthesize melanin. Melanin protects the skin from UV rays and adds color to the skin."

The nurse assesses a rash on the client's skin. What statement concerning this is true?

A rash is a temporary eruption of the skin

Eczema is defined as:

Acute, red, itchy, vesicular-crusted lesion

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

Which type of moisturizer will assist the nurse in treating a client with dry skin to replenish the oils but not leave a residue on the skin?

Emollient

Which stratum layer of the epidermis has cells working to lose cytoplasm and DNA while synthesizing keratin?

Granulosum

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 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

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

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 harmful to the body.

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 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

A nurse assesses a client with a 3-cm lipoma in the subcutaneous tissue. Which term would best describe this lesion?

Nodule

A client is instructed on the use of moisturizers to relieve dry skin. Which moisturizer is the most effective agent for relieving skin dryness?

Occlusives

A preschooler asks the parents at bath time, "Why are my nipples red?" Which form of melanin is responsible for the coloring of nipples and lips in humans?

Pheomelanin

The nurse is assessing a client who has a small pinpoint rash. What is the best cause of this rash?

Pinpoint petechiae

A client has several cysts in a particular area. Which assessment confirms this finding?

Presence of several fluid-filled semisolid masses in the subcutaneous tissue

Which are considered functions of the skin? Select all that apply.

Protection from an invasion of microbes, Synthesis of vitamin D, Protection against physical injury

Select the layer of dermis characterized by a complex meshwork of three-dimensional collagen bundles interconnected with large elastic fibers

Reticular dermis

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

Mitosis that results in the production of new epidermal cells occurs in which layer of the epidermis?

Stratum germinativum

Most of the skin's blood vessels are innervated by which component of the nervous system?

Sympathetic nervous system

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

Lichenified skin is defined as being:

Thickened skin with exaggerated markings

Why do sebaceous glands secrete sebum?

To lubricate hair and skin

When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin?

Tyrosinase

A client visiting the family medical physician is reporting her skin itching [pruritus]. Given that this is severe enough to causing excessive scratching that has broken the skin, the health care provider may want to educate the client to try which intervention?

Utilize topical antihistamines or corticosteroids for cutaneous disorders mediated by histamine

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

During an examination, a nurse notices a semisolid mass in the subcutaneous tissue on the neck of a client. When documenting this finding, the nurse would identify this condition using which term?

cyst

Which factor is genetically determined and primarily responsible for dark skin tone?

high production of melanin

The skin assessment of a black client reveals the presence of white areas on the skin that are flat, non-palpable, less than 1 cm in diameter, and have a circumscribed border. How does the nurse document the finding?

macule

A client is experiencing generalized itching. Which terminology does the nurse document in the records?

pruritis

In explaining a papule to a client, a nurse defines it as being a:

small, raised solid mass with a circumscribed border

What is the source of nutrition for the epidermis?

the dermis