Integumentary System

What equipment is most important to have readily available when a patient is undergoing skin testing for allergies? 1. Resuscitation equipment 2. Flashlight 3. Measuring device 4. Alcohol and cotton swabs

1. Resuscitation equipment

Which layer of the skin, if unbroken, prevents entry of most pathogens? 1. Stratum corneum 2. Papillary layer 3. Stratum germinativum 4. Dermis

1. Stratum corneum

Which of the following actions is appropriate initial treatment of a chemical burn? 1. Lavage with water. 2. Neutralize the chemical. 3. Apply the prescribed topical agent. 4. Wrap the patient in sterile sheets.

1. Lavage with water.

The nurse notes scratch marks on a patient with psoriasis. What interventions can the nurse teach the patient that will decrease itching and protect the skin? Select all that apply. 1. Apply pressure to the itchy area with a clean cloth. 2. Encourage use of gloves at night. 3. Bathe daily in a hot soapy bath. 4. Consider taking an antihistamine at bedtime. 5. Use a room humidifier.

1. Apply pressure to the itchy area with a clean cloth. 2. Encourage use of gloves at night. 4. Consider taking an antihistamine at bedtime. 5. Use a room humidifier.

A patient has a burn encircling the left thigh from a motorcycle accident. When the nurse enters the room during rounds, the patient appears very anxious and reports a funny feeling in the left foot. What should the nurse do first? 1. check the circulatory status in the foot and report changes 2. Explain that some numbness and tingling in the affected extremity are normal following. auburn 3. check the burn dressing for an increase in drainage 4. determine the cause of the patient's anxiety

1. check the circulatory status in the foot and report changes

A patient diagnosed with impetigo contagiosa wants to know when the disease will no longer be contagious. Which response by the nurse is correct? 1. "One week after treatment is started." 2. "After the spread of lesions has stopped." 3. "After all the lesions crust over." 4. "When all lesions are healed."

4. "When all lesions are healed."

Which instruction should the nurse provide to the patient being treated for scabies? 1. "Dry clean all linens, towels, and clothes." 2. "Wash linens, towels, and clothes." 3. "Discard infested mattresses." 4. "Remove infested pets from the home."

2. "Wash linens, towels, and clothes."

A patient is brought to the emergency department after a house fire. The patient has extensive trunk and lower extremity burns and is diagnosed with a deep partial-thickness burn. What assessment findings does the nurse expect? 1. Snowy white, painless lesions 2. Blistered, pinkish-white, painful lesions 3. Blackened, painful lesions 4. Bright-red, moist lesions

2. Blistered, pinkish-white, painful lesions

Which nursing interventions are essential to achieve maximum benefit for the patient receiving balneotherapy for widespread dermatitis? Select all that apply. 1. Maintain the bath water at the hottest temperature tolerated by the patient. 2. Keep the patient in the water for 15 to 30 minutes. 3. Keep the tub room warm. 4. Dry the skin vigorously following the bath. 5. Use gentle or emollient soaps.

2. Keep the patient in the water for 15 to 30 minutes. 3. Keep the tub room warm. 5. Use gentle or emollient soaps.

Which substances are formed in the skin when the ultraviolet rays of the sun strike the skin? 1. Vitamin A and keratin 2. Melanin and vitamin D 3. Sebum and vitamin A 4. Keratin and melanin

2. Melanin and Vitamin D

A patient develops pressure injuries on the sacrum and buttocks despite being turned and repositioned regularly. Which factors may have contributed to the patient's skin breakdown? Select all that apply. 1. The patient is 20 pounds overweight. 2. The patient commonly slides down in the chair. 3. Staff use a lift sheet to move the patient in bed. 4. The patient sits in a chair most of the day. 5. The patient is often diaphoretic. 6. The patient is incontinent of urine and stool.

2. The patient commonly slides down in the chair. 4. The patient sits in a chair most of the day. 5. The patient is often diaphoretic. 6. The patient is incontinent of urine and stool.

Which cause of or type of burn is commonly associated with an inhalation injury? 1. electrical 2. flame 3. scald 4. contact

2. flame

Which nursing intervention is essential to protecting the patient's skin integrity when applying occlusive dressings? 1. Make sure all skin surfaces are covered. 2.Remove the dressings for 12 of every 24 hours. 3. Apply a thick layer of prescribed ointment before applying the dressings. 4. Apply a gauze dressing next to the skin, underneath the plastic film.

2.Remove the dressings for 12 of every 24 hours.

How do arterioles in the dermis respond to a cold environment? 1. Dilate to release heat 2. Constrict to release heat 3. Dilate to conserve heat 4. Constrict to conserve heat

4. Constrict to conserve heat

How will the nurse know if interventions for impaired gas exchange related to smoke inhalation have been effective? 1. Partial pressure of carbon dioxide (PaCO2) is greater than 45 mm Hg. 2. Oxygen saturation (SpO2) is less than 90%. 3. pH is 7.34. 4. Partial pressure of oxygen (PaO2) is 88 mm Hg.

4. Partial pressure of oxygen (PaO2) is 88 mm Hg.

A patient is admitted to the emergency department with flame burns to the entire chest, abdomen, back, and upper extremities. Using the Rule of Nines, what approximate percentage of burns should the nurse document? 1. 36% 2. 45% 3. 54% 4. 64%

3. 54%

Which of the following tissues stores fat in subcutaneous tissue? 1. Fibrous connective tissue 2. Stratified squamous epithelium 3. Adipose tissue 4. Areolar connective tissue

3. Adipose tissue

When is the best time for the nurse to apply prescribed ointment to a patient with an inflamed skin rash? 1. In the morning before the patient dresses 2. When the patient will be resting for at least an hour 3. After the patient bathes 4. In the evening before bed

3. After the patient bathes

What information is most important for the nurse to teach patients about avoiding malignant skin lesions? 1. Shower or bathe daily. 2. Avoid contact with allergens and irritants. 3. Avoid overexposure to ultraviolet rays. 4. Avoid others with malignant lesions

3. Avoid overexposure to ultraviolet rays.

Which nursing interventions are appropriate for a patient with a circumferential burn to an extremity? Select all that apply. 1. Apply compression bandages starting at the distal end of the extremity. 2. Administer analgesics if numbness or tingling occur. 3. Check neurovascular status hourly. 4. Assist with escharotomy if indicated. 5. Elevate the extremity.

3. Check neurovascular status hourly. 4. Assist with escharotomy if indicated. 5. Elevate the extremity.

White blood cells, which destroy pathogens that enter breaks in the skin, are found in which of the following structures? 1. Stratum corneum 2. Keratinized layer 3. Subcutaneous tissue 4. Adipose tissue

3. Subcutaneous tissue

Which term should the nurse use to document a raised, fluid-filled lesion smaller than 1 centimeter? 1. Macule 2. Papule 3. Vesicle 4. Wheal

3. Vesicle

Which type of burn is caused by a hot liquid? 1. radiation 2. contact 3. scald 4. chemical

3. scald

The nurse notes a pressure injury on a newly admitted patient's ischial tuberosity, with a thick, tough black center. Which intervention is most appropriate first? 1. Coat the wound with antibiotic ointment. 2. Snip away the black tissue with sterile scissors. 3. Flush the wound with sterile saline. 4. Talk to the health care provider about débridement.

4. Talk to the health care provider about débridement.

During morning report, a nurse is assigned a patient who is in stage 3 burn care. What care can the nurse anticipate providing during the shift? 1. dressing changes 2. debridement 3. pain management 4. exercises

4. exercises

A nurse is reviewing information about a new prescription for corticosteroid cream with a client who's milk psoriasis. Which of the following instructions should the nurse include? (Select all that apply) A. Apply an occlusive dressing after application B. Apply 3 to 4 times a day C. Wear gloves after application to lesions on the hands D. Avoid applying in skin folds E. Use medication continuously over a period of several months

A. Apply an occlusive dressing after application (enhances the efficacy of the topical corticosteroid on the exposed lesions) C. Wear gloves after application to lesions on the hands (chance the efficiency of the topical medication) D. Avoid applying in skin folds (Increases the risk for yeast infections)

A nurse is contributing to a plan of care for an adult client who sustained severe burn injuries. Which of the following interventions should the nurse recommend for inclusion the plan of care? Select all tat apply A. Limit visitors in the client's room B. Encourage fresh vegetables in the diet C. Increase protein intake D. Instruct the client to consume 2,000 calories/day E. Restrict fresh flowers in the room

A. Limit visitors in the client's room (To decrease risk for infection) C. Increase protein intake (Promotes healing and prevents tissue breakdown) E. Restrict fresh flowers in the room (Due to the bacteria they carry, which increases the risk for infection)

A nurse is caring for a client who has a suspected fungal skin lesion. Which of the following lab findings should the nurse expect to review to confirm this diagnosis? A. Potassium hydroxide (KOH) B. Diascopy C. Tzanck smear report D. Biopsy

A. Potassium hydroxide (KOH) This test reveals if skin lesions are fungal in origin.

A nurse in a providers office is collecting data from a client who has a sever sunburn. Which of the following classifications should the nurse use to document this burn? A. Superficial thickness B. Superficial partial thickness C. Deep partial thickness D. Full thickness

A. Superficial thickness A sunburn is a superficial thickness burn. Superficial burns damage the top layer of the skin.

A nurse is collecting data from a client who sustained deep-partial thickness and full-thickness burns over 40% of the body 24 hr ago. Which of the following findings are common during this phase? Select all that apply. A. Temperature 97F B. Bradycardia C. Hyperkalemia D. Hyponatremia E. Decreased hematocrit

A. Temperature 97F (decreased temperature can occur in the first few hours following a burn, because the body's ability to regulate temperature is compromised) C. Hyperkalemia (happens as a result of leakage of f fluid from the intracellular space) D. Hyponatremia (As a result in sodium retention in the interstitial space)

Melanin

Acts as a barrier to UV light

A nurse is caring for a client who has herpes zoster. Which of the following medications should the nurse expect to administer for treatment? A. Clotrimazole B. Acyclovir C. Gabapentin D. Penicillin

B. Acyclovir It is an antiviral medication used to treat viral infections (herpes zoster).

A nurse is reinforcing teaching with a client who has a history of psoriasis about photo chemotherapy and UV light (PUVA) treatments. Which of the following intructions should the nurse include? A. Apply vitamin A cream before each treatment B. Administer a psoralen medication before treatment C. Use this treatment every evening D. Remove the scales gently following each treatment

B. Administer a psoralen medication before treatment PUVA treatments involves the administration of psoralen to enhance photosensitivity

A nurse caring for a client who has contact dermatitis and has a new prescription for diphenhydramine. For which of the following adverse effects should the nurse monitor. A. Elevated blood glucose levels B. Anorexia C. Increased salvation D. Insomnia

B. Anorexia

A nurse is reinforcing teaching with a client on the use of calcipotriene topical medication for the treatment of psoriasis. Which of the following laboratory values should the nurse monitor? A. Potassium B. Calcium C. Sodium D. Chloride

B. Calcium Hypercalcemia is a possible adverse effect of calcipotriene.

A nurse is reinforcing teaching to a client about a new prescription for clotrimazole topical cream. Which of the following statements should the nurse include? A. "It reduces the discomfort of a herpetic infection but does not cure the infection." B. "This is a cream to treat bacterial infection." C. "Apply the topical medication for up to 2 weeks after the fungal lesions are gone." D. "Apply the cream to lesions while they are moist."

C. "Apply the topical medication for up to 2 weeks after the fungal lesions are gone." Clotrimazole is a medication used to treat fungal infections and is applied for 1 to 2 weeks after the infection is resolved.

A nurse is reinforcing discharge instructions to a client who had a skin biopsy with sutures. The nurse should identify that which of the following client statements indicates understanding? A. "I can expect redness around the site for 5 to 7 days" B. "I will most likely have a fever in the first few days" C. "I should apply an antibiotic ointment to the area" D. "I will make a return appointment in 3 days for removal of my sutures"

C. "I should apply an antibiotic ointment to the area" Antibiotic ointment is applied as prescribed by the provider to prevent infection.

A nurse is reinforcing teaching with a client on home care after a culture for a bacterial infection and cellulitis. Which of the following information should the nurse include? A. Bathe daily with moisturizing soap B. Apply antibacterial topical medication to the crusted exudate C. Apply warm compress to the affected area D. Cover the affected area with snug fitting clothing

C. Apply warm compress to the affected area Patient should apply a warm compress to affected area to promote comfort.

A nurse is caring for a client who has sustained burns over 35% of total body surface area. The client's voice has become hoarse, a brassy cough has developed, and the client is drooling. The nurse should identify these findings as indications that the client has which of the following? A. Pulmonary edema B. Bacterial pneumonia C. Inhalation injury D. Carbon monoxide poisoning

C. Inhalation injury wheezing and hoarseness indicate inhalation injury with impending loss of the airway. These require immediate reporting to the provider.

A nurse is assisting with the care of a client who sustained deep partial-thickness and full-thickness burns over 60% of their body 24hr ago and is requesting pain medication. The nurse should ensure the medication is administered using which of the following rotes to administer the medications? A. Subcutaneous B. Oral C. Intravenous D. Transdermal

C. Intravenous Use IV route for rapid absorption and fast pain relief during the resuscitation phase.

A nurse is reinforcing teaching with the guardian of a child who has contact dermatitis. Which of the following information should the nurse include? A. Use a fabric softener dryer sheets when drying the child's clothing B. Apply a warm, dry compress to the rash area C. Place the child in a bath with colloidal oatmeal D. Leave the child's hands uncovered during the night

C. Place the child in a bath with colloidal oatmeal Will help relieve the itching

Cyst

Closed sac or pouch tumor that consists of semisolid, solid, or liquid material

Dermis

Contains the accessory structures of the skin, such as glands

Macule

Flat, non palpable change in skin color

Collagen fibers

Give strength to the dermis

Stratum corneum

Made of both living and nonliving cells

Receptors

detect changes in the external environment

Papule

Palpable, solid raised lesion

Plaque

Patch or solid, raised lesion on the skin or mucous membrane that is greater than 1cm

Wheal

Round, transient elevation of the skin caused by dermal edema and surrounding capillary dilation

Pustule

Small elevation of skin or vesicle or bulla that contains pus

Vesicle

Small raised area that contains serous fluid, less than 1cm

Petechiae

Small, purplish, hemorrhagic spots on the skin

Eccrine glands

Stimulated by exercise or heat

Erythema

diffuse redness over the skin

Partial-thickness deep burn

epidermis and dermis involved, pain from exposed nerve endings

Wood light examination

Use of UV rays to detect fluorescent materials in skin and hair

Bulla

Vesicle or blister larger than 1 cm

Skin biopsy

excision of small piece of tissue for microscopic assessment

Alopecia

absence or loss of hair

Ecchymosis

black-blue bruise, changing to greenish brown or yellow with time

Epidermis

if unbroken, prevents entry of pathogens

Full-thickness burn

leathery skin, usually painless

Stratum germinativum

mitosis takes place to produce new epidermis

Superficial partial-thickness burn

pink to red moist skin; blisters may be present

Subcutaneous tissue

stores fat

Patch test

superficial testing with allergen for delayed hypersensitivity reaction

Scratch test

superficial testing with allergen for immediate reaction