Chapter 45: Structure and Function of the Skin PrepU

A patient with albinism has a genetic lack of which of the following enzymes?

Tyrosinase

Which of the following would be a nurse's best description of a pustule?

"It is a pus-filled vesicle."

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

"It is an elevated mass with irregular borders."

Which term is correctly linked with its definition?

A corn is a keratinous thickening of skin.

Lichenified skin is defined as being which one of the following?

Thickened skin with exaggerated markings

What is the purpose of the basement membrane?

To interface between the dermis and epidermis

In explaining a papule to a patient, a nurse defines it as being which of the following?

Small, raised solid mass with a circumscribed border

A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be:

"Your body has developed antibodies against basement membrane proteins."

A skin care consultant informs the client that he needs to bath 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.

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

Which of the following structures would likely be present in a hair follicle in a man's groin but not in a follicle on his face?

Aprocrine gland

Which statement concerning blood flow to the skin is true?

Arteriovenous anastomoses in the skin regulate temperature.

The nurse is recommending to a patient ways to relieve the itching sensation of his uncontrollable pruritis. Which of the following should the nurse recommend?

Cool shower

The nurse is caring for a patient with pruritis. The nurse anticipates orders for which of the following interventions?

Corticosteroids

Which of the following is the correct definition of a plaque?

Elevated, coalesced papules greater than 0.5 cm

A 42-year-old female client complains of extreme xerosis and states nothing seems to work for her skin. The most appropriate treatment would be to apply:

Emollients or occlusives are the most effective treatment

While working in an allergy clinic, the nurse notices that many patients come in with all types of skin reactions. The nurse working in this area knows that which cells play a role in the development of allergic skin condition?

Langerhans cells

The nurse notes a blister on a patient's skin. Which of the following best defines this area?

Fluid-filled papule

A nurse assesses a patient with multiple flat brown macules on the face and arms. Which of the following would best describe this lesion?

Freckles

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

Granulosum

Select the most appropriate response that describes hair color.

Hair color is attributable to the melanin pigments that the hair contains.

A patient presents with pruritus of the lower extremities. Which of the following is the priority nursing assessment?

Inspection for presence of dry skin

A school 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 nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the Langerhans cells based on which of the following statements?

Langerhans cells are the immunologic cells responsible for recognizing foreign antigens harmful to the body.

A patient comes to the clinic with a "terrible itch" on the abdomen and waist that has lasted for several months and has been scratched continuously. Inspection reveals an area of thickened rough skin. The nurse documents this condition using which of the following terms?

Lichenification

The skin assessment of an African American patient reveals the presence of white areas on the skin that are flat, nonpalpable, less than 1cm in diameter, and have a circumscribed border. The nurse documents the presence of which of the following?

Macule

A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by light touch of the individual's face. Which of the following components of the woman's skin innervation likely contributes the most to this ability?

Meissner corpuscles

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

Which are the sparsest cells in the epidermis?

Merkel cells

A nurse assesses a patient with a 3-cm lipoma in the subcutaneous tissue. Which of the following terms would best describe this lesion?

Nodule

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

Papillary dermis layer

A patient presents with lesions on his face and arms. Some are flat and some are raised. Depending on the diameter of the lesion, the nurse should document that flat lesions are either macules or

Patches

While studying the skin in a science class, a student asks why all people have a pinkish color to their lips/mucous membranes. The instructor would respond by citing which of the following responses?

Pheomelanin is the yellow to red pigment particularly concentrated in the lips and nipples in humans.

The nurse is assessing a patient who has a small pinpoint rash. Which of the following is the best cause of this rash?

Pinpoint petechiae

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 that lubricates the hair and skin. What is this mixture called?

Sebum

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 most correct student answer is:

Sebum, secreted by the sebaceous gland

A child comes in to show his parents (who are nurses) a blister on his foot from "breaking in" a new pair of shoes. The child wants to "pop the blister" to get all the fluid out of it so it won't hurt so much when he puts on shoes and socks. The parents know that breaking the skin of the blister will put him at risk for which of the following?

Secondary infection

The nurse planning a sun safety community education class should include the information that the increased melanin produced by dark-colored skin decreases the risk for which of the following?

Skin cancer

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

In assessing a client's integumentary system, what assessment finding does the nurse report as "normal"?

Sweat glands in the axillae

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

Sympathetic nervous system

Among the skin's protective functions is the fact that it serves as an immunologic barrier. What cells detect foreign antigens?

The Langerhans cells

What is the source of nutrition for the epidermis?

The dermis

The pars reticularis is characterized by what?

Three-dimensional collagen bundles

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 healthcare provider may want to educate the client to try which intervention?

Utilize topical antihistamines or corticosteroids for cutaneous disorders mediated by histamine.

During a physical assessment, a nurse determines that a patient has excessively dry skin. Which of the following terms would the nurse use to document this condition?

Xerosis

A patient with a history of chronic renal disease has severe pruritus. Which of the following interventions should the nurse include in the teaching plan for the patient? Select all that apply.

• Keep fingernails trimmed • Moisturize the skin frequently • Take a cool shower before bed

Which of the following would be considered functions of the skin? Select all that apply.

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

Which client is most likely to have a rash? Select all that apply.

• The client with an infectious disease • A baby that wears a diaper • A client who is in a hot room and has a fever

A client of Asian decent 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 healthcare provider about using a bleaching agent