CH 51 PREP U

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."

A child arrives to the outpatient clinic with a high fever of 103°F (39.5°C). The parents have the child wrapped in many blankets to "keep them warm, since the child is shivering." What is the rationale for the health care provider to educate the parents that less blankets will help the child more?

"Fever dilates vessels and results in sweating, the purpose of the eccrine sweat glands. Too many blankets are counterproductive and will actually help the temperature to go higher."

A grandchild asks the grandparent, "Why is your hair so gray?" Which response by the grandparent gives the physiologic reason for hair turning gray with aging?

"I have a decreased number of melanosome-producing melanocytes.

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

"It is an elevated mass with irregular borders."

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.

While working in an allergy clinic, the nurse notices that many clients 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

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.

Which clients are most likely to have a rash? Select all that apply

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

A client has begun to have dry skin and has asked the nurse to recommend a moisturizing agent. The client wants a product that won't leave a greasy skin residue and is willing to apply the product frequently. Which product would be the nurse's best recommendation?

An emollient

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.

Which statement concerning blood flow to the skin is true?

Arteriovenous anastomoses in the skin regulate temperature

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 40-year-old male client has a congenital syndrome that affects the function of the Langerhans cells of his epidermis. The man's care provider would expect which manifestation of his condition?

Increased susceptibility to infection

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 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 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

A nurse is teaching a client about the role that skin plays in forming a barrier to environmental agents and microorganisms. The nurse would recognize that which type of cells/junctions are involved in the communication and regulation of the immune response and the secretions of cytokines?

Keratinocytes

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

A client 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 term?

Lichenification

The health care provider has just completed a skin assessment on a client. The client asks what causes the numerous freckles that she has. The best response is:

Localized collections of eumelanin contribute to the development.

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 component of the woman's skin innervation likely contributes the most to this ability?

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

Which are the sparsest cells in the epidermis?

Merkel cells

A nurse is interviewing a light-skinned client to complete a detailed health history and functional health assessment. The client's work environment involves daily exposure to sunlight. Based on this assessment, the nurse determines that the client is at risk for which problem?

Skin cancer and wrinkles

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

Stratum germinativum

A nurse educator is teaching students about the layers of the skin. Which layer is commonly referred to as prickle cells?

Stratum spinosum

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:

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:

The pars reticularis is characterized by what?

Three-dimensional collagen bundles

Why do sebaceous glands secrete sebum

To lubricate skin and hair

Which skin disorder is likely to result from the localized lack of melanin production by melanocytes

Vitiligo

What is a physiologic basis for albinism?

What is a physiologic basis for albinism?

During a physical assessment, a nurse determines that a client has excessively dry skin. Which term would the nurse use to document this condition?

Xerosis

The nurse is caring for a client with pruritis. The nurse anticipates orders for which intervention?

corticorsteriods

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, as they are the most effective treatment

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

macule

A client reports "terrible itching" to the skin regions that are affected by eczema. This client's unpleasant sensation is best understood as a:

result of stimulation of free nerve endings.

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

small, raised solid mass with a circumscribed border

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

small, raised solid mass with a circumscribed border

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

sympathetic nervous system