Deck 49: Assessment of Integumentary Function

Question 1

The nurse correlates an older patient's complaints of always feeling cold to which age-related change to the integumentary system?
1)Fewer protein stores
2)Decreased subcutaneous tissue
3)Reduced levels of immune cells
4)Slower blood flow to the skin layers

Answer 1

2

Question 2

The nurse correlates which clinical manifestation to the patient diagnosed with chronic dermatitis?
1)Dry exudate in the wound bed
2)Flaky skin
3)Red, moist, open vesicle
4)Irregularly shaped patches of rough, thick skin

Answer 2

4

Question 3

The nurse correlates dry, itchy, burning skin in an older patient to which age-related change in the integumentary system?
1)Xerosis
2)Eczema
3)Psoriasis
4)Herpes zoster

Answer 3

1

Question 4

The nurse notes that a male patient is bald. What is the status of the hair follicles on the head of this patient?
1)Dead
2)In the resting phase
3)Awaiting keratinization
4)Pausing in the growth cycle

Question 5

An older patient says that sunlight has always been avoided because of the risk for developing skin cancer. Which function of the skin has been most affected by this patient's practice?
1)Sensation
2)Protection
3)Vitamin D metabolism
4)Temperature regulation

Question 6

A patient asks why it takes so long for fingernails to grow. How should the nurse respond to this patient?
1)"Nail growth speeds up as a person ages."
2)"Nails have a slow but continuous growth process."
3)"Slow nail growth is associated with vitamin deficiencies."
4)"This could mean you have an undiagnosed disease process."

Question 7

The nurse monitors which skin changes in the patient diagnosed with vascular insufficiency?
1)Cyanosis
2)Erythema
3)Icterus
4)Hemosiderin

Question 8

In preparing a teaching session about hair loss, the nurse incorporates which information about the relationship between hair and the skin?
1)Hair follicles are anchored and protrude through the dermis.
2)Hair follicles are anchored and protrude through the epidermis.
3)Hair follicles are anchored in the dermis and protrude through the epidermis.
4)Hair follicles are anchored in the hypodermis and protrude through the dermis.

Question 9

The nurse is preparing information on the integumentary system for a group of high school students. Which layer of the skin should the nurse explain plays an initial role in immunity?
1)Dermis
2)Hypodermis
3)Innermost layer of the epidermis
4)Outermost layer of the epidermis

Question 10

In documenting a patient's skin lesion, what term does the nurse use to document a ring-shaped lesion?
1)Linear
2)Annular
3)Satellite
4)Polymorphous

Question 11

An older adult patient asks why a wound is taking so long to heal. What is the nurse's best response?
1)"There is less protein in the skin with aging."
2)"The tissue between the skin cells is weaker."
3)"The amount of blood flow to the skin is slower with aging."
4)"The number of immune cells in the skin reduces with aging."

Question 12

In collecting a wound culture, what action does the nurse need to take prior to obtaining the specimen?
1)Apply clean gloves
2)Flush the wound bed with sterile saline
3)Cleanse the wound with antimicrobial solution
4)Keep the wound open to air for several minutes

Question 13

In completing a skin assessment, the nurse notes small, firm, elevated lesions less than one centimeter in diameter. What term does the nurse use to document these finding?
1)Macules
2)Papules
3)Vesicles
4)Cysts

Question 14

The nurse monitors for which skin changes in the patient diagnosed with liver disease?
1)Pallor
2)Jaundice
3)Cyanosis
4)Brown spots

Question 15

In using the Braden Scale to assess a patient's skin, which category does the nurse recognize as the most sensitive indicator for risk of pressure injury?
1)Friction
2)Mobility
3)Moisture
4)Pain

Question 16

The nurse correlates longitudinal red lines in the fingernails to which health problem?
1)Lymphedema
2)Respiratory failure
3)Bacterial endocarditis
4)Inflammatory bowel disease

Question 17

The nurse monitors for which skin changes in the patient diagnosed with type 2 diabetes mellitus (DM)?
1)Finger clubbing
2)Dermatitis
3)Numbness in the extremities
4)Wet wounds from the ankle to the midcalf

Question 18

The nurse is caring for a patient with a major burn on the right arm. Which function of the skin is most affected by this injury?
1)Sensation
2)Excretion
3)Protection
4)Metabolism

Question 19

The nurse notes that a patient's skin and hair are dry. Which function of the skin is most likely malfunctioning?
1)Sensation
2)Excretion
3)Protection
4)Metabolism

Question 20

Which medication does the nurse correlate to the treatment of areas of psoriasis on the arms and legs?
1)Topical steroids
2)Topical Benadryl
3)Lidocaine patches
4)Systemic antibiotics

Question 21

The results of a patient's biopsy indicate a malignant growth. The nurse prepares the patient for which treatment?
1)Systemic medication
2)Additional diagnostic testing
3)Topical antibiotic medication
4)Surgical removal of the lesion

Question 22

The nurse is preparing information for high school students about the skin. What does the nurse include about the function of the glands in the skin? Select all that apply.
1)Eccrine sweat glands serve to cool the body.
2)Apocrine sweat glands contribute to body odor.
3)The glands create strength and elastic recoil to the skin.
4)They support temperature regulation through dilation and constriction.
5)Sebaceous glands produce a substance that moisturizes the hair and skin.

Question 23

The nurse correlates chemical damage to the skin to which factors? Select all that apply.
1)Urine
2)Stool
3)Adhesives
4)Immobility
5)Gastric fluids

Question 24

A patient recovering from a punch biopsy calls the community clinic because the site is red, warm, and painful. What does the nurse direct this patient to do?
1)Take an over-the-counter analgesic
2)Clean the site with hydrogen peroxide
3)Go immediately to the emergency department
4)Remove the dressing and flush with sterile saline

Question 25

A patient is to undergo a punch biopsy of a lesion. What actions does the nurse take when assisting in the collection of this specimen? Select all that apply.
1)A sterile blade will be used.
2)The site may need stitches.
3)Local anesthesia will be provided.
4)The entire lesion may be removed.
5)The sample includes epidermis, dermis, and subcutaneous tissue.

Question 26

A patient is suspected as having a fungal infection. What does the nurse need to have available during the evaluation of this skin area?
1)Sterile water
2)Potassium chloride
3)Sterile normal saline
4)Potassium hydroxide

Question 27

In assessing a change in a patient's integrity, which findings require the nurse to notify the healthcare provider? Select all that apply.
1)A lesion with irregular borders.
2)A lesion with no color variations.
3)A lesion that is 7 mm in diameter.
4)A lesion with a symmetrical shape.
5)A lesion with a sparse amount of hair.

Question 28

The nurse instructs a patient on care required after a punch biopsy. Which patient statement indicates that teaching has been effective?
1)"I should avoid showering for several days."
2)"I should change the bandage on the site once a day."
3)"I should call the doctor if there is any blood on the dressing."
4)"I should call the doctor if the site is not healed in a few days."

Question 29

"Possible viral skin infection" is documented in a patient's medical record. Which infections does the nurse consider as causing the patient's skin problem? Select all that apply.
1)Rubella
2)Measles
3)Cellulitis
4)Folliculitis
5)Herpes simplex

Question 30

The nurse notes that a patient's skin is dry, discolored, and easily torn. The nurse correlates these skins changes to the patient taking which medications? Select all that apply.
1)Steroids
2)Furosemide
3)Amiodarone
4)Warfarin sodium
5)Nonsteroidal anti-inflammatory drugs (NSAIDs)