Question 1

After falling off his bicycle, an 8-year-old boy has a large abrasion on his posterior thigh that has removed the epidermis in the region but left the dermis largely intact. Which of the following changes in integumentary system would be expected in the area of his wound?

A) Profuse bleeding from removal of his epidermis
B) Fewer Merkel and Langerhans cells in the region
C) Exposure of the underlying subcutaneous tissue
D) Removal of hair follicle roots from the area of the wound bed

Fewer Merkel and Langerhans cells in the region

Accepted Answer

Merkel cells and Langerhans cells are components of the epidermis. Bleeding may be minimal since the epidermis is avascular. Subcutaneous tissue is below the dermis and would not be directly exposed, and hair follicle roots exist at a deeper level than the epidermis.

Question 2

Which of the following statements best conveys an aspect of the process of keratinization?&#10;A) Keratin cells synthesized in the dermis migrate to the surface over 20 to 30 days.&#10;B) Mitosis that begins with the cells of the stratum granulosum results in a continual supply of new keratinocytes.&#10;C) The stratum germinativum continuously produces new keratinocytes to replace losses.&#10;D) The basal cells of the epidermis migrate to the skin surface at a rate that matches superficial losses of skin cells.

Accepted Answer

The stratum germinativum, or stratum basale, consists of a single layer of basal cells that are attached to the basal lamina. The basal cells, which are columnar, undergo mitosis to produce new keratinocytes that move toward the skin surface to replace cells lost during normal skin shedding. Keratinization does not originate in the dermis or stratum granulosum, and the basal cells of the epidermis do not migrate to the surface.

Question 3

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 of the following types of cells/junctions are involved in the communication and regulation of the immune response and the secretions of cytokines?

A) Gap junctions
B) Desmosomes
C) Adherens junctions
D) Keratinocytes

Keratinocytes

Accepted Answer

Keratinocytes are now known to be active secretory cells that play an important role in the immunobiology of the skin by communicating and regulating cells of the immune response and secreting cytokines and inflammatory mediators. Gap junctions allow ions and molecules to pass between skin cells, and adherens junctions provide a mechanical connection between cells. Desmosomes are localized patches or plaques that hold two cells tightly together by proteins called cadherins. They are terminal end points on the cell walls of keratinocytes.

Question 4

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?&#10;A) Melanocytes are the pigment-synthesizing cells.&#10;B) Pheomelanin is the yellow to red pigment particularly concentrated in the lips and nipples of humans.&#10;C) Tyrosinase is responsible for all-colored cell production.&#10;D) A person with tiny melanocytes will have more concentrated pigment resulting in darker color.

Accepted Answer

Pheomelanin, the yellow to red pigment, is found in all humans. It is particularly concentrated in the lips, nipples, glans penis, and vagina. Melanocytes arepigment-synthesizing cells that are scattered in the basal layer and are responsible for skin color (not mucous membranes). Tyrosinase converts the amino acid tyrosine to a precursor of melanin. If one has a lack of tyrosinase, the end result will be albinism. In dark-skinned people, larger melanin-containing melanosomes are produced and transferred individually to the keratinocyte.

Question 5

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 of the following manifestations of his condition?

A) Increased susceptibility to infection
B) High permeability of his epidermis to environmental materials
C) Lighter skin tone than other individuals of the same ethnicity
D) Frequent separation between the dermal and epidermal layer of his skin

Accepted Answer

Langerhans cells are the immunologic cells responsible for recognizing foreign antigens harmful to the body, and they play an important role in defending the body against foreign antigens. A lack of Langerhans cells would not manifest in increased permeability of the skin, unexpected coloration, or separation between layers.

Question 6

Clinical investigation of a 40-year-old female client with diverse dermatological signs and symptoms has focused on the woman's basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?

A) Lack of sensory nerve impulse conduction
B) Formation of blisters on various skin surfaces
C) Lack of adhesion between the dermis and epidermis
D) Large immunoglobulin deposits

Accepted Answer

While the basement membrane plays roles in adhering between skin layers and is a common site of immunoglobulin deposition and blister formation, it is not a major site of afferent nerve endings and consequent sensory transmission.

Question 7

A person with severe lymphedema is asking the nurse where specifically are the lymph vessels located in the skin layers. The nurse would respond,&#10;A) &#34;Basement membrane.&#34;&#10;B) &#34;Merkel cell layer.&#34;&#10;C) &#34;Subcutaneous tissue layer.&#34;&#10;D) &#34;Papillary dermis layer.&#34;

Accepted Answer

Dermal papillae contain capillaries, end arterioles, and venules that nourish the epidermal layers of the skin. This layer of the dermis is richly vascularized. Lymph vessels and nerve tissue also are found in this layer. The basement membrane is a layer of intercellular and extracellular matrices that serves as an interface between the dermis and the epidermis. Merkel cells are connected to afferent nerve terminals, forming a Merkel disk. They are believed to be neuroendocrine cells. Subcutaneous tissue consists of fat cells and connective tissues that lend support to the vascular and neural structures.

Question 8

Which of the following components of immune function is absent in the dermis?&#10;A) Macrophages&#10;B) T cells&#10;C) Lymph nodes&#10;D) Mast cells

Accepted Answer

While macrophages, T cells, fibroblasts, and mast cells are all present in the dermis, lymph nodes are not noted to be present in this layer.

Question 9

The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. What is the primary significance of these structures?

A) They regulate body temperature.
B) They process sensory information.
C) They control the formation of "goose bumps"
D) They combat skin infections.

Accepted Answer

Anastomoses are important for temperature regulation. They can open up, letting blood flow through the skin vessels when there is a need to dissipate body heat, or close off, conserving body heat if the environmental temperature is cold. Although goose bumps are a reaction to cold, they are actually caused by the contraction of the arrector pili muscles.

Question 10

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?

A) Ruffini corpuscles
B) Meissner corpuscles
C) Pacinian corpuscles
D) Nociceptors

Accepted Answer

Meissner corpuscles are rapidly adapting nerve endings located on the palmar surfaces of the fingers and hands; as such, they would be likely to be involved in fine distinction using the fingers. Ruffini corpuscles are located in the subcutaneous tissue of hairy and glabrous skin, while pacinian corpuscles detect gross pressure and vibration.Nociceptors detect painful stimuli.

Question 11

A frustrated 26-year-old female has sought a referral to a dermatologist in an effort to resolve her sweating and body odor that persists despite good hygiene. Which of the following facts would underlie the explanation that her physician provides about her problem?

A) Sebaceous secretions vary in both quantity and constituency between individuals.
B) Excess production by eccrine sweat glands, combined with bacteria, produces a characteristic odor in moist areas of the body.
C) Apocrine sweat glands produce a substance that is more oily than sweat from other sources.
D) Occlusion of sebaceous glands in the axillae and groin results in proliferation of microorganisms.

Accepted Answer

The answer of A frustrated 26-year-old female has sought a...

Question 12

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?&#10;A) Arrector pili muscle&#10;B) Sebaceous gland&#10;C) Apocrine gland&#10;D) Hair papilla

Accepted Answer

The answer of Which of the following structures would likely...

Question 13

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?

A) Langerhans cells
B) Merkel cells
C) Spherical melanosomes
D) Keratin

Accepted Answer

The answer of While working in an allergy clinic, the...

Question 14

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 as to avoid lichenization. What is the most likely categorization of the man's skin lesion?

A) A blister
B) A corn
C) A callus
D) A rash

Accepted Answer

The answer of A man's primary care physician has characterized...

Question 15

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 would not hurt so much when he puts on shoes/socks. The parents know that breaking the skin of the blister will put him at risk for

A) fluid volume deficit.
B) further edema due to loss of proteins.
C) secondary infection.
D) activity intolerance.

Accepted Answer

The answer of A child comes in to show his...

Question 16

Following exposure to poison oak while camping, a 20-year-old male is experiencing pruritus as a consequence of his immune response to irritants in the plant. What physiological process best accounts for his complaint?

A) His body is communicating a low-level pain response as a protective measure.
B) Free nerve endings are initiating an itch-specific signal to the somatosensory cortex.
C) Local irritation of Langerhans cells is sending signals by way of myelinated type C nerve fibers.
D) Ruffini corpuscles are transmitting the message of pruritus to the cerebral cortex.

Accepted Answer

The answer of Following exposure to poison oak while camping,...

Question 17

A boy has arrived home after experiencing his first outdoor camping trip with his Boy Scout troupe. Upon arrival at home, he is very uncomfortable and scratching at a rash. It appears that he contacted poison ivy and that it has spread to many areas on his body. The nurse in the clinic will likely prescribe which of the following treatment measures for this child? Select all that apply.

A) Prescription for corticosteroids.
B) Cool showers especially right before bedtime.
C) Over-the-counter antihistamines.
D) Occlusive ointments with high petroleum content.

Accepted Answer

The answer of A boy has arrived home after experiencing...

Question 18

An 81-year-old woman has noted a gradual decrease in the moisture of her skin over many years. Which phenomena associated with the aging process are known to contribute to her xerosis? Select all that apply.

A) Separation of the basement membrane from adjacent dermal and epidermal layers
B) Changing composition of sebaceous gland secretions
C) Flattening of the dermal rete ridges
D) Decreased moisture secretions from sweat glands
E) Decrease in skin capillaries

Accepted Answer

The answer of An 81-year-old woman has noted a gradual...

Question 19

When trying to explain the advantages of using an emollient over other products to a patient suffering from dry skin, the nurse will emphasize emollients&#10;A) can replenish the oils on the skin surface because they contain fatty acids.&#10;B) will draw water out from the deeper skin layers.&#10;C) provide moisture-proof material to the skin by providing a thick creamy layer as a barrier.&#10;D) will contain some form of numbing agent like lidocaine to help with the itching.

Accepted Answer

The answer of When trying to explain the advantages of...

Question 20

Which of the following facts accounts for the variation in skin tone that exists between individuals?&#10;A) Someone with dark skin has more melanocytes in his or her skin layers.&#10;B) Darker-skinned individuals have melanosomes that produce melanin faster.&#10;C) Dark skin is associated with spherical melanosomes , which produce and &#34;package&#34; pigment differently.&#10;D) Greater numbers of keratinocytes result in darker skin tone.

Accepted Answer

The answer of Which of the following facts accounts for...

Deck 57: Understanding the Processes and Functions of the Skin