Deck 15: Assessing the Integumentary System

Question 1

The nurse is assessing a patient's health perception and health management. Which of the following questions would be the best for the nurse to use to obtain this information?

A)"Do you bruise easily?"
B)"How well do your cuts and scratches heal?"
C)"Do you have any allergies to foods, plants, or pets?"
D)"Have you noticed swelling around your eyes or ankles?"

Answer 1

"Do you have any allergies to foods, plants, or pets?"

Question 2

During a conversation with the nurse, the patient comments that he rarely goes outside when the sun is shining because he is afraid of developing skin cancer. This would predispose the patient for developing which of the following?

A)vitamin D deficiency
B)hypercholesterolemia
C)hypokalemia
D)hypernatremia

Answer 2

vitamin D deficiency

Question 3

A nurse is caring for an African American patient who has an ashen cast to his normally black skin. Which of the following labs test would the nurse review when looking for a possible cause of the skin color change?

A)BUN
B)hemoglobin and hematocrit
C)bilirubin
D)oxygen saturation
E)arterial blood gases

Answer 3

hemoglobin and hematocrit

Question 4

The nurse should use skillful interviewing techniques when completing a health assessment of a patient's skin, hair, and nails in order to do which of the following?

A)Explore and investigate each symptom.
B)Gain the patient's trust.
C)Discard unimportant data.
D)Speed up the interview.

Question 5

During an integumentary assessment, an elderly patient is found to have a brown benign macule with a defined border. The nurse realizes that this skin lesion would be documented as being which of the following?

A)a keratoses
B)an angioma
C)a lentigine
D)a telangiectases

Question 6

A female patient asks the nurse why she has so much hair on her arms and legs. She states, "My mother had the same problem." What is the best response by the nurse?

A)"The excessive hair growth could be a result of your diet."
B)"Your hair growth patterns may be inherited."
C)"Your excessive hair growth could be caused by too much sun."
D)"Maybe you shave too much and that causes more hair growth."
E)"Perhaps wearing panty hose all the time caused the hair growth."

Question 7

The nurse is caring for an African American patient who has a serum bilirubin of 6 mg/100 mL. What is the best way of assessing for changes in skin color in this patient?

A)Assess the sclera.
B)Assess the palms of the hands.
C)Assess the fingernails.
D)Assess the mucous membranes.

Question 8

The nurse, assessing integumentary changes in an elderly patient, realizes that which of the following changes is expected in an older adult?

A)a decrease in abdominal fat
B)an increase in perfusion
C)a decrease in vitamin D production
D)an increase in vasomotor response

Question 9

A patient, being seen for an elevated, darkened area of excess scar tissue, asks the nurse why this occurred. With which of the following should the nurse respond to the patient?

A)"This scar was caused by the wearing away of the superficial epidermis, causing a moist, shallow depression."
B)"This scar was caused by excessive collagen formation during healing."
C)"This scar was caused by skin loss extending into the dermis or subcutaneous tissue."
D)"This scar was caused by wasting of the skin due to loss of collagen."

Question 10

A patient is experiencing a problem with the eccrine sweat glands. Because of this structural problem, the nurse realizes that which function will be impacted in this patient?

A)body temperature regulation
B)regulation of body heat by excretion of perspiration
C)sebum secretion
D)sexual scent gland

Question 11

A patient is seen for an erythematous generalized rash. Which of the following Select all that apply.

A)"Have you recently eaten any new foods?"
B)"Do you have any allergies?"
C)"What SPF sunscreen do you use when you are outside?"
D)"Does the rash itch?"
E)"How long have you had this rash?"

Question 12

A patient who has experienced a burn involving both the epidermis and the dermis asks if the area will heal and be as it was prior to the burn. The nurse's response should be based on what knowledge regarding the skin structures involved? Select all that applying. Select all that apply.

A)Most hair follicles are in the dermis.
B)Most sweat glands are in the dermis.
C)Hair follicles are located in the subcutaneous tissue.
D)Sebaceous glands are located in the dermis.
E)Receptors for pain and touch are located in the dermis.

Question 13

A nurse is performing an assessment of the patient's nails. Which assessment should be included in this examination? Select all that apply.

A)Inspect nail thickness.
B)Inspect nail color.
C)Inspect nail curvature.
D)Inspect for nail length.
E)Inspect for grooves.

Question 14

When the nurse is conducting a physical examination of the skin, hair, and nails, the age of the patient is an important factor because

A)there are age-related changes.
B)skin changes in the older population are pathologic.
C)scaly, dry skin is common in young adults.
D)it is the most significant risk factor for cancer.

Question 15

While conducting a patient's health history, the nurse learns that the patient worked at a landfill for the last 35 years. This information is most significant because it could indicate which of the following?

A)possible exposure to environmental toxins
B)the patient's lack of communication skills
C)the patient is elderly
D)the patient's level of education

Question 16

A patient complains of the sudden appearance of white patches on the skin. The nurse, suspecting vitiligo, would ask the patient which of the following Select all that apply.

A)"Have any of your parents or grandparents had this problem also?"
B)"Have you been using bleach lately?"
C)"Have you had anything rubbing on those areas excessively?"
D)"What have you been eating lately?"
E)"Where are the white patches located on your body?"

Question 17

Which of the following assessment findings would the nurse recognize as being the result of genetics in the skin of an African American patient? Select all that apply.

A)an ashen hue to black skin
B)a yellowish cast on the palms
C)very dry scalp and dry, fragile hair
D)several keloids
E)patches of white spots on the hands

Question 18

When caring for an elderly patient, the nurse must remember that the following change occurs as an individual ages.

A)Subcutaneous tissue decreases.
B)Both the epidermis and the dermis thicken.
C)The number of Merkel's cells and Langerhans' cells increase.
D)Sebaceous gland activity increases.

Question 19

A Caucasian patient is admitted with possible carbon monoxide poisoning. What skin color can the nurse expect to find that supports this probable diagnosis?

A)bluish
B)dusky red
C)cherry red
D)orange green
E)yellow

Question 20

The nurse is caring for a patient diagnosed with oculocutaneous albinism. The nurse realizes this health problem is

A)hypopigmentation of the skin, hair, and eyes as a result of an inability to synthesize melanin.
B)characterized by elevated scars, has a familial tendency, and is most commonly found in African Americans.
C)the sudden appearance of white patches on the skin, and has a familial tendency.
D)an autosomal-dominant inheritance disorder that causes hyperpigmentation of the skin, hair, and eyes.

Question 21

Place an "X" over the structure whose decreased activity in older patients causes dry skin or absence of perspiration.

Question 22

The patient states, "This dark spot on my arm is getting bigger and it bleeds occasionally." Which health information is most important regarding this report? Select all that apply.

A)The patient's father had chronic obstructive pulmonary disease.
B)The patient plays golf three or four times a week.
C)The patient is male.
D)There is a history of cardiac disease in the patient's family.
E)The patient is a blue-eyed blonde.

Question 23

The nurse documents that a patient has 4+ pitting edema on the lower right tibia. How many millimeters of depression are generally associated with 4+ pitting edema?

Question 24

Place an "X" on the area of the fingernail the nurse assesses for the presence of clubbing.

Question 25

The nurse is preparing to conduct the health history of a new clinic patient. The intake notes reveal that the patient has albinism. What assessment findings should the nurse expect in this patient? Select all that apply.

A)excessive body hair
B)white patches on the skin
C)very light blue eyes
D)overgrowth of scar tissue
E)very pale skin

Question 26

A patient is waiting to have a skin biopsy and asks, "What is going to happen when this is done?" Which of the following would be an appropriate response for the nurse to make?

A)"Didn't your doctor tell you?"
B)"Maybe you shouldn't have it done."
C)"I'm not sure."
D)"Let me check to see exactly what you are having done and then we can talk more about what you can expect."

Question 27

The nurse notes the presence of this lesion on the patient's anterior chest. How should this finding be documented in the medical record? 11ea992e_0a6e_2fb5_9f38_6119e13e0a6a

A)purpura
B)ecchymosis
C)telangiectasis
D)spider angioma

Question 28

The nurse is assessing the integumentary status of a 79-year-old female. Which of the following findings are considered common in older adults? Select all that apply.

A)keratoses
B)skin tags
C)urticaria
D)photoaging
E)acne

Question 29

A nurse is assessing a patient with the following laboratory values: sodium 144 mEq/L; potassium 3.8 mEq/L; hemoglobin 8.4 g/dL; glucose 105 mg/dL. Which assessment might correlate with these findings?

A)The nail plate is separate from the nail bed.
B)The nail folds are inflamed and swollen.
C)The nail is spoon shaped.
D)The nail has a transverse groove.

Question 30

What is the nurse assessing when using the technique shown in this picture? 11ea992e_0a6e_56c7_9f38_f14afa050ee8

A)hydration status
B)skin temperature
C)skin color
D)liver function

Question 31

The nurse has assessed a flat, nonpalpable change in the skin color on a patient's back. At which size in centimeters does this area change from being described as a macule to being described as a patch?

Question 32

A patient diagnosed with heart failure has 3+ lower extremity edema. Which description most accurately describes this patient's edema?

A)slight pitting, no obvious distortion
B)deeper pit, no obvious distortion
C)pit is obvious, extremities are swollen
D)pit remains with obvious distortion

Question 33

The nurse notes this distribution of lesions on a patient's skin. Based upon this finding, the nurse would perform additional assessment looking for indications of which problem? 11ea992e_0a6e_2fb6_9f38_8732c33f0072

A)vitamin B deficiency
B)increased intravenous pressure
C)bleeding disorders
D)psoriasis

Question 34

Place an "X" on the area of the fingernail that becomes inflamed when the patient experiences paronychia.

Question 35

Place an "X" over the diagram that represents a skin fissure.

Question 36

The nurse is caring for a patient with thinning of the nails. Which test result would be used to aid in the diagnosis of this nail disorder?

A)pulse oximetry
B)hemoglobin
C)serum albumin
D)white blood cell count

Question 37

The nurse is preparing to assess a patient's integumentary status. Which of the following techniques should the nurse use to conduct this assessment?

A)inspection
B)inspection and percussion
C)inspection and palpation
D)percussion and palpation

Question 38

After the completion of an integumentary status assessment, the nurse documents "+1 edema right lower leg." Which of the following does this documentation indicate?

A)slight pitting, no obvious distortion
B)deep pitting, no obvious distortion
C)pitting is obvious, extremities are swollen
D)pitting remains with obvious distortion

Question 39

A patient has an area of rough, thickened, hardened epidermis. The nurse realizes that the reason for this skin lesion would be which of the following?

A)chronic dermatitis
B)athlete's foot
C)earr piercing
D)psoriasis

Question 40

An adolescent patient has extensive acne over his face and upper neck. The nurse realizes that this condition is caused by which of the following?

A)inflamed sebaceous glands
B)blocked endocrine glands
C)blocked exocrine glands
D)inflamed ceruminous glands

Question 41

The nurse is planning to document the appearance of herpetic lesions found over a patient's nose and mouth region. Which of the following terms would the nurse most likely use to describe this finding?

A)scaly
B)pustular
C)pruritic
D)ulcerated

Question 42

A patient is seen in the clinic after having a biopsy done that sampled a small section of dermis and subcutaneous fat. The nurse realizes that this patient has had which of the following?

A)an incisional skin biopsy
B)a punch skin biopsy
C)an excisional skin biopsy
D)a shave skin biopsy

Question 43

During the assessment of an elderly patient's integumentary status, the nurse notes small areas of hyperpigmentation on the patient's hands. The nurse realizes that this finding is due to which of the following?

A)hyperplasia of melanocytes in sun-exposed areas
B)reduced vitamin D production
C)decreased blood perfusion of the dermis
D)redistribution of adipose tissue

Question 44

A patient is scheduled for a test to diagnose the presence of a herpes infection. The nurse realizes that the patient is most likely going to have which of the following?

A)apatch test
B)a Tzanck test
C)a potassium chloride test
D)a Wood's light examination

Question 45

The nurse is planning to assess an African American's integumentary status. Which of the following findings would indicate the presence of cyanosis in this patient?

A)yellow hue in the eyes
B)bluish-tinged nail beds
C)cherry red lips
D)orange-green cast to the skin