Deck 42: the Integumentary System

Question 1

The nurse notes that the patient has a 2 ´ 1 cm skin tear on the right buttock.The nurse notes a full-thickness skin loss.Which category of skin tears is most consistent with this description?

A)I
B)II
C)III
D)IV

Answer 1

III

Question 2

A newly admitted 86-year-old patient has scratch marks in the groin and axilla and on her limbs.There are small,punctate red lesions that the patient says itch "like crazy." Which is the most likely cause and the best nursing action?

A)Senile purpura, and employs skin tear precautions
B)Scabies, and employs Standard Precautions
C)Senile itch, and employs use of emollient
D)Allergy, and employs focused assessment for cause

Answer 2

Scabies, and employs Standard Precautions

Question 3

The nurse assesses that the older adult is not dehydrated when a fold of skin pinched up on the upper chest of the patient returns to normal position in _____ seconds.

A)6
B)8
C)9
D)10

Answer 3

6

Question 4

A 93-year-old resident eats only a few bites at meals and then refuses to eat more.To help delay skin breakdown from diminished nutrition,the nurse would:

A)spoon-feed the resident.
B)request an order for a feeding tube.
C)inform resident of the need to increase intake.
D)offer 4 ounces of fluid every hour.

Question 5

The nurse is aware that the gradual graying of an older adult's hair is related to:

A)reduced hair follicles.
B)less sebaceous gland activity.
C)loss of collagen fibers in dermis.
D)decreased melanocytes at hair follicle.

Question 6

The nurse teaches the patient the "ABCD" technique for evaluating melanomas.In this memory prompt,the "D" stands for:

A)darkness.
B)drainage.
C)dimpling.
D)diameter.

Question 7

When applying lotion to the skin,the nurse should:

A)avoid shaking lotion as this causes bubble formation.
B)apply lotion heavily as the water from lotion evaporates.
C)wash off residue before applying fresh lotion.
D)"dab" on lotion to reduce skin irritation.

Question 8

The nurse best describes a "shave biopsy" of a skin lesion as:

A)removal of the central core of the lesion.
B)excising the entire lesion with a 1/4-inch border around it.
C)removal of the top of the lesion that stands above the skin line.
D)excising the lesion down to the dermis.

Question 9

An 80-year-old resident prefers to lie in bed on her left side.The nurse will take extra care in assessing the left ______ for evidence of skin breakdown.

A)buttock
B)heel
C)trochanter
D)ribs

Question 10

The action of the CNA that the nurse observes that would be harmful to a patient's skin is:

A)lifting the patient on the draw sheet to the stretcher.
B)pulling the draw sheet out from under the patient.
C)rolling the patient to the side to change the draw sheet.
D)using the gait belt to lift the patient from the bed to a wheelchair.

Question 11

To decrease the threat of a pressure ulcer,the nurse instructs a person who is in a wheelchair for long periods to:

A)reposition self every 2 hours.
B)lift weight on the arms of the chair every 15 minutes.
C)massage bony prominences of the buttocks and hips.
D)use a donut device to keep weight off of the buttocks.

Question 12

The nurse includes in the discharge teaching of a person with a skin condition that in order to reduce the soap in bed linens and sleeping garments,the patient should:

A)use fabric softener sheets in the dryer.
B)use vinegar in the rinse water.
C)use a fragrant detergent.
D)send linens to a professional laundry.

Question 13

The nurse reminds the CNAs that the main chemical that damages skin of the immobilized patient is:

A)urine.
B)medications.
C)skin lotions.
D)laundry soap.

Question 14

After a medicated bath,the patient is assisted from the tub and lotion is applied:

A)immediately after drying the patient.
B)in a thick layer to warm skin.
C)when the patient is returned to bed.
D)by the patient to preserve modesty.

Question 15

The nurse is teaching a group of teenagers about skin care and sun damage.Which statement by a participant indicates the need for further instruction?

A)"Although I have a darker complexion, I am still at risk for sun damage."
B)"The safest time of day to engage in water sports and avoid sun damage is from 10 AM to noon."
C)"My sunscreen should ideally have SPF 30 or higher."
D)"It is important to apply sunscreen about 30 minutes before sun exposure."

Question 16

The school nurse advises a group of high school girls that to avoid permanent skin damage from sun exposure they should:

A)use a tanning booth.
B)use a "spray-on" tan.
C)sunbathe on a cloudy day.
D)wear light, loose clothing while in sun.

Question 17

When planning care for an 80-year-old African American woman,the nurse would include interventions to:

A)bathe twice a week.
B)use liberal amount of soap and water.
C)use friction while drying patient to stimulate the skin.
D)apply emollient to limbs and back.

Question 18

The student nurse is preparing to document a suspicious area over a bony prominence.Which description would be most appropriate?

A)Reddened area on left hip
B)Reddened, nonblanching area approximately 1 cm ´ 1 cm
C)Suspicious area over left trochanter
D)Nonblanching area over left trochanter 0.8 cm ´ 1.2 cm

Question 19

The nurse is aware that an order for an "open dressing" requires that:

A)the lesion is left open to air.
B)wet compresses are changed frequently enough to keep them wet.
C)medicated ointment is placed directly in the open wound.
D)dressings are redampened to keep wet, but not changed.

Question 20

The patient reports to the nurse that the physician has ordered a Wood's light examination.The nurse correctly recognizes the physician is concerned that the patient may have which condition?

A)Tinea corpus
B)Scabies
C)Herpes simplex
D)Dermatitis

Question 21

Matching
The nurse uses a picture to show the structure of the integument.Match the options with the characteristic that best describes them.(Each option may be used once, more than once, or not at all.)

Consists of dense connective tissue

A)Epidermis
B)Dermis
C)Sebaceous glands
D)Sweat glands

Question 22

The nurse lists the age-related changes to the integumentary system,which include: (Select all that apply.)

A)elastic fibers and adipose tissue diminish.
B)skin thins and becomes transparent.
C)hair thins as follicles decrease.
D)skin becomes dry.
E)thinned skin leads to intolerance of cold.
F)None of the above.

Question 23

The nurse clarifies the descriptive terms for skin disorders.Match each option with the characteristic that best describes it.

Benign wartlike lesions on trunk,arms,and scalp

A)Erythrasma
B)Wheal
C)Fungal infection
D)Keratosis
E)Keloid

Question 24

A skin biopsy has been scheduled on a patient to rule out the presence of a malignancy.Which instruction should be provided to the patient?

A)A general anesthesia will be used during the procedure.
B)The bandage should be changed the day after the procedure and then weekly for 2 weeks.
C)The sutures placed at the site of the biopsy will be removed in approximately 10 days.
D)The patient will need to be NPO 6 to 8 hours before the procedure.

Question 25

The nurse clarifies the descriptive terms for skin disorders.Match each option with the characteristic that best describes it.

Thick ridge of scar tissue

A)Edema
B)Hyperkalemia
C)Hypovolemia
D)Tissue hypoxia
E)Hypermetabolism

Question 26

Matching
The nurse uses a picture to show the structure of the integument.Match the options with the characteristic that best describes them.(Each option may be used once, more than once, or not at all.)

Contains vessels,nerves,and hair follicles

A)Epidermis
B)Dermis
C)Sebaceous glands
D)Sweat glands

Question 27

Matching
The nurse uses a picture to show the structure of the integument.Match the options with the characteristic that best describes them.(Each option may be used once, more than once, or not at all.)

Keeps skin and hair pliable

A)Epidermis
B)Dermis
C)Sebaceous glands
D)Sweat glands

Question 28

An 86-year-old resident struck her forearm on a table,causing a category I L-shaped skin tear 6 cm ´ 2 cm.The nurse should: (Select all that apply.)

A)clean the tear with alcohol.
B)approximate the edges of the tear.
C)secure the skin flap with Steri-Strips.
D)cover with a nonadherent dressing.
E)assess closely for 5 days for signs of infection.

Question 29

The nurse reminds the junior high school health class that the first line of defense from pathogens for the body is the ____________.

Question 30

The nurse clarifies the descriptive terms for skin disorders.Match each option with the characteristic that best describes it.

Fluoresces under Wood's light

A)Erythrasma
B)Wheal
C)Fungal infection
D)Keratosis
E)Keloid

Question 31

Matching
The nurse uses a picture to show the structure of the integument.Match the options with the characteristic that best describes them.(Each option may be used once, more than once, or not at all.)

Squamous epithelium,no blood vessels

A)Epidermis
B)Dermis
C)Sebaceous glands
D)Sweat glands

Question 32

The nurse assesses several risk factors for skin tears on the admission of a 90-year-old resident,which include: (Select all that apply.)

A)incontinence.
B)bruised areas.
C)obesity.
D)prolonged use of corticosteroids.
E)history of congestive heart disease.

Question 33

The nurse clarifies the descriptive terms for skin disorders.Match each option with the characteristic that best describes it.

Smooth,elevated area that is pale or reddened

A)Erythrasma
B)Wheal
C)Fungal infection
D)Keratosis
E)Keloid

Question 34

The nurse advises the older adult to alter bathing practices to include: (Select all that apply.)

A)using lotion-based soaps.
B)using hot water to stimulate skin.
C)strenuous toweling to dry skin.
D)applying lotion twice a day.
E)using talcum to dry out skin.

Question 35

Matching
The nurse uses a picture to show the structure of the integument.Match the options with the characteristic that best describes them.(Each option may be used once, more than once, or not at all.)

Excretes water and salt

A)Epidermis
B)Dermis
C)Sebaceous glands
D)Sweat glands

Question 36

The nurse clarifies the descriptive terms for skin disorders.Match each option with the characteristic that best describes it.

Chronic bacterial infection in skinfolds,especially axilla and between toes

A)Erythrasma
B)Wheal
C)Fungal infection
D)Keratosis
E)Keloid