Deck 41: The Integumentary System

Question 1

An 80-year-old resident prefers to lie in bed on her left side.The nurse anticipates that the risk for skin breakdown is greatest over which area?

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

Answer 1

Left trochanter

Question 2

After a medicated bath,the patient is assisted from the tub.Which statement about lotion application is correct?

A) Apply lotion immediately after drying the patient.
B) Apply lotion in a thick layer to warm skin.
C) Apply lotion after returning the patient to bed.
D) Allow the patient to apply the lotion.

Answer 2

Apply lotion immediately after drying the patient.

Question 3

Which method is best to use for lotion application?

A) Avoid shaking lotion to prevent bubble formation.
B) Apply lotion heavily as the water from lotion evaporates.
C) Wash off residue before applying fresh lotion.
D) Apply a scant film of lotion on eyelids and in the nose.

Answer 3

Wash off residue before applying fresh lotion.

Question 4

Which chemical irritant causes the most damage to skin of the immobilized patient?

A) Urine
B) Topical medication
C) Bath soap
D) Laundry soap

Question 5

The patient reports to the nurse that the physician has ordered a Wood 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 6

A 93-year-old resident eats only a few bites at meals and then refuses to eat more.Which intervention might the nurse use to help delay skin breakdown from diminished nutrition?

A) Spoon-feed the resident.
B) Request an order for a feeding tube.
C) Inform the resident of the need to increase intake.
D) Offer 4 ounces of fluid every hour.

Question 7

The nurse observes the CNA who is changing a patient's bed.Which action demonstrates that the CNA requires additional teaching?

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 8

The nurse teaches the patient the "ABCD" technique for evaluating melanomas.What does the "D" in this memory prompt represent?

A) Darkness
B) Drainage
C) Dimpling
D) Diameter

Question 9

The nurse is assessing an older adult patient's hydration status.The nurse observes that a fold of skin on the upper chest returns to normal position.The nurse should conclude that hydration is adequate if the skin returns to normal position in how many seconds?

A) 6 seconds
B) 9 seconds
C) 10 seconds
D) 15 seconds

Question 10

The school nurse is advising a group of high school girls about ways to avoid permanent skin damage from sun exposure.Which information is most important to include in the teaching plan?

A) Avoid using cosmetics that have sunscreen added.
B) Consider a spray tan in the summer.
C) Limit sunbathing times on a cloudy day.
D) Wear light, loose clothing while in sun.

Question 11

When planning care for an 80-year-old African American woman,which intervention is most important for the nurse to include?

A) Bathe the patient twice weekly.
B) Use liberal amounts of soap and water.
C) Use quick, brisk motions to dry the patient's skin.
D) Apply emollient to limbs and back.

Question 12

The nurse is caring for a patient and during the assessment,observes a full-thickness 2 cm × 1 cm skin tear on the right buttock.How should the nurse stage this pressure ulcer?

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

Question 13

Which statement best describes a "shave biopsy" of a skin lesion?

A) A removal of the central core of a lesion
B) Excision of an entire lesion with a -inch border around it
C) Removal of the top of a lesion that stands above the skin line
D) Excision of a lesion down to the dermis

Question 14

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 15

The nurse is providing discharge teaching of a patient.Which instructions should the nurse include to teach reduction of soap in bed linens and sleeping garments?

A) Only use high-efficiency detergents.
B) Use vinegar in the rinse water.
C) Only wash clothing in hot water.
D) Send linens to a professional laundry.

Question 16

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 nursing action is most appropriate?

A) Employ skin tear precautions
B) Employ Standard Precautions
C) Employ use of emollient
D) Employs focused assessment for cause

Question 17

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 A.M. 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 18

The nurse is caring for a patient with an order for an "open dressing." Which action indicates that the nurse accurately understands the order?

A) The nurse leaves the entire lesion open to air.
B) The nurse changes wet compresses frequently enough to keep them wet.
C) The nurse applies medicated ointment directly in the open wound.
D) The nurse applies dressings to the perimeter of the wound while leaving the center of the wound open to air.

Question 19

Which intervention is most important for a person who is in a wheelchair for long periods?

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 20

What underlying pathophysiology explains the gradual graying of an older adult's hair?

A) Reduced hair follicles
B) Less sebaceous gland activity
C) Loss of collagen fibers in dermis
D) Decreased melanocytes at hair follicle

Question 21

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 22

The nurse is advising an older adult regarding age-appropriate bathing practices.Which instruction(s)is/are most important for the nurse to include?

A) Using lotion-based soaps.
B) Using hot water to stimulate skin.
C) Towel skin dry with quick, brisk motions.
D) Apply lotion twice a day.
E) Apply talcum powder after bathing.

Question 23

A skin biopsy has been scheduled on a patient to rule out the presence of a malignancy.Which instruction is most important for the nurse to include in patient teaching?

A) General anesthesia will be used during the procedure.
B) Change the bandage the day after the procedure and then weekly for 2 weeks.
C) Sutures placed at the site of the biopsy will be removed in approximately 10 days.
D) Do not eat or drink anything after midnight the night before the procedure.

Question 24

An 86-year-old resident struck her forearm on a table,causing a category I L-shaped skin tear 6 cm × 2 cm.Which action(s)is/are appropriate for the nurse to take?

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 25

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 26

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.)
a.Epidermis
b.Dermis
c.Sebaceous glands
d.Sweat glands
Contains vessels,nerves,and hair follicles

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

Question 27

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.)
a.Epidermis
b.Dermis
c.Sebaceous glands
d.Sweat glands
Excretes water and salt

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

Question 28

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.)
a.Epidermis
b.Dermis
c.Sebaceous glands
d.Sweat glands
Keeps skin and hair pliable

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

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 light

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

Question 31

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

Question 32

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.)
a.Epidermis
b.Dermis
c.Sebaceous glands
d.Sweat glands
Consists of dense connective tissue

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

Question 33

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

Question 34

Which factor(s)could increase the risk for skin tears in a 90-year-old resident?

A) Incontinence
B) Bruised areas
C) Obesity
D) Prolonged use of corticosteroids
E) History of congestive heart disease

Question 35

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.)
a.Epidermis
b.Dermis
c.Sebaceous glands
d.Sweat glands
Squamous epithelium,no blood vessels

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

Question 36

Which age-related change(s)occur(s)in the integumentary system?

A) Elastic fibers and adipose tissue diminish.
B) Skin thins and becomes transparent.
C) Hair thickens as follicles decrease.
D) Skin becomes dry.
E) Thinned skin leads to cold intolerance.