Nokea
A client has joined a rowing team and has been enjoying the activity for approximately 1 month. The client comes to the clinic for a routine physical examination and shows the nurse the hands, which are observed to have thickened areas in several areas. What does the nurse recognize these are in response to the repeated friction of the oars?
- A. Calluses
- B. Senile keratosis
- C. Senile lentigines
- D. Rheumatoid nodules
Correct Answer: A
Rationale: Areas of skin subjected to friction, such as where a pencil is held repeatedly, have accelerated rates of epidermal cell production. A callus, which is a thick layer of epidermal cells, forms in response to recurring friction on an area of skin. Senile keratosis is small, yellow or brown raised lesions that appear on the face and trunk in an older adult client. Senile lentigines are also known as liver spots and are found on the hands and forearms of older people. Rheumatoid nodules affect those clients with rheumatoid arthritis.
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A client is coming to the office to have a growth removed by the doctor. The client asks 'What does cryosurgery do to the growth?' What is the correct response by the nurse?
- A. Removes the entire growth
- B. Through the application of extreme cold, the tissue is destroyed.
- C. Freezes the growth, so the physician can remove it at the next appointment
- D. Lasers the growth off
Correct Answer: B
Rationale: Cryosurgery is the application of extreme cold to destroy tissue. The other statements are false.
A female client comes to the clinic and tells the nurse, 'I am getting all these little hairs on my chin. I never had them before I turned 50.' What does the nurse understand is the cause of the terminal hairs on the face?
- A. Overproduction of melanin
- B. Increased secretion of sebum
- C. Decline in the number of eccrine glands
- D. Decreased ratio of estrogen to androgen hormones
Correct Answer: D
Rationale: After menopause, some women develop sparse terminal hairs about their face as the ratio of estrogen to androgen hormones decreases. An overproduction of melanin would cause altered color of the skin. Increased secretion of sebum is an oily substance that may cause blackheads and pustules. A decline in the number of eccrine glands will cause a decrease in perspiration in the older adult.
The nurse is caring for a client who has had emphysema for 10 years. When performing a fingernail assessment, what does the nurse anticipate the client's nails will be documented as?
- A. Concave
- B. Brittle
- C. Discolored
- D. Clubbing
Correct Answer: D
Rationale: Clubbing of the nails is evidenced by an angle greater than 160?° and suggests long-standing cardiopulmonary disease and chronic hypoxic states. Concave or 'spooning' may indicate iron-deficiency anemia. Discolored or brittle nails may result from other disorders or smoking.
A client has a boil that is located in the left axillary area and is elevated with a raised border, and filled with pus. How would the nurse document this type of lesion?
- A. Macule
- B. Vesicle
- C. Pustule
- D. Cyst
Correct Answer: C
Rationale: A pustule has an elevated, raised border, filled with pus. A macule is a flat, round, colored lesion such as a freckle or rash. A vesicle is a lesion that is elevated, round, and filled with serum. A cyst is an encapsulated, round, fluid-filled or solid mass beneath the skin.
Plantar warts may be treated with what method?
- A. Photochemotherapy
- B. Radiation
- C. Electrodesiccation
- D. Cryosurgery
Correct Answer: C
Rationale: Electrodesiccation is the use of electrical energy converted to heat, which destroys the tissue. Photochemotherapy involves a combination of psoralen methoxsalen and type A ultraviolet light. Radiation therapy is used to treat malignant skin lesions. Cryosurgery is the application of extreme cold to destroy tissue.