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A nurse in the emergency department (ED) is triaging a 5-year-old who has been brought to the ED by her parents for an outbreak of urticaria. What would be the most appropriate question to ask this patient and her family?
- A. Has she eaten any new foods today?
- B. Has she bathed in the past 24 hours?
- C. Did she go to a friends house today?
- D. Was she digging in the dirt today?
Correct Answer: A
Rationale: Food allergies are a common cause of urticaria in children. Bathing, visiting friends, or soil exposure are less likely to be relevant triggers.
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A young student is brought to the school nurse after falling off a swing. The nurse is documenting that the child has bruising on the lateral aspect of the right arm. What term will the nurse use to describe bruising on the skin in documentation?
- A. Telangiectasias
- B. Ecchymoses
- C. Purpura
- D. Urticaria
Correct Answer: B
Rationale: Ecchymoses are bruises, characterized by larger areas of blood extravasation under the skin. Telangiectasias are dilated superficial blood vessels, purpura are pinpoint hemorrhages, and urticaria are wheals or hives.
A nurse is working with a patient who has a diagnosis of Cushing syndrome. When completing a physical assessment, the nurse should specifically observe for what integumentary manifestation?
- A. Alopecia
- B. Yellowish skin tone
- C. Patchy, bronze pigmentation
- D. Hirsutism
Correct Answer: D
Rationale: Cushing syndrome causes hirsutism, especially in women, due to excess cortisol. Alopecia, yellowish skin, and bronze pigmentation are not typical features.
A wound care nurse is reviewing skin anatomy with a group of medical nurses. Which area of the skin would the nurse identify as providing a cushion between the skin layers, muscles, and bones?
- A. Dermis
- B. Subcutaneous tissue
- C. Epidermis
- D. Stratum corneum
Correct Answer: B
Rationale: The subcutaneous tissue (hypodermis) cushions between skin layers, muscles, and bones. The dermis provides strength, the epidermis is the outer layer, and the stratum corneum is the outermost epidermal layer.
A new patient presents at the clinic and the nurse performs a comprehensive health assessment. The nurse notes that the patients fingernail surfaces are pitted. The nurse should suspect the presence of what health problem?
- A. Eczema
- B. Systemic lupus erythematosus (SLE)
- C. Psoriasis
- D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: C
Rationale: Pitted nails are a hallmark of psoriasis. Eczema, SLE, and COPD do not typically cause nail pitting.
An 80-year-old patient is brought to the clinic by her son. The son asks the nurse why his mother has gotten so many spots on her skin. What would be an appropriate response by the nurse?
- A. As people age, they normally develop uneven pigmentation in their skin.
- B. These spots are called liver spots or age spots.
- C. Older skin is more apt to break down and tear, causing sores.
- D. These are usually the result of nutritional deficits earlier in life.
Correct Answer: A
Rationale: Uneven pigmentation, such as age spots, is a common age-related skin change. Naming the spots or discussing skin breakdown does not directly address the cause, and nutritional deficits are not typically responsible.