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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.
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A nurse is aware that the outer layer of the skin consists of dead cells that contain large amounts of keratin. The physiologic functions of keratin include which of the following? Select all that apply.
- A. Producing antibodies
- B. Absorbing electrolytes
- C. Maintaining acidbase balance
- D. Physically repelling pathogens
- E. Preventing fluid loss
Correct Answer: D,E
Rationale: The dead cells of the epidermis contain large amounts of keratin, an insoluble, fibrous protein that forms the outer barrier of the skin. Keratin has the capacity to repel pathogens and prevent excessive fluid loss from the body. It does not contribute directly to antibody production, acidbase balance, or electrolyte levels.
A patient with a suspected malignant melanoma is referred to the dermatology clinic. The nurse knows to facilitate what diagnostic test to rule out a skin malignancy?
- A. Tzanck smear
- B. Skin biopsy
- C. Patch testing
- D. Skin scrapings
Correct Answer: B
Rationale: A skin biopsy is used to diagnose or rule out skin malignancies like melanoma. Tzanck smears diagnose blistering conditions, patch testing identifies allergens, and skin scrapings detect fungal infections.
A nurse is providing an educational presentation addressing the topic of Protecting Your Skin. When discussing the anatomy of the skin with this group, the nurse should know that what cells are responsible for producing the pigmentation of the skin?
- A. Islets of Langerhans
- B. Squamous cells
- C. T cells
- D. Melanocytes
Correct Answer: D
Rationale: Melanocytes produce melanin, the pigment responsible for skin color. Islets of Langerhans are pancreatic cells, squamous cells are epithelial, and T cells are immune cells.
The outer layer of the epidermis provides the most effective barrier to penetration of the skin by environmental factors. Which of the following is an example of penetration by an environmental factor?
- A. An insect bite
- B. Dehydration
- C. Sunburn
- D. Excessive perspiration
Correct Answer: A
Rationale: An insect bite represents penetration of the skin by an environmental factor, breaching the stratum corneum. Dehydration, sunburn, and perspiration are not examples of penetration.
While assessing a dark-skinned patient at the clinic, the nurse notes the presence of patchy, milky white spots. The nurse knows that this finding is characteristic of what diagnosis?
- A. Cyanosis
- B. Addisons disease
- C. Polycythemia
- D. Vitiligo
Correct Answer: D
Rationale: Vitiligo is characterized by patchy, milky white spots due to the destruction of melanocytes. Cyanosis causes dusky nail beds, Addisons disease results in a bronzed appearance, and polycythemia causes a ruddy blue coloration.