Nokea
A patient with an exceptionally low body mass index has been admitted to the emergency department with signs and symptoms of hypothermia. The nurse should know that this patients susceptibility to heat loss is related to atrophy of what skin component?
- A. Epidermis
- B. Merkel cells
- C. Dermis
- D. Subcutaneous tissue
Correct Answer: D
Rationale: Subcutaneous tissue, with its fat content, insulates against heat loss. Atrophy in patients with low BMI increases hypothermia risk. The epidermis, Merkel cells, and dermis do not primarily regulate temperature.
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A nurse is conducting a health interview and is assessing for integumentary conditions that are known to have a genetic component. What assessment question is most appropriate?
- A. Does anyone in your family have eczema or psoriasis?
- B. Have any of your family members been diagnosed with malignant melanoma?
- C. Do you have a family history of vitiligo or port-wine stains?
- D. Does any member of your family have a history of keloid scarring?
Correct Answer: A
Rationale: Eczema and psoriasis have a known genetic component, making this the most relevant question. Melanoma, vitiligo, port-wine stains, and keloid scarring have less consistent genetic links.
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.
A nurse is preparing to perform the physical assessment of a newly admitted patient. During which of the following components of the assessment should the nurse wear gloves? Select all that apply.
- A. Palpation of the patients scalp
- B. Palpation of the patients upper extremities
- C. Palpation of a rash on the patients trunk
- D. Palpation of a lesion on the patients upper back
- E. Palpation of the patients fingers
Correct Answer: C,D
Rationale: Gloves are required when palpating rashes or lesions to prevent contact with potential infectious material. Palpation of scalp, extremities, or fingers does not typically require gloves unless body fluids are present.
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.
A nurse is doing a shift assessment on a group of patients after first taking report. An elderly patient is having her second dose of IV antibiotics for a diagnosis of pneumonia. The nurse notices a new rash on the patients chest. The nurse should ask what priority question regarding the presence of a reddened rash?
- A. Is the rash worse at a particular time or season?
- B. Are you allergic to any foods or medication?
- C. Are you having any loss of sensation in that area?
- D. Is your rash painful?
Correct Answer: B
Rationale: A new rash during antibiotic therapy suggests a possible allergic reaction, which could be life-threatening. Assessing for allergies is the priority over timing, sensation, or pain.