Nokea
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.
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A gerontologic nurse is teaching a group of nursing students about integumentary changes that occur in older adults. How should these students best integrate these changes into care planning?
- A. By avoiding the use of moisturizing lotions on older adults skin
- B. By protecting older adults against shearing injuries
- C. By avoiding the use of ice packs to treat muscle pain
- D. By protecting older adults against excessive sweat accumulation
Correct Answer: B
Rationale: Aging causes thinning at the dermis-epidermis junction, increasing the risk of shearing injuries. Moisturizers are beneficial for dry skin, ice packs can be used with caution, and sweat accumulation is not a concern in older adults.
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 patient presents at the dermatology clinic with suspected herpes simplex. The nurse knows to prepare what diagnostic test for this condition?
- A. Skin biopsy
- B. Patch test
- C. Tzanck smear
- D. Examination with a Woods light
Correct Answer: C
Rationale: The Tzanck smear examines cells from blistering conditions like herpes simplex. Biopsies diagnose malignancies, patch tests identify allergens, and Woods light assesses pigmentation.
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 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.