Nokea
An older adult client is brought to the emergency department reporting having become overheated while sitting in the sun. The client states, 'But I wasn't even perspiring.' What occurs in older adults that decreases spontaneous sweating and makes them vulnerable to heat?
- A. Decrease in the number of eccrine glands
- B. Increase in the number of eccrine glands
- C. Decreased number of apocrine glands
- D. Increased number of apocrine glands
Correct Answer: A
Rationale: A decline in the number of eccrine glands, along with decreased cutaneous vascularity, causes a decrease in spontaneous sweating with age, this makes older persons more vulnerable to heat. Apocrine glands are found around the nipples, in the anogenital region, in the eyelids, in the mammary glands of the breast, and in the external ear canals where the secretion is referred to as cerumen.
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Which of the following conditions is the cause of thickening of the nail?
- A. Fungal infection
- B. Long-standing pulmonary disease
- C. Myocardial infarction
- D. Iron-deficiency anemia
Correct Answer: A
Rationale: Long-standing poor circulation leads to nail thickening, especially of the lower extremities. Nails thicken when there is a fungal infection and poor circulation. Clubbing of the nails suggests a long-standing cardiopulmonary disease. Concave-shaped nails are a sign of iron-deficiency anemia. Myocardial infarction does not cause thickening of nails.
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.
A client has a wart on the left knee but wants to try an over-the-counter medication to dissolve the wart. What type of solution would the nurse educate the client about?
- A. Antiseborrheic agents
- B. Antihistamine
- C. Antiseptics
- D. Keratolytics
Correct Answer: D
Rationale: Keratolytics dissolve thickened, cornified skin such as warts, corns, and calluses. Their action causes the treated area to soften and swell, facilitating removal. Antiseborrheic agents are applied to the scalp or incorporated into shampooing products to control dandruff. Antihistamines are used to relieve itching. An antiseptic would be used to reduce bacteria on the arm.
During a routine checkup, a nurse observes the client's skin to be tight and shiny. Which of the following is the correct indication of this sign?
- A. Sebum deficiency
- B. Fluid retention
- C. Dehydration
- D. Protein deficiency
Correct Answer: B
Rationale: Tight, shiny skin suggests fluid retention. Loose, dry skin may indicate dehydration. Tight, shiny skin does not suggest protein deficiency or sebum deficiency.
The nurse is performing a skin assessment on a client that is admitted to the hospital and observes an area over the left heel that is reddened but intact. How would the nurse stage this pressure sore?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage IV
Correct Answer: A
Rationale: Stage I pressure sores are characterized by redness of intact skin. The reddened skin of a beginning pressure sore fails to resume its normal color, or blanch when pressure is relieved. Stage II is the same as stage I but has a blister or shallow break in the skin. Stage III has superficial skin impairment that progresses to a shallow crater that extends to the subcutaneous tissue. Stage IV has tissue damage that is deeply ulcerated, exposing muscle and sometimes bone.