Online Nursing Practice Test about Skin (Integumentary Disorder 21-25)

21. The nurse is assessing for the presence of cyanosis in a dark-skinned client. The nurse understands that which body area would provide the best assessment?

a) lips
b) sacrum
c) earlobes
d) back of the hands


22. A male client calls the emergency room and tells the nurse that he had been cleaning a wooded area in the backyard and came directly into contact with poison ivy shrubs. The client tells the nurse that he cannot see anything on the skin and asks the nurse what to do. Which of the following is the appropriate nursing response?

a) come to the emergency room
b) apply calamine lotion immediately to the expected skin areas
c) take a shower immediately , lathering and rinsing several times
d) it is not necessary to do anything if you cannot see anything on your skin



23. The clinic nurse assesses the skin of a white client with a diagnosis of psoriasis. The nurse understands that which characteristic is associated with this skin disorder?

a) clear, thin nail beds
b) red-purplish scaly lesions
c) oily skin and no episodes of pruritis
d) silvery-white scaly patches on the scalp, elbows, knees, and sacral regions

24. The clinic nurse notes that the physician has documented a diagnosis of herpes zoster (shingles) in the client's chart. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made following which diagnosis test?

a) patch test
b) skin biopsy
c) culture of the lesions
d) wood's light examination

25. A client returns to the clinic for follow-up treatment following a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse understands that which of the following describes a characteristic of this type of a lesion?

a) metastasis rare
b) melanoma is encapsulated
c) melanoma is highly metastatic
d) melanoma is characterized by local invasion




ANSWERS AND RATIONALE

21) A
- In a dark-skinned client, the nurse examines the lips, tongue, nail beds, conjunctivae, and palms of the hands and soles of the feet at regular intervals for subtle color changes. In a client with cyanosis, the lips and tongue are gray; the palms, soles, conjunctivae, and nail beds have a bluish tinge.

22)  C
- When an individual comes in contact with a poison ivy plant, the sap from the plant forms an invisible film on the human skin. The client should be instructed to shower immediately and to lather the skin several times and rinse each time in running water. Calamine lotion is a treatment used if dermatitis develops. The client does not need to be seen in the emergency room at this time.

23) D
- Psoriatic patches are covered with silvery white scales. Affected areas include the scalp, elbows, knees, shins, sacral area, and trunk. Thickening, pitting, and discoloration of the nails occur. Pruritus may occur. The lesions in psoriasis are not red-purplish scaly lesions.

24) C
- With the classic presentation of herpes zoster, the clinical examination is diagnostic. A viral culture of the lesion provides the definitive diagnosis. Herpes zoster (shingles) is caused by a reactivation of the varicella-zoster virus, the virus that causes chickenpox. A patch test is a skin test that involves the administration of an allergen to the surface of the skin to identify specific allergies. A biopsy would provide a cytological examination of tissue. In a Wood’s light examination, the skin is viewed under ultraviolet light to identify superficial infections of the skin.

25) C
- Melanomas are pigmented malignant lesions originating in the melanin-producing cells of the epidermis. This skin cancer is highly metastatic, and a person’s survival depends on early diagnosis and treatment. Options A, B, and D are not characteristics of a melanoma.


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