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Nursing 251 Exam 2 Questions and CorrectAnswers Updated Version 2023.
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Nursing 251 Exam 2 Questions and CorrectAnswers Updated Version 2023
3 types of skin cancer - Correct Ansbasal cell carcinoma
squamous cell carcinoma
melanoma
A bluish hue to the skin and nails that develops as a result of decreased blood flow to
an area as seen in cold conditions for example is called which term? - Correct
AnsPeripheral cyaanosis
A description of a lesion grouping or configuration as localized and following a nerve
path or dermatome would be classified as which one of the following? - Correct
AnsZosteriform
A female client visits the clinic and complains to the nurse that her skin feels "dry". The
nurse should instruct the client that skin elasticity is related to adequate . . . - Correct
AnsFluid intake
A hard, enlarged and nontender supraclavicular lymph node may be an indication of
which of the following conditions? - Correct AnsBreast cancer
A nurse is examining a new patient admitted to the hospital unit from home. The patient
is bed-ridden and transfers to a chair only with the assist of family members. The nurse
notes an area of redness that does not blanch with palpation on the patient's buttocks;
however, the area's skin is intact. What stage of pressure ulcer development does the
nurse document? - Correct AnsStage 1
A nurse is performing a nutritional assessment on a client. Which of the following
clinical findings are suggestive of malnutrition? Select all that may apply. - Correct
AnsPoor would healing
Dry brittle skin
Weak hand grips
Impaired coordination
A PATIENT HAS A FLAT LESION GREATER THAN 1 CM WITH AN IRREGULAR
BORDER. WHICH LESION MATCHES THIS DESCRIPTION? - Correct AnsPATCH
A PATIENT HAS POISON AND A LESION LESS THAN 0.5 CM. WHICH TYPE OF
LESION IS DESCRIBED? - Correct AnsVESICLE
A PATIENT'S SKIN TENTS AND DOES NOT RETURN FLAT FOR 10 SECONDS.
WHAT IS THIS FINDING INDICATIVE OF? - Correct AnsSEVERE DEHYDRATION
, A statement such as "OK, now I want to discuss your sleep and rest patterns" is an
example of which component of the interviewing process? The use of a . . . - Correct
AnsTransitional phase
Abnormal findings for hard and soft palate: - Correct AnsCleft Palate - opening in hard
palate
Jaundice - yellow coloration to hard palate
Abnormal nails - Correct AnsCyanosis
Hypertrophy
Thinning/brittleness
Abnormal: Lesions - Red Flags - Correct AnsActinic keratoses: Small reddened areas,
changing to rough, yellow to brown lesions
PRE-CANCEROUS (any age)
Acrocyanosis - Correct AnsCyanosis of hands & feet, disappears within hours to days
of birth (bluish hue)
Adipose tissue - Correct Ans-Insulation
-Padding
-Calorie reserves
Adolescents - Correct Ans-Sweat from apocrine glands: Body odor
-Increased sebum from sebaceous glands: Acne
-Terminal hair
--Areolae, axillae,
--Pubic areas
Age-Related Variations: Children: Past Health History - Correct AnsYoung child
-Teeth erupting (when/what), care of, use of Fluoride
-To bed with bottle, caries?
-Suck thumb or pacifier
-Frequency of Sore throat or colds
-Eustachian tube is straighter for infant & child
Older child
-Same questions as for young (focus on teeth and care)
-Daily care habits, brushing and flossing, dentist (how often), teeth straight?
Aging - Correct AnsSkin:
-Loses elasticity - wrinkles, lax, loses turgor
Color:
-Decreased vascularity of dermis - pale, opaque
,Texture:
-Thin, fragile, transparent
-Purple macules
Dry skin:
-Asteosis - flaky, rough, itchy
-Brown macules
Actinic keratoses:
-Small reddened areas, changing to rough, yellow to brown lesions (pre-cancerous)
Cherry angiomas:
-Bright or ruby red lesions
Nails lose luster and thicken
Annular lesions - Correct Anscircular
Apocrine glands - Correct Ans-Sweat axillae
-Nipples, areolae, eyelids, external ears, anogenital area
-Body odor secondary to bacterial growth
Arterial ulcer - Correct Ansrash
Assess and document pressure ulcers - Correct Ans-Size
-Length
-Width
-Depth
-Documenting Healing of Pressure Ulcers
Assess Temporomandibular Joint (TMJ) - Correct AnsPlace index finger in front of ear
"NORMAL":
No swelling, tenderness,
crepitus with movement
Open 3-6 cms
up and down
Lower jaw:
1-2 cm laterally
Assessment of lesions - Correct Ans-Location, distribution
-Grouping
-Type of lesion
-Color
-Size: L x W x D or H in cm
-Shape
, -Color
-Texture
-Elevations or depressions
-Pedunculations
Assessment of lesions pt. 2 - Correct Ans-Exudates: Color, amount, odor, consistency
-Configuration: Annular, grouped, linear, arciform, diffuse
-Location and Distribution: Generalized or localized; Region of body, patterns; Discrete
or confluent
Associated with overall sun exposure and common on body sites with heavy sun
exposure - Correct AnsSquamous cell carcinoma
Atrophy - Correct AnsThinning, appears shifty; arterial insufficiency
Basal cell carcinoma - Correct Ans-Most common in Whites
-Most common on body sites with moderate skin exposure
Birthmarks newborn - Correct AnsCapillary hemangioma
Blanch Test for Capillary Refill - Correct Ans- Quickly press nail to blanch, should
return to normal pink color < 3 seconds
Buccal mucosa pink and moist - Correct AnsNormal
Bulla - Correct AnsLarge blisters - more than 0.5cm
Changes in skin, hair, and nails - Correct Ans-Timing
-Symptoms
-Location
-Associated conditions, symptoms, activities
-Exposures
-Known allergies
-Nutrition
-Travel history
-Apparent cause: Patient's perception
-Alleviating and aggravating conditions
-Medications tried
-How is patient coping/living with problem?
Cherry angioma - Correct Ansa small, round, bright red blood vessel tumor on the skin,
often on the trunk of the elderly
Cherry Angioma - Correct AnsBright red, ruby lesions common with aging
Children - Correct AnsCry with tears
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