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Test Bank For Brunner & Suddarth's Textbook of Medical- Surgical Nursing 15th Edition By Janice L Hinkle, Kerry H. Cheever, Et al. chapter55$2.99
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Chapter 55: Assessment of Integumentary Function
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
MULTIPLE CHOICE
1. When planning the skin care of a client with decreased mobility, the nurse is aware of the varying
thickness of the epidermis. At what location is the epidermal layer thickest?
A. The scalp
B. The elbows
C. The palms of the hands
D. The knees
ANS: C
Rationale: The epidermis is the thickest over the palms of the hands and the soles of the feet.
PTS: 1 REF: p. 1799
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 55: Assessment of Integumentary Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
2. 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
ANS: B
Rationale: Telangiectasias consist of red marks on the skin caused by stretching of superficial blood
vessels. Ecchymoses are bruises, and purpura consists of pinpoint hemorrhages into the skin. Urticaria
is wheals or hives.
PTS: 1 REF: p. 1804
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 55: Assessment of Integumentary Function
KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Understand
NOT: Multiple Choice
3. The nurse in an ambulatory care center is admitting an older adult client who has bright red moles on
the skin. What benign changes in the skin of an older adult appear as bright red moles?
A. Cherry angiomas
B. Solar lentigines
C. Seborrheic keratoses
D. Xanthelasmas
ANS: A
Rationale: Cherry angiomas appear as bright red "moles," while solar lentigines are commonly called
"liver spots." Seborrheic keratoses are described as crusty brown "stuck on" patches, while
xanthelasmas appear as yellowish, waxy deposits on the upper eyelids.
PTS: 1 REF: p. 1803
, NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 55: Assessment of Integumentary Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
4. While assessing a dark-skinned client at the clinic, the nurse notes the presence of patchy, milky-white
spots. The nurse knows that this finding is characteristic of what diagnosis?
A. Cyanosis
B. Addison disease
C. Polycythemia
D. Vitiligo
ANS: D
Rationale: With cyanosis, nail beds are dusky. With polycythemia, the nurse notes ruddy blue face,
oral mucosa, and conjunctiva. A bronzed appearance, or "external tan," is associated with Addison
disease. Vitiligo is a condition characterized by destruction of the melanocytes in circumscribed areas
of skin and appears in light or dark skin as patchy, milky-white spots, often symmetric bilaterally.
PTS: 1 REF: p. 1804
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 55: Assessment of Integumentary Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
5. While waiting to see the health care provider, a client shows the nurse skin areas that are flat,
nonpalpable, and have had a change of color. The nurse recognizes that the client is demonstrating:
A. macules.
B. papules.
C. vesicles.
D. pustules.
ANS: A
Rationale: A macule is a flat, nonpalpable skin color change, while a papule is an elevated, solid,
palpable mass. A vesicle is a circumscribed, elevated, palpable mass containing serous fluid, while a
pustule is a pus-filled vesicle.
PTS: 1 REF: p. 1806
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 55: Assessment of Integumentary Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze
NOT: Multiple Choice
6. A dark-skinned client is admitted to the medical unit with liver disease. To correctly assess this client
for jaundice, on what body area should the nurse look for yellow discoloration?
A. Elbows
B. Lips
C. Nail beds
D. Sclerae
ANS: D
Rationale: Jaundice, a yellowing of the skin, is directly related to elevations in serum bilirubin and is
often first observed in the sclerae and mucous membranes.
PTS: 1 REF: p. 1805
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
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