Test Bank for Saunders Comprehensive Re-
view for the NCLEX-RN Examination, 7th Edi-
tion, Linda Anne Silvestri, Questions with
Verified Answer 2024 Update
MULTIPLE CHOICE
1. The nurse reviews the health record of a patient with melasma. The nurse
would anticipate that this patient will exhibit:
1. Skin that is uniformly dark in color
2. Very pale skin with little pigmentation
3. Patches of skin that have loss of pigmentation
4. Blotchy brown macules across the cheeks and forehead
CORRECT: 4
Elaboration: Melasma is a condition caused by hormonal influences on melanin
production and is noted by the appearance of blotchy brown macules across the cheeks
and forehead. “Skin that is uniformly dark in color” describes vitiligo. “Very pale skin
with little pigmentation” and “patches of skin that have loss of pigmentation” refer to
normal variations in skin color.
Test-Taking Strategy: To answer this question correctly, you must be familiar with the
various terms used when discussing skin structures and functions. “Skin that is
uniformly dark in color” describes vitiligo. “Very pale skin with little pigmentation” and
“patches of skin that have loss of pigmentation” refer to normal variations in skin color.
Review the description of melasma if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Black, J., & Hawks, J. (2009). Medical-surgical nursing: clinical management for
positive outcomes (8th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
2. The patient with cellulitis of the lower leg has had cultures done on the affected area.
The nurse reviewing the results of the culture report interprets that which of the
following organisms is not part of the normal flora of the skin?
1. Escherichia coli
, Test Bank 2
2. Candida albicans
3. Staphylococcus aureus
4. Staphylococcus epidermidis
CORRECT: 1
Elaboration: E. coli is normally found in the intestines and is a common source of
infection of wounds and the urinary system. C. albicans, S. aureus, and S. epidermis are
part of the normal flora of the skin.
Test-Taking Strategy: To answer this question correctly, you must be familiar with the
normal microorganisms that inhabit the skin. Note that the question asks for the
organism that is not part of normal flora. Remember that E. coli is normally found in the
intestines. Review basic skin structures if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing:
patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
3. The patient complains of chronic pruritus. Which of the following diagnoses would
the nurse expect to support this patient’s complaint?
1. Anemia
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus
CORRECT: 2
Elaboration: Patients with renal failure often have pruritus, or itchy skin. This is because
of impaired clearance of waste products by the kidneys. The patient who is markedly
anemic is likely to have pale skin. Hypothyroidism may lead to complaints of dry skin.
Patients with diabetes mellitus are at risk for skin infections and skin breakdown.
Test-Taking Strategy: Focus on the subject, chronic pruritus. Remember that patients
with renal failure often experience this problem. If this question was difficult, review the
common causes of pruritus.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing:
patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
, Test Bank 3
4. A patient being seen in an ambulatory clinic for an unrelated complaint has a butterfly
rash noted across the nose. The nurse interprets that this finding is consistent with early
manifestations of which of the following disorders?
1. Hyperthyroidism
2. Pernicious anemia
3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE)
CORRECT: 4
Elaboration: An early sign of SLE is the appearance of a butterfly rash across the nose.
Hyperthyroidism often leads to moist skin and increased perspiration. Pernicious anemia
is exhibited by pale skin. Severe cardiopulmonary disorders may lead to clubbing of the
fingers.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
impact of systemic conditions on the skin. Remember that SLE causes a characteristic
butterfly rash. If this question was difficult, review the disorders identified in the options
and the associated skin conditions that occur in each disorder.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing:
patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
5. The nurse notes that the older adult patient has a number of bright, ruby-colored,
round lesions scattered on the trunk and thighs. The nurse correctly interprets the
finding as alterations in blood vessels of the skin and defines them as:
1. Purpura
2. Venous star
3. Cherry angioma
4. Spider angioma
CORRECT: 3
Elaboration: A cherry angioma occurs with increasing age and has no clinical
significance. It is noted by the appearance of small, bright, ruby-colored round lesions on
the trunk and/or extremities. Purpura results from hemorrhage into the skin. A venous star
results from increased pressure in veins, usually in the lower legs, and has an irregularly
shaped bluish center with radiating branches. Spider angiomas have a bright red center,
with
legs that radiate outward. These are commonly seen in those with liver disease or
vitamin B deficiency, although they can occur occasionally without underlying
pathology.
, Test Bank 4
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
various alterations in vascularity that can occur in the skin. Note the relationship of the
words “ruby” in the question and “cherry” in the correct option. If you had difficulty
with this question, review the various skin alterations identified in each of the options.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing:
patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
6. The patient has been diagnosed with paronychia. The nurse understands that this is
a disorder of the:
1. Nails
2. Hair follicles
3. Pilosebaceous glands
4. Epithelial layer of skin
CORRECT: 1
Elaboration: Paronychia is a fungal infection that is most often caused by Candida
albicans. This results in inflammation of the nail fold, with separation of the fold from
the nail plate. The area is generally tender to touch, with purulent drainage. Disorders of
the hair follicles include folliculitis, furuncles, and carbuncles. Disorders of the
pilosebaceous glands include acne vulgaris and seborrheic dermatitis. There are a variety
of disorders involving the epithelial skin.
Test-Taking Strategy: To answer this question accurately, you must be familiar with a
variety of skin disorders and their causes. Remember that paronychia is a nail disorder.
If this question was difficult, review the characteristics of paronychia.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing:
patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Patient Needs: Physiological Integrity
TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
7. The patient is diagnosed with a full-thickness burn. The nurse understands that which
of the following structural areas of the skin is involved?
1. Epidermis only
2. Epidermis and deeper dermis
3. Epidermis and upper layer of dermis
4. Epidermis, entire dermis, and epithelial portion of subcutaneous fat
