Exam View - Chapter 09 - Seidals Guide To Physical Examination 9Th Edition PDF

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Chapter 09: Skin, Hair, and Nails Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. The skin repairs surface wounds by: a. exaggerating cell replacement. b. excreting lactic acid. c. producing vitamins. d. providing a mechanical barrier. ANS: A

The skin’s tissue cells have a rapid rate of turnover and constant renewal, thereby enabling the skin to re DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 2. The adipose tissue in the hypodermis serves to: a. provide sensory input. b. generate heat and insulate. c. create tensile strength. d. secrete collagen. ANS: B

The hypodermis layer consists of adipose tissue that serves to generate heat and provide insulation, shoc of calories. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 3. The secretory activity of the sebaceous glands is stimulated by: a. body heat. b. ambient temperature. c. sex hormones. d. dietary protein. ANS: C

The sebaceous glands, when stimulated by the sex hormones, produce a lipid-rich substance that keeps t DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 4. Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails

structure is the site of new nail growth? a. Cuticle b. Perionychium c. Matrix d. Nail bed ANS: C

The white crescent-shaped area beyond the proximal nail fold is called the matrix, which is the site of ne DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 5. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the h

teach her that newborns are more vulnerable to hypothermia because of: a. the presence of coarse terminal hair. b. desquamation of the stratum corneum. c. their covering of vernix caseosa. d. a poorly developed subcutaneous fat layer. ANS: D

Newborns have a poorly developed subcutaneous fat layer and therefore have a reduced ability to genera DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation

7. Expected hair distribution changes in older adults include: a. increased terminal hair follicles on the scalp. b. more prominent axillary and pubic hair production. c. increased terminal hair follicles to the tragus of men’s ears. d. more prominent peripheral extremity hair production. ANS: C

The transition from a vellous to terminal hair pattern occurs in older men at the nares and tragus. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. Brittle nails are typical findings in: a. adolescents. b. infants. c. pregnant women. d. older adults. ANS: D

Older adults typically have decreased peripheral circulation to the nails, causing the nails to develop lon more brittle and susceptible to splitting into layers. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. Mrs. Franklin is a 68-year-old patient who presents to the office with a complaint that her nails do not se

healthcare provider, you explain to her that the nails of older adults grow slowly because of: a. decreased circulation. b. dietary deficiencies. c. fungal infections. d. low hormone levels. ANS: A

Decreased circulation to the nails of older adults causes nail growth retardation. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. As part of your health promotion education for a new patient, you explain that the risk factors for skin ca a. an olive complexion. b. repeated trauma or irritation to skin. c. history of allergic reactions to sunscreen. d. dark eyes and hair. ANS: B

Fair-skinned persons with light eyes with repeated trauma or skin irritation have higher risk factors for s DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 11. The type and brand of grooming products used are important to the health history of: a. adolescents. b. everyone. c. older adults. d. persons with rashes. ANS: B

Knowledge of exposure to environmental chemicals is valid health history data for all age groups, not ju or persons with rashes. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 12. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best con a. using an episcope.

b. c. d.

under fluorescent lighting. with illumination provided by daylight. using a Wood’s light.

13. Tangential lighting is best used for inspecting skin: a. color. b. contour. c. exudates. d. symmetry. ANS: B

Tangential lighting—light shined laterally to the surface—is best for inspecting skin contour. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 14. Unusual white areas on the skin may be caused by: a. adrenal disease. b. polycythemia. c. vitiligo. d. Down syndrome. ANS: C

The absence of melanin produces unpigmented white areas known as vitiligo. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 15. Which cultural group has the lowest incidence of nevi? a. Native Americans b. African Americans c. Mexican Americans d. Asians ANS: B

Nevi are more common in persons who burn, rather than tan; therefore, African Americans have the low DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 16. You are inspecting the lower extremities of a patient and have noted pale, shiny skin of the lower extrem a. systemic disease. b. a history of vigorous exercise. c. peptic ulcer disease. d. mental retardation. ANS: A

Pale, shiny skin of the lower extremities may reflect peripheral changes that occur with systemic disorde mellitus and cardiovascular disease. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 17. A 29-year-old white woman appears jaundiced. Liver disease as a cause has been excluded. What history

nurse ask? a. Whether she had unprotected sex b. Whether she has a history of diabetes mellitus c. Whether she had unusual bleeding problems d. Whether she eats a lot of yellow and orange vegetables ANS: D

In the absence of liver disease, another cause of jaundice is increased carotene pigmentation. Diets high and squash are high in carotene and can make the skin appear to be jaundiced. Whether she had unprotec diabetes mellitus, or unusual bleeding problems would not be relevant when assessing the jaundiced skin DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 18. Mrs. Bower is a 39-year-old patient who has come to the office for a routine physical examination. As a

know that the skin temperature is best assessed with the: a. dorsal surface of the examiner’s hand. b. palmar surface of the examiner’s hand.

19. You are examining a pregnant patient and have noted a vascular lesion. When you blanch over the vascu

and refills evenly from the center outward. The nurse documents this lesion as a: a. telangiectasia. b. spider angioma. c. petechiae. d. purpura. ANS: B

Spider angiomas are dilated arterioles. A network of dilated capillaries radiate from the center arteriole, legs. Spider angiomas are often associated with high estrogen levels, as occur in pregnancy. Blanching o by a rapid return of redness from the center outward. Telangiectasias refill erratically. Petechiae and pur DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 20. Small, minute bruises are called: a. ecchymoses. b. petechiae. c. spider veins. d. telangiectasias. ANS: B

Petechiae are smaller than 0.5 cm in diameter. Ecchymoses are larger than 0.5 cm in diameter. Spider ve vascular lesions. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 21. A flat, nonpalpable lesion is described as a macule if the diameter is: a. larger than 1 cm. b. smaller than 1 cm. c. 3 cm exactly. d. too irregular to measure. ANS: B

A macule, by definition, is a flat, circumscribed area smaller than 1 cm in diameter and is measurable. A rash is measles. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 22. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have

elevated area of psoriasis. This is an example of a: a. plaque. b. patch. c. macule. d. papule. ANS: A

A plaque, by definition, is an elevated, firm, rough lesion with a flat top surface larger than 1 cm in diam with, for example, psoriasis. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 23. Skin turgor checks are performed to determine the: a. temperature of the skin. b. hydration status. c. actual age. d. extent of an ecchymosis. ANS: B

Skin will remain tented if the patient is dehydrated or will not tent if edema is present. DIF: Cognitive Level: Understanding (Comprehension)

OBJ: Nursing process—assessment

MSC: Physiologic Integrity: Physiologic Adaptation

24. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transillumi

25. Fluorescing lesions are best distinguished using a(n): a. incandescent lamp. b. magnifying glass. c. transilluminator. d. Wood’s lamp. ANS: D

Fluorescing lesions (e.g., some tinea lesions) show a characteristic yellow-green color under a Wood’s l DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 26. Women with terminal hair growth in a male distribution pattern should receive further evaluation for a(n a. circulation condition. b. endocrine disorder. c. inflammatory state. d. nutritional deficit. ANS: B

Hirsutism in women (growth of terminal hair in a male distribution) can be a clinical sign of an endocrin associated with poor circulation, inflammation, or nutritional deficits. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 27. Which nail change found on examination would be most alarming? a. Dark bands seen on all fingernails of a dark-skinned person b. Yellow discoloration of the great toe of an older adult c. Single dark band in a white adult d. Pits in both index fingernails of an adult ANS: C

Dark bands in a dark-skinned person are normal; yellow in the toe of an older adult can represent a nail respiratory condition; and pits are related to psoriasis. A single dark band in a white adult indicates a mo condition—melanoma. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 28. Transient mottling of the patient’s skin in a cool room is a common finding in: a. menopausal women. b. newborn infants. c. pregnant women. d. sedentary adults. ANS: B

Cutis marmorata, a mottled appearance, is part of the newborn’s response to changes in temperature. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 29. A single transverse line seen in the palm of a small child may imply: a. Down syndrome. b. Turner syndrome. c. systemic sclerosis. d. profound dehydration. ANS: A

The simian line, a single transverse crease, is seen on the palm of children with Down syndrome. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 30. Cafe au lait patches are numbered with each assessment of infants and young children because: a. the numbers are expected to increase each year....