Chapter 46 Integumentary System

Chapter 46  Integumentary System

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A client has a stasis ulcer on the left ankle. Nursing assessment of this open area involves which skin assessment parameter?
a.
integrity
c.
turgor
b.
moisture
d.
vascularity

ANS: A
Skin should be intact (integrity) with no evidence of tissue injury; the nurse should note any broken skin or open areas, and the color, size, and location of any rashes or lesions such as nodules or pustules.

PTS: 1 DIF: Comprehension REF: White (2010)

2. A nurse notes that a client’s skin is loose, thin, and wrinkled. Which of these skin parameters has the nurse assessed?
a.
integrity
c.
texture
b.
moisture
d.
turgor

ANS: C
Skin texture is normally soft and smooth; the nurse should note any variations such as skin that is wrinkled, rough, or scaling. Skin should move freely and return to normal position after being pinched (turgor and mobility); skin that is taut or slack should be noted.

PTS: 1 DIF: Comprehension REF: White (2010)

3. The skin of a client’s feet is very taut with edema. Which of these skin parameters has the nurse assessed?
a.
integrity
c.
turgor
b.
texture
d.
vascularity

ANS: C
Skin texture is normally soft and smooth; the nurse should note any variations such as skin that is wrinkled, rough, or scaling. Skin should move freely and return to normal position after being pinched (turgor and mobility); skin that is taut or slack should be noted.

PTS: 1 DIF: Comprehension REF: White (2010)

4. A client has numerous petechiae over the face, neck, and upper chest and areas of ecchymosis on the abdomen and upper legs. Which of these skin parameters has the nurse assessed?
a.
integrity
c.
turgor
b.
texture
d.
vascularity

ANS: D
Skin normally has no areas of discoloration (vascularity); the nurse should note evidence of ecchymosis, petechiae, or telangiectasia.

PTS: 1 DIF: Comprehension REF: White (2010)

5. Which phase of wound healing lasts the longest period of time?
a.
initial
c.
reconstructive
b.
defensive
d.
maturation

ANS: D
In the maturation phase, which begins about 3 weeks after the initial injury and may continue indefinitely if the wound is extensive and deep, the process of scar tissue remodeling occurs.

PTS: 1 DIF: Comprehension REF: White (2010)