Seidel Guide to Physical Examination 8th Edition Jane W. Ball Test bank

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Seidel Guide to Physical Examination 8th Edition Jane W. Ball Test bank

Description

Chapter 08: Skin, Hair, and Nails
Test BankNursing

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 skins tissue cells have a rapid rate of turnover and constant renewal, thereby enabling the skin to repair damaged surfaces.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 115
OBJ: Nursing processassessment 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, shock absorption, and a reserve of calories.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 115
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

3. Sweat glands, hair, and nails are all formed from:
a. basement membranes under cellular strata.
b. closely packed squamous cells.
c. invaginations of epidermis into dermis.
d. papillae that penetrate the epidermis.

ANS: C
Skin appendages are formed embryonically when the epidermis invaginates into the dermis.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 115
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

4. 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 the skin moist.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 116
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

5. Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which 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 new nail growth.

DIF: Cognitive Level: Applying (Application) REF: p. 116
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

6. Mrs. Leonard brings her newborn infant into the pediatricians office for a first well-baby visit. As the health care provider, you 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 generate heat.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 116
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

7. Mrs. Mulligan brings her 16-year-old son into the office for a sports physical examination. As the health care provider, you explain that normal hormone-related changes of adolescence include:
a. increased oil production.
b. slowed hair growth.
c. depleted apocrine glands.
d. decreased sebaceous gland activity.

ANS: A
During adolescence, the sebaceous glands increase sebum production, which causes the skin to have an oily appearance and predisposes the individual to acne.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 116
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

8. 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 mens 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) REF: p. 117
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

9. 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 longitudinal ridges that are more brittle and susceptible to splitting into layers.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 117
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

10. Mrs. Franklin is a 68-year-old patient who presents to the office with a complaint that her nails do not seem to be growing. As the health care 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) REF: p. 117
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

11. As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include:
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 skin cancer development.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 117
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

12. 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 just adolescents, older adults, or persons with rashes.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 118
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

13. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:
a. using an episcope.
b. under fluorescent lighting.
c. with illumination provided by daylight.
d. using a Woods light.

ANS: C
Daylight provides the best illumination source for determining color variations of the skin.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 119
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

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

ANS: B
Tangential lightinglight shined laterally to the surfaceis best for inspecting skin contour.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 120
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

15. 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) REF: p. 122
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

16. 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 lowest rates of nevi.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 121
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

17. You are inspecting the lower extremities of a patient and have noted pale, shiny skin of the lower extremities. This may reflect:
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 disorders, such as diabetes mellitus and cardiovascular disease.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 123
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

18. A 29-year-old white woman appears jaundiced. Liver disease as a cause has been excluded. What history questions should the 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 in carrots, sweet potatoes, and squash are high in carotene and can make the skin appear to be jaundiced. Whether she had unprotected sex, a history of diabetes mellitus, or unusual bleeding problems would not be relevant when assessing the jaundiced skin.

DIF: Cognitive Level: Applying (Application) REF: p. 119
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

19. Mrs. Bower is a 39-year-old patient who has come to the office for a routine physical examination. As the health care provider, you know that the skin temperature is best assessed with the:
a. dorsal surface of the examiners hand.
b. palmar surface of the examiners hand.
c. ulnar surface of the examiners hand.
d. pads of the examiners fingers.

ANS: A
The dorsal surface of the hand is best for estimating temperature variations.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 124
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

20. You are examining a pregnant patient and have noted a vascular lesion. When you blanch over the vascular lesion, the site blanches 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, outward like a spiders legs. Spider angiomas are often associated with high estrogen levels, as occur in pregnancy. Blanching over the center is followed by a rapid return of redness from the center outward. Telangiectasis refill erratically. Petechiae and purpura do not blanch.

DIF: Cognitive Level: Applying (Application) REF: p. 123
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

21. 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 veins and telangiectasias are vascular lesions.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 124
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

22. 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. An example of a macular rash is measles.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 126
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

23. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4- 3-cm, rough, 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 diameter, as seen in someone with, for example, psoriasis.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 126
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

24. The nurse inspects an annular lesion. Which type of additional lighting source should be used for further assessment?
a. Fluorescent lighting
b. Woods lamp
c. Goose-neck lamp
d. Sunlight

ANS: B
Annular lesions are characteristic of tinea, which are fluorescing lesions that illuminate as yellow-green under a Woods lamp.

DIF: Cognitive Level: Applying (Application) REF: p. 133
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

25. 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) REF: p. 140
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

26. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
a. vascular from nonvascular lesions.
b. furuncles from folliculitis lesions.
c. fluid-filled lesions from solid cysts or masses.
d. herpes zoster from varicella.

ANS: C
Transillumination is used to determine the presence of fluid in cysts and masses. Fluid-filled lesions will transilluminate with a red glow, and solid masses will not transilluminate.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 133
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

27. Fluorescing lesions are best distinguished using a(n):
a. incandescent lamp.
b. magnifying glass.
c. transilluminator.
d. Woods lamp.

ANS: D
Fluorescing lesions (e.g., some tinea lesions) show a characteristic yellow-green color under a Woods lamp.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 133
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

28. 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 endocrine disorder. Hair loss can be associated with poor circulation, inflammation, or nutritional deficits.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 155
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

29. 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 disease or a chronic respiratory condition; and pits are related to psoriasis. A single dark band in a white adult indicates a more serious conditionmelanoma.

DIF: Cognitive Level: Applying (Application) REF: p. 134
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

30. Transient mottling of the patients 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 newborns response to changes in temperature.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 137
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

31. 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) REF: p. 138
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

32. Caf au lait patches are numbered with each assessment of infants and young children because:
a. the numbers are expected to increase each year.
b. coalescent lesions are a more serious finding.
c. the presence of more than five patches suggests neurofibromatosis.
d. decreasing numbers are expected with growth.

ANS: C
The presence of more than five patches with diameters larger than 1 cm in children younger than 5 years of age suggests neurofibromatosis. Fewer than five patches is usually considered harmless. The numbers of caf au lait patches are not expected to increase each year. Coalescent lesions are not a more serious finding. Decreasing numbers are not expected with growth.

DIF: Cognitive Level: Analyzing (Analysis) REF: p. 137
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

33. A Dennie-Morgan fold is probably caused by:
a. birth trauma.
b. high fever.
c. excess adipose tissue.
d. chronic rubbing.

ANS: D
Persons with chronic atopic or allergic conditions tend to rub the eyes sufficiently to cause an extra crease or pleat of skin below the eye, called the Dennie-Morgan fold.

DIF: Cognitive Level: Applying (Application) REF: p. 140
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

34. Linea nigra is commonly found on the abdomens of:
a. infants and children.
b. adolescents.
c. pregnant women.
d. older adults.

ANS: C
Pregnant women commonly develop pigmentation of the abdomen from the symphysis pubis to the top of the fundus in the midline.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 140
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

35. Cherry angiomas are a common finding in:
a. adults older than 30 years.
b. newborns.
c. pregnant women.
d. sunbathers.

ANS: A
Cherry angiomas occur in almost everyone older than 30 years and increase numerically with age.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 142
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

36. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
a. cutaneous tags from lentigines.
b. furuncles from folliculitis.
c. sebaceous hyperplasia from eczema.
d. seborrheic keratoses from actinic keratoses.

ANS: D
Actinic keratoses have malignant potential, and seborrheic keratoses do not. Because they can look similar, an experienced practitioner should make the determination.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 142
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

37. Age spots are also called:
a. seborrheic keratoses.
b. solar lentigines.
c. cutaneous horns.
d. acrochordon.

ANS: B
Solar lentigines are irregular, round, gray-brown lesions with a rough surface that occur in sun-exposed areas and are referred to as age spots.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 143
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

38. The most common inflammatory skin condition is:
a. cutis marmorata.
b. eczematous dermatitis.
c. intradermal nevus.
d. pityriasis rosea.

ANS: B
The most common inflammatory skin disorder is eczematous dermatitis.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 144
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

39. Which of the following is a noncandidal fungal infection?
a. Pityriasis rosea
b. Psoriasis
c. Tinea corporis
d. Rosacea

ANS: C
Tinea corporis is the only listed fungal infection (noncandidal); the others are not fungal in origin.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 146
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

40. The characteristic that best differentiates psoriasis from other skin abnormalities is the:
a. color of the scales.
b. formation of tiny papules.
c. general distribution over the body.
d. recurrence.

ANS: A
Unlike other skin conditions, silvery papules and plaques characterize psoriasis.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 146
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

41. Painful vesicles are associated with:
a. psoriasis.
b. pityriasis rosea.
c. paronychia.
d. herpes zoster.

ANS: D
Herpes zoster (shingles) produces painful itching or burning of the dermatome area.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 148
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

42. A 17-year-old student complains of a rash for 3 days. You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurses next action?
a. Teach infectious control measures.
b. Inquire about another recent skin lesion.
c. Inspect the palms and the soles.
d. Inform the patient that this will resolve within a week.

ANS: B
The described rash is the typical presentation of pityriasis rosea. The rash is not infectious or contagious, does not involve the palms and soles, and usually lasts for several weeks. Pityriasis rosea begins with a sudden primary (herald) patch, with generalized eruption to the trunk and extremities following 1 to 3 weeks later.

DIF: Cognitive Level: Analyzing (Analysis) REF: p. 148
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

43. Which of the following is an ABCD characteristic of malignant melanoma?
a. Asymmetric borders
b. Borders well demarcated
c. Color of lesion is uniform
d. Diameter less than 6 mm

ANS: A
ABCD melanoma mnemonic includes asymmetry, borders that are irregular, color that is not the same all over, and diameter larger than 6 mm and growing.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 154
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

44. The most common cutaneous neoplasm is:
a. basal cell carcinoma.
b. compound nevus.
c. seborrheic keratosis.
d. senile actinic keratosis.

ANS: A
Basal cell carcinoma is the most common form of skin cancer. It occurs more frequently on sun-exposed parts of the body.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 152
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

45. Soft, painless, bluish papules in persons who are HIV-positive are most likely:
a. Kaposi sarcoma.
b. malignant melanoma.
c. molluscum contagiosum.
d. pityriasis rosea.

ANS: A
Kaposi sarcoma is the more common malignant skin lesion of HIV-infected persons. The lesions are soft, painless, bluish-purple macules or papules.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 153
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

46. A 5-year-old child presents with discrete vesicles on an erythematous base (dew drops on a rose petal appearance) that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurses next action?
a. Teach infectious control measures.
b. Inquire about other patterns of physical abuse.
c. Inspect the buccal mucosa for Koplik spots.
d. Inform the parent that this will resolve within a couple of days.

ANS: A
The description of this childs complaint is a varicella rash, not physical abuse or rubeola. Chickenpox is a highly communicable disease and can be prevented by immunization. The period of communicability lasts from 1 or 2 days before onset of the rash until all the vesicles have crusted over, which usually takes about 1 week. This is not physical abuse. Inspecting the buccal mucosa for Koplik spots will not diagnose the problem. This will not resolve within a couple of days.

DIF: Cognitive Level: Analyzing (Analysis) REF: p. 161
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

47. During history taking, a mother states that her son awoke in the middle of the night complaining of intense itching to his legs. Today, your inspection reveals a honey-colored exudate from the vesicular rash on his legs. Which condition is consistent with these findings?
a. Exanthem
b. Impetigo
c. Solar keratoses
d. Trichotillomania

ANS: B
Impetigo causes intense pruritus, regional lymphadenopathy, and honey-colored exudative crusting as the vesicles or bullae rupture and dry.

DIF: Cognitive Level: Applying (Application) REF: p. 160
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

48. You are conducting a preschool examination on a 5-year-old child. Which injury would most likely raise your suspicion that the child was being abused?
a. Recent bruising over both knees
b. A healed laceration under the chin
c. A bruise on the right shin with associated abrasion of tissue
d. Bruises in various stages of resolution over body soft tissues

ANS: D
Toddlers and older children who bruise themselves accidentally do so over bony prominences, like the knees, chin, and shin. Bruises over soft tissues are more consistent with abuse.

DIF: Cognitive Level: Applying (Application) REF: p. 163
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

49. Assessment of poor hygiene, healed fractures with deformity, or unexplained trauma in older adults indicates:
a. sexual abuse.
b. physical neglect.
c. psychological abuse.
d. violated rights.

ANS: B
Described is the most common form of elder abuse, physical neglect.

DIF: Cognitive Level: Applying (Application) REF: p. 165
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

50. The nurse assesses the nail base angle using the Schamroth technique. The normal expected examination finding is nail beds that are _____ at the bases.
a. flat
b. convex
c. concave
d. bowed

ANS: C
The normal nail base angle should be 160 degrees, which results in a concave nail base that produces a diamond-shaped window with the Schamroth technique.

DIF: Cognitive Level: Applying (Application) REF: p. 135
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

COMPLETION

1. A slightly elevated brownish papule with indistinct borders is a typical characteristic of a(n) _____ nevus.

ANS:
compound

Only a compound nevus is slightly elevated and brown, with indistinct borders.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 121
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

2. Individuals with dark pigmentary demarcation lines show lighter coloration on ________ body surfaces.

ANS:
inward

Individuals with pigmentary demarcation lines have darker skin on the outward-facing surfaces and lighter skin on the inward-facing surfaces.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 121
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

3. Damage into the subcutaneous tissue in a decubitus ulcer occurs at stage _____.

ANS:
III

Stage III describes damage through to the subcutaneous tissue.

DIF: Cognitive Level: Remembering (Knowledge) REF: p. 142
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

MULTIPLE RESPONSE

1. Which of the following identify the signs and symptoms of basal cell cancer? (Select all that apply.)
a. Itching
b. Reddish patch
c. Starts from a nevi
d. Various clinical formscystic, nodular, pigmented
e. Macule type

ANS: A, B, D
Common signs and symptoms of basal cell carcinoma include a, pink, red, tan, white, black, or brown shiny nodule, in a variety of clinical forms, which may be crusted and itching.

DIF: Cognitive Level: Applying (Application) REF: p. 152
OBJ: Nursing processassessment MSC: Physiologic Integrity: Physiologic Adaptation

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