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Exam 3 (MedSurg): Skin

Total questions: 105

Worksheet time: 53mins

Name
Class
Date
1.

Skin Care Health Care Promotion includes which of the following?

a)

Avoidance of environmental hazards

b)

Adequate hygiene and nutrition

c)

Skin self-examination

d)

All of the above

2.

Which of the following is an environmental hazard for skin health?

a)

Sun exposure

b)

Irritants and allergens

c)

Radiation

d)

All of the above

3.

Actinic keratosis is classified as what type of skin lesion?

a)

Premalignant skin lesions

b)

Benign skin lesions

c)

Infectious skin lesions

d)

Autoimmune skin lesions

e)

Malignant skin lesions

4.

What is the most common skin cancer?

a)

Basal cell carcinoma

b)

Squamous cell carcinoma

c)

Melanoma

d)

Merkel cell carcinoma

5.

Which skin cancer is the least deadly?

a)

Basal cell carcinoma

b)

Melanoma

c)

Squamous cell carcinoma

d)

Merkel cell carcinoma

6.

Which type of non-melanoma skin cancer has the potential to metastasize?

a)

Squamous cell carcinoma

b)

Basal cell carcinoma

c)

Actinic keratosis

d)

Seborrheic keratosis

7.

Pipe, cigar, and cigarette smoking are risk factors for which type of skin cancer?

a)

Squamous cell carcinoma

b)

Basal cell carcinoma

c)

Melanoma

d)

Kaposi's sarcoma

8.

Atypical/dysplastic nevus is described as what?

a)

Flat red splotch

b)

Raised blue nodule

c)

Yellow crusted plaque

d)

White scaly patch

9.

What does the 'A' in the ABCDE rule for self-examination of malignant skin neoplasms stand for?

a)

Asymmetry

b)

Alopecia

c)

Adenoma

d)

Atrophy

10.

What does the 'B' in the ABCDE rule for self-examination of malignant skin neoplasms stand for?

a)

Border irregularity

b)

Bleeding tendency

c)

Benign appearance

d)

Brown coloration

11.

What does the 'C' in the ABCDE rule for self-examination of malignant skin neoplasms stand for?

a)

Color change

b)

Circumference

c)

Consistency

d)

Compression

12.

Which of the following is NOT a risk factor for malignant melanoma?

a)

Red or blonde hair

b)

Light colored eyes

c)

Dark skin with no freckles

d)

Chronic sun exposure

13.

Fill in the blank: The cause of malignant melanoma is usually ______ or genetic factors.

a)

environmental

b)

nutritional

c)

bacterial

d)

mechanical

14.

To diagnose malignant melanoma, lesions are _____-biopsied and/or _____-excised.

a)

shave

b)

scrape

c)

scratch

d)

stab

15.

Which of the following is included in the collaborative care for malignant melanoma?

a)

Only chemotherapy

b)

Only radiation therapy

c)

Surgical incision and adjuvant therapy

d)

No treatment required

16.

SATA: Tumor staging for malignant melanoma includes which of the following?

a)

Tumor size

b)

Nodal involvement

c)

Metastasis

d)

Blood pressure

17.

Fill in the blank: The treatment for malignant melanoma is determined by the site of original tumor, stage of cancer, patient's age, and ______.

a)

general health

b)

blood type

c)

hair color

d)

height

18.

Family history is a risk factor for malignant melanoma.

a)

True

b)

False

19.

What is the purpose of electrodessication in dermatologic therapy?

a)

High frequency electricity is used to kill skin cells.

b)

It is used to cool the skin surface before laser treatment.

c)

It is a method to moisturize dry skin.

d)

It is a technique to inject medication into the skin.

20.

Which procedure involves removing thin layers of skin one at a time?

a)

Mohs procedure

b)

Cryotherapy

c)

Laser resurfacing

d)

Electrodessication

21.

What is lichenification?

a)

Thickening and leathering of the skin.

b)

Loss of skin pigmentation.

c)

Formation of blisters on the skin.

d)

Excessive hair growth on the skin.

22.

Which of the following is NOT a diagnostic or surgical therapy for dermatologic problems?

a)

A) Skin scraping

b)

B) Cryosurgery

c)

C) Support groups

d)

D) Curettage

23.

Which type of therapy burns microvessels in dermatologic treatment?

a)

Electrocoagulation

b)

Cryotherapy

c)

Phototherapy

d)

Laser resurfacing

24.

Which of the following is a method to control pruritis in nursing management of dermis?

a)

Wet dressings

b)

Excision

c)

Camouflage

d)

Laser therapy

25.

SATA: What are the primary purposes of the sequential response to cell injury in inflammation?

a)

Neutralize and dilute inflammatory agent

b)

Removal of necrotic materials

c)

Establish an environment suitable for healing and repair

d)

Speed up flow of blood around the injured site

e)

Migrate WBCs against the concentration gradient of chemotactic factors

26.

Which of the following is NOT a phase of the inflammatory response?

a)

Vascular response

b)

Cellular response

c)

Formation of exudate

d)

Neural response

e)

Healing phase

27.

What is the effect of histamine and other mediators released by injured cells on blood vessels?

a)

They cause the vessels to dilate, resulting in hyperemia.

b)

They cause the vessels to constrict, reducing blood flow.

c)

They cause the vessels to become impermeable to white blood cells.

d)

They cause the vessels to thicken, preventing nutrient exchange.

28.

Name two effects of vasodilation chemical mediators during the vascular response phase of inflammation.

a)

Endothelial cell retraction and increased capillary permeability.

b)

Decreased blood flow and reduced oxygen delivery.

c)

Platelet aggregation and clot formation.

d)

Decreased leukocyte migration and reduced phagocytosis.

29.

Initially, the fluid in tissue spaces during inflammation is composed of ________ fluid, but later it contains plasma proteins primarily ________.

a)

serous; albumin

b)

fibrinous; globulin

c)

purulent; fibrinogen

d)

hemorrhagic; immunoglobulin

30.

Proteins exert ______ pressure that further draws fluid FROM blood vessels.

a)

oncotic

b)

hydrostatic

c)

osmotic

d)

turgor

31.

Tissue becomes ______ during inflammation.

a)

edematous

b)

fibrous

c)

calcified

d)

atrophic

32.

As plasma protein fibrinogen leaves blood, it is activated to ______ by products of the injured cells.

a)

fibrin

b)

albumin

c)

globulin

d)

thrombin

33.

Fibrin strengthens a blood clot formed by ______.

a)

platelets

b)

red blood cells

c)

lymphocytes

d)

white blood cells

34.

Which of the following is the first leukocyte to arrive at the site of injury?

a)

Monocytes

b)

Neutrophils

c)

Lymphocytes

d)

Eosinophils

35.

Neutrophils have a short life span of ______ hours.

a)

24-48

b)

72-96

c)

6-8

d)

120-144

36.

SATA: Pus is composed of:

a)

Living neutrophils

b)

Dead neutrophils

c)

Platelets

d)

Cellular debris

e)

Digested bacteria

37.

Which type of cell is the SECOND leukocyte to migrate to the site of injury?

a)

Monocytes

b)

Neutrophils

c)

Lymphocytes

d)

Eosinophils

38.

How long after the onset of inflammation do monocytes arrive?

a)

Within 3-7 days

b)

Within 1 hour

c)

Within 24 hours

d)

After 2 weeks

39.

What do monocytes transform into upon entering tissue spaces?

a)

Macrophages

b)

Neutrophils

c)

Erythrocytes

d)

Lymphocytes

40.

What is the primary function of macrophages in the healing process?

a)

Cleaning the area before healing can occur

b)

Producing antibodies to fight infection

c)

Forming new blood vessels

d)

Contracting the wound edges

41.

Which type of cell arrives later at the site of injury and is primarily involved in immunity?

a)

Lymphocytes

b)

Neutrophils

c)

Erythrocytes

d)

Platelets

42.

Which chemical mediators of inflammation are listed in the notes?

a)

Histamine, serotonin, kinins, complement proteins, prostaglandins, leukotrienes, cytokines

b)

Insulin, glucagon, adrenaline, thyroxine, melatonin, cortisol

c)

Hemoglobin, myoglobin, actin, myosin, collagen, elastin

d)

DNA, RNA, ATP, GTP, cAMP, NADH

43.

Bone marrow releases more neutrophils in response to infection, resulting in what?

a)

Elevated WBC count

b)

Decreased platelet count

c)

Lowered hemoglobin levels

d)

Reduced lymphocyte production

44.

By using a CBC with differential, a high neutrophil number indicates what stage of infection?

a)

Early stage of infection

b)

Late stage of infection

c)

Chronic stage of infection

d)

Recovery stage of infection

45.

What are the two main things neutrophils digest?

a)

Digested bacteria and other cellular debris

b)

Hormones and vitamins

c)

Proteins and lipids

d)

Red blood cells and platelets

46.

Which of the following is NOT a chemical mediator listed in the notes?

a)

A) Histamine

b)

B) Serotonin

c)

C) Insulin

d)

D) Cytokines

47.

The major function of the complement system is to enhance the ability of antibodies and phagocytic cells to clear microbes and damaged cells

a)

True

b)

False

48.

Fill in the blank: Enhanced phagocytosis, increased vascular permeability, chemotaxis, and cellular lysis are all effects associated with the inflammatory response. One of these effects is _________.

a)

Enhanced phagocytosis

b)

Decreased oxygen transport

c)

Reduced antibody production

d)

Inhibition of nerve impulses

49.

Which of the following is a function of thromboxane?

a)

Decreases vascular permeability

b)

Powerful vasoconstrictor

c)

Inhibits clot formation

d)

Reduces platelet aggregation

50.

Fill in the blank: Thromboxane acts as a platelet-aggregating agent and promotes ________ formation.

a)

clot

b)

enzyme

c)

hormone

d)

antibody

51.

Which substances are described as slow reacting substances of anaphylaxis (SRS-A)?

a)

Thromboxane

b)

Leukotrienes

c)

Prostaglandins

d)

Cyclooxygenase

52.

Fill in the blank: The cyclooxygenase pathway, which is inhibited by NSAIDs and aspirin, creates prostaglandins and _________

a)

thromboxane

b)

serotonin

c)

histamine

d)

acetylcholine

53.

Which pathway creates leukotrienes?

a)

Cyclooxygenase pathway

b)

Lipoxygenase pathway

c)

Thromboxane pathway

d)

Prostaglandin pathway

54.

Fill in the blank: Exudate consists of fluid and ________ that move from the circulation to the site of injury.

a)

leukocytes

b)

erythrocytes

c)

platelets

d)

antibodies

55.

What are the local signs of inflammation?

a)

Redness, heat, swelling, pain, loss of function.

b)

Fever, chills, headache, nausea, vomiting.

c)

Cough, sneezing, runny nose, sore throat, fatigue.

d)

Itching, rash, dizziness, blurred vision, dry mouth.

56.

Which of the following is NOT a systemic response to inflammation?

a)

Increased WBC count with a shift to the left

b)

Malaise, nausea, anorexia

c)

Decreased HR and RR

d)

FEVER

57.

Fill in the blank: Cytokines cause fever by initiating metabolic changes in the ________-regulating center in the hypothalamus.

a)

temperature

b)

hormone

c)

glucose

d)

oxygen

58.

Epinephrine released from the adrenal medulla increases the metabolic rate during a systemic response to inflammation.

a)

True

b)

False

59.

What are the beneficial aspects of fever during inflammation?

a)

Increased killing of microorganisms, increased phagocytosis, and increased proliferation of T lymphocytes.

b)

Decreased immune response, reduced phagocytosis, and suppressed T lymphocyte activity.

c)

Lowered body temperature, decreased metabolic rate, and reduced antibody production.

d)

Inhibition of white blood cell production, decreased inflammation, and reduced cytokine release.

60.

Which type of inflammation is characterized by healing that occurs in 2-3 weeks, usually leaving NO residual damage?

a)

Acute

b)

Subacute

c)

Chronic

61.

Fill in the blank: Neutrophils are the predominant cell type at the site of ________ inflammation.

a)

acute

b)

chronic

c)

granulomatous

d)

allergic

62.

Subacute inflammation has the same features as acute inflammation but persists longer.

a)

True

b)

False

63.

What is the final phase of the inflammation process?

a)

healing

b)

initiation

c)

proliferation

d)

degeneration

64.

Which of the following is NOT a drug therapy used in the management of inflammation SPECIFICALLY?

a)

A) Aspirin/ASA

b)

B) Acetaminophen

c)

C) NSAIDs

d)

D) Antibiotics

65.

What does RICE stand for in the management of inflammation?

a)

REST, ICE, COMPRESSION, AND ELEVATION

b)

REST, INJECTION, COLD, AND EXERCISE

c)

RELAX, IMMOBILIZE, COOL, AND ELEVATE

d)

RUN, ICE, COMPRESS, AND EXERCISE

66.

Pressure ulcers are usually localized injuries to skin and/or underlying tissue over what type of body area?

a)

bony prominences

b)

muscular regions

c)

cartilaginous areas

d)

vascular tissues

67.

Which cell types are predominantly involved in chronic inflammation?

a)

lymphocytes and macrophages

b)

neutrophils and eosinophils

c)

basophils and mast cells

d)

platelets and erythrocytes

68.

Healing includes tissue regeneration and repair.

a)

True

b)

False

69.

Fill in the blank: Pressure ulcers most commonly occur at the ______ and ______.

a)

sacrum, heels

b)

elbows, knees

c)

scalp, neck

d)

wrists, ankles

70.

Which of the following is NOT an influencing/risk factor for pressure ulcers?

a)

Amount of pressure

b)

Length of time pressure is exerted

c)

Ability of tissue to tolerate externally applied pressure

d)

Amount of skin turgor

71.

Fill in the blank: Excessive ______ increases risk for skin breakdown.

a)

moisture

b)

exercise

c)

sunlight

d)

vitamin C

72.

Which of the following is a contributing factor to pressure ulcers?

a)

Advanced age

b)

High diastolic BP

c)

Frequent exercise

d)

Low body temperature

73.

Fill in the blank: Pressure ulcers are staged or categorized based on visible or palpable tissue in the ______.

a)

ulcer bed

b)

epidermis

c)

dermal layer

d)

subcutaneous fat

74.

Stage 1 pressure ulcers are considered severe, while Stage 4 are minor.

a)

True

b)

False

75.

Fill in the blank: With suspected deep tissue injury, a ______ or ______ localized area of discolored intact skin or blood-filled blister may be present.

a)

purple, maroon

b)

red, yellow

c)

blue, green

d)

black, white

76.

Which of the following is NOT a contributing factor to pressure ulcers?

a)

Friction

b)

Immobility

c)

High diastolic BP (over 90)

d)

Mental deterioration

77.

Which stage of pressure ulcer is characterized by intact skin with NON BLANCHABLE redness of a localized area usually over a bony prominence?

a)

Stage 1

b)

Stage 2

c)

Stage 3

d)

Stage 4

78.

Stage 2 pressure ulcers are characterized by which of the following?

a)

Full-thickness loss

b)

Partial thickness loss of dermis

c)

Bone, tendon, or muscle visible

d)

Necrotic tissue

79.

A shallow open ulcer with a red/pink wound bed is most likely seen in which stage of pressure ulcer?

a)

Stage 2

b)

Stage 1

c)

Stage 3

d)

Stage 4

80.

Stage 3 pressure ulcers present as deep craters with possible ________ of adjacent tissue.

a)

undermining

b)

swelling

c)

calcification

d)

pigmentation

81.

In Stage 3 pressure ulcers, bone, tendon, or muscle are visible.

a)

True

b)

False

82.

Which stage of pressure ulcer can extend to muscle, bone, or supporting structures?

a)

Stage 1

b)

Stage 2

c)

Stage 3

d)

Stage 4

83.

Unstageable pressure ulcers are defined by full-thickness loss of tissue in which the actual depth of the ulcer is completely obscured by ________ or ________.

a)

slough or eschar

b)

granulation tissue or pus

c)

serum or fibrin

d)

blood or lymph

84.

Which of the following is NOT a sign of ulcer formation?

a)

Leukocytosis, fever

b)

Increased ulcer size, odor, and/or drainage

c)

Necrotic tissue

d)

Acne

85.

The site of ulcer formation is often indurated, warm, and ________.

a)

painful

b)

itchy

c)

dry

d)

cold

86.

What is the most common complication of pressure ulcers?

a)

Osteomyelitis

b)

Recurrence

c)

Cellulitis

d)

Possible death

87.

Which of the following is NOT a possible complication of pressure ulcers?

a)

Cellulitis

b)

Osteomyelitis

c)

Diabetes

d)

Possible death

88.

Choose the BEST answer: Assessment of pressure ulcer risk should be done on admission and at periodic intervals based on what?

a)

Nurse's preference

b)

Patient's condition

c)

Hospital policy

d)

Family request

89.

A thorough ________ should be done on admission to assess for pressure ulcers.

a)

head to toe

b)

abdominal

c)

respiratory

d)

neurological

90.

Stage 3 or 4 pressure ulcer AFTER admission to a health care setting is considered a ________.

a)

Serious Reportable Event

b)

Minor Incident

c)

Routine Occurrence

d)

Non-Reportable Event

91.

When assessing patients with dark skin for pressure ulcers, which of the following is NOT recommended?

a)

Look for areas of darker skin

b)

Use fluorescent light for assessment

c)

Assess skin temperature with your hand

d)

Ask about pain or an itchy sensation

92.

Boggy or edematous tissue may indicate a stage 1 pressure ulcer.

a)

True

b)

False

93.

One of the overall goals in the management of pressure ulcers is to ________ contributing factors.

a)

reduce

b)

increase

c)

ignore

d)

exaggerate

94.

What is the best way to prevent pressure ulcer formation?

a)

frequent bathing

b)

soft bedding

c)

topical ointments

d)

mobilization

95.

The wound bed should be kept slightly _____, and the area around the wound dressing should be kept _______.

a)

wet, wet

b)

dry, dry

c)

wet, dry

d)

dry, wet

96.

How is replacement different from repair in terms of wound healing?

a)

Replacement uses the same type of cells and tissues to heal wounds, repair uses connective tissue to heal wounds

b)

Repair uses the same type of cells and tissues to heal wounds, replacement uses connective tissue to heal wounds

c)

They mean the same thing

97.

SATA: Select the phases of primary intention repair.

a)

initial phase

b)

granulation phase

c)

maturation phase

d)

dehiscence phase

e)

infectious phase

98.

The initial phase of repair by primary intention lasts ____ days.

a)

1-2

b)

3-5

c)

5-7

d)

7-10

99.

In the granulation phase of repair by primary intention, ______ migrate into the injured site and secrete collagen.

a)

macrophages

b)

neutrophils

c)

leukocytes

d)

fibroblasts

e)

osteoblasts

100.

Wounds requiring secondary intention repair have edges that ______ be approximated.

a)

can

b)

cannot

c)

must

d)

don't have to be

101.

What would necessitate repair by tertiary intention?

a)

trauma

b)

ulceration

c)

delayed suturing

d)

infection

e)

large amounts of exudate

102.

A wound vacuum would be considered what type of wound therapy?

a)

hyperbaric oxygen therapy

b)

topical antimicrobial therapy

c)

negative pressure therapy

d)

granulation therapy

103.

It is ok for the RN to freely touch recently injured areas.

a)

True

b)

False

104.

What does dehiscence mean?

a)

bulbous scarring

b)

change in wound shape

c)

separation of wound edges

d)

leathering of wound site

105.

When a patient has pressure ulcers, what should happen to their diet to maintain adequate nutrition and assist with the healing process?

a)

increase calories and/or protein

b)

increase calcium and/or potassium

c)

increase carbohydrates and/or simple sugars

d)

increase cholesterol and/or complex sugars

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