EAQ- Lewis Med Surg CH.24, Nursing Management:
Integumentary Problems Exam Study Set
Questions Solved to Score A+
A patient with psoriasis tells the nurse that the patient has quit his or her job as a restaurant hostess
because the patient believes the lesions on his or her hands and arms are unattractive to customers. The
nursing diagnosis that best describes this patient response is
1. Social isolation related to fear of rejection
2. Ineffective coping related to lack of social support
3. Impaired skin integrity related to presence of lesions
4. Ineffective health maintenance because of presence of lesions - Answer 1. Social isolation related to
fear of rejection
The chronicity of psoriasis can be severe and disabling as people withdraw from social contacts because
of visible lesions. Quality of life is also affected negatively. The information presented does not indicate
the patient does not have support. Impaired skin integrity is not a priority diagnosis. There is no
information to indicate the patient has ineffective health maintenance.
When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin
cancer cases have been reported in white patients than in African American patients. What could be the
most likely cause of such an occurrence?
1. Whites have less melanin content in their skin than African Americans.
2. Whites have greater melanin content in their skin than African Americans.
3. Whites usually have more exposure to the sun than African Americans.
4. Whites usually have less exposure to the sun than African Americans. - Answer 1. Whites have less
melanin content in their skin than African Americans.
Melanin provides natural protection to the skin against the harmful radiation of the sun. Therefore,
melanin plays a major role in preventing skin cancer. African American people are darker skinned and
have greater melanin content in their skin. Therefore, they are less susceptible to skin cancer than white
people. White people are lighter skinned and have less melanin. Differences in sun exposure between
the two populations cannot be predicted.
, The nurse assesses an elevated, dry, hyperkeratotic, scaly papule in an older adult patient. With what
condition does the assessment data correlate?
1. Dysplastic nevus
2. Actinic keratosis
3. Basal cell carcinoma
4. Squamous cell carcinoma - Answer 2. Actinic keratosis
Actinic keratosis manifests clinically as dry, scaly, hyperkeratotic papules, either flat or elevated. A
dysplastic or atypical nevus is often larger than 5 mm. It features irregular borders, which may be
notched; variegated color (e.g., tan, brown, black, red, or pink) within a single mole; and at least one flat
portion, often at the edge of the mole. Basal cell carcinoma is characterized by a small, slowly enlarging
papule with semitranslucent or pearly borders. Squamous cell carcinoma appears as a thin, scaly,
erythematous plaque that does not invade the dermis.
A nurse is assessing a patient who reports extreme fatigue and muscle pain. The patient reports
spending very little time outdoors. The skeletal muscles of the patient are very weak. Which deficiency is
most likely to cause such symptoms?
1. Vitamin A deficiency
2. Vitamin B deficiency
3. Vitamin C deficiency
4. Vitamin D deficiency - Answer 4. Vitamin D deficiency
Muscle pain and weakness are signs of Vitamin D deficiency. Vitamin D is produced naturally by
cutaneous photosynthesis due to exposure to UVB light. The patient is most likely to have Vitamin D
deficiency because of restricted sun exposure. Vitamin C deficiency causes scurvy, which is characterized
by purpura, bleeding gums and petechiae. Deficiency of vitamin A causes dryness of the conjunctiva and
poor wound healing. Deficiency of Vitamin B causes dermatologic symptoms such as erythema, bullae,
and seborrhea-like lesions.
A 54-year-old patient with diabetes mellitus has cellulitis of the right lower extremity. Which assessment
finding would the nurse expect on physical examination?
Integumentary Problems Exam Study Set
Questions Solved to Score A+
A patient with psoriasis tells the nurse that the patient has quit his or her job as a restaurant hostess
because the patient believes the lesions on his or her hands and arms are unattractive to customers. The
nursing diagnosis that best describes this patient response is
1. Social isolation related to fear of rejection
2. Ineffective coping related to lack of social support
3. Impaired skin integrity related to presence of lesions
4. Ineffective health maintenance because of presence of lesions - Answer 1. Social isolation related to
fear of rejection
The chronicity of psoriasis can be severe and disabling as people withdraw from social contacts because
of visible lesions. Quality of life is also affected negatively. The information presented does not indicate
the patient does not have support. Impaired skin integrity is not a priority diagnosis. There is no
information to indicate the patient has ineffective health maintenance.
When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin
cancer cases have been reported in white patients than in African American patients. What could be the
most likely cause of such an occurrence?
1. Whites have less melanin content in their skin than African Americans.
2. Whites have greater melanin content in their skin than African Americans.
3. Whites usually have more exposure to the sun than African Americans.
4. Whites usually have less exposure to the sun than African Americans. - Answer 1. Whites have less
melanin content in their skin than African Americans.
Melanin provides natural protection to the skin against the harmful radiation of the sun. Therefore,
melanin plays a major role in preventing skin cancer. African American people are darker skinned and
have greater melanin content in their skin. Therefore, they are less susceptible to skin cancer than white
people. White people are lighter skinned and have less melanin. Differences in sun exposure between
the two populations cannot be predicted.
, The nurse assesses an elevated, dry, hyperkeratotic, scaly papule in an older adult patient. With what
condition does the assessment data correlate?
1. Dysplastic nevus
2. Actinic keratosis
3. Basal cell carcinoma
4. Squamous cell carcinoma - Answer 2. Actinic keratosis
Actinic keratosis manifests clinically as dry, scaly, hyperkeratotic papules, either flat or elevated. A
dysplastic or atypical nevus is often larger than 5 mm. It features irregular borders, which may be
notched; variegated color (e.g., tan, brown, black, red, or pink) within a single mole; and at least one flat
portion, often at the edge of the mole. Basal cell carcinoma is characterized by a small, slowly enlarging
papule with semitranslucent or pearly borders. Squamous cell carcinoma appears as a thin, scaly,
erythematous plaque that does not invade the dermis.
A nurse is assessing a patient who reports extreme fatigue and muscle pain. The patient reports
spending very little time outdoors. The skeletal muscles of the patient are very weak. Which deficiency is
most likely to cause such symptoms?
1. Vitamin A deficiency
2. Vitamin B deficiency
3. Vitamin C deficiency
4. Vitamin D deficiency - Answer 4. Vitamin D deficiency
Muscle pain and weakness are signs of Vitamin D deficiency. Vitamin D is produced naturally by
cutaneous photosynthesis due to exposure to UVB light. The patient is most likely to have Vitamin D
deficiency because of restricted sun exposure. Vitamin C deficiency causes scurvy, which is characterized
by purpura, bleeding gums and petechiae. Deficiency of vitamin A causes dryness of the conjunctiva and
poor wound healing. Deficiency of Vitamin B causes dermatologic symptoms such as erythema, bullae,
and seborrhea-like lesions.
A 54-year-old patient with diabetes mellitus has cellulitis of the right lower extremity. Which assessment
finding would the nurse expect on physical examination?
