Chapter 58 Osborn, Medical-Surgical Nursing, 2e

Question 1 Type: MCSA The nurse is conducting an integumentary assessment on an older adult. Which patient statement would the nurse prioritize as it does not reflect a normal age-related change? 1. “My skin is so thin and gets injured so easily.” 2. “My skin is so greasy even though I wash frequently.” 3. “My nails are growing more slowly.” 4. “I’ve had mostly gray hair since I was in my thirties.” Correct Answer: 2 Rationale 1: Both the epidermis and the dermis thin with aging, making skin more susceptible to breakdown. Rationale 2: Sebaceous gland activity decreases in older adults, resulting in drier and scalier skin. Greasy skin is not part of normal aging. Rationale 3: Both hair and nail growth slows with aging. Rationale 4: Hair graying is related to genetics. Some patients gray very early, and others do not gray until late in life. Global Rationale: Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Physiological Adaptation Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 58-1 Question 2 Type: MCSA During a conversation with the nurse, a patient says, “I avoid going outside when the sun is shining because I don’t want to get skin cancer.” The nurse should inform the patient that sun avoidance may predispose the patient to which condition? 1. Vitamin D deficiency 2. Hypokalemia 3. Hypernatremia 4. Hypercholesterolemia Correct Answer: 1 Rationale 1: The skin functions as a synthesizer of vitamin D (sunlight reacts with cholesterol). Rationale 2: Exposure to sunlight is not a primary cause of hypokalemia. Rationale 3: Exposure to sun would not cause an increase in sodium. Rationale 4: Hypercholesterolemia results from factors such as dietary intake and cholesterol that is produced by the body, not from exposure to the sun. Global Rationale: Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Physiological Adaptation Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 58-1