SILVESTRI SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-RN EXAMINATION, 6TH EDITION COMPLETE QUESTIONS AND ANSWERS | RATED A+
anticipate that this client
... [Show More] will exhibit:
1. Skin that is uniformly dark in color
2. Very pale skin with little pigmentation
3. Patches of skin that have loss of pigmentation
4. Blotchy brown macules across the cheeks and forehead
ANS: 4
Rationale: Melasma is a condition caused by hormonal influences on melanin production and is noted by the appearance of blotchy brown macules across the cheeks and forehead. “Skin that is uniformly dark in color” describes vitiligo. “Very pale skin with little pigmentation” and “patches of skin that have loss of pigmentation” refer to normal variations in skin color.
Test-Taking Strategy: To answer this question correctly, you must be familiar with the various terms used when discussing skin structures and functions. “Skin that is uniformly dark in color” describes vitiligo. “Very pale skin with little pigmentation” and “patches of skin that have loss of pigmentation” refer to normal variations in skin color. Review the description of melasma if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Black, J., & Hawks, J. (2009). Medical-surgical nursing: clinical management for positive outcomes (8th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment
2. The client with cellulitis of the lower leg has had cultures done on the affected area. The nurse reviewing the results of the culture report interprets that which of the following organisms is not part of the normal flora of the skin?
1. Escherichia coli
2. Candida albicans
3. Staphylococcus aureus
4. Staphylococcus epidermidis
ANS: 1
Rationale: E. coli is normally found in the intestines and is a common source of infection of wounds and the urinary system. C. albicans, S. aureus, and S. epidermis are part of the normal flora of the skin.
Test-Taking Strategy: To answer this question correctly, you must be familiar with the normal microorganisms that inhabit the skin. Note that the question asks for the organism that is not part of normal flora. Remember that E. coli is normally found in the intestines. Review basic skin structures if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: patient-centered collaborative care (6th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Adult Health/Integumentary
MSC: Integrated Process: Nursing Process—Assessment [Show Less]