SEM 580 MODULE III QUESTIONS & VERIFIED
ANSWERS
What is a comprehensive patient assessment? - Answers - A global assessment that
provides insight on the patient's medical status and factors that could impair wound,
ostomy, or continence progress. This helps determine the etiology of the WOC issue..
What is a risk assessment? - Answers - An assessment that assists in determining the
patient's level of risk in developing complications or skin injury and development of a
plan of care to provide prevention/protection for the skin.
What 4 factors are included in the comprehensive patient assessment? - Answers -
history, focused physical exam, identify barriers, and setting goals
What does OLDCART stand for? - Answers - Onset
Location
Duration
Characteristics
Aggravating factors
Relieving factors
Treatment
What are objective findings in a focused physical exam? - Answers - What you SEE,
HEAR, SMELL, FEEL, and MEASURE.
VS, age, gender, appearance, cognitive function, characteristics of WOC area,
diagnostic assessments (braden, fall, morse...), lab results
What 4 factors need to be included in goal setting? - Answers - - patient centered
- realistic and evidence-based
- short term
- long term
What is subjective data in a physical assessment? - Answers - history of present
problem, past medical history, review of systems, medication review
Skin inspection vs assessment - Answers - skin inspection is a visual observation from
head to toe
skin assessment is inspection plus palpation
What is a flat, circumscribed skin discoloration <0.5 cm. Ex) Freckle, flat mole, petechia
- Answers - Macule
, What is a flat, nonpalpable, irregular-shaped macule >0.5 cm ex) Vitiligo, port-wine stain
- Answers - Patch
What is an elevated, firm, circumscribed palpable area of skin <0.5 cm ex) Wart,
elevated mole - Answers - Papule
What is an elevated, firm circumscribed, palpable area deeper in dermis than a papule
>0.5 cm; tumor if >2cm - Answers - Nodule
What is an elevated, firm, rough lesion with flat top surface >0.5 cm ex) Psoriasis,
seborrheic keratosis - Answers - Plaque
What is an elevated, circumscribed, serous fluid beneath the epidermis <0.5 cm ex)
chicken pox, herpes zoster - Answers - Vesicle
What is an elevated, superficial lesion like a vesicle but filled with purulent fluid? ex)
acne, impetigo - Answers - Pustule
What is an elevated, circumscribed, encapsulated lesion in the dermis or subcutaneous
layer; filled with liquid or semisolid material? - Answers - Cyst
What is a circumscribed, irregular-shaped, elevated area of cutaneous edema; solid,
transient ex) bug bite, allergic reaction, TB test - Answers - Wheal
What is a vesicle >0.5 cm - Answers - Bulla
What are the fine, irregular lines produced by capillaries? Ex) Rosacea around nose,
spider veins - Answers - Telangiectasia
What are palpable and nonpalpable red or violaceous discoloration due to extravasation
of blood in the skin or vascular inflammation? - Answers - Purpura
What is extravasation of blood into the skin or mucous membranes? Flat, color changes
progress over time. - Answers - Bruise/ecchymosis
What are the time 1-2 mm, red macules that result from tiny hemorrhages? - Answers -
Petechiae
What is a linear epidermal abrasion caused by scratching? - Answers - Excoriation
What is a burning, itching (pruritis), erythema, and scaling, maculopapular rash with
satellite lesions, advancing border with central redness? - Answers - Candidiasis
What is a linear crack in the epidermis? May be moist or dry. ex) Athlete's foot -
Answers - Fissure
ANSWERS
What is a comprehensive patient assessment? - Answers - A global assessment that
provides insight on the patient's medical status and factors that could impair wound,
ostomy, or continence progress. This helps determine the etiology of the WOC issue..
What is a risk assessment? - Answers - An assessment that assists in determining the
patient's level of risk in developing complications or skin injury and development of a
plan of care to provide prevention/protection for the skin.
What 4 factors are included in the comprehensive patient assessment? - Answers -
history, focused physical exam, identify barriers, and setting goals
What does OLDCART stand for? - Answers - Onset
Location
Duration
Characteristics
Aggravating factors
Relieving factors
Treatment
What are objective findings in a focused physical exam? - Answers - What you SEE,
HEAR, SMELL, FEEL, and MEASURE.
VS, age, gender, appearance, cognitive function, characteristics of WOC area,
diagnostic assessments (braden, fall, morse...), lab results
What 4 factors need to be included in goal setting? - Answers - - patient centered
- realistic and evidence-based
- short term
- long term
What is subjective data in a physical assessment? - Answers - history of present
problem, past medical history, review of systems, medication review
Skin inspection vs assessment - Answers - skin inspection is a visual observation from
head to toe
skin assessment is inspection plus palpation
What is a flat, circumscribed skin discoloration <0.5 cm. Ex) Freckle, flat mole, petechia
- Answers - Macule
, What is a flat, nonpalpable, irregular-shaped macule >0.5 cm ex) Vitiligo, port-wine stain
- Answers - Patch
What is an elevated, firm, circumscribed palpable area of skin <0.5 cm ex) Wart,
elevated mole - Answers - Papule
What is an elevated, firm circumscribed, palpable area deeper in dermis than a papule
>0.5 cm; tumor if >2cm - Answers - Nodule
What is an elevated, firm, rough lesion with flat top surface >0.5 cm ex) Psoriasis,
seborrheic keratosis - Answers - Plaque
What is an elevated, circumscribed, serous fluid beneath the epidermis <0.5 cm ex)
chicken pox, herpes zoster - Answers - Vesicle
What is an elevated, superficial lesion like a vesicle but filled with purulent fluid? ex)
acne, impetigo - Answers - Pustule
What is an elevated, circumscribed, encapsulated lesion in the dermis or subcutaneous
layer; filled with liquid or semisolid material? - Answers - Cyst
What is a circumscribed, irregular-shaped, elevated area of cutaneous edema; solid,
transient ex) bug bite, allergic reaction, TB test - Answers - Wheal
What is a vesicle >0.5 cm - Answers - Bulla
What are the fine, irregular lines produced by capillaries? Ex) Rosacea around nose,
spider veins - Answers - Telangiectasia
What are palpable and nonpalpable red or violaceous discoloration due to extravasation
of blood in the skin or vascular inflammation? - Answers - Purpura
What is extravasation of blood into the skin or mucous membranes? Flat, color changes
progress over time. - Answers - Bruise/ecchymosis
What are the time 1-2 mm, red macules that result from tiny hemorrhages? - Answers -
Petechiae
What is a linear epidermal abrasion caused by scratching? - Answers - Excoriation
What is a burning, itching (pruritis), erythema, and scaling, maculopapular rash with
satellite lesions, advancing border with central redness? - Answers - Candidiasis
What is a linear crack in the epidermis? May be moist or dry. ex) Athlete's foot -
Answers - Fissure
