Test Bank for Saun-
ders Comprehensive
Review for the
NCLEX-RN Exami-
nation, 7th Edition,
Linda Anne Silvestri,
ISBN:
9780323358514
, Adult Health
Test Bank
MULTIPLE CHOICE
1. The nurse reviews the health record of a client with melasma. The nurse would
anticipate that this client 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
3. The client complains of chronic pruritus. Which of the following diagnoses would the
nurse expect to support this client’s complaint?
1. Anemia
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus
ANS: 2
Rationale: Clients with renal failure often have pruritus, or itchy skin. This is because of
impaired clearance of waste products by the kidneys. The client who is markedly anemic
is likely to have pale skin. Hypothyroidism may lead to complaints of dry skin. Clients
with diabetes mellitus are at risk for skin infections and skin breakdown.
Test-Taking Strategy: Focus on the subject, chronic pruritus. Remember that clients
with renal failure often experience this problem. If this question was difficult, review the
common causes of pruritus.
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
4. A client being seen in an ambulatory clinic for an unrelated complaint has a butterfly
rash noted across the nose. The nurse interprets that this finding is consistent with early
manifestations of which of the following disorders?
1. Hyperthyroidism
2. Pernicious anemia
, 3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE)
ANS: 4
Rationale: An early sign of SLE is the appearance of a butterfly rash across the nose.
Hyperthyroidism often leads to moist skin and increased perspiration. Pernicious anemia
is exhibited by pale skin. Severe cardiopulmonary disorders may lead to clubbing of the
fingers.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
impact of systemic conditions on the skin. Remember that SLE causes a characteristic
butterfly rash. If this question was difficult, review the disorders identified in the options
and the associated skin conditions that occur in each disorder.
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
5. The nurse notes that the older adult client has a number of bright, ruby-colored, round
lesions scattered on the trunk and thighs. The nurse correctly interprets the finding as
alterations in blood vessels of the skin and defines them as:
1. Purpura
2. Venous star
3. Cherry angioma
4. Spider angioma
ANS: 3
Rationale: A cherry angioma occurs with increasing age and has no clinical significance.
It is noted by the appearance of small, bright, ruby-colored round lesions on the trunk
and/or extremities. Purpura results from hemorrhage into the skin. A venous star results
from increased pressure in veins, usually in the lower legs, and has an irregularly shaped
bluish center with radiating branches. Spider angiomas have a bright red center, with
legs that radiate outward. These are commonly seen in those with liver disease or
vitamin B deficiency, although they can occur occasionally without underlying
pathology.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
various alterations in vascularity that can occur in the skin. Note the relationship of the
words “ruby” in the question and “cherry” in the correct option. If you had difficulty
with this question, review the various skin alterations identified in each of the options.
PTS: 1
ders Comprehensive
Review for the
NCLEX-RN Exami-
nation, 7th Edition,
Linda Anne Silvestri,
ISBN:
9780323358514
, Adult Health
Test Bank
MULTIPLE CHOICE
1. The nurse reviews the health record of a client with melasma. The nurse would
anticipate that this client 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
3. The client complains of chronic pruritus. Which of the following diagnoses would the
nurse expect to support this client’s complaint?
1. Anemia
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus
ANS: 2
Rationale: Clients with renal failure often have pruritus, or itchy skin. This is because of
impaired clearance of waste products by the kidneys. The client who is markedly anemic
is likely to have pale skin. Hypothyroidism may lead to complaints of dry skin. Clients
with diabetes mellitus are at risk for skin infections and skin breakdown.
Test-Taking Strategy: Focus on the subject, chronic pruritus. Remember that clients
with renal failure often experience this problem. If this question was difficult, review the
common causes of pruritus.
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
4. A client being seen in an ambulatory clinic for an unrelated complaint has a butterfly
rash noted across the nose. The nurse interprets that this finding is consistent with early
manifestations of which of the following disorders?
1. Hyperthyroidism
2. Pernicious anemia
, 3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE)
ANS: 4
Rationale: An early sign of SLE is the appearance of a butterfly rash across the nose.
Hyperthyroidism often leads to moist skin and increased perspiration. Pernicious anemia
is exhibited by pale skin. Severe cardiopulmonary disorders may lead to clubbing of the
fingers.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
impact of systemic conditions on the skin. Remember that SLE causes a characteristic
butterfly rash. If this question was difficult, review the disorders identified in the options
and the associated skin conditions that occur in each disorder.
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
5. The nurse notes that the older adult client has a number of bright, ruby-colored, round
lesions scattered on the trunk and thighs. The nurse correctly interprets the finding as
alterations in blood vessels of the skin and defines them as:
1. Purpura
2. Venous star
3. Cherry angioma
4. Spider angioma
ANS: 3
Rationale: A cherry angioma occurs with increasing age and has no clinical significance.
It is noted by the appearance of small, bright, ruby-colored round lesions on the trunk
and/or extremities. Purpura results from hemorrhage into the skin. A venous star results
from increased pressure in veins, usually in the lower legs, and has an irregularly shaped
bluish center with radiating branches. Spider angiomas have a bright red center, with
legs that radiate outward. These are commonly seen in those with liver disease or
vitamin B deficiency, although they can occur occasionally without underlying
pathology.
Test-Taking Strategy: To answer this question accurately, you must be familiar with the
various alterations in vascularity that can occur in the skin. Note the relationship of the
words “ruby” in the question and “cherry” in the correct option. If you had difficulty
with this question, review the various skin alterations identified in each of the options.
PTS: 1
