Bill Jones is a 24-year-old mechanic who sustained a 25% burn injury cleaning his engine with gasoline. Currently he is in his room with all the lights out. He has refused to see his girlfriend. He requires his mother to stay at the hospital and refuses to eat unless she feeds him. When asked any question, he replies negatively with vulgar language. On the basis of this data what is your nursing diagnosis of his problem?

Correct Answer: B

Rationale: Correct Answer: B - Inability to cope with alteration in body image Rationale: 1. Mechanic got burn injury, impacting his appearance. 2. Isolating himself, refusing to see girlfriend, needing mother's presence suggest body image concerns. 3. Refusing to eat, using vulgar language may indicate distress over changes in appearance. Summary of Incorrect Choices: A: Regression related to pain - Not regression behavior, rather coping with altered body image. C: Fear due to hospitalization - Not directly related to hospitalization fear, but more about body image concerns. D: Depression related to inability to work - Symptoms do not align with inability to work, but rather body image distress.

Correct Answer: B

Rationale: The correct answer is B: melanin. Melanin is the pigment responsible for giving the skin its color. It is produced by melanocytes in the skin's epidermis. Melanin protects the skin from harmful UV radiation and determines the skin's color. Keratin (A) is a structural protein found in the skin, hair, and nails. Collagen (C) is a protein that provides structure and elasticity to the skin. Elastin (D) is a protein that helps the skin to stretch and recoil. However, neither collagen nor elastin are responsible for skin color. The presence of melanin is what primarily determines an individual's skin color.

Correct Answer: C

Rationale: The correct answer is C: number of receptors. Sensitivity to touch is determined by the presence and distribution of sensory receptors in the skin. These receptors detect touch, pressure, temperature, and pain. The more receptors present in an area, the more sensitive it is to touch. Skin thickness (Choice A), number of pores (Choice B), and number of follicles (Choice D) do not directly impact sensitivity to touch, as they are not involved in the detection of tactile stimuli. Therefore, the correct answer is C as it directly relates to the mechanism of touch sensation.

Correct Answer: C

Rationale: The correct answer is C. In a cold environment, vasoconstriction in the dermis does not keep the skin warm. Vasoconstriction reduces blood flow to the skin, which actually decreases heat loss and helps conserve body heat. This is a physiological response to cold temperatures to maintain core body temperature. Choices A, B, and D are incorrect because they accurately describe the functions of the skin and body temperature regulation. Vasodilation in the dermis promotes heat loss in a warm environment, eccrine glands increase sweat secretion as environmental temperature rises to cool the body through evaporation, and pilomotor muscles contract to provide insulation by trapping air close to the skin in cold conditions.

Correct Answer: D

Rationale: The correct answer is D: Thinning and atrophy of the skin. Prolonged use of corticosteroid ointment can lead to skin thinning and atrophy due to its ability to inhibit collagen synthesis and promote breakdown of skin proteins. This can result in fragile, easily bruised skin. Desensitization and nerve damage (Choice A) are not common side effects of corticosteroid ointment. Formation of petechiae (Choice B) is not typically associated with corticosteroid use. Avascularization of the affected skin (Choice C) is not a known consequence of prolonged corticosteroid use.