ATI RN
NCLEX Skin Integrity Questions Questions
Question 1 of 5
Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion?
Correct Answer: B
Rationale: The correct answer is B: Actinic keratosis. Actinic keratosis is considered a premalignant lesion because it is caused by prolonged sun exposure and can progress to squamous cell carcinoma if left untreated. It appears as rough, scaly patches on the skin and is commonly seen in elderly individuals with a history of sun damage. Cherry angiomas (A), solar lentigines (C), and telangiectases (D) are not considered premalignant lesions. Cherry angiomas are benign skin growths, solar lentigines are age spots caused by sun exposure, and telangiectases are dilated blood vessels.
Question 2 of 5
The patient's incision is fading to a pale pink following surgery 2 months previously. Which stage of the healing describes the current status of the patient's wound?
Correct Answer: B
Rationale: A pale pink incision 2 months post-surgery is in 'remodeling phase' , per Potter's. Collagen reorganizes e.g., scar strengthens 80% by 6 weeks unlike 'hemostasis' , initial bleeding stop e.g., minutes post-op. 'Proliferative' builds tissue e.g., days 3-21, red granulation. 'Inflammation' cleans e.g., first 3 days, swelling. A nurse assesses e.g., Faint scar' remodeling's 3-month span, per healing science, a physiological marker. Potter defines this as scar maturation, distinct from proliferative's growth, making the correct, late stage.
Question 3 of 5
The patient just sustained a deep laceration that is bleeding profusely. Which stage of healing describes the current state of the patient's wound?
Correct Answer: A
Rationale: A fresh, bleeding laceration is in 'hemostasis phase' , per Potter's. Clotting e.g., platelets seal in 5 minutes stops blood e.g., 100 mL loss unlike 'proliferative' , tissue growth e.g., day 3. 'Inflammation' cleans e.g., next 2 days. 'Remodeling' scars e.g., months later. A nurse sees e.g., Clot forming' hemostasis's 100% start, per healing science, a physiological must. Potter marks this as bleeding control, making the correct, immediate stage.
Question 4 of 5
The nurse is caring for a patient who is experiencing a full-thickness repair. Which type of tissue will the nurse expect to observe when the wound is healing?
Correct Answer: C
Rationale: In full-thickness repair, 'granulation' is expected. Red, moist tissue e.g., new vessels marks healing e.g., 2 weeks in unlike 'eschar' , black necrosis e.g., to remove. 'Slough' is yellow, dead e.g., blocks healing. 'Purulent drainage' signals infection e.g., delays. A nurse sees e.g., Pink, budding' per 70% of repairs, a physiological sign. The text ties granulation to progress, making the correct, healing tissue.
Question 5 of 5
The nurse is collaborating with the dietitian about a patient with a Stage III pressure ulcer. Which nutrient will the nurse most likely increase after collaboration with the dietitian?
Correct Answer: B
Rationale: Protein' is most likely increased for a Stage III ulcer. Healing needs e.g., 1.5 g/kg/day rebuild tissue e.g., 50% faster unlike 'fat' , energy e.g., not repair. 'Vitamin E' is minor e.g., not key. 'Carbohydrate' fuels e.g., not structure. A nurse plans e.g., Add 20 g protein' per nutritional guidelines, a physiological need. The text prioritizes protein with vitamins A/C, making the correct, essential nutrient.