Other Systems Review Questions #1

Question 1

Which of the following exerts its primary influence on the hair follicles?

arrector pili muscles
Meissner’s glands
melanocytes
sebaceous glands

Answer 1

arrector pili muscles

Question 2

Which structure in the epidermis serves as a barrier against fluid, electrolyte, and chemical loss?

basal cells
Langerhans cells
keratinocytes
stratum corneum

Answer 2

Stratum corneum

Question 3

What is the proper order of skin layers from superficial to deep?

1. epidermis, papillary dermis, reticular dermis, subcutaneous
2. epidermis, reticular dermis, papillary dermis, subcutaneous
3. reticular dermis, papillary dermis, epidermis, subcutaneous
4. epidermis, subcutaneous, papillary dermis, reticular dermis

Answer 3

1. epidermis, papillary dermis, reticular dermis, subcutaneous

Question 4

Which layer of the skin contains melanocytes?

epidermis
dermis
hypodermis
subcutaneous

Answer 4

epidermis

Question 5

Which substance is responsible for the pigmentation of the skin?

melatonin
melanin
serotonin
keratin

Answer 5

melanin

Question 6

What organ provides the first physical line of defense for the body from external harm?

thyroid
skin
liver
lymph nodes

Answer 6

skin

Question 7

What type of gland helps to protect the skin by producing sebum?

apocrine sweat gland
sebaceous gland
ceruminous gland
mammary gland

Answer 7

sebaceous gland

Question 8

Which of the following inflammatory mediators is responsible for causing pain in an acute wound?

histamine
prostaglandins
phagocytes
renin

Answer 8

prostaglandins

Question 9

The process by which epithelial cells die and produce a protective outer layer is called:

epithelialization
keratinization
granulation
necrotizing

Answer 9

keratinization

Question 10

Which of the following types of burns would be the least painful?

superficial
superficial partial-thickness
deep partial-thickness
full-thickness

Answer 10

full thickness

Question 11

Which burn classification is most likely to result in hypertrophic and keloid scarring after the healing process is complete?

superficial
superficial partial-thickness
deep partial-thickness
full-thickness

Answer 11

deep partial thickness

Question 12

Which of the following zones of injury corresponds with the most severe area of injury at a burn site that sustained irreversible cell damage?

zone of erythema
zone of stasis
zone of coagulation
zone of hyperemia

Answer 12

zone of coagulation

Question 13

What is the primary cause of burns in adolescents and adults?

hot liquids
electricity
chemicals
fire

Answer 13

hot liquids

Question 14

A burn that blanches and exhibits brisk capillary refill would most likely be classified as:

epidermal
superficial partial-thickness
deep partial-thickness
full-thickness

Answer 14

superficial partial thickness

Question 15

Which burn classification would most likely affect the pH of systemic tissue?

chemical burn
electrical burn
flash burn
scald burn

Answer 15

chemical burn

Question 16

Which classification of burn could potentially cause ventricular fibrillation?

chemical burn
electrical burn
flash burn
scald burns

Answer 16

electrical burn

Question 17

A burn that presents with significant pain and blistering is most likely to be classified as a:

superficial burn
superficial partial-thickness burn
deep partial-thickness burn
full thickness burn

Answer 17

superficial partial thickness burn

Question 18

What burn classification would be given to an area of the skin that was bright red, painful, and dry without blisters?

superficial burn
superficial partial-thickness burn
deep partial-thickness burn
full-thickness burn

Answer 18

superficial burn

Question 19

Which of the following burn classifications is characterized by complete destruction of the epidermal and dermal layers, in addition to the involvement of the subcutaneous fat or muscle?

superficial burn
superficial partial-thickness burn
deep partial-thickness burn
full-thickness burn

Answer 19

full-thickness burn

Question 20

Which of the following would not be used with mechanical debridement?

pulsatile lavage
Hubbard tank
wet-to-dry dressings
transparent film dressings

Answer 20

transparent film dressing

Question 21

Which of the following is a form of non-selective debridement technique?

autolytic debridement
enzymatic debridement
wet-to-dry dressing
sharp debridement

Answer 21

wet to dry dressing

Question 22

Which type of debridement accelerates the body’s own ability to clean up debris?

mechanical
autolytic
biosurgical
surgical

Answer 22

autolytic

Question 23

Which form of wound debridement converts a chronic wound into an acute wound using specific instruments, decreasing the surface bacterial burden, and removing senescent cells?

sharp
autolytic
enzymatic
mechanical

Answer 23

sharp

Question 24

Which method is an example of mechanical debridement?

collagenases
maggots
film dressings
pulsed lavage

Answer 24

pulsed lavage

Question 25

Which of the following is a selective form of debridement? wet-to-dry dressing whirlpool pulsed lavage autolytic

Answer 25

autolytic

Question 26

Which method of debridement removes both viable and nonviable tissues? nonselective debridement enzymatic debridement autolytic debridement sharp debridement

Answer 26

nonselective debridement

Question 27

During sharp debridement, caution should be taken with patients who are currently taking: antidiuretics anticoagulants antihypertensives antitussives

Answer 27

anticoagulants

Question 28

Which of the following is not an example of mechanical debridement? whirlpool pulsed lavage wet-to-dry dressings hydrocolloids

Answer 28

hydrocolloids

Question 29

Which color demonstrates the greatest severity of necrotic tissue? white tan yellow black

Answer 29

black

Question 30

Which of the following dressings would be most appropriate for partial or full-thickness wounds exhibiting minimal to moderate drainage? transparent film foams calcium alginates collagen matrix

Answer 30

foam

Question 31

Moisture retentive dressings such as hydrocolloids, films, and hydrogels can be used for which of the following debridement methods? sharp autolytic enzymatic mechanical

Answer 31

autolytic

Question 32

Which of the following would be the most appropriate type of wound dressing to place over an intravenous access site? hydrocolloid dressing transparent film dressing non-adherent gauze dressing foam dressing

Answer 32

transparent film dressing

Question 33

Which of the following is considered the most occlusive of the moisture-retentive dressings? transparent films foams hydrogels hydrocolloids

Answer 33

hydrocolloids

Question 34

Which type of dressing would be the most appropriate for an infected wound if the goal is to reduce exudate while maintaining a moist wound environment? impermeable film hydrogel foam alginates

Answer 34

alginates

Question 35

Which of the following is not an indication for applying a wound dressing? protect the area from injury prevent contamination prevent scarring promote healing

Answer 35

prevent scarring

Question 36

Which of the following would typically be the dressing of choice to treat a stage 1 or 2 pressure injury? transparent film hydrocolloids calcium alginates wet-to-dry dressings

Answer 36

transparent film

Question 37

Which of the following wound dressings are most helpful in maintaining a moist wound bed in a superficial wound with minimal drainage? transparent film alginates hydrogels wet-to-dry dressings

Answer 37

hydrogels

Question 38

Which of these wound dressings can be utilized to treat an infected pressure injury? transparent film hydrocolloids hydrogels calcium alginates

Answer 38

calcium alginates

Question 39

Which type of dressing would be the least moisture retentive? alginates semipermeable foams hydrocolloids semipermeable films

Answer 39

semipermeable films

Question 40

According to the rule of nines which body segment would occupy the greatest percentage of the total body surface area? anterior trunk arm head posterior leg

Answer 40

anterior trunk

Question 41

According to the rule of nines, what percentage of the total body surface area would be allocated to the posterior surface of the bilateral legs and feet? 9% 18% 27% 36%

Answer 41

18

Question 42

The rule of nines is not appropriate to assess which type of burn? superficial partial-thickness superficial deep partial-thickness full-thickness

Answer 42

superficial

Question 43

According to the rule of nines, a burn affecting the anterior right leg and foot would constitute what percentage of the total body surface area? 1.0% 9.0% 13.5% 18.0%

Answer 43

9

Question 44

According to the rule of nines, a burn affecting the posterior trunk and posterior left arm, forearm and hand, would constitute what percentage of the total body surface area? 9% 13.5% 18% 22.5%

Answer 44

22.5

Question 45

According to the rule of nines, at what age does a child reach the same body proportions as an adult? 9 12 15 18

Answer 45

9

Question 46

When using the rule of nines for a young child, which part of the body makes up a larger percentage as compared to an adult? head and neck trunk upper extremity lower extremity

Answer 46

head and neck

Question 47

Using the rule of nines, what percentage of the body is affected if there is a burn to the posterior trunk, posterior left lower extremity, and the entire left upper extremity? 31.5% 36.0% 40.5% 45.0%

Answer 47

36

Question 48

According to the rule of nines, what percentage of the body would be affected by burns covering the anterior surface of the arms and legs bilaterally? 18.0% 22.5% 27.0% 36.0%

Answer 48

27

Question 49

What percentage of the total body surface area would be affected with a burn that covers the anterior portions of the bilateral lower extremities and the anterior portion of the right arm? 13.5% 18.0% 22.5% 23.0%

Answer 49

22.5

Question 50

nutritional status level of hydration skin maceration body composition

Answer 50

skin maceration

Question 51

What score on the Braden scale would most warrant initiation of a pressure injury prevention program? 16 19 21 23

Answer 51

Correct Answer: 16 It is recommended that individuals who score an 18 or less on the Braden scale be placed on a pressure injury prevention program. The scale assesses sensory perception, moisture, activity, mobility, nutrition, and friction and shear. Each section of assessment is scored from one to four with the exception of friction and shear, which is scored one to three. The maximum score on the Braden scale is 23.

Question 52

What is the bacterial agent commonly responsible for skin infection? gonococcus chlamydia mycobacterium tuberculosis staphylococcus aureus

Answer 52

staphylococcus aureus

Question 53

Which condition would not increase the risk of developing a pressure injury during a prolonged hospitalization? diabetic neuropathy body mass index of 21 incontinence malnutrition

Answer 53

BMI of 21 eighteen - twenty five is normal

Question 54

In order to relieve pressure on the skin and prevent contractures, a patient’s position should be changed every: 2 hours 4 hours 6 hours 8 hours

Answer 54

2 hours

Question 55

Which of the following is not considered as a primary risk factor for development of a pressure injury? insensate body areas dry epidermal surfaces prolonged weight bearing persistent incontinence

Answer 55

dry epidermal surfaces

Question 56

A deep tissue wound with intact skin (i.e., unstageable wound) may be especially difficult to identify in which demographic? males females dark skinned individuals fair skinned individuals

Answer 56

dark skin

Question 57

A rubor of dependency test can help to identify which of the following risk factors for developing skin ulceration? venous insufficiency arterial insufficiency neuropathy insensate skin

Answer 57

Correct Answer: arterial insufficiency The rubor of dependency test is used to evaluate arterial circulation by observing skin color changes that occur with the lower extremity in an elevated position as opposed to on a level surface. Arterial insufficiency is a significant risk factor for developing skin breakdown.

Question 58

A percussion test can help to identify which of the following risk factors for developing skin ulceration? venous insufficiency arterial insufficiency neuropathy insensate skin

Answer 58

Correct Answer: venous insufficiency A percussion test assesses the valves of the saphenous vein by percussing a distal segment of the vein while palpating a proximal segment. If the proximal hand senses blood movement, the valves are not functioning properly. Venous insufficiency is a major risk factor for developing skin breakdown.

Question 59

Which diagnosis would be most likely to negatively impact the healing of a pressure injury? adhesive capsulitis rotator cuff tendonitis peripheral vascular disease emphysema

Answer 59

emphysema

Question 60

Which structure is especially vulnerable to pressure injuries in a side lying position greater trochanter ischial tuberosity iliac crest sacrum

Answer 60

greater trochanter

Question 61

What bony prominence would not be susceptible to a pressure injury in a supine position? occiput lateral head of the humerus sacrum heel

Answer 61

lateral head of the humerus

Question 62

What bony prominence would not be susceptible to pressure injury when a patient is sitting in a properly sized standard wheelchair? ischial tuberosity vertebral spinous processes spine of the scapula posterior superior iliac spines

Answer 62

Correct Answer: spine of the scapula A properly fit standard wheelchair should have a back height that falls below the inferior angle of the scapula. The therapist should measure from the seat of the chair to the floor of the axilla with the user’s shoulder flexed to 90 degrees and then subtract approximately 4 inches. The seat back would not make contact with the spine of the scapula in this scenario.

Question 63

Which position of the shoulder would be the most appropriate to prevent a contracture following a burn to the anterior chest? abduction, flexion, lateral rotation adduction, extension, medial rotation abduction, flexion, medial rotation adduction, extension, lateral rotation

Answer 63

abduction, flexion, lateral rotation

Question 64

Which position of the hip would be the most appropriate to prevent a contracture following a burn to the anterior hip? hip extension and internal rotation hip flexion and external rotation hip extension and abduction hip flexion and adduction

Answer 64

hip extension and abduction

Question 65

Which of the following anatomical landmarks would be unlikely to cause a pressure injury if the patient is positioned in prone? sternum acromion process anterior superior iliac spine anterior inferior iliac spine

Answer 65

anterior inferior iliac spine

Question 66

An airplane splint applied following a burn would most likely be used to avoid a contracture affecting the: neck shoulder elbow wrist

Answer 66

Correct Answer: shoulder An airplane splint is used to immobilize a shoulder during healing from an injury, surgery or burn. The splint maintains the arm in an abducted position at or below shoulder level with the elbow typically flexed.

Question 67

In order to prevent the development of wounds, how often should a skin assessment in an acute care setting typically occur? every 24 hours weekly quarterly every physical therapy visit

Answer 67

24 hours

Question 68

The medial and lateral condyles of the tibia are areas that are likely to develop pressure injuries in which position? sidelying sitting supine prone

Answer 68

sidelying

Question 69

Which positions would make the sacrum most susceptible to develop a pressure injury with prolonged positioning? sitting and sidelying supine and sitting supine and prone prone and sitting

Answer 69

supine and sitting

Question 70

Whirlpool is contraindicated for which of the following scenarios? necrotic tissue callous multiple necrotic areas venous insufficiency

Answer 70

Correct Answer: venous insufficiency Whirlpool, a type of mechanical debridement, may be used to debride loosely adhered tissue and deodorize the wound. It may be inappropriate to place the lower extremity of a patient with venous insufficiency into a dependent position with warm water due to increased blood pooling.

Question 71

Ulceration on the medial aspect of the lower leg, around the malleoli, is most characteristic of a/an: venous insufficiency ulcer neuropathic ulcer arterial insufficiency ulcer pressure ulcer

Answer 71

venous insufficiency ulcer

Question 72

The most appropriate action to temporarily relieve night pain due to an arterial insufficiency ulcer is to: elevate the legs on pillows place the legs in a dependent position take an aspirin use a heating pad

Answer 72

place the legs in a dependent position

Question 73

Lower extremity pain that is most prominent during sleep and awakens the patient is most consistent with: arterial insufficiency venous insufficiency diabetic neuropathy venous reflux

Answer 73

arterial insufficiency

Question 74

What is the most common location for an arterial insufficiency ulcer? plantar surface of the feet and toes proximal to the medial malleoli lateral malleoli, dorsum of the feet and toes over bony prominences throughout the body

Answer 74

lateral malleoli, dorsum of the feet and toes

Question 75

An ulcer proximal to the medial malleolus with an irregular shape and a red wound bed would most likely be classified as a/an: neuropathic ulcer arterial insufficiency ulcer pressure ulcer venous insufficiency ulcer

Answer 75

venous insufficiency

Question 76

A wound located over a bony prominence is most accurately identified as a: venous ulcer arterial ulcer pressure ulcer neuropathic ulcer

Answer 76

pressure ulcer

Question 77

What type of wound is depicted in the image? partial-thickness wound full-thickness wound superficial wound subcutaneous wound

Answer 77

partial thickness

Question 78

Which lower extremity peri-wound characteristic would suggest that arterial insufficiency is a major contributing factor to the wound development? moist skin thin toenails hairless skin brusied skin

Answer 78

hairless skin

Question 79

Which treatment option is most appropriate when treating a venous insufficiency ulcer? sharp debridement use of a foam dressing external compression of the limb whirlpool irrigation

Answer 79

external compression of the limb