A female client was horseback riding when her horse slipped and fell on her leg, crushing but not breaking it, and resulting in a large amount of edema over the crushed area. Which pathophysiological mechanism is responsible for the edema?

Increase in interstitial osmotic pressure due to cellular damage.

Decrease in interstitial pressures due to low blood pressure.

Increased intravascular osmotic pressure due to crushing injury.

Increased intravascular hydrostatic pressure due to trauma.

Answer and Explanation

The Correct Answer is A

A. Increase in interstitial osmotic pressure due to cellular damage. A crushing injury damages cells, leading to the release of intracellular proteins and solutes into the interstitial space. This increases interstitial osmotic pressure, drawing fluid from the blood vessels into the injured tissues, causing edema. The inflammatory response further contributes to capillary permeability and fluid leakage.
B. Decrease in interstitial pressures due to low blood pressure. Blood pressure does not directly regulate interstitial pressure in a localized trauma area. Even if systemic blood pressure were low, localized edema can still occur due to tissue damage and increased capillary permeability.
C. Increased intravascular osmotic pressure due to crushing injury. Osmotic pressure in the blood is primarily determined by plasma proteins, such as albumin. A crushing injury does not increase intravascular osmotic pressure; instead, it increases interstitial osmotic pressure, pulling fluid out of the blood vessels.
D. Increased intravascular hydrostatic pressure due to trauma. While trauma can cause localized vascular changes, hydrostatic pressure primarily affects systemic circulation. In this case, localized tissue damage and inflammation—not increased intravascular pressure—are responsible for edema formation.

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Correct Answer is C

Explanation

A. A 70-year-old fair-skinned client who works as a secretary. While fair skin and older age increase skin cancer risk, indoor work minimizes UV exposure, which is the primary risk factor for skin cancer.
B. A 16-year-old dark-skinned client who tans in tanning beds once a week. Tanning bed use increases the risk of skin cancer, but darker skin has more melanin, which provides some UV protection. A fair-skinned person with prolonged outdoor exposure would be at higher risk.
C. A 65-year-old fair-skinned client who is a construction worker. This client has the highest risk due to chronic UV exposure from outdoor work, fair skin (which burns more easily), and older age (increased cumulative sun damage). Occupational sun exposure is a major risk factor for basal cell carcinoma, squamous cell carcinoma, and melanoma.
D. A 25-year-old dark-skinned client whose mother had skin cancer. Family history is a risk factor, but darker skin provides more UV protection. Additionally, younger age and less cumulative sun exposure make this client lower risk than an older, fair-skinned construction worker.

A. To serve as sensory receptors and transmitters for the sense of touch. B. To anchor the epidermis to the dermis skin layer. C. To provide skin pigmentation as protection from the sun's ultraviolet rays. D. To produce a tough, fibrous structural protein for skin protection.

Correct Answer is D

Explanation

A. To serve as sensory receptors and transmitters for the sense of touch. Merkel cells, not keratinocytes, function as sensory receptors in the skin, particularly for touch perception.

B. To anchor the epidermis to the dermis skin layer. Hemidesmosomes and basement membrane proteins help anchor the epidermis to the dermis, not keratinocytes.

C. To provide skin pigmentation as protection from the sun's ultraviolet rays. Melanocytes, not keratinocytes, produce melanin, which provides skin pigmentation and protects against UV radiation.

D. To produce a tough, fibrous structural protein for skin protection. Keratinocytes are the primary cells of the epidermis and produce keratin, a strong, fibrous protein that provides structure, durability, and waterproofing to the skin. They also play a role in wound healing and immune defense.

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A female client was horseback riding when her horse slipped and fell on her leg, crushing but not breaking it, and resulting in a large amount of edema over the crushed area. Which pathophysiological mechanism is responsible for the edema?

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Naxlex Comprehensive Predictor Exams

Which client has the highest risk for developing skin cancer?

Correct Answer is C

Explanation

Which is the function of the keratinocytes, a type of skin cell?

Correct Answer is D

Explanation

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