When black and blue marks appear on skin due to trauma, they are called:

Appeared in: RIMS Nursing Officer - 2022

Explanation

Bruises are the common term for skin discoloration resulting from trauma.
The trauma causes small blood vessels (capillaries) just beneath the skin's surface to break.
Blood leaks out of these vessels and gets trapped under the skin, causing the visible black-and-blue mark, also known as a contusion or ecchymosis.
The color changes over time as the body breaks down the hemoglobin from the leaked blood.

Option B: Necrosis is the death of tissue, not just discoloration from bleeding. It often appears as black, hardened, dead tissue (eschar) and is a much more severe condition.
Option C: Lanugo is the fine, downy hair that covers a fetus and newborn. It has no connection to trauma or bruising.
Option D: Vernix (vernix caseosa) is the waxy, white, protective coating on a newborn's skin at birth. It is unrelated to trauma.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of skin manifestations following trauma as background academic context rather than a clinical decision trigger.
While most bruises are harmless, their location, pattern, and frequency can be clinically significant. Bruises are the most common manifestation of physical abuse, and certain patterns or locations (e.g., on the torso, ears, or neck of a pre-ambulatory infant) are highly suspicious.
Nurses should assess for unexplained or frequent bruising, as it can indicate an underlying bleeding disorder (like hemophilia or von Willebrand disease) or an adverse effect of anticoagulant medications (e.g., warfarin, heparin).
What if? If a patient on warfarin presents with multiple large bruises without significant trauma, the nurse's priority is to suspect an excessively high INR (International Normalized Ratio). The nurse should notify the physician immediately, anticipate an order for a stat INR lab test, and assess for other signs of bleeding (e.g., hematuria, epistaxis).

How to Approach the Question

This is a factual recall question that tests your knowledge of basic medical terminology.
First, read the question carefully to understand the key elements: 'black and blue marks,' 'skin,' and 'trauma.'
Mentally define the phenomenon described: bleeding under the skin from an injury.
Evaluate each option against this definition.
Option A, 'Bruises,' is the common term for this condition.
Options B, C, and D describe unrelated concepts: 'Necrosis' (tissue death), 'Lanugo' (fetal hair), and 'Vernix' (newborn skin coating). Eliminate these as incorrect.

Concept Tested & Keywords

Q_HJNzVhsOr1kEWeOJYkCc

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 157-159

E6 Medicine Harrison 22e Part 1 p. 447-449

Practise the full RIMS Nursing Officer - 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.