Deck 8: Skin, Hair, and Nails

Question 1

Expected hair distribution changes in the older adults include

A)increased terminal hair follicles to the scalp.
B)more prominent axillary and pubic hair production.
C)increased terminal hair follicles to the tragus of men's ears.
D)more prominent peripheral extremity hair production.
E)women possibly developing less coarse facial hair.

Answer 1

increased terminal hair follicles to the tragus of men's ears.

Question 2

The skin repairs epidermal wounds by

A)exaggerating cell replacement.
B)excreting lactic acid.
C)producing vitamins.
D)providing a mechanical barrier.
E)increasing the vascularity of the epidermis.

Answer 2

exaggerating cell replacement.

Question 3

Pigmentary demarcation lines are

A)a precursor of skin cancer
B)more common on people with fair skin
C)commonly seen on the face
D)a normal variation
E)may decrease during pregnancy

Answer 3

a normal variation

Question 4

Sweat glands, hair, and nails are all formed from

A)basement membranes under cellular strata.
B)closely packed squamous cells.
C)invaginations of epidermis into dermis.
D)papillae that penetrate the epidermis.
E)evaginations of the hypodermis.

Question 5

Unusual white areas on the skin may be caused by:

A)adrenal disease.
B)polycythemia.
C)vitiligo.
D)Down syndrome.
E)lentigo.

Question 6

The adipose tissue in the hypodermis serves to

A)provide sensory input.
B)generate heat and insulate.
C)create tensile strength.
D)restrict water loss.
E)secrete collagen.

Question 7

The nails of older adults grow slowly because of

A)decreased circulation.
B)dietary deficiencies.
C)fungal infections.
D)low hormone levels.
E)high estrogen levels.

Question 8

Normal hormone-related changes of adolescence include

A)increased oil production.
B)the development of fine silky lanugo hair.
C)depletion of apocrine glands.
D)decreased sebaceous gland activity.
E)slowed hair growth.

Question 9

The type and brand of grooming products used are important to the health history of

A)adolescents.
B)everyone.
C)older adults.
D)persons with rashes.
E)children.

Question 10

Newborns are more vulnerable to hypothermia because of

A)the presence of coarse terminal hair.
B)desquamation of the stratum corneum.
C)their covering of vernix caseosa.
D)a poorly developed subcutaneous fat layer.
E)excessive secretion of eccrine sweat glands.

Question 11

A 29-year-old white woman appears jaundiced. A cause of liver disease has been excluded. What history questions should the nurse ask?

A)Whether she had unprotected sex
B)If she has a history of diabetes mellitus
C)Whether she has unusual bleeding problems
D)If she eats a lot of yellow and orange vegetables
E)If she has a family history of peripheral vascular disease

Question 12

Which of the following, if reported, belongs in the family history of a patient with a skin rash?

A)Father has chronic asthma.
B)Sister repeatedly uses a tanning booth.
C)Mother trims patient's nails too short.
D)Sister had measles as a child.
E)Grandparent had chemical burn.

Question 13

Which structure is the site of new nail growth?

A)Cuticle
B)Paronychium
C)Eponychium
D)Nail bed
E)Matrix

Question 14

Brittle nails are typical findings in

A)adolescents.
B)infants.
C)pregnant women.
D)older adults.
E)children.

Question 15

Which cultural group has the lowest incidence of nevi?

A)Native Americans
B)African Americans
C)Mexican Americans
D)Asians
E)Eastern Europeans

Question 16

Pale, shiny skin of the lower extremities may reflect

A)excessive steroids.
B)a history of vigorous exercise.
C)peptic ulcer disease.
D)vasculitis.
E)systemic disease.

Question 17

Risk factors for skin cancer include

A)an olive complexion.
B)repeated trauma or irritation to the skin.
C)a history of allergic reactions to sunscreen.
D)dark eyes and hair.
E)pigmented bands in the nails.

Question 18

Tangential lighting is best used for inspecting skin

A)color.
B)turgor.
C)exudates.
D)symmetry.
E)contour.

Question 19

The secretory activity of the sebaceous glands is stimulated by

A)body heat.
B)ambient temperature.
C)sex hormones.
D)dietary protein.
E)emotional stimuli.

Question 20

Inspection to determine color variations of the skin is best conducted:

A)using an episcope.
B)under fluorescent lighting.
C)with illumination provided by daylight.
D)using a Wood's lamp.
E)using a pen light.

Question 21

Linea nigra is commonly found on the abdomens of

A)newborns.
B)infants and children.
C)adolescents.
D)pregnant women.
E)older adults.

Question 22

A 4 $\times$ 3-cm, rough, elevated area of psoriasis is an example of a

A)plaque.
B)patch.
C)macule.
D)papule.
E)wheal.

Question 23

A single transverse crease seen on the palm of a small child may imply

A)Down syndrome.
B)Turner syndrome.
C)systemic sclerosis.
D)profound dehydration.
E)neurofibromatosis.

Question 24

Women with terminal hair growth in a male distribution pattern should receive further evaluation for a(n)

A)circulation condition.
B)gastrointestinal disorder.
C)inflammatory state.
D)nutritional deficit.
E)endocrine disorder.

Question 25

The nurse assesses the nail base angle using the Schamroth technique. The normal expected examination finding is nail beds that are _____ at the bases.

A)flat
B)convex
C)concave
D)bowed
E)elevated

Question 26

Skin lesions are transilluminated to determine

A)vascular from nonvascular lesions.
B)furuncles from folliculitis lesions.
C)fluid-filled lesions in solid cysts or masses.
D)herpes zoster from varicella.
E)macules from papules.

Question 27

Fluorescing lesions are best distinguished using a(n)

A)incandescent lamp.
B)magnifying glass.
C)transilluminator.
D)Wood's lamp.
E)halogen lamp.

Question 28

The nurse assesses the patient's nails and finds transverse white bands that cover the nail except for a narrow zone at the distal tip. Additional physical examination of this patient should include

A)palpation of the liver.
B)auscultation for carotid bruits.
C)inspection for jaundice.
D)fist percussion of the kidney.
E)chest percussion.

Question 29

Cherry angiomas are a common finding in

A)adults older than 30 years.
B)newborns.
C)pregnant women.
D)sunbathers.
E)adolescents.

Question 30

Which nail change found on examination would be most alarming?

A)Dark bands seen in all fingernails of a dark-skinned person
B)A yellow discoloration of the great toe of an older adult
C)A single blue nail
D)Pits in both index fingernails of an adult
E)Longitudinal ridges in an older adult

Question 31

Transient mottling of the patient's skin in a cool room is a common finding in

A)menopausal women.
B)newborn infants.
C)pregnant women.
D)sedentary adults.
E)older adults.

Question 32

Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish

A)cutaneous tags from lentigines.
B)furuncles from folliculitis.
C)sebaceous hyperplasia from eczema.
D)seborrheic keratoses from actinic keratoses.
E)herpes zoster from varicella.

Question 33

Small, less than 0.5-cm in diameter, red-purple nonblanchable discolorations of the skin are

A)ecchymoses.
B)petechiae.
C)spider veins.
D)telangiectasias.
E)purpura.

Question 34

Skin turgor checks are performed to determine

A)the temperature of the skin.
B)hydration status.
C)skin texture.
D)the extent of an ecchymosis.
E)skin moisture.

Question 35

Which decubitus ulcer stage indicates damage into the subcutaneous tissue?

A)Stage I
B)Stage II
C)Stage III
D)Stage IV
E)Stage V

Question 36

The nurse inspects an annular lesion. What type of additional lighting source should be used for further assessment?

A)Florescent lighting
B)Wood's lamp
C)Goose-neck lamp
D)Sunlight
E)Cobalt blue

Question 37

A flat, nonpalpable lesion is described as a macule if the diameter is

A)greater than 1 cm.
B)less than 1 cm.
C)greater than 2 cm.
D)too irregular to measure.
E)exactly 5 mm.

Question 38

The nurse blanches over a vascular lesion on a pregnant patient. The site blanches and refills evenly from the center outward. The nurse documents this lesion as

A)telangiectasia.
B)a spider angioma.
C)petechiae.
D)purpura.
E)ecchymosis.

Question 39

A Dennie-Morgan fold is probably caused by

A)birth trauma.
B)high fever.
C)excess adipose tissue.
D)kidney disease.
E)chronic rubbing.

Question 40

Café au lait patches are numbered with each assessment of infants and young children because

A)their numbers are expected to increase each year.
B)coalescent lesions are a more serious finding.
C)the presence of more than six patches suggests neurofibromatosis.
D)decreasing numbers are expected with growth.
E)a higher number correlates with the development of erythema toxicum.

Question 41

The most common inflammatory skin condition is

A)cutis marmorata.
B)eczematous dermatitis.
C)intradermal nevus.
D)pityriasis rosea.
E)psoriasis.

Question 42

A 17-year-old student complains of a "rash for 3 days." You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern with parallel alignment. What is the nurse's next action?

A)Teach infectious control measures.
B)Inquire about another recent skin lesion.
C)Inspect the palms and the soles.
D)Inform the patient that this will resolve within 1 week.
E)Ask about sexual contacts.

Question 43

The characteristic that best differentiates psoriasis from other skin abnormalities is the

A)color of the scales.
B)formation of tiny papules.
C)general distribution over the body.
D)recurrence.
E)loss of hair.

Question 44

A 5-year-old child presents with discrete vesicles on an erythemic base (dew drops on a rose petal appearance) that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse's next action?

A)Ask about a family history of rashes.
B)Inquire about other patterns of physical abuse.
C)Inspect the buccal mucosa for Koplik spots.
D)Inform the parent that this will resolve within a couple of days.
E)Teach infectious control measures.

Question 45

You are conducting a preschool examination on a 5-year-old child. Which injury would most likely raise your suspicion that the child was being abused?

A)Recent bruising over both knees
B)A healed laceration under the chin
C)A bruise on the right shin with associated abrasion of tissue
D)Bruises in various stages of resolution over body soft tissues
E)A scab on the elbow

Question 46

Soft, painless, bluish papules in persons who are HIV-positive are most likely

A)Kaposi sarcoma (KS).
B)malignant melanoma.
C)molluscum contagiosum.
D)pityriasis rosea.
E)herpes zoster.

Question 47

Which of the following is a noncandidal fungal infection?

A)Pityriasis rosea
B)Psoriasis
C)Milia
D)Rosacea
E)Tinea corporis

Question 48

The most common cutaneous neoplasm is

A)basal cell carcinoma.
B)compound nevus.
C)seborrheic keratosis.
D)senile actinic keratosis.
E)malignant melanoma.

Question 49

Age spots are also called

A)seborrheic keratoses.
B)senile lentigines.
C)cutaneous horns.
D)acrochordon.
E)cutaneous tags.

Question 50

During history taking, a mother states that her son awoke in the middle of the night complaining of intense itching on his legs. Today your inspection reveals honey-colored exudate from the vesicular rash on his legs. Which condition is consistent with these findings?

A)Exanthem
B)Impetigo
C)Solar keratoses
D)Trichotillomania
E)Drug eruption

Question 51

Assessment of poor hygiene, healed fractures with deformity, or unexplained trauma in older adults indicates

A)sexual abuse.
B)physical neglect.
C)psychologic abuse.
D)violated rights.
E)financial abuse.

Question 52

Which of the following is an ABCD characteristic of malignant melanoma?

A)Asymmetric borders
B)Borders well demarcated
C)Color of lesion is uniform
D)Diameter less than 6 mm
E)Severe blistering or sunburns as a child

Question 53

Painful vesicles are associated with

A)psoriasis.
B)pityriasis rosea.
C)paronychia.
D)herpes zoster.
E)rosacea.