Question 1

During assessment, the nurse notices that the skin of a patient of Asian descent is yellowish brown in colour. The skin on the hard and soft palate is, however, pink in colour. From this finding, the nurse could probably rule out:

Accepted Answer

One of the manifestations of jaundice is yellow colour of the skin,which indicates rising amounts of bilirubin in the blood and is first noticed in the junction of the hard and soft palate in the mouth and in the sclera.

Question 2

A newborn infant is found to have Down syndrome. During skin assessment, the nurse notices a transient mottling on the trunk and extremities in response to the cooler temperature in the examination room. The infant's mother has also noticed the mottling and wants to know what it is. The nurse knows that this mottling is called:

Accepted Answer

Persistent or pronounced cutis marmorata occurs with Down syndrome or prematurity and is a transient mottling found on the trunk and extremities in response to cooler temperatures.

Question 3

A man has come in to the clinic because he is afraid he might have skin cancer. During the skin assessment, the nurse notices several areas of pigmentation that look greasy, dark, and "stuck on" on his skin. Which of the following is the best prediction?

Accepted Answer

Seborrheic keratoses are lesions that look dark,greasy,and "stuck-on," and develop mostly on the trunk.It is uncommon for them to become cancerous.

Question 4

A 35-year-old pregnant woman comes to the clinic for her monthly appointment. During assessment, the nurse notices that she has a brown patch of hyperpigmentation on her face. The nurse continues the skin assessment aware that another finding may be:

Accepted Answer

In pregnancy,skin changes can include striae,linea nigra,chloasma (brown patches of hyperpigmentation),and vascular spiders.

Question 5

The nurse notices that the patient has bluish white, red-based spots in her mouth that are elevated about 1 to 3 mm. What other signs would the nurse expect to find in this patient?

Accepted Answer

With measles (rubeola),the examiner would find a red-purple,blotchy rash on the third or fourth day of illness that appears first behind the ears and spreads over the face and then over the neck,trunk,arms,and legs.The rash looks coppery and does not blanch.Koplik's spots in the mouth would also be present.

Question 6

A woman has noticed that her son, who has a new babysitter, has some blisters and scabs on his face and buttocks. On examination, the nurse notices moist, thin-roofed vesicles with a thin erythematous base and suspects:

Accepted Answer

Impetigo is characterized by moist,thin-roofed vesicles with a thin erythematous base.This is a contagious bacterial infection of the skin and most common in infants and children.

Question 7

A physician has diagnosed a patient with purpura. After leaving the room, a nursing student asks the nurse what the physician saw that led to that diagnosis. The nurse should say:

Accepted Answer

Purpura is a confluent and extensive patch of petechiae and ecchymoses and a flat macular hemorrhage seen in generalized disorders such as thrombocytopenia and scurvy.

Question 8

A 70-year-old woman who loves to garden has small, flat, brown macules over her arms and hands. She asks, "What causes these liver spots?" The nurse tells her:

Accepted Answer

Liver spots,or senile lentigines,are clusters of melanocytes that appear on the forearms and dorsa of the hands after extensive sun exposure.

Question 9

A patient has had a "terrible itch" for several months that he has been scratching continuously. On examination, the nurse might expect to find:

Accepted Answer

Lichenification results from prolonged,intense scratching that eventually thickens the skin and produces tightly packed sets of papules.

Question 10

The nurse has discovered decreased skin turgor in a patient. In which of the following would this be an expected finding?

Accepted Answer

Decreased skin turgor is associated with severe dehydration,aging,or extreme weight loss.

Question 11

A 45-year-old farmer comes in for skin evaluation and complains of hair loss. He has noticed that the hair on his head seems to be breaking off in patches and that there is some scaling on his scalp. The nurse would begin the examination suspecting:

Accepted Answer

Tinea capitis is rounded patchy hair loss on scalp,leaving broken-off hairs,pustules,and scales on the skin.It is due to fungal infection.Lesions are fluorescent under Wood light.It is usually seen in children and farmers and is highly contagious.

Question 12

A 32-year-old female patient complains that she has noticed several small, slightly raised, bright-red dots on her chest. On examination, the nurse thinks that the spots are probably:

Accepted Answer

Cherry (senile)angiomas are small,punctate,slightly raised bright-red dots that commonly appear on the trunk in all adults over 30 years old.

Question 13

A patient comes to the clinic and states that he has noticed that his skin appears redder than normal.The nurse understands this condition to be due to hyperemia and knows that it can be caused by:

Accepted Answer

Erythema is an intense redness of the skin caused by excess blood (hyperemia)in the dilated superficial capillaries.

Question 14

A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment. On assessment of his skin, the nurse would expect to find which of the following?

Accepted Answer

Clubbing of the nails occurs with congenital,chronic,cyanotic heart disease and with emphysema and chronic bronchitis.

Question 15

The nurse notices that the patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding, the nurse would report this as a:

Accepted Answer

A papule is something that can be felt,is solid,elevated,circumscribed,less than 1 cm diameter,and is due to superficial thickening in the epidermis.

Question 16

A patient's medical record describes a lesion that is confluent in nature. On examination, the nurse would expect to find:

Accepted Answer

Confluent lesions run together.Polycyclic lesions are annular in nature.Zosteriform lesions are arranged along a nerve route.Grouped lesions are clustered together.

Question 17

The nurse is assessing the skin of a patient who has acquired immunodeficiency syndrome (AIDS). Which of the following will the nurse most likely observe?

Accepted Answer

An aggressive form of Kaposi's sarcoma is one of the diseases that characterize AIDS.In the patch stage,multiple early lesions are faint pink on the temple and beard area.They could be mistaken easily for bruises or nevi.

Question 18

A mother brings her child in to the clinic for scalp and hair examination. She says that the child has developed irregularly shaped patches on her head with broken-off, stublike hair, and she is worried that this could be some form of premature baldness. She tells the nurse that the child's hair is always kept very short. The nurse reassures her by telling her that it is:

Accepted Answer

Trichotillomania,self-induced hair loss,is usually due to habit.It forms irregularly shaped patches with broken-off,stublike hair of varying lengths.The affected person,however,does not go completely bald.It occurs when the person rubs the head or twirls the hair absent-mindedly while falling asleep,reading,or watching television.

Question 19

A patient is experiencing tingling sensations in her feet and has also noticed that her tongue has become very red and painful. The nurse suspects that she has:

Accepted Answer

Pernicious anemia is indicated by neurological deficits and a red,painful tongue,along with a lemon-yellow tint of the facial skin and slightly yellow sclera.

Question 20

A patient of African descent is in the critical care unit to be monitored for shock after an accident. What skin characteristics would the nurse expect to find in this patient?

Accepted Answer

Pallor in dark-skinned people will appear ashen,grey,or dull.

Quiz 13: Skin, hair, and Nails