Question 1

A few days after a summer hiking trip,a 25-year-old man comes to the clinic with a rash.On examination,the nurse notes that the rash is red and circular with central clearing,and is located across his midriff and behind his knees.The nurse suspects:

Accepted Answer

Lyme disease is characterized by a red macular or papular rash that radiates from the site of the tick bite.Some central clearing that is 5 cm or larger is present usually in the axilla,midriff,inguina,or behind the knee,with regional lymphadenopathy.

Question 2

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-Elevated cavity containing free fluid,up to 1 cm;clear serum flows if wall is ruptured

Accepted Answer

A vesicle is an elevated cavity containing free fluid, up to 1 cm in size, and clear serum flows if the wall is ruptured.

Answer: F
 An ecchymosis or bruise is a purplish patch resulting from extravasation of blood into the skin.

The other terms are:

A) Bulla - an elevated cavity containing free fluid, larger than 1 cm in size
B) Petechiae - tiny punctate hemorrhages, 1-3 mm, round and discrete, dark red, purple, or brown in color
C) Nodule - palpable solid lesion, >0.5 cm in diameter, may be raised or deep-seated
D) Keloid - hypertrophic scar, elevated beyond site of original injury, progressively enlarging.

Question 3

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-A hypertrophic scar

Accepted Answer

A keloid is a type of raised scar that occurs due to excess collagen production at the site of an injury or incision.

Answer: E
 A vesicle is a small, fluid-filled blister that can occur on the skin.

Answer: C
 A nodule is a raised, solid bump that can occur on or beneath the skin.

Answer: A
 A bulla is a large, fluid-filled blister that can occur on the skin.

Answer: F
 Ecchymosis, or bruising, occurs when blood vessels beneath the skin are ruptured and blood leaks out into the surrounding tissue.

Answer: B
 Petechiae are small, pinpoint-sized spots on the skin that occur due to bleeding under the skin.

Question 4

A father brings his 2-month-old infant to the clinic because the infant has had diarrhea for the last 24 hours.He says that his baby has not been able to keep any formula down and that the diarrhea has been occurring at least every 2 hours.The nurse suspects dehydration.Where should the nurse test skin mobility and turgor in this infant?

Accepted Answer

Test mobility and turgor over the abdomen in an infant.Poor turgor,or "tenting," indicates dehydration or malnutrition.

Question 5

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-Tiny punctate hemorrhages,1-3 mm,round and discrete,dark red,purple,or brown in colour

Accepted Answer

The description matches with petechiae, which are tiny punctate hemorrhages.

Answer: F
 The description matches with ecchymosis, which are commonly known as bruises and are dark red, purple, or brown in color.

The other options are:
A) Bulla: Large blister filled with clear fluid (>1 cm) 
C) Nodule: Elevated solid mass, deeper and firmer than papule (>1 cm) 
D) Keloid: Hypertrophic scar that extends beyond the boundaries of the original incision or wound 
E) Vesicle: Small blister filled with clear fluid (<1 cm)

Question 6

Which of the following assessment findings is most consistent with clubbing of the fingernails?

Accepted Answer

The normal nail is firm at its base and has an angle of 160 degrees.In clubbing,the angle straightens to 180 degrees or greater,and the nail base feels spongy.

Question 7

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-A large patch showing capillary bleeding into tissues

Accepted Answer

Ecchymosis (bruise) is a large patch showing capillary bleeding into tissues.

Answer: B 
 Petechiae are small, pinpoint-sized lesions that appear as tiny red or purple spots on the skin, caused by capillary bleeding.

Note: The other terms listed have different descriptions and do not match the given description in the question.

Question 8

A patient has been admitted for severe iron-deficiency anemia.What can the nurse expect to find in the patient's fingernails?

Accepted Answer

Spoon nails are thin,depressed nails with lateral edges tilted up,forming a concave profile.If all nails are involved,it may be due to iron-deficiency anemia.

Question 9

Jaundice is manifested by a yellow skin colour,indicating rising levels of bilirubin in the blood.Which of the following findings is indicative of true jaundice?

Accepted Answer

In jaundice,yellow coloration is present in the sclera and extends up to the edge of the iris.Calluses on the palms and soles of the feet often look yellow but are not classified as jaundice.

Question 10

The papule on the nose of a 52-year-old woman has rounded,pearly borders and a central red ulcer.She tells the nurse that it has been present for several months and is slowly growing larger.Which of the following conditions does the nurse suspect?

Accepted Answer

Basal cell carcinoma usually starts as a skin-coloured papule that develops rounded,pearly borders with a central red ulcer.It is the most common form of skin cancer,and it grows slowly.

Question 11

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-Solid,elevated,hard or soft,larger than 1 cm

Accepted Answer

This description matches the term "nodule," which is a solid and elevated lesion that is larger than 1 cm.

Answer: D
 This description matches the term "keloid," which is a raised and thickened scar that may be hard or soft.

The other terms do not match the given description:
A) A bulla is a fluid-filled blister that is larger than 1 cm.
B) Petechiae are small, pinpoint, non-raised red or purple spots caused by bleeding under the skin.
E) A vesicle is a fluid-filled blister that is smaller than 1 cm.
F) Ecchymosis (bruise) is a flat, purplish patch caused by bleeding under the skin.

Question 12

When assessing inflammation in a dark-skinned person,the nurse may need to:

Accepted Answer

Inflammation is not easily recognized in dark-skinned people,so it is often necessary to palpate the skin for increased warmth,taut surfaces that may be indicative of edema,and hardening of deep tissues or blood vessels.

Question 13

MATCHING
The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term.

-Also known as a friction blister

Accepted Answer

A bulla is a large blister that is filled with fluid and is often caused by friction.

Question 14

A 40-year-old woman reports a change in mole size,accompanied by colour changes,itching,burning,and bleeding over the past month.She has a dark complexion and has no family history of skin cancer,but she has had many blistering sunburns in the past.The nurse would:

Accepted Answer

The ABCDE danger signs of melanoma are asymmetry,border irregularity,colour variation,diameter increase,and elevation and enlargement.In addition,individuals may report a change in lesion size,development of itching,burning,bleeding,or new pigmentation.Any of these signs should raise suspicion of malignant melanoma and warrant referral.

Question 15

When performing an assessment of a 65-year-old man with a history of hypertension and coronary artery disease, the nurse notices bilateral pitting edema in the lower legs. The skin is puffy and tight but of normal colour. There is no increased redness or tenderness, and the peripheral pulses are equal and strong. In this situation, which of the following is the most likely cause of the edema?

Accepted Answer

Bilateral edema or edema that is generalized over the entire body is caused by a central problem such as heart failure or kidney failure.Unilateral edema usually has a local or peripheral cause.

Question 16

A semiconscious woman is brought to the emergency department after being found on the floor in her kitchen.Her face,nail beds,lips,and oral mucosa are a bright cherry-red colour.The nurse suspects that this colouring is due to:

Accepted Answer

A bright cherry-red colouring in the face,upper torso,nail beds,lips,and oral mucosa appears in cases of carbon monoxide poisoning.

Quiz 13: Skin, hair, and Nails

A few days after a summer hiking trip,a 25-year-old man comes to the clinic with a rash.On examination,the nurse notes that the rash is red and circular with central clearing,and is located across his midriff and behind his knees.The nurse suspects:

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -Elevated cavity containing free fluid,up to 1 cm;clear serum flows if wall is ruptured

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -A hypertrophic scar

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -Tiny punctate hemorrhages,1-3 mm,round and discrete,dark red,purple,or brown in colour

Which of the following assessment findings is most consistent with clubbing of the fingernails?

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -A large patch showing capillary bleeding into tissues

A patient has been admitted for severe iron-deficiency anemia.What can the nurse expect to find in the patient's fingernails?

Jaundice is manifested by a yellow skin colour,indicating rising levels of bilirubin in the blood.Which of the following findings is indicative of true jaundice?

The papule on the nose of a 52-year-old woman has rounded,pearly borders and a central red ulcer.She tells the nurse that it has been present for several months and is slowly growing larger.Which of the following conditions does the nurse suspect?

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -Solid,elevated,hard or soft,larger than 1 cm

When assessing inflammation in a dark-skinned person,the nurse may need to:

MATCHING The nurse needs to be familiar with the various lesions that may be identified during skin assessment. Match each description given below with the appropriate term. -Also known as a friction blister

A 40-year-old woman reports a change in mole size,accompanied by colour changes,itching,burning,and bleeding over the past month.She has a dark complexion and has no family history of skin cancer,but she has had many blistering sunburns in the past.The nurse would:

A semiconscious woman is brought to the emergency department after being found on the floor in her kitchen.Her face,nail beds,lips,and oral mucosa are a bright cherry-red colour.The nurse suspects that this colouring is due to: