Deck 8: Skin, Hair, and Nails
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Deck 8: Skin, Hair, and Nails
1
Which cultural group has the lowest incidence of nevi?
A) Native Americans
B) African Americans
C) Mexican Americans
D) Asians
A) Native Americans
B) African Americans
C) Mexican Americans
D) Asians
African Americans
2
Brittle nails are typical findings in:
A) adolescents.
B) infants.
C) pregnant women.
D) older adults.
A) adolescents.
B) infants.
C) pregnant women.
D) older adults.
older adults.
3
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.
A) basement membranes under cellular strata.
B) closely packed squamous cells.
C) invaginations of epidermis into dermis.
D) papillae that penetrate the epidermis.
invaginations of epidermis into dermis.
4
The secretory activity of the sebaceous glands is stimulated by:
A) body heat.
B) ambient temperature.
C) sex hormones.
D) dietary protein.
A) body heat.
B) ambient temperature.
C) sex hormones.
D) dietary protein.
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5
You are inspecting the lower extremities of a patient and have noted pale, shiny skin of the lower extremities. This may reflect:
A) systemic disease.
B) a history of vigorous exercise.
C) peptic ulcer disease.
D) mental retardation.
A) systemic disease.
B) a history of vigorous exercise.
C) peptic ulcer disease.
D) mental retardation.
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6
Unusual white areas on the skin may be caused by:
A) adrenal disease.
B) polycythemia.
C) vitiligo.
D) Down syndrome.
A) adrenal disease.
B) polycythemia.
C) vitiligo.
D) Down syndrome.
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7
Tangential lighting is best used for inspecting skin:
A) color.
B) contour.
C) exudates.
D) symmetry.
A) color.
B) contour.
C) exudates.
D) symmetry.
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8
Mrs. Mulligan brings her 16-year-old son into the office for a sports physical examination. As the health care provider, you explain that normal hormone-related changes of adolescence include:
A) increased oil production.
B) slowed hair growth.
C) depleted apocrine glands.
D) decreased sebaceous gland activity.
A) increased oil production.
B) slowed hair growth.
C) depleted apocrine glands.
D) decreased sebaceous gland activity.
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9
Expected hair distribution changes in older adults include:
A) increased terminal hair follicles on 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.
A) increased terminal hair follicles on 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.
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10
Mrs. Bower is a 39-year-old patient who has come to the office for a routine physical examination. As the health care provider, you know that the skin temperature is best assessed with the:
A) dorsal surface of the examiner's hand.
B) palmar surface of the examiner's hand.
C) ulnar surface of the examiner's hand.
D) pads of the examiner's fingers.
A) dorsal surface of the examiner's hand.
B) palmar surface of the examiner's hand.
C) ulnar surface of the examiner's hand.
D) pads of the examiner's fingers.
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11
As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include:
A) an olive complexion.
B) repeated trauma or irritation to skin.
C) history of allergic reactions to sunscreen.
D) dark eyes and hair.
A) an olive complexion.
B) repeated trauma or irritation to skin.
C) history of allergic reactions to sunscreen.
D) dark eyes and hair.
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12
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.
A) adolescents.
B) everyone.
C) older adults.
D) persons with rashes.
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13
You are examining a pregnant patient and have noted a vascular lesion. When you blanch over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:
A) telangiectasia.
B) spider angioma.
C) petechiae.
D) purpura.
A) telangiectasia.
B) spider angioma.
C) petechiae.
D) purpura.
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14
Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which structure is the site of new nail growth?
A) Cuticle
B) Perionychium
C) Matrix
D) Nail bed
A) Cuticle
B) Perionychium
C) Matrix
D) Nail bed
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15
A 29-year-old white woman appears jaundiced. Liver disease as a cause has been excluded. What history questions should the nurse ask?
A) Whether she had unprotected sex
B) Whether she has a history of diabetes mellitus
C) Whether she had unusual bleeding problems
D) Whether she eats a lot of yellow and orange vegetables
A) Whether she had unprotected sex
B) Whether she has a history of diabetes mellitus
C) Whether she had unusual bleeding problems
D) Whether she eats a lot of yellow and orange vegetables
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16
Mrs. Leonard brings her newborn infant into the pediatrician's office for a first well-baby visit. As the health care provider, you teach her that 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.
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.
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17
Mr. Donalds is a 45-year-old roofer. Your 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 light.
A) using an episcope.
B) under fluorescent lighting.
C) with illumination provided by daylight.
D) using a Wood's light.
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18
The skin repairs surface wounds by:
A) exaggerating cell replacement.
B) excreting lactic acid.
C) producing vitamins.
D) providing a mechanical barrier.
A) exaggerating cell replacement.
B) excreting lactic acid.
C) producing vitamins.
D) providing a mechanical barrier.
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19
Mrs. Franklin is a 68-year-old patient who presents to the office with a complaint that her nails do not seem to be growing. As the health care provider, you explain to her that the nails of older adults grow slowly because of:
A) decreased circulation.
B) dietary deficiencies.
C) fungal infections.
D) low hormone levels.
A) decreased circulation.
B) dietary deficiencies.
C) fungal infections.
D) low hormone levels.
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20
The adipose tissue in the hypodermis serves to:
A) provide sensory input.
B) generate heat and insulate.
C) create tensile strength.
D) secrete collagen.
A) provide sensory input.
B) generate heat and insulate.
C) create tensile strength.
D) secrete collagen.
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21
The most common inflammatory skin condition is:
A) cutis marmorata.
B) eczematous dermatitis.
C) intradermal nevus.
D) pityriasis rosea.
A) cutis marmorata.
B) eczematous dermatitis.
C) intradermal nevus.
D) pityriasis rosea.
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22
Café au lait patches are numbered with each assessment of infants and young children because:
A) the numbers are expected to increase each year.
B) coalescent lesions are a more serious finding.
C) the presence of more than five patches suggests neurofibromatosis.
D) decreasing numbers are expected with growth.
A) the numbers are expected to increase each year.
B) coalescent lesions are a more serious finding.
C) the presence of more than five patches suggests neurofibromatosis.
D) decreasing numbers are expected with growth.
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23
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.
A) cutaneous tags from lentigines.
B) furuncles from folliculitis.
C) sebaceous hyperplasia from eczema.
D) seborrheic keratoses from actinic keratoses.
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24
You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
A) vascular from nonvascular lesions.
B) furuncles from folliculitis lesions.
C) fluid-filled lesions from solid cysts or masses.
D) herpes zoster from varicella.
A) vascular from nonvascular lesions.
B) furuncles from folliculitis lesions.
C) fluid-filled lesions from solid cysts or masses.
D) herpes zoster from varicella.
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25
The nurse inspects an annular lesion. Which type of additional lighting source should be used for further assessment?
A) Fluorescent lighting
B) Wood's lamp
C) Goose-neck lamp
D) Sunlight
A) Fluorescent lighting
B) Wood's lamp
C) Goose-neck lamp
D) Sunlight
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26
Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4- 3-cm, rough, elevated area of psoriasis. This is an example of a:
A) plaque.
B) patch.
C) macule.
D) papule.
A) plaque.
B) patch.
C) macule.
D) papule.
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27
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.
A) color of the scales.
B) formation of tiny papules.
C) general distribution over the body.
D) recurrence.
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28
A single transverse line seen in the palm of a small child may imply:
A) Down syndrome.
B) Turner syndrome.
C) systemic sclerosis.
D) profound dehydration.
A) Down syndrome.
B) Turner syndrome.
C) systemic sclerosis.
D) profound dehydration.
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29
A Dennie-Morgan fold is probably caused by:
A) birth trauma.
B) high fever.
C) excess adipose tissue.
D) chronic rubbing.
A) birth trauma.
B) high fever.
C) excess adipose tissue.
D) chronic rubbing.
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30
Women with terminal hair growth in a male distribution pattern should receive further evaluation for a(n):
A) circulation condition.
B) endocrine disorder.
C) inflammatory state.
D) nutritional deficit.
A) circulation condition.
B) endocrine disorder.
C) inflammatory state.
D) nutritional deficit.
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31
Fluorescing lesions are best distinguished using a(n):
A) incandescent lamp.
B) magnifying glass.
C) transilluminator.
D) Wood's lamp.
A) incandescent lamp.
B) magnifying glass.
C) transilluminator.
D) Wood's lamp.
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32
Cherry angiomas are a common finding in:
A) adults older than 30 years.
B) newborns.
C) pregnant women.
D) sunbathers.
A) adults older than 30 years.
B) newborns.
C) pregnant women.
D) sunbathers.
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33
Small, minute bruises are called:
A) ecchymoses.
B) petechiae.
C) spider veins.
D) telangiectasias.
A) ecchymoses.
B) petechiae.
C) spider veins.
D) telangiectasias.
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34
Skin turgor checks are performed to determine the:
A) temperature of the skin.
B) hydration status.
C) actual age.
D) extent of an ecchymosis.
A) temperature of the skin.
B) hydration status.
C) actual age.
D) extent of an ecchymosis.
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35
Age spots are also called:
A) seborrheic keratoses.
B) solar lentigines.
C) cutaneous horns.
D) acrochordon.
A) seborrheic keratoses.
B) solar lentigines.
C) cutaneous horns.
D) acrochordon.
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36
Which nail change found on examination would be most alarming?
A) Dark bands seen on all fingernails of a dark-skinned person
B) Yellow discoloration of the great toe of an older adult
C) Single dark band in a white adult
D) Pits in both index fingernails of an adult
A) Dark bands seen on all fingernails of a dark-skinned person
B) Yellow discoloration of the great toe of an older adult
C) Single dark band in a white adult
D) Pits in both index fingernails of an adult
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37
Which of the following is a noncandidal fungal infection?
A) Pityriasis rosea
B) Psoriasis
C) Tinea corporis
D) Rosacea
A) Pityriasis rosea
B) Psoriasis
C) Tinea corporis
D) Rosacea
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38
Linea nigra is commonly found on the abdomens of:
A) infants and children.
B) adolescents.
C) pregnant women.
D) older adults.
A) infants and children.
B) adolescents.
C) pregnant women.
D) older adults.
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39
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.
A) menopausal women.
B) newborn infants.
C) pregnant women.
D) sedentary adults.
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40
A flat, nonpalpable lesion is described as a macule if the diameter is:
A) larger than 1 cm.
B) smaller than 1 cm.
C) 3 cm exactly.
D) too irregular to measure.
A) larger than 1 cm.
B) smaller than 1 cm.
C) 3 cm exactly.
D) too irregular to measure.
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41
Soft, painless, bluish papules in persons who are HIV-positive are most likely:
A) Kaposi sarcoma.
B) malignant melanoma.
C) molluscum contagiosum.
D) pityriasis rosea.
A) Kaposi sarcoma.
B) malignant melanoma.
C) molluscum contagiosum.
D) pityriasis rosea.
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42
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
A) flat
B) convex
C) concave
D) bowed
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43
Assessment of poor hygiene, healed fractures with deformity, or unexplained trauma in older adults indicates:
A) sexual abuse.
B) physical neglect.
C) psychological abuse.
D) violated rights.
A) sexual abuse.
B) physical neglect.
C) psychological abuse.
D) violated rights.
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44
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 a week.
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 a week.
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45
During history taking, a mother states that her son awoke in the middle of the night complaining of intense itching to his legs. Today, your inspection reveals a 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
A) Exanthem
B) Impetigo
C) Solar keratoses
D) Trichotillomania
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46
A slightly elevated brownish papule with indistinct borders is a typical characteristic of a(n) _____ nevus.
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47
Individuals with dark pigmentary demarcation lines show lighter coloration on ________ body surfaces.
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48
Damage into the subcutaneous tissue in a decubitus ulcer occurs at stage _____.
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49
Which of the following identify the signs and symptoms of basal cell cancer?
A) Itching
B) Reddish patch
C) Starts from a nevi
D) Various clinical forms-cystic, nodular, pigmented
E) Macule type
A) Itching
B) Reddish patch
C) Starts from a nevi
D) Various clinical forms-cystic, nodular, pigmented
E) Macule type
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50
A 5-year-old child presents with discrete vesicles on an erythematous 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) Teach infectious control measures.
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.
A) Teach infectious control measures.
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.
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51
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
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
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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
A) Asymmetric borders
B) Borders well demarcated
C) Color of lesion is uniform
D) Diameter less than 6 mm
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53
Painful vesicles are associated with:
A) psoriasis.
B) pityriasis rosea.
C) paronychia.
D) herpes zoster.
A) psoriasis.
B) pityriasis rosea.
C) paronychia.
D) herpes zoster.
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54
The most common cutaneous neoplasm is:
A) basal cell carcinoma.
B) compound nevus.
C) seborrheic keratosis.
D) senile actinic keratosis.
A) basal cell carcinoma.
B) compound nevus.
C) seborrheic keratosis.
D) senile actinic keratosis.
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