Deck 10: Skin, hair, and Nails

Question 1

You are most likely to find petechiae during an examination of a dark-skinned individual when inspecting the

A) palmar surfaces.
B) mucous membranes and axillae.
C) sclera of the eyes.
D) tongue.

Answer 1

mucous membranes and axillae.

Question 2

Light-skinned patients with chronic renal disease often have a characteristic skin color associated with retained urochrome pigments and anemia described as

A) bright red to ruddy appearance.
B) grayish cast to their skin.
C) orange-yellow coloration.
D) brown cast to their skin.

Answer 2

grayish cast to their skin.

Question 3

Your patient is a 20-year-old college student who worked for the past four summers as a lifeguard at the community swimming pool.During the examination,the patient asks many questions related to the care of her skin and hair.Because your patient's work environment involved daily exposure to sunlight,the patient is at risk for which of the following?

A) contact dermatitis and eczema
B) rashes, urticaria, and angioedema
C) basal or squamous cell carcinoma and wrinkles
D) seborrheic keratosis and acne

Answer 3

basal or squamous cell carcinoma and wrinkles

Question 4

Which skin diseases are found more commonly in light-skinned than in dark-skinned individuals?

A) keloid formation and acne keloidal folliculitis
B) dermatosis papulosa nigra and seborrheic dermatitis
C) squamous and basal cell carcinoma, and actinic keratosis
D) hypopigmented sarcoidosis and granulomatous skin lesions

Question 5

When performing an examination of skin,hair,and nails,you should enhance your visual inspection by using a magnifying glass and the best source of light,which is

A) daylight.
B) fluorescent light.
C) incandescent light.
D) a flashlight.

Question 6

A nursing student informs you that the examination revealed ecchymoses on the face,breasts,and buttocks of a 14-year-old patient.Your best response is to inform the student that these findings are most likely related to which of the following?

A) liver dysfunction
B) heparin or Coumadin use
C) trauma from physical abuse
D) familial blood condition

Question 7

A bright red,star-shaped lesion on the face,neck,or chest that blanches with pressure is called a

A) venous star.
B) cherry angioma.
C) hemangioma.
D) spider angioma.

Question 8

The presence of jaundice in a dark-skinned individual appears as a yellow to orange coloration of the

A) skin, mucous membranes, and palmar and plantar surfaces.
B) fingernails and skin.
C) sclera, hard palate, and palmar and plantar surfaces.
D) sclera only.

Question 9

A white cast to the skin resulting from a congenital inability to form melanin is known as

A) vitiligo.
B) pallor.
C) jaundice.
D) albinism.

Question 10

The terms discrete,linear,annular,and zosteriform refer to which characteristic of skin lesions?

A) morphology
B) size
C) grouping or arrangement
D) types of exudate

Question 11

A patient relates that she has received a weekly manicure and pedicure in various commercial salons within and outside of the United States for many years.You caution the patient that because standards of sterilizing equipment used in salons vary,she has an increased risk of

A) hepatitis B.
B) Staphylococcus infection.
C) Candidiasis infection.
D) herpes simplex infection.

Question 12

Your patient asks you about the small,reddish purple discolorations of the skin,less than 0.5 cm in diameter.You inform the patient that this is known as which of the following?

A) ecchymoses
B) petechiae
C) purpura
D) spider telangiectasia

Question 13

Which diseases,reported by a patient during the family health history,are familial in nature?

A) cutaneous moniliasis and paronychia
B) pediculosis pubis and tinea capitis
C) psoriasis, brittle nails, and hair loss
D) verruca vulgaris and acne

Question 14

The order of the integumentary system from the outermost layer to the innermost layer is

A) epidermis, hypodermis, dermis.
B) dermis, subcutaneous tissue, epidermis.
C) epidermis, dermis, subcutaneous tissue.
D) subcutaneous tissue, dermis, epidermis.

Question 15

When examining a patient who complains of a problem with her fingernails,the nurse should specifically question her about a history of

A) eczema, melanoma, and herpes zoster.
B) psoriasis, fungal infections, and trauma.
C) alopecia, trichotillomania, and chemotherapy.
D) vitiligo and lupus erythematosus.

Question 16

The palms of the hands and soles of the feet have an extra epidermal layer called the

A) stratum corneum.
B) stratum lucidum.
C) stratum granulosum.
D) stratum spinosum.

Question 17

Which skin manifestation caused by substance abuse is related to alcohol abuse?

A) yellow discoloration of the fingertips of one hand
B) telangiectasia (spider veins) on the nose, neck, and upper chest
C) leathery facial appearance
D) bruises between the toes and under the nails

Question 18

You ask your patient,who is exposed to sunlight daily,a number of questions so that together you can develop a realistic plan of care for the patient's skin and hair.Which question is the least helpful?

A) Do you wear a hat, visor, long sleeves, or pants in the sun?
B) Do you use a hair dryer, heated curlers, or curling iron?
C) How frequently do you cut your hair?
D) What strength of sunscreen product do you use?

Question 19

Your patient complains of pruritus.You should examine the patient for which of the following associated signs and symptoms?

A) rash and edema
B) coolness and pallor
C) cyanosis and coolness
D) ecchymosis and purpura

Question 20

When inspecting the skin,you should observe each area for the ten key characteristics,which are color,moisture,temperature,texture,turgor,edema,

A) lesions, vascularity, bleeding, and ecchymosis.
B) pigmentation, bruising, bleeding, and eruptions.
C) xerosis, ecchymosis, distribution of hair, and vascularity.
D) vascularity, pigmentation, xerosis, and lesions.

Question 21

A patient shows you an area on his right hand where a loss of epidermal tissue exposes the dermis.You recognize this lesion as a(n)

A) excoriation.
B) wheal.
C) keloid.
D) scar.

Question 22

A nodule is an example of which type of lesion?

A) nonpalpable
B) palpable
C) secondary
D) tertiary

Question 23

Which of the following is a priority to include when the nurse instructs a patient to perform a skin examination?

A) "Begin performing skin examinations after age 40."
B) "Look for any changes in moles, especially color and size."
C) "Evaluate the evenness of skin color, moisture, and temperature."
D) "Examine the entire body and look for changes in skin or moles."

Question 24

A 5-year-old girl has had a rash on her arms and trunk for the past 48 hours and complains of pruritus.Three types of lesions are noted are macules,papules,and vesicles.Some of the vesicles have crusts.Based on your examination,you hypothesize the girl has which disorder?

A) varicella
B) scabies
C) psoriasis
D) impetigo

Question 25

Central cyanosis is secondary to

A) changes in outside temperature.
B) marked heart and lung disease.
C) nervous anxiety.
D) age-related changes in skin color.

Question 26

The nurse checks the capillary refill of a new patient.The amount of time for the nail color to return after the pressure is released on the patient's nail should not exceed which of the following?

A) 1-2 seconds
B) 2-3 seconds
C) 3-4 seconds
D) 4-5 seconds

Question 27

When examining for changes in skin color in an African American patient,the nurse should examine which of the following first?

A) palms of the hands
B) nail beds or oral mucosa
C) soles of the feet
D) conjunctiva or sclera

Question 28

Clubbing occurs when

A) purpura or ecchymosis develops under the nail plate.
B) the nail separates from the nail bed.
C) depression ridges develop horizontally down the middle of the nail.
D) the nail base is spongy and the angle is greater than 160°.

Question 29

Your are assigned to a 69-year-old patient who complains that her legs are cold all the time and her skin is dry and itchy.Which are of the patient's body are optimal for examining skin turgor?

A) the upper arms and lower back
B) the thighs and lower abdomen
C) the anterior chest and abdomen
D) over the clavicle and the lower arms

Question 30

A nursing instructor quizzes a group of students on risk factors for basal and squamous cell cancer.Which responses by the students indicate that further teaching is needed? Select all that apply.

A) Older adults
B) Radiation therapy
C) Personal history of skin cancer
D) Fair-skinned people with dark color eyes
E) Long-term or severe skin inflammation or injury
F) Chemical exposure (e.g.arsenic, industrial tar, coal, paraffin, petroleum products)

Question 31

Apocrine glands are found primarily in which areas? Select all that apply.

A) Naval
B) Axillae
C) Genital
D) Nipples
E) Neck
F) Rectal areas

Question 32

Diascopy,an enhancement technique useful in examining skin lesions,consists of which of the following?

A) using a magnifying glass to evaluate lesions and discolorations for morphology
B) observing for blanching after pressing a microscope slide over the skin lesion
C) noting color changes of the skin lesion under ultraviolet light
D) using various stains to enhance microscopic examination of skin scrapings

Question 33

The reticular lay of the dermis is composed of which of the following? Select all that apply.

A) Nerves
B) Small elastic fibers
C) Lymphatic tissue
D) Loose connective tissue
E) Extensive network of capillaries
F) Dense bed of vascular connective tissue

Question 34

Which individual should receive further examination to determine the cause of the change in hair distribution?

A) 60-year-old male, who has lost all of the hair on his scalp over the past 15 years.
B) 26-year-old female, who has experienced an increase of facial hair in the past year.
C) 55-year-old male, who has developed coarse dark hairs in his ears and nose.
D) 11-year-old girl, who has recently developed several dark hairs in her axillae and pubic area.

Question 35

After releasing the pressure of your thumb on your patient's lower legs,ankles,and feet,you observe a 4 mm depression of the skin that disappears in 10 to 15 seconds.You would report this finding as which of the following?

A) 1+ pitting edema
B) 2+ pitting edema
C) 3+ pitting edema
D) 4+ pitting edema

Question 36

What is the function of hair? Select all that apply.

A) Warmth
B) Moisture
C) Protection
D) Circulation
E) Sensation
F) Cooling

Question 37

The nurse is caring for a patient with a burn injury.Which of the following examinations would provide the nurse with the most accurate information about the type of burn?

A) red, dry, painful skin with no blisters
B) red, blistery, painful skin with serous exudate
C) leathery, dry, hard, painless skin
D) leathery, dry, hard, painless skin with exposed and damaged muscle and bone

Question 38

Your patient expresses concern about a mole on her right leg that has recently started itching.Which accompanying finding most likely indicates a developing cancerous lesion?

A) regular and distinct border
B) multiple colorations
C) edema in both feet
D) inflammation of periungual tissue

Question 39

Your are assigned to a 69-year-old patient in a nursing home.Your patient complains that his legs are cold all the time and his skin is dry and itchy.You note that the patient is wearing flannel nightclothes and has a wool blanket over his legs as he sits in a chair.Your hypothesize that he has areas of lichenification and excoriations on his arms and legs,which have most likely developed because of tissue damage from which of the following?

A) excessive scratching
B) repeated skin infections
C) poor nutrition and circulation
D) scabies infestation

Question 40

You note that your patient has diaphoresis,generalized hyperthermia,and very soft and silklike skin.In the absence of a fever or recent exercise,you determine that the most likely cause of these findings is

A) hypothyroidism.
B) anxiety.
C) hyperthyroidism.
D) peripheral vascular disease.

Question 41

Located in subcutaneous tissue,____________________ cells trigger the body's reaction to allergens.

Question 42

The largest organ of the body is the skin,also known as the ____________________ system,or cutaneous tissue.

Question 43

A white cast to the skin resulting from a congenital inability to form melanin is known as ____________________.

Question 44

The fine hair that covers the majority of the body is called ____________________ hair.

Question 45

Which of the following practices should be implemented to reduce exposure to integumentary irritants? Select all that apply.

A) Notify HAZMAT officials if a dangerous chemical or toxin exposure occurs.
B) Follow Occupational Safety and Health Administration (OSHA) and employer's safety guidelines.
C) Use rubber gloves when handling toxins or caustic substances.
D) Follow the directions on the labels of all products; pay special attention to warning labels.
E) Contact a poison control center for treatment guidelines if exposed to toxic or caustic substances.
F) If using a personal care product for the first time, perform a patch test to evaluate for sensitivity.

Question 46

A stage ____________________ pressure ulcer will show damage to the subcutaneous tissues.