Deck 12: Skin, Hair, and Nails

Question 1

A patient comes in for a physical,and she complains of "freezing to death" while waiting for her examination.The nurse notes that her skin is pale and cool and attributes this finding to:

A) venous pooling.
B) peripheral vasodilation.
C) peripheral vasoconstriction.
D) decreased arterial perfusion.

Answer 1

peripheral vasoconstriction.

Question 2

A newborn infant is in the clinic for a well-baby check.The nurse observes the infant for the possibility of fluid loss because of which of these factors?

A) Subcutaneous fat deposits are high in the newborn.
B) Sebaceous glands are overproductive in the newborn.
C) The newborn's skin is more permeable than that of the adult.
D) The amount of vernix caseosa rises dramatically in the newborn.

Answer 2

The newborn's skin is more permeable than that of the adult.

Question 3

The nurse is bathing an 80-year-old man and notices that his skin is wrinkled,thin,lax,and dry.This finding would be related to which factor?

A) Increased vascularity of the skin in the elderly
B) Increased numbers of sweat and sebaceous glands in the elderly
C) An increase in elastin and a decrease in subcutaneous fat in the elderly
D) An increased loss of elastin and a decrease in subcutaneous fat in the elderly

Answer 3

An increased loss of elastin and a decrease in subcutaneous fat in the elderly

Question 4

The nurse is caring for a black child who has been diagnosed with marasmus.The nurse would expect to find the:

A) hair to be less kinky and to be a copper-red color.
B) head to be larger than normal, with wide-set eyes.
C) skin on the hands and feet to be scaly and tender.
D) lymph nodes in the groin to be enlarged and tender.

Question 5

The nurse educator is preparing an education module for the nursing staff on the dermis layer of skin.Which of these statements would be included in the module? The dermis:

A) contains mostly fat cells.
B) consists mostly of keratin.
C) is replaced every 4 weeks.
D) contains sensory receptors.

Question 6

During the aging process,the hair can look gray or white and begin to feel thin and fine.The nurse knows that this occurs because of a decrease in the number of functioning:

A) metrocytes.
B) fungacytes.
C) phagocytes.
D) melanocytes.

Question 7

A 75-year-old woman who has a history of diabetes and peripheral vascular disease has been trying to remove a corn on the bottom of her foot with a pair of scissors.The nurse will encourage her to stop trying to remove the corn with scissors because:

A) the woman could be at increased risk for infection and lesions because of her chronic disease.
B) with her diabetes, she has increased circulation to her foot and it could cause severe bleeding.
C) she is 75 years old and is unable to see, so she puts herself at greater risk for self-injury with the scissors.
D) with her peripheral vascular disease, her range of motion is limited and she may not be able to reach the corn safely.

Question 8

The nurse educator is preparing an education module for the nursing staff on the epidermal layer of skin.Which of these statements would be included in the module? The epidermis is:

A) highly vascular.
B) thick and tough.
C) thin and nonstratified.
D) replaced every 4 weeks.

Question 9

During an examination,the nurse finds that a patient has excessive dryness of the skin.The best term to describe this condition is:

A) xerosis.
B) pruritus.
C) alopecia.
D) seborrhea.

Question 10

The nurse keeps in mind that a thorough skin assessment is very important because the skin holds information about a person's:

A) support systems.
B) circulatory status.
C) socioeconomic status.
D) psychological wellness.

Question 11

The nurse is examining a patient who tells the nurse,"I sure sweat a lot,especially on my face and feet but it doesn't have an odor." The nurse knows that this could be related to:

A) the eccrine glands.
B) the apocrine glands.
C) a disorder of the stratum corneum.
D) a disorder of the stratum germinativum.

Question 12

The nurse is discussing epidermal appendages with a newly graduated nurse.Which of these would be included in the discussion?

A) Skin
B) Arms
C) Sweat glands
D) Parotid glands

Question 13

An Inuit visiting Nevada from Anchorage has come to the clinic in July during the hottest part of the day.It so happens that the clinic's air conditioning is broken and the temperature is very hot.The nurse knows that which of these statements is true about the Inuit sweating tendencies?

A) They will sweat profusely all over their bodies because they are not used to the hot temperatures.
B) They don't sweat because their apocrine glands are less efficient in hot climates.
C) They will sweat more on their faces and less on their trunks and extremities.
D) There is no difference in their sweating tendencies when compared to other ethnic groups.

Question 14

A 13-year old girl is interested in obtaining information about the cause of her acne.The nurse would share with her that acne:

A) is contagious.
B) is caused by a poor diet.
C) has no known cause.
D) has been found to be related to poor hygiene.

Question 15

A patient tells the nurse that he has noticed that one of his moles has started to burn and bleed.When assessing his skin,the nurse would pay special attention to the danger signs for pigmented lesions and would be concerned with which additional finding?

A) Color variation
B) Border regularity
C) Symmetry of lesions
D) Diameter less than 6 mm

Question 16

A patient comes to the clinic and tells the nurse that he has been confined to his recliner chair for about 3 days with his feet down and he wants the nurse to evaluate his feet.During the assessment,the nurse might expect to find:

A) pallor.
B) coolness.
C) distended veins.
D) prolonged capillary filling time.

Question 17

A 22-year-old woman comes to the clinic because of a severe sunburn and states,"I was just out in the sun for a couple of minutes." The nurse begins a medication review with her,paying special attention to which medication class?

A) Nonsteroidal anti-inflammatory drugs for pain
B) Tetracyclines for acne
C) Proton pump inhibitors for heartburn
D) Thyroid replacement hormone for hypothyroidism

Question 18

A patient is especially worried about an area of skin on her feet that has turned white.The health care provider has told her that her condition is vitiligo.The nurse explains to her that vitiligo is:

A) caused by an excess of melanin pigment.
B) caused by an excess of apocrine glands in her feet.
C) caused by the complete absence of melanin pigment.
D) related to impetigo and can be treated with an ointment.

Question 19

Because hair for humans is no longer needed for protection from cold or trauma,it is called:

A) vellus.
B) vagus.
C) vestigial.
D) vestibule.

Question 20

A woman is leaving on a trip to Hawaii and has come in for a checkup.During the examination the nurse notices that she is diabetic and takes oral hypoglycemic agents.The patient needs to be concerned about which possible effect of her medications?

A) An increased possibility of bruising
B) Skin sensitivity as a result of exposure to salt water
C) Lack of availability of glucose monitoring supplies
D) The importance of sunscreen and avoiding direct sunlight

Question 21

The nurse notices that a 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:

A) bulla.
B) wheal.
C) nodule.
D) papule.

Question 22

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,"The physician is referring to:

A) that blue dilation of blood vessels in a star-shaped linear pattern on the legs."
B) that fiery red, star-shaped marking on the cheek that has a solid circular center."
C) that confluent and extensive patch of petechiae and ecchymoses on the feet."
D) those tiny little areas of hemorrhage that are less than 2 mm, round, discrete, and dark red in color."

Question 23

A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment.On assessment,the nurse might expect to see which assessment finding?

A) Anasarca
B) Scleroderma
C) Pedal erythema
D) Clubbing of the nails

Question 24

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

A) café au lait.
B) carotenemia.
C) acrocyanosis.
D) cutis marmorata.

Question 25

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,"They are:

A) signs of decreased hematocrit related to anemia."
B) due to destruction of melanin in your skin from exposure to the sun."
C) clusters of melanocytes that appear after extensive sun exposure."
D) areas of hyperpigmentation related to decreased perfusion and vasoconstriction."

Question 26

A man has come in to the clinic for a skin assessment 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" his skin.Which is the best prediction? He probably has:

A) senile lentigines, which do not become cancerous.
B) actinic keratoses, which are precursors to basal cell carcinoma.
C) acrochordons, which are precursors to squamous cell carcinoma.
D) seborrheic keratoses, which do not become cancerous.

Question 27

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

A) A pink, papular rash on the face and neck
B) Pruritic vesicles over her trunk and neck
C) Hyperpigmentation on the chest, abdomen, and the back of the arms
D) A red-purple, maculopapular, blotchy rash behind the ears and on the face

Question 28

A black patient is in the intensive care unit because of impending shock after an accident.The nurse would expect to find what characteristics in this patient's skin?

A) Ruddy blue
B) Generalized pallor
C) Ashen, gray, or dull
D) Patchy areas of pallor

Question 29

A patient's mother has noticed that her son,who has been to 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:

A) eczema.
B) impetigo.
C) herpes zoster.
D) diaper dermatitis.

Question 30

The nurse just noted from a patient's medical record that the patient has a lesion that is confluent in nature.On examination,the nurse would expect to find:

A) lesions that run together.
B) annular lesions that have grown together.
C) lesions arranged in a line along a nerve route.
D) lesions that are grouped or clustered together.

Question 31

A 35-year-old pregnant woman comes to the clinic for a monthly appointment.During the 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:

A) keratoses.
B) xerosis.
C) linea nigra.
D) acrochordons.

Question 32

During a skin assessment,the nurse notices that a Mexican-American patient has skin that is yellowish-brown;however,the skin on the hard and soft palate is pink and the patient's scleras are not yellow.From this finding,the nurse could probably rule out:

A) pallor.
B) jaundice.
C) cyanosis.
D) iron deficiency.

Question 33

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

A) tinea capitis.
B) folliculitis
C) toxic alopecia.
D) seborrheic dermatitis.

Question 34

A mother brings her child in to the clinic for an examination of the scalp and hair.She states that the child has developed some places where there are irregularly shaped patches with broken-off,stub-like hair and she is worried that this could be some form of premature baldness.The nurse tells her that it is:

A) folliculitis and that it can be treated with an antibiotic.
B) traumatic alopecia that can be treated with antifungal medications.
C) tinea capitis and that it is highly contagious and needs immediate attention.
D) trichotillomania and that her child probably has a habit of twirling her hair absentmindedly.

Question 35

The nurse is assessing the skin of a patient who has AIDS and notices multiple patch-like lesions on the temple and beard area that are faint pink in color.The nurse recognizes these lesions as:

A) measles (rubeola).
B) Kaposi's sarcoma.
C) angiomas.
D) herpes zoster.

Question 36

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

A) a keloid.
B) a fissure.
C) keratosis.
D) lichenification.

Question 37

A 42-year-old female patient complains that she has noticed several small,slightly raised,bright red dots on her chest.On examination,the nurse expects that the spots are probably:

A) anasarca.
B) scleroderma.
C) senile angiomas.
D) latent myeloma.

Question 38

The nurse has discovered decreased skin turgor in a patient and knows that this is an expected finding in which of these conditions?

A) Severe obesity
B) Childhood growth spurts
C) Severe dehydration
D) Connective tissue disorders such as scleroderma

Question 39

An elderly woman is brought to the emergency department after being found lying on the kitchen floor 2 days,and she is extremely dehydrated.What would the nurse expect to see upon examination?

A) Smooth mucous membranes and lips
B) Dry mucous membranes and cracked lips
C) Pale mucous membranes
D) White patches on the mucous membranes

Question 40

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

A) decreased amounts of bilirubin in the blood.
B) excess blood in the underlying blood vessels.
C) decreased perfusion to the surrounding tissues.
D) excess blood in the dilated superficial capillaries.

Question 41

A patient has been admitted to a hospital after the staff in the nursing home noticed a pressure ulcer in his sacral area.The nurse examines the pressure ulcer and determines that it is a stage II ulcer.Which of these findings are characteristic of a stage II pressure ulcer? Select all that apply.

A) Intact skin appears red but not broken.
B) Partial thickness skin erosion with loss of epidermis or dermis.
C) Ulcer extends into the subcutaneous tissue.
D) Localized redness in light skin will blanch with fingertip pressure.
E) Open blister areas have a red-pink wound bed.
F) Patches of eschar cover parts of the wound.

Question 42

A 40-year-old woman reports a change in mole size,accompanied by color 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) tell the patient to watch the lesion and report back in 2 months.
B) refer the patient because of the suspicion of melanoma on the basis of her symptoms.
C) ask additional questions regarding environmental irritants that may have caused this condition.
D) suspect that this is a compound nevus, which is very common in young to middle-aged adults.

Question 43

The nurse is assessing for inflammation in a dark-skinned person.Which is the best technique?

A) Assess the skin for cyanosis and swelling.
B) Assess the oral mucosa for generalized erythema.
C) Palpate the skin for edema and increased warmth.
D) Palpate for tenderness and local areas of ecchymosis.

Question 44

The nurse is preparing for a certification course in skin care and needs to be familiar with the various lesions that may be identified on assessment of the skin.Which of the following definitions are correct? Select all that apply.

A) Petechiae: Tiny punctate hemorrhages, 1 to 3 mm, round and discrete, dark red, purple, or brown in color
B) Bulla: An elevated, circumscribed lesion filled with turbid fluid (pus)
C) Papule: A hypertrophic scar
D) Vesicle: Also known as a friction blister
E) Nodule: Solid, elevated, hard or soft, larger than 1 cm

Question 45

A 52-year-old woman has a papule on her nose that has rounded,pearly borders and a central red ulcer.She said she first noticed it several months ago and that it has slowly grown larger.The nurse suspects which condition?

A) Acne
B) Basal cell carcinoma
C) Malignant melanoma
D) Squamous cell carcinoma

Question 46

While performing an assessment of a 65-year-old man with a history of hypertension and coronary artery disease,the nurse notices the presence of pitting edema in the lower legs bilaterally.The skin is puffy and tight but of normal color.There is no increased redness or tenderness over his lower legs,and the peripheral pulses are equal and strong.In this situation,the nurse suspects that the likely cause of the edema would be:

A) heart failure.
B) venous thrombosis.
C) a local inflammation.
D) blockage of lymphatic drainage.

Question 47

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

A) polycythemia.
B) carbon monoxide poisoning.
C) carotenemia.
D) uremia.

Question 48

A patient has been admitted for severe psoriasis.The nurse can expect to see what finding in the patient's fingernails?

A) Splinter hemorrhages
B) Paronychia
C) Pitting
D) Beau lines

Question 49

A father brings in 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 at least every 2 hours.The nurse suspects dehydration.The nurse should test skin mobility and turgor in this infant over the:

A) sternum.
B) forehead.
C) forearms.
D) abdomen.

Question 50

The nurse is assessing a patient who has liver disease for jaundice.Which of these assessment findings is indicative of true jaundice?

A) Yellow patches in the outer sclera
B) Yellow color of the sclera that extends up to the iris
C) Skin that appears yellow when examined under low light
D) Yellow deposits on the palms and soles of the feet where jaundice first appears

Question 51

The nurse is assessing for clubbing of the fingernails and would expect to find:

A) a nail base that is firm and slightly tender.
B) curved nails with a convex profile and ridges across the nail.
C) a nail base that feels spongy with an angle of the nail base of 150 degrees.
D) an angle of the nail base of 180 degrees or greater with a nail base that feels spongy.

Question 52

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,macular,with a bull's eye pattern across his midriff and behind his knees.The nurse suspects:

A) rubeola.
B) Lyme disease.
C) allergy to mosquito bites.
D) Rocky Mountain spotted fever.