Deck 13: Skin, Hair, and Nails

Question 1

During the aging process, the hair can look grey 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.

Answer 1

Melanocytes.

Question 2

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

A)Is contagious.
B)Has no known cause.
C)Is caused by increased sebum production.
D)Has been found to be related to poor hygiene.

Answer 2

Is caused by increased sebum production.

Question 3

While assessing a patient's skin, the nurse notes multiple skin fissures on the hands.The nurse recognizes this as:

A)Diaphoresis in the patient.
B)Potential openings for bacterial infection.
C)Poor temperature regulation.
D)Impaired perception to pain.

Answer 3

Potential openings for bacterial infection.

Question 4

A 62-year-old patient with heart failure comes to the clinic for his annual examination.During skin assessment, the nurse notes slight swelling to the patient's feet, and indentations which quickly fade when both feet are palpated.The nurse will chart this finding as:

A)No edema noted.
B)Unilateral deep pitting 3+ edema.
C)Bilateral moderate pitting 2+ edema.
D)Mild pitting 1+ edema.

Question 5

During an examination, the nurse finds that a patient has excessive dryness of the skin.When charting, the nurse describes this condition as:

A)Xerosis.
B)Pruritus.
C)Alopecia.
D)Seborrhea.

Question 6

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 7

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 results from 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 8

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 pays special attention to the danger signs for pigmented lesions and is concerned with which additional finding?

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

Question 9

A patient is especially worried about the white coloration of an area of skin on her feet, and she has been told it is vitiligo.The nurse explains 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 10

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 11

During a skin assessment, the nurse initially is concerned that the patient who is of East Asian origin has skin that is yellowish-brown.On further assessment, the nurse notes that the skin on the hard and soft palate is pink and the patient's sclerae are not yellow.From this finding, the nurse recognizes that the patient likely does not have:

A)Pallor.
B)Jaundice.
C)Cyanosis.
D)Iron deficiency.

Question 12

A 75-year-old woman with 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 encourages her to stop trying to remove the corn with scissors because:

A)Her actions could increase her risk for infection and lesions because of her chronic disease.
B)She has increased circulation to her foot because of her diabetes, and it could cause severe bleeding.
C)She is 75 years old and has vision issues, which places her at greater risk for self-injury with the scissors.
D)Her range of motion is limited because of her peripheral vascular disease, and she may not be able to reach the corn safely.

Question 13

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

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

Question 14

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

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

Question 15

An older adult woman is brought to the emergency department after she was found lying on the kitchen floor for 2 days; she is extremely dehydrated.What would the nurse expect to see during the 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 16

A newborn infant is in the clinic for a well-baby checkup.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 dramatically rises in the newborn.

Question 17

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 in the older adult?

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

Question 18

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 odour." The nurse knows that this condition could be related to:

A)Eccrine glands.
B)Apocrine glands.
C)Disorder of the stratum corneum.
D)Disorder of the stratum germinativum.

Question 19

A woman is leaving on a trip to Hawaii and has come in for a checkup.During the health history interview, the patient informs the nurse that she takes an oral hypoglycemic medication for diabetes.The nurse provides teaching about the medication and:

A)Increased possibility of bruising.
B)Skin sensitivity as a result of exposure to salt water.
C)Lack of availability of glucose-monitoring supplies.
D)Importance of sunscreen and avoiding direct sunlight.

Question 20

A patient comes in for a physical examination and 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.

Question 21

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

A)Bulla.
B)Wheal.
C)Nodule.
D)Papule.

Question 22

A 45-year-old farmer comes in for a skin evaluation and complains of hair loss on his head.His hair seems to be breaking off in patches, and he notices some scaling on his head.The nurse begins the examination suspecting:

A)Tinea capitis.
B)Folliculitis.
C)Toxic alopecia.
D)Seborrheic dermatitis.

Question 23

The nurse has discovered decreased skin turgor in a patient and knows that this finding is expected in which condition?

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

Question 24

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

A)Folliculitis, which can be treated with an antibiotic.
B)Traumatic alopecia, which can be treated with antifungal medications.
C)Tinea capitis, which is highly contagious and needs immediate attention.
D)Trichotillomania; her child probably has a habit of absentmindedly twirling her hair.

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)"Caused by the 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

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

A)Measles (rubeola).
B)Kaposi's sarcoma.
C)Angiomas.
D)Herpes zoster.

Question 27

A 42-year-old woman is concerned about several small, slightly raised, bright red dots that have appeared on her chest.On examination, the nurse explains that the spots are probably:

A)Anasarca.
B)Scleroderma.
C)Senile angiomas.
D)Latent myeloma.

Question 28

A patient has had a "terrible itch" for several months and states that he has been continuously scratching it.During examination, the nurse finds:

A)A keloid.
B)A fissure.
C)Keratosis.
D)Lichenification.

Question 29

A man has come in to the clinic for a skin assessment because he is worried 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.The nurse informs the patient that they are:

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 30

The nurse notices that a school-aged child has bluish-white, red-based spots in her mouth and that the lesions are raised approximately 1 to 3 mm.The nurse will assess the child for:

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 back of the arms.
D)A red-purple, maculopapular, blotchy rash behind the ears and on the face.

Question 31

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)Tell the patient to watch the lesion and report back in 2 months.
B)Refer the patient for further assessment because of the risk for melanoma based on signs and symptoms.
C)Ask additional questions regarding environmental irritants that may have caused this condition.
D)Tell the patient that these signs suggest a compound nevus, which is very common in young to middle-aged adults.

Question 32

A newborn infant has Down's syndrome.During the skin assessment, the nurse notices a transient mottling in the trunk and extremities in response to the cool temperature in the examination room.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 33

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 bilateral pitting edema in the lower legs.The skin is puffy and tight but normal in colour.No increased redness or tenderness is observed 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 is which condition?

A)Heart failure
B)Venous thrombosis
C)Local inflammation
D)Blockage of lymphatic drainage

Question 34

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

A)Yellow patches in the outer sclera
B)Yellow coloration 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 35

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 replies, "The physician is referring to the:

A)"Blue dilation of blood vessels in a star-shaped linear pattern on the legs."
B)"Fiery red, star-shaped marking on the cheek that has a solid circular centre."
C)"Merging extensive patch of red dots and larger bruises on the feet."
D)"Tiny areas of bruising that are less than 2 mm, round, discrete, and dark red in colour."

Question 36

A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment.On assessment, the nurse notes:

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

Question 37

The nurse is assessing a patient with emphysema for clubbing of the fingernails, which is confirmed by:

A)Nail bases that are firm and slightly tender.
B)Curved nails with a convex profile and ridges across the nails.
C)Nail bases that feel spongy with an angle of the nail base of 150 degrees.
D)Nail bases with an angle of 180 degrees or greater and nail bases that feel spongy.

Question 38

From reviewing the patient's medical record, the nurse notes that the patient has a lesion that is confluent in nature.During assessment, the nurse observes:

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 39

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 will chart this finding as:

A)Keratoses.
B)Xerosis.
C)Chloasma.
D)Acrochordons.

Question 40

A 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 red base and suspects:

A)Eczema.
B)Impetigo.
C)Herpes zoster.
D)Diaper dermatitis.

Question 41

The nurse initiates a Braden Scale assessment of the 85-year-old patient who is independent with activities of daily living and frequently ambulates around the unit.The patient scores a 23 which the nurse documents as:

A)At increased risk for pressure ulcers.
B)No risk for pressure ulcer development.
C)Requires monthly Braden Scale assessment.
D)Initiate a weekly assessment schedule.

Question 42

A 52-year-old woman has a small solid bump on her nose that has rounded, pearly borders and a central red ulcer.She states that 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)Melanoma
D)Squamous cell carcinoma

Question 43

The nurse recognizes the importance of assessing the patient's skin as the skin has many protective and adaptive functions which include: (Select all that apply.)

A)Protection from bacterial intrusion.
B)Increasing dehydration through water loss.
C)Regulation of body temperature.
D)Supporting wound healing.
E)Decreasing the wastes excreted.

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 colour
B)Bulla: Elevated, circumscribed lesion filled with turbid fluid (pus)
C)Papule: Hypertrophic scar
D)Vesicle: Known as a friction blister
E)Nodule: Solid, elevated, and hard or soft growth that is larger than 1 cm

Question 45

The nurse is working with the older adult population, and recognizes that the aging process can increase: (Select all that apply.)

A)Heat stroke risk.
B)Skin vascularity.
C)Occurrence of skin tear injuries.
D)Muscle tone.
E)Time for a wound to heal.
F)Skin elasticity.

Question 46

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

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

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 colour.The nurse suspects that this colouring is caused by:

A)Polycythemia.
B)Carbon monoxide poisoning.
C)Carotenemia.
D)Uremia.

Question 48

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

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

Question 49

The nurse is assessing a 50-year-old patient who is restricted to the bed.The patient has limited mobility and needs to be frequently repositioned.The nurse will use the Braden Scale to assess for:

A)Mobility and positioning needs.
B)Risk for developing pressure ulcers.
C)Progression of limitations.
D)Cognitive status and functioning.

Question 50

A father brings in his 2-month-old infant to the clinic because the infant has had diarrhea for the past 24 hours.He says 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 and tests skin mobility and turgor over the infant's:

A)Sternum.
B)Forehead.
C)Forearms.
D)Abdomen.

Question 51

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 is not broken.
B)Partial thickness skin erosion is observed with a 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 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 consists of small, red, flat skin spots 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.

Question 53

The nurse is performing a Braden Scale assessment on a 65-year-old bedbound patient with limited mobility.The patient is unable to communicate needs or discomfort but does respond to verbal commands.The nurse notes that the patient's skin is moist and will likely require a linen change each shift.The patient is confined to the bed with no ability to walk and makes very limited changes to body extremities occasionally.The patient requires frequent repositioning with maximum assistance.The patient eats about half of the food offered.The nurse charts the findings as:

A)At risk for pressure ulcers.
B)Low risk for pressure ulcer development.
C)Moderate risk for pressure ulcers.
D)High Risk for developing pressure ulcers.