Deck 8: Assessing the Skin, Hair, and Nails

Question 1

The layer of the skin that adds strength and elasticity, and gives individuals the ability to feel is the:

A) Epidermis.
B) Dermis.
C) Subcutaneous.
D) Stratum corneum.

Answer 1

Dermis.

Question 2

A decrease in the number of functioning melanocytes results in:

A) Melanomas.
B) Thinning of the skin.
C) Graying of hair.
D) Darkening of the skin.

Answer 2

Graying of hair.

Question 3

The pink color of the nail beds is due to:

A) Pigment from melanocytes.
B) Vascularity of epithelial cells.
C) Genetic predisposition.
D) Inflammation of the epidermis.

Answer 3

Vascularity of epithelial cells.

Question 4

Apocrine sweat glands differ from eccrine sweat glands in that they:

A) Produce body odor when reacting to bacterial decomposition.
B) Decrease in response to emotional stress.
C) Maintain body temperature.
D) Are located only on the palms, soles, and forehead.

Question 5

During your assessment of a 17-year-old female, you determine that she uses tanning beds on a regular basis. You should inform her that:

A) Tanning beds should not be used by persons under 18 years of age.
B) Tanning beds increase the risk of melanoma by 75%.
C) Tanning beds are less dangerous than sun exposure.
D) 1 and 2
E) 1, 2, and 3

Question 6

Keloid formation is commonly seen in:

A) Overexposure to the sun.
B) Allergic reactions.
C) Dark-skinned individuals.
D) Individuals with poor skin hygiene.

Question 7

The nurse pinches the patient's skin over the clavicle between two fingers and lets it go. The skin remains tented and slowly returns to the flat position. The nurse knows this is a sign of:

A) Dehydration.
B) A large amount of recent weight gain.
C) Inflammation.
D) Poor peripheral circulation.

Question 8

The nurse assesses excessive moisture of the skin, called hyperhidrosis, which can indicate a(n):

A) Cardiac condition.
B) Endocrine disorder.
C) Renal disorder.
D) Neurological condition.

Question 9

A bruise caused by bleeding under the skin or mucous membranes after a local trauma is called:

A) Ecchymosis.
B) Hematoma.
C) Purpura.
D) Petechiae.

Question 10

The most common form of cutaneous malignancy is:

A) Malignant melanoma.
B) Squamous cell carcinoma.
C) Basal cell carcinoma.
D) Skin cancer.

Question 11

If lice are found during an inspection of the hair, the best way to pick them up is with a:

A) Hemostat.
B) Tongue blade.
C) Piece of clear tape.
D) Gloved hand.

Question 12

An inflammation of a hair follicle with white pustules is called:

A) Alopecia.
B) Folliculitis.
C) Seborrhea dermatitis.
D) Tinea capitis.

Question 13

While assessing the patient's fingernails, the nurse notices a thickening, yellow discoloration and scaling of the nail bed. The nurse would suspect:

A) Onychomycosis.
B) Paronychia.
C) Spoon nails.
D) Pitting.

Question 14

The nurse is assessing a wound on a patient's buttocks. The wound depth would be measured with a:

A) Tape measure.
B) Sterile cotton-tipped applicator.
C) Gloved finger.
D) Sterile hemostat.

Question 15

While assessing a pressure ulcer, the nurse notes that the exudate is light red or pink in color. The term for correct documentation of this exudate is:

A) Serous.
B) Serosanguineous.
C) Sanguinous.
D) Purulent.

Question 16

When changing a dressing on a pressure ulcer, the nurse notes maceration around the area and teaches the patient and his family that this is caused by a dressing that is:

A) Dry.
B) Left on too long.
C) Not covering the wound adequately.
D) Taped too tightly.

Question 17

A patient comes to the health-care provider's office complaining of a red, raised rash. The nurse assesses lesions distributed over the entire body and documents this distribution as:

A) Localized.
B) Scattered.
C) Regional.
D) Diffuse/generalized.

Question 18

During an assessment, the nurse notices a lesion on the patient's leg that is round with central clearing. This would be documented as a(n):

A) Discrete lesion.
B) Confluent lesion.
C) Iris lesion.
D) Circular lesion.

Question 19

Moles (nevi) are examples of which type of lesion pattern?

A) Round/oval
B) Discrete
C) Linear
D) Reticula

Question 20

The patient in the emergency room is assessed as having scrapes of the superficial layers of the skin of his arms and legs following a motorcycle accident. This would be documented as:

A) Contusions.
B) Lacerations.
C) Abscesses.
D) Abrasions.

Question 21

A child presents at the urgent care center after falling through a glass window. A large shard of glass is still lodged in his leg. This type of wound would be documented as a:

A) Puncture wound.
B) Penetrating wound.
C) Tunnel wound.
D) Crushing wound.

Question 22

Upon admission, the patient is assessed using the Braden Scale for Predicting Pressure Sore Risk. The patient responds to verbal commands, but cannot communicate discomfort or the need to be turned. His skin is moist, requiring extra linen changes daily. His ability to walk is severely limited and he must be assisted into a wheelchair. He requires maximum assistance in moving and frequently slides down in bed. When in bed, he makes occasional slight changes in body or extremity positions. He eats over half of most meals, including at least four servings of meat and dairy products. His Braden Scale Score is 14 and translates to:

A) No risk.
B) Low risk.
C) Moderate risk.
D) High risk.

Question 23

The nurse would implement the pressure ulcer prevention protocol if he or she assesses a Braden Scale for Predicting Pressure Sore Risk of:

A) 24 or less.
B) 20 or less.
C) 18 or less.
D) 16 or less.

Question 24

The nurse assesses a patient with a chronic skin disorder that causes the skin to be scaly, itchy, inflamed, and irritated. The patient states that her mother and sister have the same condition. The nurse recognizes this as:

A) Acne.
B) Eczema.
C) Psoriasis.
D) Seborrhea dermatitis.

Question 25

During an assessment, the nurse notices smooth white patches all over the skin. She documents this as possible:

A) Hypopigmentation.
B) Albinism.
C) Hyperpigmentation.
D) Vitiligo.

Question 26

In the recovery room, the nurse assesses a bluish discoloration of the patient's oral mucosa and conjunctiva of the eyes, lips, and tongue. These changes in color could indicate:

A) Jaundice.
B) Pallor.
C) Peripheral cyanosis.
D) Central cyanosis.

Question 27

While changing a surgical dressing, the nurse explains to the patient that the pink skin color surrounding his wound indicates:

A) Infection.
B) Increased blood flow.
C) Delayed healing.
D) Imminent wound separation.

Question 28

Yellowing of the skin without yellowing of the sclera of the eye might indicate:

A) Jaundice.
B) Hyperpigmentation.
C) Carotenemia.
D) Erythema.

Question 29

A patient presents with concern about yellowing of her skin. The nurse assesses that there is no yellowing of the sclera of the eye and inquires about the patient's:

A) Exposure to the sun.
B) Dietary intake.
C) Exposure to chemicals.
D) Allergies.

Question 30

The patient presents with redness, swelling, and spider-like blood vessels on the middle of the face. The nurse suspects this is a condition called:

A) Rosacea.
B) Acne vulgaris.
C) Eczema.
D) Erythema.

Question 31

You are performing a skin assessment on a patient's face and inspect many freckles on both sides. A freckle is a:

A) Macule.
B) Papule.
C) Vesicle.
D) Nodule.

Question 32

A patient comes to the clinic to have an elevated brown mole removed. You measure the mole and it is 0.9 mm. The nurse knows that this is a:

A) Macule.
B) Papule.
C) Vesicle.
D) Nodule.

Question 33

The nurse assesses a skin lesion that is elevated, encapsulated, and filled with fluid. The nurse knows that this is a:

A) Nodule.
B) Wheal.
C) Cyst.
D) Pustule.

Question 34

The dried collection of blood, serum, or pus that is part of the normal healing process is called a:

A) Fissure.
B) Scar.
C) Scale.
D) Crust.

Question 35

A postoperative patient exhibits thick and raised tissue extending beyond the original boundaries of the incision. The nurse recognizes this as:

A) A scar.
B) Erosion.
C) A keloid.
D) Excoriation.

Question 36

Dysplastic nevi or Clark's nevi, which have a greater potential for developing into melanoma, are characterized by:

A) Irregular, poorly defined borders.
B) No variations in color.
C) Being smaller in size than typical nevi.
D) Maintaining a consistent size.

Question 37

The nurse is assessing and staging a pressure ulcer. She determines that there is full thickness loss involving subcutaneous tissue. The ulcer extends to but not through fascia. A deep crater undermines adjacent tissues. The nurse assesses this pressure ulcer to be:

A) Stage 1.
B) Stage 2.
C) Stage 3.
D) Stage 4.
E) Unstageable.

Question 38

Nail growth can be affected by which of the following? Select all that apply.

A) Seasons
B) Stress
C) Disease
D) Hormone deficiency
E) Weight

Question 39

The integumentary system comprises skin, hair, and nails but also includes which of the following? Select all that apply.

A) Glands
B) Tendons
C) Mucous membranes
D) Capillaries
E) Cartilage

Question 40

The nurse explains to the patient's family that persons at risk for developing pressure ulcers include which of the following? Select all that apply.

A) Those who are immobile or have decreased mobility
B) Those who have poor nutrition
C) Those who are confined to a bed or wheelchair
D) Those who have decreased blood circulation
E) Those who are hydrated

Question 41

Which skin diseases tend to be familial? Select all that apply.

A) Basal cell carcinoma
B) Eczema
C) Psoriasis
D) Herpes simplex
E) HPV

Question 42

Using the Braden Scale for Predicting Pressure Sore Risk, the nurse assesses several factors. Select all that apply.

A) Sensory perception
B) Moisture
C) Activity
D) Mobility
E) Nutrition
F) Friction and shear

Question 43

In assessing a pressure ulcer, the nurse notes areas of eschar and areas of slough. Which of the following statements are true of these findings? Select all that apply.

A) Eschar is dry, leathery, indurated, and black.
B) Slough is yellow, moist, and stringy.
C) Eschar is hydrated necrotic tissue.
D) Slough is dehydrated necrotic tissue.

Question 44

The skin assessment indicates a mole on the patient's back. The nurse will assess it for which of the following? Select all that apply.

A) Asymmetry
B) Border
C) Color
D) Diameter
E) Evolving characteristics

Question 45

In assessing for cyanosis, the nurse would inspect which of the following? Select all that apply.

A) Lips
B) Oral mucosa
C) Extremities
D) Sclera of the eyes
E) Neck

Question 46

Intertriginous areas trap moisture and can easily become infected. These areas include which of the following? Select all that apply.

A) Under the breasts
B) Under the arms
C) Under stomach folds of obese individuals
D) Groin areas
E) Behind the ears

Question 47

To protect the skin from sun damage, what does the nurse teach about sunblock? Select all that apply.

A) It should have an SPF of at least 15.
B) It should be water resistant.
C) It should be reapplied after the user has been in the water.
D) It should be applied immediately before sun exposure.

Question 48

The skin is involved in several functions of the body, including which of the following? Select all that apply.

A) Sensation and perception
B) Thermoregulation
C) Fluid balance
D) Synthesis of vitamin K
E) Excretion
F) Immunity

Question 49

Sebum is secreted through hair follicles in which areas of the body? Select all that apply.

A) Soles of the feet
B) Palms of the hand
C) Axilla
D) Face

Question 50

Your adult patient presents with a severe, red rash over both arms and hands. There are no other symptoms. In taking a health history you would assess which of the following? Select all that apply.

A) Onset of the rash
B) Associated or alleviating factors
C) History/family history of skin disorders
D) Effects on body image
E) Age of patient

Question 51

The nurse is staging the patient's pressure ulcer and determines full thickness loss with extensive involvement of muscle. This ulcer is almost completely covered in eschar. The nurse determines this ulcer to be ____________________.

Question 52

A college student comes to Student Health Services stating that he thinks he is having an allergic reaction. He states that these lesions are itchy and getting worse. You inspect his skin and see the skin lesion in the accompanying figure. This lesion is called a ____________________.

Question 53

The patient reports that he has been under a lot of stress since he lost his job last month. He wants the health-care provider to look at the above lesions that are on his bottom lip. The configuration of the lesions in the picture is ____________________.

Question 54

A patient is at his dermatologist's office to have a skin lesion on his face evaluated. The health-care provider tells that patient that she is going to do a biopsy to rule out ___________________ cell carcinoma, a malignant cutaneous malignancy arising from keratinocytes of the skin.

Question 55

You are inspecting and palpating a patient's fingernails. The patient has chronic obstructive pulmonary disease related to smoking for the past 30 years. You look at his nails and note an increased nail base angle. You know that the normal nail base angle is __________ degrees.