Chapter 14: Assessing Skin, Hair, and Nails

Question 1

Connecting the skin to underlying structures is/are the

a. papillae.
b. sebaceous glands.
c. dermis layer.
d. subcutaneous tissue.

Answer 1

d. subcutaneous tissue

Question 2

The skin plays a vital role in temperature maintenance, fluid and electrolyte balance, and
synthesis of vitamin

a. A.
b. B12.
c. C.
d. D.

Answer 2

c. D.

Question 3

The only layer of the skin that undergoes cell division is the

a. innermost layer of the epidermis.
b. outermost layer of the epidermis.
c. innermost layer of the dermis.
d. outermost layer of the dermis.

Answer 3

a. innermost layer of the epidermis.

Question 4

A client’s skin color depends on melanin and carotene contained in the skin, and the

a. client’s genetic background.
b. volume of blood circulating in the dermis.
c. number of lymph vessels near the dermis.
d. vascularity of the apocrine glands.

Answer 4

b. volume of blood circulating in the dermis.

Question 5

Hair follicles, sebaceous glands, and sweat glands originate from the

a. epidermis.
b. eccrine glands.
c. keratinized tissue.
d. dermis.

Answer 5

d. dermis.

Question 6

The apocrine glands are dormant until puberty and are concentrated in the axillae, the perineum, and the

a. areola of the breast.
b. entire skin surface.
c. soles of the feet.
d. adipose tissue.

Answer 6

a. areola of the breast

Question 7

Short, pale, and fine hair that is present over much of the body is termed

a. vellus.
b. dermal.
c. lanugo.
d. terminal.

Answer 7

a. vellus

Question 8

A primary function of hair in the nose and eyelashes is to serve as a

a. response to cold.
b. filter for dust.
c. pigment producer.
d. response to fright.

Answer 8

b. filter for dust.

Question 9

The nails, located on the distal phalanges of the fingers and toes, are composed of

a. ectodermal cells.
b. endodermal cells.
c. keratinized epidermal cells.
d. stratum cells.

Answer 9

c. keratinized epidermal cells.

Question 10

Squamous cell carcinoma is associated with

a. overall amount of sun exposure.
b. intermittent exposure to ultraviolet rays.
c. precursor lesions.
c. an increase in the rates of melanoma.

Answer 10

a. overall amount of sun exposure.

Question 11

An adult female client visits the clinic for the first time. The client has many bruises around her neck and face, and she tells the nurse that the bruises are the “result of an accident.” The nurse suspects that the client may be experiencing

a. leukemia.
b. diabetes mellitus.
c. melanoma.
d. domestic abuse.

Answer 11

d. domestic abuse.

Question 12

An adult male client visits the outpatient center and tells the nurse that he has been experiencing patchy hair loss. The nurse should further assess the client for

a. symptoms of stress.
b. recent radiation therapy.
c. pigmentation irregularities.
d. allergies to certain foods.

Answer 12

a. symptoms of stress.

Question 13

The nurse is instructing a group of high school students about risk factors associated with various skin cancers. The nurse should instruct the group that

a. melanoma skin cancers are the most common type of cancers.
b. African-Americans are the least susceptible to skin cancers.
c. usually there are precursor lesions for basal cell carcinomas.
d. squamous cell carcinomas are most common on body sites with heavy sun exposure.

Answer 13

d. squamous cell carcinomas are most common on body sites with heavy sun exposure.

Question 14

The nurse is assessing an African-American client’s skin. After the assessment, the nurse should instruct the client that African-American persons are more susceptible to

a. skin cancers than persons of European origin.
b. melanomas if they reside in areas without ozone depletion.
c. chronic discoid lupus erythematosus.
d. genetic predisposition to melanomas.

Answer 14

c. chronic discoid lupus erythematosus.

Question 15

A 20-year-old client visits the outpatient center and tells the nurse that he has been experiencing sudden generalized hair loss. After determining that the client has not received radiation or chemotherapy, the nurse should further assess the client for signs and symptoms of

a. hypothyroidism.
b. hyperthyroidism.
c. infectious conditions.
d. hypoparathyroidism.

Answer 15

a. hypothyroidism.

Question 16

A client visits the clinic for a routine physical examination. The nurse prepares to assess the
client’s skin. The nurse asks the client if there is a family history of skin cancer and should explain to the client that there is a genetic component with skin cancer, especially

a. basal cell carcinoma.
b. actinic keratoses.
c. squamous cell carcinoma.
d. malignant melanoma.

Answer 16

d. malignant melanoma.

Question 17

A female client visits the clinic and complains to the nurse that her skin feels “dry.” The nurse should instruct the client that skin elasticity is related to adequate

a. calcium.
b. vitamin D.
c. carbohydrates.
d. fluid intake.

Answer 17

d. fluid intake.

Question 18

An adult white client visits the clinic for the first time. During assessment of the client’s skin, the nurse should assess for central cyanosis by observing the client’s

a. nailbeds.
b. oral mucosa.
c. sclera.
d. palms.

Answer 18

b. oral mucosa.

Question 19

To assess for anemia in a dark-skinned client, the nurse should observe the client’s skin for a color that appears

a. greenish.
b. ashen.
c. bluish.
d. olive.

Answer 19

b. ashen.

Question 20

The nurse is assessing a dark-skinned client who has been transported to the emergency room by ambulance. When the nurse observes that the client’s skin appears pale, with blue-tinged lips and oral mucosa, the nurse should document the presence of

a. a great degree of cyanosis.
b. a mild degree of cyanosis.
c. lupus erythematosus.
d. hyperthyroidism.

Answer 20

a. a great degree of cyanosis.

Question 21

A dark-skinned client visits the clinic because he “hasn’t been feeling well.” To assess the client’s skin for jaundice, the nurse should inspect the client’s

a. abdomen.
b. arms.
c. legs.
d. sclera.

Answer 21

d. sclera.

Question 22

While assessing the skin of an older adult client, the nurse observes that the client has small yellowish brown patches on her hands. The nurse should instruct the client that these spots are

a. signs of an infectious process.
b. caused by aging of the skin in older adults.
c. precancerous lesions.
d. signs of dermatitis.

Answer 22

b. caused by aging of the skin in older adults.

Question 23

While assessing an adult client’s feet for fungal disease using a Wood light, the nurse documents the presence of a fungus when the fluorescence is

a. blue.
b. red.
c. yellow.
d. purple.

Answer 23

a. blue.

Question 24

The nurse assesses an older adult bedridden client in her home. While assessing the client’s buttocks, the nurse observes that a small area of the skin is broken and resembles an erosion. The nurse should document the client’s pressure ulcer as

a. stage I.
b. stage II.
c. stage III.
d. stage IV.

Answer 24

b. stage II.

Question 25

To assess an adult client’s skin turgor, the nurse should

a. press down on the skin of the feet.
b. use the dorsal surfaces of the hands on the client’s arms.
c. use the fingerpads to palpate the skin at the sternum.
d. use two fingers to pinch the skin under the clavicle.

Answer 25

d. use two fingers to pinch the skin under the clavicle.

Question 26

While assessing the nails of an adult client, the nurse observes Beau’s lines. The nurse should ask the client if he has had

a. chemotherapy.
b. radiation.
c. a recent illness.
d. steroid therapy.

Answer 26

c. a recent illness.

Question 27

While assessing the nails of an older adult, the nurse observes early clubbing. The nurse should further evaluate the client for signs and symptoms of

a. hypoxia.
b. trauma.
c. anemia.
d. infection.

Answer 27

a. hypoxia.

Question 28

While assessing an adult client, the nurse observes freckles on the client’s face. The nurse should document the presence of

a. macules.
b. papules.
c. plaques.
d. bulla.

Answer 28

a. macules.

Question 29

While assessing an adult client, the nurse observes an elevated, palpable, solid mass with a circumscribed border that measures 1 cm. The nurse documents this as a

a. plaque.
b. macule.
c. papule.
d. patch.

Answer 29

a. plaque.

Question 30

The nurse is preparing to examine the skin of an adult client with a diagnosis of herpes simplex. The nurse plans to measure the client’s symptomatic lesions and measure the size of the client’s

a. nodules.
b. bullae.
c. vesicles.
d. wheals.

Answer 30

c. vesicles.

Question 31

An adult male client visits the clinic and tells the nurse that he believes he has athlete’s foot. The nurse observes that the client has linear cracks in the skin on both feet. The nurse should document the presence of

a. ulcers.
b. erosion.
c. scales.
d. fissures.

Answer 31

d. fissures.

Question 32

An African-American female client visits the clinic. She tells the nurse that she had her ears pierced several weeks ago, and an elevated, irregular, reddened mass has now developed at the earlobe. The nurse should document a

a. cyst.
b. lichenification.
c. bulla.
d. keloid.

Answer 32

d. keloid.

Question 33

A client who is an active outdoor swimmer recently received a diagnosis of discoid systemic lupus erythematosus. The client visits the clinic for a routine examination and tells the nurse that she continues to swim in the sunlight three times per week. She has accepted her patchy hair loss and wears a wig on occasion. A priority nursing diagnosis for the client is

a. ineffective individual coping related to changes in appearance.
b. anxiety related to loss of outdoor activities and altered skin appearance.
c. dry flaking skin and dull dry hair as a result of disease.
d. risk for ineffective health maintenance related to deficient knowledge of effects of sunlight on skin lesions.

Answer 33

d. risk for ineffective health maintenance related to deficient knowledge of effects of sunlight on skin lesions.

Question 34

Hardening of the skin, usually caused by
edema

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 34

i. Induration

Question 35

Solid, elevated, circumscribed superficial lesion; more than 1 cm in diameter

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 35

c. Papule

Question 36

Elevated, solid, transient lesion; often irregularly shaped; an edematous response

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 36

d. Wheal

Question 37

Thickening of the skin characterized by accentuated skin markings

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 37

a. Lichenification

Question 38

An elevated, circumscribed, fluid-filled lesion; greater than 1 cm in diameter

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 38

j. Bulla

Question 39

Describes a lesion that forms a ring around a
clear center of normal skin

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 39

h. Annular

Question 40

Tiny, flat, purple, or red spots on the surface of the skin resulting from minute hemorrhage

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 40

g. Petechiae

Question 41

Hypertrophic scar tissue; prevalent in nonwhite races

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 41

e. Keloid

Question 42

Congenital pigmented area on the skin, for example, mole, birthmark

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla

Answer 42

f. Nevus

Question 43

a. Lichenification
b. Urticaria
c. Papule
d. Wheal
e. Keloid
f. Nevus
g. Petechiae
h. Annular
i. Induration
j. Bulla