Chapter 9: Skin, Hair, & Nails

Question 1

1. The skin repairs surface wounds by
   a. exaggerating cell replacement.
   b. excreting lactic acid.
   c. producing vitamins.
   d. providing a mechanical barrier.

Answer 1

a. exaggerating cell replacement.

Question 2

2. The adipose tissue in the hypodermis serves to
   a. provide sensory input.
   b. generate heat and insulate.
   c. create tensile strength.
   d. secrete collagen.

Answer 2

b. generate heat and insulate.

Question 3

3. The secretory activity of the sebaceous glands is stimulated by
   a. body heat.
   b. ambient temperature.
   c. sex hormones.
   d. dietary protein

Answer 3

c. sex hormones.

Question 4

4. Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which structure is the site of new nail growth?
   a. Cuticle
   b. Perionychium
   c. Matrix
   d. Nail bed

Answer 4

c. Matrix

Question 5

5. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the healthcare provider, you teach her that newborns are more vulnerable to hypothermia because of
   a. the presence of coarse terminal hair.
   b. desquamation of the stratum corneum.
   c. their covering of vernix caseosa.
   d. a poorly developed subcutaneous fat layer

Answer 5

d. a poorly developed subcutaneous fat layer

Question 6

6. Mrs. Mulligan brings her 16-year-old son into the office for a sports physical examination. As the healthcare provider, you explain that normal hormone-related changes of adolescence include
   a. increased oil production.
   b. slowed hair growth.
   c. depleted apocrine glands.
   d. decreased sebaceous gland activity.

Answer 6

a. increased oil production.

Question 7

. Expected hair distribution changes in older adults include
a. increased terminal hair follicles on the scalp.
b. more prominent axillary and pubic hair production.
c. increased terminal hair follicles to the tragus of men’s ears.
d. more prominent peripheral extremity hair production.

Answer 7

c. increased terminal hair follicles to the tragus of men’s ears.

Question 8

8. Brittle nails are typical findings in
   a. adolescents.
   b. infants.
   c. pregnant women.
   d. older adults.

Answer 8

d. older adults.

Question 9

9. Mrs. Franklin is a 68-year-old patient who presents to the office with a complaint that her nails do not seem to be growing. As the healthcare provider, you explain to her that the nails of older adults grow slowly because of
   a. decreased circulation
   b. dietary deficiencies.
   c. fungal infections.
   d. low hormone levels.

Answer 9

a. decreased circulation

Question 10

10. As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include
    a. an olive complexion.
    b. repeated trauma or irritation to skin.
    c. history of allergic reactions to sunscreen.
    d. dark eyes and hair.

Answer 10

b. repeated trauma or irritation to skin.

Question 11

11. The type and brand of grooming products used are important to the health history of
    a. adolescents.
    b. everyone.
    c. older adults.
    d. persons with rashes.

Answer 11

b. everyone.

Question 12

12. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted
    a. using an episcope.
    b. under fluorescent lighting.
    c. with illumination provided by daylight.
    d. using a Wood’s light.

Answer 12

c. with illumination provided by daylight.

Question 13

13. Tangential lighting is best used for inspecting skin
    a. color.
    b. contour.
    c. exudates
    d. symmetry.

Answer 13

b. contour.

Question 14

14. Unusual white areas on the skin may be caused by
    a. adrenal disease.
    b. polycythemia.
    c. vitiligo.
    d. Down syndrome

Answer 14

c. vitiligo.

Question 15

15. Which cultural group has the lowest incidence of nevi?
    a. Native Americans
    b. African Americans
    c. Mexican Americans
    d. Asians

Answer 15

b. African Americans

Question 16

16. You are inspecting the lower extremities of a patient and have noted pale, shiny skin of the lower extremities. This may reflect
    a. systemic disease.
    b. a history of vigorous exercise.
    c. peptic ulcer disease
    d. mental retardation.

Answer 16

a. systemic disease.

Question 17

17. A 29-year-old white woman appears jaundiced. Liver disease as a cause has been excluded. What history questions should the nurse ask?
    a. Whether she had unprotected sex
    b. Whether she has a history of diabetes mellitus
    c. Whether she had unusual bleeding problems
    d. Whether she eats a lot of yellow and orange vegetables

Answer 17

d. Whether she eats a lot of yellow and orange vegetables

Question 18

18. Mrs. Bower is a 39-year-old patient who has come to the office for a routine physical examination. As a healthcare provider, you know that the skin temperature is best assessed with the
    a. dorsal surface of the examiner’s hand.
    b. palmar surface of the examiner’s hand.
    c. ulnar surface of the examiner’s hand.
    d. pads of the examiner’s fingers.

Answer 18

a. dorsal surface of the examiner’s hand.

Question 19

19. You are examining a pregnant patient and have noted a vascular lesion. When you blanch over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a
    a. telangiectasia.
    b. spider angioma.
    c. petechiae.
    d. purpura.

Answer 19

b. spider angioma.

Question 20

20. Small, minute bruises are called
    a. ecchymoses.
    b. petechiae.
    c. spider veins.
    d. telangiectasias.

Answer 20

b. petechiae.

Question 21

21. A flat, nonpalpable lesion is described as a macule if the diameter is a. larger than 1 cm.
    b. smaller than 1 cm.
    c. 3 cm exactly.
    d. too irregular to measure.

Answer 21

b. smaller than 1 cm.

Question 22

22. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4.3-cm, rough, elevated area of psoriasis. This is an example of a
    a. plaque.
    b. patch.
    c. macule.
    d. papule

Answer 22

a. plaque.

Question 23

23. Skin turgor checks are performed to determine the
    a. temperature of the skin.
    b. hydration status.
    c. actual age.
    d. extent of an ecchymosis

Answer 23

b. hydration status.

Question 24

24. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions
    are transilluminated to distinguish
    a. vascular from nonvascular lesions.
    b. furuncles from folliculitis lesions.
    c. fluid-filled lesions from solid cysts or masses.
    d. herpes zoster from varicella.

Answer 24

c. fluid-filled lesions from solid cysts or masses.

Question 25

25. Fluorescing lesions are best distinguished using a(n)
    a. incandescent lamp.
    b. magnifying glass.
    c. transilluminator.
    d. Wood’s lamp.

Answer 25

d. Wood’s lamp.

Question 26

26. Women with terminal hair growth in a male distribution pattern should receive further evaluation for a(n)
    a. circulation condition.
    b. endocrine disorder.
    c. inflammatory state.
    d. nutritional deficit.

Answer 26

b. endocrine disorder.

Question 27

27. Which nail change found on examination would be most alarming?
    a. Dark bands seen on all fingernails of a dark-skinned person
    b. Yellow discoloration of the great toe of an older adult
    c. Single dark band in a white adult
    d. Pits in both index fingernails of an adult

Answer 27

c. Single dark band in a white adult

Question 28

28. Transient mottling of the patient’s skin in a cool room is a common finding in
    a. menopausal women.
    b. newborn infants.
    c. pregnant women.
    d. sedentary adults.

Answer 28

b. newborn infants.

Question 29

29. A single transverse line seen in the palm of a small child may imply
    a. Down syndrome.
    b. Turner syndrome.
    c. systemic sclerosis.
    d. profound dehydration.

Answer 29

a. Down syndrome.

Question 30

30. Cafe au lait patches are numbered with each assessment of infants and young children because
    a. the numbers are expected to increase each year.
    b. coalescent lesions are a more serious finding.
    c. the presence of six or more patches suggests neurofibromatosis.
    d. decreasing numbers are expected with growth

Answer 30

c. the presence of six or more patches suggests neurofibromatosis.

Question 31

31. A Dennie-Morgan fold is probably caused by
    a. birth trauma.
    b. high fever.
    c. excess adipose tissue.
    d. chronic rubbing.

Answer 31

d. chronic rubbing.

Question 32

32. Linea nigra is commonly found on the abdomens of
    a. infants and children.
    b. adolescents.
    c. pregnant patients.
    d. older adults.

Answer 32

c. pregnant patients.

Question 33

33. Cherry angiomas are a common finding in
    a. adults older than 30 years.
    b. newborns.
    c. pregnant women.
    d. sunbathers.

Answer 33

a. adults older than 30 years.

Question 34

34. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish
    a. cutaneous tags from lentigines.
    b. furuncles from folliculitis.
    c. sebaceous hyperplasia from eczema.
    d. seborrheic keratoses from actinic keratoses.

Answer 34

d. seborrheic keratoses from actinic keratoses.

Question 35

35. Age spots are also called
    a. seborrheic keratoses.
    b. solar lentigines.
    c. cutaneous horns.
    d. acrochordon.

Answer 35

b. solar lentigines.

Question 36

36. The most common inflammatory skin condition is
    a. cutis marmorata.
    b. eczematous dermatitis.
    c. intradermal nevus.
    d. pityriasis rosea.

Answer 36

b. eczematous dermatitis.

Question 37

37. Which is a noncandidal fungal infection?
    a. Pityriasis rosea
    b. Psoriasis
    c. Tinea corporis
    d. Rosacea

Answer 37

c. Tinea corporis

Question 38

38. The characteristic that best differentiates psoriasis from other skin abnormalities is the
    a. color of the scales.
    b. formation of tiny papules.
    c. general distribution over the body.
    d. recurrence

Answer 38

a. color of the scales.

Question 39

39. Painful vesicles are associated with
    a. psoriasis.
    b. pityriasis rosea.
    c. paronychia.
    d. herpes zoster.

Answer 39

d. herpes zoster.

Question 40

40. A 17-year-old student complains of a ―rash for 3 days.‖ You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurse’s next action?
    a. Teach infectious control measures.
    b. Inquire about another recent skin lesion.
    c. Inspect the palms and the soles.
    d. Inform the patient that this will resolve within a week.

Answer 40

b. Inquire about another recent skin lesion.

Question 41

41. Which of the following is an ABCDE characteristic of malignant melanoma?
    a. Asymmetric borders
    b. Borders well demarcated
    c. Color of lesion is uniform
    d. Diameter less than 6 mm

Answer 41

a. Asymmetric borders

Question 42

42. The most common cutaneous neoplasm is
    a. basal cell carcinoma.
    b. compound nevus.
    c. seborrheic keratosis.
    d. senile actinic keratosis.

Answer 42

a. basal cell carcinoma.

Question 43

43. Soft, painless, bluish papules in persons who are HIV-positive are most likely
    a. Kaposi sarcoma.
    b. malignant melanoma.
    c. molluscum contagiosum.
    d. pityriasis rosea

Answer 43

a. Kaposi sarcoma.

Question 44

44. A 5-year-old child presents with discrete vesicles on an erythematous base that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse’s next action?
    a. Teach infectious control measures.
    b. Inquire about other patterns of physical abuse.
    c. Inspect the buccal mucosa for Koplik spots.
    d. Inform the parent that this will resolve within a couple of days.

Answer 44

a. Teach infectious control measures.

Question 45

45. During history taking, a mother states that her son awoke in the middle of the night complaining of intense itching to his legs. Today, your inspection reveals a honey-colored exudate from the vesicular rash on his legs. Which condition is consistent with these findings?
    a. Exanthem
    b. Impetigo
    c. Solar keratoses
    d. Trichotillomania

Answer 45

b. Impetigo

Question 46

46. You are conducting a preschool examination on a 5-year-old child. Which injury would most likely raise your suspicion that the child is being abused?
    a. Recent bruising over both knees
    b. A healed laceration under the chin
    c. A bruise on the right shin with associated abrasion of tissue
    d. Bruises in various stages of resolution over body soft tissues

Answer 46

d. Bruises in various stages of resolution over body soft tissues

Question 47

47. Assessment of poor hygiene, healed fractures with deformity, or unexplained trauma in older adults indicates
    a. sexual abuse.
    b. physical neglect.
    c. psychological abuse.
    d. violated rights.

Answer 47

b. physical neglect.

Question 48

48. The nurse assesses the nail base angle using the Schamroth technique. Which nail bed shape indicates a normal expected examination finding?
    a. Flat
    b. Convex
    c. Concave
    d. Bowed

Answer 48

c. Concave

Question 49

1. Which identify the signs and symptoms of basal cell cancer? (Select all that apply.)
   a. Itching
   b. Reddish patch
   c. Starts from a nevi
   d. Various clinical forms—cystic, nodular, pigmented
   e. Macule type

Answer 49

ANS: A, B, D