Question 1

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:

Accepted Answer

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. B

Question 2

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.)

Accepted Answer

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 A, D, E

Question 3

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:

Accepted Answer

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. D

Question 4

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:

Accepted Answer

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

Question 5

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:

Accepted Answer

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 6

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

Accepted Answer

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 7

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?

Accepted Answer

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 8

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:

Accepted Answer

A)  Venous pooling.
B)  Peripheral vasodilation.
C)  Peripheral vasoconstriction.
D)  Decreased arterial perfusion.

Question 9

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:

Accepted Answer

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 10

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:

Accepted Answer

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 11

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:

Accepted Answer

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 12

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:

Accepted Answer

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

Question 13

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:

Accepted Answer

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

Question 14

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:

Accepted Answer

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

Question 15

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:

Accepted Answer

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 16

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?

Accepted Answer

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

Question 17

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:

Accepted Answer

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

Question 18

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

Accepted Answer

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 19

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?

Accepted Answer

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

Question 20

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.)

Accepted Answer

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.

Exam 13: Skin, Hair, and Nails