Health Assessment: Assessing Skin, Hair, and Nails
When assessing a client's terminal hair distribution, the nurse inspects all the following areas except: a) Limbs b) Vertex c) Palmar surfaces d) Eyebrows
Correct response: Palmar surfaces Explanation: The palms are one of the few areas not covered with hair, while the limbs, vertex, and eyebrows all have terminal hair present.
What is the most important focus area for the integumentary system? a) UV radiation exposure b) Moles with defined borders smaller than 6 mm c) Washing the face and hands d) Chemical exposure
Correct response: UV radiation exposure Explanation: Excessive UV radiation is the most important focus area for the integumentary system, because exposure to it has been shown to cause skin cancers, particularly melanoma. Chemical exposure, moles with defined borders smaller than 6 mm, and hygiene of the face and hands are not the most important focus areas for the integumentary system.
A patient admitted with dehydration would typically have a decrease in skin turgor. a) False b) True
TRUE Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 253.
The terms "generalized," "exposed surfaces," "upper arm," and "skin folds" are used to describe which major characteristic of skin lesions? a) Distribution b) Colour c) Arrangement d) Type
Correct response: Distribution Explanation: The given terms denote anatomic location, or distribution, of skin lesions over the body.
A nurse is teaching a client how to assess her own skin for possible signs of malignant melanoma. Which of the following should the nurse point out as danger signs associated with skin lesions indicating this disease? Select all that apply. a) Asymmetrical b) Flat c) Change in size d) Bleeding of a mole e) Itching f) Regular borders
Correct response: • Asymmetrical • Change in size • Itching • Bleeding of a mole Explanation: Malignant melanoma is usually evaluated according to the mnemonic ABCDE: A for asymmetrical; B for borders that are irregular (uneven or notched); C for color variations; D for diameter exceeding 1/8 to 1/4 of an inch; and E for elevated, not flat. Danger signs of malignant melanoma include any of these factors. However, smaller areas may indicate early-stage melanomas. Other warning signs include itching, tenderness, or pain, and a change in size or bleeding of a mole. New pigmentations are also warning signs.
A nurse cares for a client with a stage II pressure ulcer on the right hip. The nurse anticipates finding what type of appearance to the skin over this area? a) Broken with the presence of a blister b) Exposure of subcutaneous tissue and muscle c) Ulceration resembling a crater d) Unbroken but red in color
Correct response: Broken with the presence of a blister Explanation: A stage II pressure ulcer results in a superficial skin loss of the epidermis alone or the dermis also. A stage I pressure ulcer is red in color but without skin breakdown. Stage III pressure ulcers involve the epidermis, dermis, and subcutaneous tissue. In stage IV, the muscle, bone, and other supportive tissue may be involved.
A nurse observes the presence of hirsutism on a female client. The nurse should perform further assessment on this client for findings associated with which disease process? a) Basal cell carcinoma b) Iron deficiency anemia c) Cushing's disease d) Lupus erythematosus
Correct response: Cushing's disease Explanation: Hirsutism, or facial hair on females, is a characteristic of Cushing's disease and results from an imbalance of adrenal hormones. Iron deficiency anemia is associated with spoon-shaped nails but not with excessive hair. Carcinoma of the skin causes lesions but not facial hair. Lupus erythematosus causes patchy hair loss but does not cause excessive facial hair.
What clinical manifestation of the nails should the nurse anticipate assessing in a client with iron deficiency anemia? a) Beau's lines b) Paronychia c) Spooning d) Clubbing
Correct response: Spooning Explanation: Spoon nails are indicative of iron deficiency anemia. Clubbing may not be present because it is evident in people who have oxygen deficiency. Beau's lines occur after acute illness and eventually grow out. Paronychia is an infection of the nail bed and is not a characteristic feature of iron deficiency anemia.
Upon assessing the skin, the nurse finds pustular lesions on on the face. The nurse identifies that these could be what? a) Herpes simplex b) Varicella c) Acne d) Psoriasis
Correct response: Acne Explanation: Pustular lesions include acne, furuncles and carbuncles. Varicella and herpes simplex are vesicular lesions and psoriasis are plaque lesions
Mrs. Anderson presents with an itchy raised rash that appears and disappears in various locations. Each lesion lasts for many minutes. Which most likely accounts for this rash? a) Urticaria or hives b) Insect bites c) Purpura d) Psoriasis
Correct response: Urticaria or hives Explanation: This is a typical case of urticaria. The most unusual aspect of this condition is that the lesions "move" from place to place. This would be distinctly unusual for the other causes listed. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 265.
Choice Multiple question - Select all answer choices that apply. The nurse is providing discharge teaching to a client who underwent a hip fracture repair. The nurse should instruct the client to report which findings that indicate surgical site infection? (Select all that apply.) a) Tenderness at incision site b) Surgical site warm to touch c) Redness over hip area d) Diffuse hives over body e) Pain at incision site
Correct answer: • Tenderness at incision site • Redness over hip area • Surgical site warm to touch • Pain at incision site Explanation: Signs of surgical site infection include: pain or tenderness, localized swelling, redness, or heat. Hives are not indicative of surgical site infection; localized swelling is more likely to occur with infection. (less) Reference: Weber, J., and Kelley, J. Health Assessment in Nursing, 5th ed., Philadelphia: Wolters Kluwer Health, 2014, Chapter 14: Assessing Skin, Hair, and Nails, pp. 239-272.
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on a ventilator for 3 weeks. The nurse is completing an initial assessment and evaluating the client's skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter with damage to the subcutaneous tissue. The underlying muscle is not affected. What is the stage of this pressure ulcer? a) 4 b) 3 c) 1 d) 2
Correct answer: 3 Explanation: A stage III ulcer is a full-thickness skin loss with damage to or necrosis of subcutaneous tissue that may extend to, but not through, the underlying muscle. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 264.
Which layer of the skin contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands? a) Subcutaneous layer b) Epidermis c) Dermis d) Connective layer
Correct answer: Dermis. Explanation: The second layer, the dermis, functions as support for the epidermis. The dermis contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands, which support the nutritional needs of the epidermis and provide support for its protective function. the top layer of the skin is the dermis layer outermost skin layer, and serves as the body's first line of defense against pathogens, chemical irritants, and moisture loss. The subcutaneous layer provides insulation, storage of caloric reserves, and cushioning against external forces. Composed mainly of fat and loose connective tissue, it also contributes to the skin's mobility. The connective layer is a distracter to the question. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 239.
A nurse is teaching a group of 5th grade children about characteristics of the skin. Which of the following should she mention? Select all that apply. a) Aids in maintaining body temperature b) Involved in digestion of food c) Circulates blood throughout the body d) Protects against damage to the body from sunlight e) Helps make vitamin D in the body f) Largest organ of the body
Correct response: • Largest organ of the body • Protects against damage to the body from sunlight • Helps make vitamin D in the body • Aids in maintaining body temperature Explanation: The skin is the largest organ of the body. The skin is a physical barrier that protects the underlying tissues and organs from microorganisms, physical trauma, ultraviolet radiation, and dehydration. It plays a vital role in temperature maintenance, fluid and electrolyte balance, absorption, excretion, sensation, immunity, and vitamin D synthesis. The heart, not the skin, circulates blood throughout the body. The digestive system, not the skin, is involved in digestion of food
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It has been there for about 1 year and is getting larger. He says his wife has been able to squeeze out a cheesy textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely? a) An enlarged lymph node b) An actinic keratosis c) A malignant lesion d) A sebaceous cyst
Correct response: A sebaceous cyst Explanation: This is a classic description of an epidermal inclusion cyst resulting from a blocked sebaceous gland. The fact that any lesion is enlarging is worrisome, but the other descriptors are so distinctive that cancer is highly unlikely. This would be an unusual location for a lymph node and these do not usually drain to the skin. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 266.
A client asks a nurse to look at a raised lesion on the skin that has been present for about 5 years. Which is an "ABCD" characteristic of malignant melanoma? a) Asymmetrical shape b) Borders well demarcated c) Color is uniform d) Diameter less than 6mm
Correct response: Asymmetrical shape Explanation: Malignant melanomas are evaluated according to the mnemonic ABCDE: A for asymmetrical, B for irregular borders, C for color variations, D for diameter exceeding 1/8 to1/4 inch (3-4mm), and E for elevated. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 268.
The nurse should use which assessment tool to assess the client's risk for skin breakdown? a) Hendrich II b) VTE prophylaxis algorithm c) Braden Scale d) Morse Scale
Correct response: Braden Scale Explanation: The Braden Scale or Norton Scale, or another skin assessment tool should be used to assess for skin breakdown risk factors according to hospital standard protocol. The Hendrick II and Morse scale assess fall risk. Upon admission, clients are evaluated for venous thromboembolism (VTE) risk; but a separate skin assessment tool is used as well.
The nurse enters a client's hospital room and the client asks the nurse to raise him up in the bed. What is the nurse's best action? a) Place the client in trendelenburg so the client can slide up in bed. b) Push the client toward the head of the bed to prevent back injury. c) Call for help and use the draw sheet to move the client. d) Lower the head of bed and pull the client up with both arms.
Correct response: Call for help and use the draw sheet to move the client. Explanation: Friction and shear forces are risk factors for developing pressure ulcers. The nurse should ask for help and use a draw sheet to avoid shearing forces. Pulling the client up in bed and allowing the client to slide in bed create friction and shear forces. Pushing the client also creates shearing forces.
A nurse is instructing a client on how to assess himself for herpes simplex lesions by their configuration. Which configuration should the nurse tell the client to look for? a) Annular b) Clustered c) Discrete d) Linear
Correct response: Clustered Explanation: In a clustered configuration, lesions are grouped together; an example is herpes simplex. In a linear configuration, the lesion is a straight line, such as in a scratch or streak due to dermatographism. In an annular configuration, the lesion is circular; an example is tinea corporis. In a discrete configuration, the lesions are individual and distinct; an example is multiple nevi.
A nurse is working with a 13-year-old boy who complains that he has begun to sweat a lot more than he used to. He asks the nurse where sweat comes from. The nurse knows that sweat glands are located in which layer of skin? a) Dermis b) Stratum lucidum c) Stratum corneum d) Epidermis
Correct response: Dermis Explanation: The dermis is a well-vascularized, connective tissue layer containing collagen and elastic fibers, nerve endings, and lymph vessels. It is also the origin of sebaceous glands, sweat glands, and hair follicles. The epidermis, the outer layer of skin, is composed of four distinct layers: the stratum corneum, stratum lucidum, stratum granulosum, and stratum germinativum. The outermost layer consists of dead, keratinized cells that render the skin waterproof.
Which layer of the skin contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands? a) Connective layer b) Epidermis c) Dermis d) Subcutaneous layer
Correct response: Dermis Explanation: The second layer, the dermis, functions as support for the epidermis. The dermis contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands, which support the nutritional needs of the epidermis and provide support for its protective function. the top layer of the skin is the dermis layer outermost skin layer, and serves as the body's first line of defense against pathogens, chemical irritants, and moisture loss. The subcutaneous layer provides insulation, storage of caloric reserves, and cushioning against external forces. Composed mainly of fat and loose connective tissue, it also contributes to the skin's mobility. The connective layer is a distracter to the question.
A patient recovering from a burn injury is told by the health care provider that hair will no longer grow on the body part that was burned. The nurse realizes that this patient's burn extended into which skin layer? a) Dermis b) Distal phalanx c) Epidermis d) Subcutaneous tissue
Correct response: Dermis Explanation: The skin has three layers. The epidermis is the outermost layer and is comprised of dead keratinized cells and an inner layer that forms melanin and keratin. The dermis contains connective tissue and hair follicles. If the hair follicles are damaged by a burn, hair will not regrow. The subcutaneous tissue layer of the skin continues fatty tissue. The distal phalanx is a bone in the finger.
The nurse is beginning the examination of the skin of a 25-year-old teacher. She previously visited the office for evaluation of fatigue, weight gain, and hair loss. The previous clinician had a strong suspicion that the client has hypothyroidism. What is the expected moisture and texture of the skin of a client with hypothyroidism? a) Dry and smooth b) Moist and rough c) Dry and rough d) Moist and smooth
Correct response: Dry and rough Explanation: A client with hypothyroidism is expected to have dry and rough skin. This is a good example of how the skin can give clues to systemic diseases.
The nurse is preparing to perform a physical examination of a client who is an Orthodox Jew. Which of the following accommodations should the nurse be prepared to make for this client, based on his religious beliefs? a) Avoid asking any questions regarding the client's lifestyle b) Allow the client to pray before the examination c) Let the client remained fully dressed for the examination d) Have a nurse who is the same sex as the client examine him
Correct response: Have a nurse who is the same sex as the client examine him. Explanation: Clients from conservative religious groups (e.g., Orthodox Jews or Muslims) may require that the nurse be the same sex as the client. The client must still undress and put on an examination gown. It is not likely that the client will want to pray before the examination, and it is not necessary to avoid asking questions regarding his lifestyle. (less) Reference: Weber, J. R., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 248.
A client presents to the health care clinic with reports of new onset of generalized hair loss for the past 2 months. The client denies the use of any new shampoos or other hair care products and claims not to be taking any new medications. The nurse should ask the client questions related to the onset of which disease process? a) Liver disease b) Crohn's disease c) Diabetes mellitus d) Hypothyroidism
Correct response: Hypothyroidism Explanation: Generalized hair loss can be a finding in hypothyroidism. None of the other conditions listed is associated with generalized hair loss. Diabetes is a problem with glucose regulation. Crohn's disease is an inflammatory process in the large intestines. Liver disease results in many problems with fluid regulation, metabolism of drugs, and storage of glucose.
The RN should intervene and further educate the nursing assistant when observing which action? a) Assisting feeding a client ground chicken with dentures in place b) Propping a client on the side using pillows under the hip, knees, and shoulder c) Independently pulling an immobile client up in bed d) Ambulating a client using a walker in the hallway
Correct response: Independently pulling an immobile client up in bed Explanation: Friction/shear forces are risks to breaks in skin integrity that can occur when pulling a client up in bed alone. The nursing assistant needs to ask for assistance when repositioning an immobile client. Assisting with feeding or ambulating, and using pillows under bony prominences to prevent pressure ulcers are all appropriate nursing assistant tasks.
A nurse receives a report from the shift nurse that a client has new onset of peripheral cyanosis. The nurse recognizes that which of the following is the most likely underlying cause? a) Local vasoconstriction b) Skin cancer c) Diabetes mellitus d) Cardiopulmonary problem
Correct response: Local vasoconstriction Explanation: Peripheral cyanosis is usually a local problem with manifestations of cyanosis, a blue-tinged color to the skin, caused by problems resulting in vasoconstriction. Central cyanosis results from a cardiopulmonary problem. Diabetes mellitus and skin cancer are not associated with peripheral cyanosis. (less) Reference: Weber, J. R., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 249.
A nurse inspects a client's skin and notices several flat, brown color change areas on the forearms. What is the proper term for documentation of this finding by the nurse? a) Vesicle b) Papule c) Nodule d) Macule
Correct response: Macule Explanation: A macule is a flat, non-palpable skin color change that may manifest as brown, white, tan, red, or purple. Freckles and port wine birthmarks are examples of a macule. A circumscribed elevated mass containing fluid is called a vesicle or bulla, depending on it size. A nodule is a solid, palpable mass. A papule is an elevated, palpable, solid mass that is smaller in diameter than a nodule.
Which technique should the nurse use to properly assess a client's skin turgor? a) Pinch the skin on the sternum and observe its return to the original shape. b) Pinch the skin on the abdomen and observe for color changes c) Palpate the skin around the umbilicus to assess for intactness d) Palpate the skin on the sternum to determine its flexibility
Correct response: Pinch the skin on the sternum and observe its return to the original shape. Explanation: The nurse should assess the skin turgor by pinching the skin on the sternum and determining how quickly the skin returns back to its original shape. Skin turgor is assessed on the sternum and not on the abdomen. Palpation is not a technique used to assess for skin turgor. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 253.
A client presents to the clinic and reports numerous skin tags in the left axillary area. The client is worried about skin cancer. What can the nurse tell the client about skin tags to alleviate fear of cancer? a) Skin tags can turn into skin cancer if they are not removed b) Skin tags are an early precursor to more serious skin cancer conditions c) Skin tags are common benign skin lesions d) Skin tags need to be removed as soon as possible or they will keep growing
Correct response: Skin tags are common benign skin lesions Explanation: Common benign skin lesions include freckles, birth marks, skin tags, moles, and cherry angiomas. Skin tags will not turn into skin cancer and are not early precursors to other more serious skin cancer conditions. Skin tags do not keep growing if not removed. Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 258
Which of the following is an important function of the skin? a) Maintenance of acid-base balance b) Synthesis of vitamin D c) Protection against melanin deposits d) Production of carotene
Correct response: Synthesis of vitamin D Explanation: A vital role of the skin is the synthesis of vitamin D. Carotene exists in sebaceous fat, and melanin deposits are a normal component of skin. Skin does not significantly contribute to pH maintenance. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 239.
During the integument health history, the nurse asks the patient about prescription medications, immunizations, and diagnosed illnesses. What will this information provide to the nurse? a) Patient's risk for skin cancer b) Patient's risk for pressure ulcer formation c) Systemic diseases that have skin manifestations d) History of physical abuse
Correct response: Systemic diseases that have skin manifestations Explanation: One purpose of the integumentary health history is to identify systemic diseases that have skin manifestations. Questions to determine systemic diseases that the patient may have include asking about prescribed medications, immunizations, and diagnosed illnesses. Asking about medications, immunizations, and diagnosed illnesses will not provide information about the patient's history of physical abuse, risk for skin cancer, or risk for pressure ulcer formation.
An adult client is having his skin assessed. The client tells the nurse he has been a heavy smoker for the last 40 years. The client has clubbing of the fingernails. What does this finding tell the nurse? a) The client has melanoma b) The client has chronic hypoxia c) The client has asthma d) The client has COPD
Correct response: The client has chronic hypoxia Explanation: Clubbing of the nails indicates chronic hypoxia. Clubbing is identified when the angle of the nail to the finger is more than 160 degrees. Melanoma does not present with the symptom of clubbing. The scenario described does not give enough information to indicate that the client has COPD or asthma. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 256.
Why is it important for the nurse to ask the client what they think caused a skin condition? a) Doing so allows the client to decide what treatment is the best course of action b) The client's perception affects the approach and effectiveness in treating the skin condition c) Doing so encourages the client to use home remedies to reduce medical cost d) The nurse can alleviate the client's fears about what caused the skin condition
Correct response: The client's perception affects the approach and effectiveness in treating the skin condition Explanation: The client's perception of the cause, reason for onset, type of treatment needed, and fears related to a skin problem or any illness will affect the approach and effectiveness in treating the client's skin condition. The nurse would not ask the client what they thought caused the skin condition to alleviate the client's fear about what caused the skin condition. The nurse would not ask to include the client in deciding what treatment is best or to encourage the client to use home remedies. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 241.
Which of the following statements most accurately conveys an aspect of the anatomy and physiology of the skin? a) The colour of normal skin is primarily a consequence of the character and quantity of hemoglobin. b) The skin plays a central role in the synthesis of vitamin A. c) Migration from the inner layer to the top of the epidermis takes approximately 1 year. d) The skin is composed of an epidermis, dermis, and subcutaneous tissue.
Correct response: The skin is composed of an epidermis, dermis, and subcutaneous tissue. Explanation: The skin is commonly divided into the three layers of the epidermis, dermis, and subcutaneous tissue. Migration to the epidermis takes approximately 1 month, and vitamin D synthesis is a function of the skin. Colour is primarily a result of pigmentation. Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 239.
Which area of the body should a nurse inspect for possible loss of skin integrity when performing a skin examination on a female who is obese? a) Under the breast b) Upper abdomen c) On the neck d) Anterior chest
Correct response: Under the breast Explanation: The nurse should inspect the area under the breast for skin integrity in obese clients. The area between the skin folds is more prone to loss of skin integrity; therefore, the presence of skin breakdown should be inspected on the skin on the limbs, under the breasts, and in the groin area. Perspiration and friction often cause skin problems in these areas in obese clients. The areas over the chest and abdomen and on the neck are not prone to skin breakdown.
A nurse cares for a client of Asian decent and notices that the client sweats very little and produces no body odor. What is an appropriate action by the nurse in regards to this finding? a) Document the findings in the client's record as normal b) Ask the client about overuse of antiperspirant products c) Assess the client for changes in sensation due to vascular problems d) Monitor the client for additional findings of cystic fibrosis
Explanation: Asians and Native Americans have fewer sweat glands than Caucasians and therefore produce less sweat and less body odor. Changes in sensation are not caused by alterations in sweat glands but are a circulation issue. Cystic fibrosis is an alteration in the exocrine glands that causes the production of thick mucous, especially in the lungs. Overuse of antiperspirants would be needed for excessive sweating, not decrease in sweating. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 242.