CH13 Skin, Hair, Nails EAQ

The patient had a red macular rash of the axillae and regional lymphadenopathy because of a tick bite, but the rash disappeared without treatment. Which additional questions would the nurse ask the patient? Select all that apply.

"Do you have fatigue?" "Do you have fever and chills?" "Have you experienced joint or muscle aches?"

Which statement would the nurse expect to hear from a patient who has folliculitis barbae?

"I like shaving closely with an electric razor." Folliculitis barbae, also called razor bumps, occurs after shaving when growing-out hairs curl in on themselves and pierce the skin, making a foreign-body inflammatory reaction.

Which statement made by the parent indicates effective learning about ways to prevent diaper rash?

"I should change my baby's diapers frequently." Changing the diapers frequently prevents excessive exposure of the newborn's skin to moisture and prevents diaper rash.

Which statement by the nurse indicates a correct understanding about skin turgor?

"Skin turgor is affected by extreme weight loss."

Which condition would cause a light-skinned patient's skin tone to be whitish-pink in color?

Albinism

When would the nurse begin to assess a newborn for physiologic jaundice?

Around the fourth day of life Physiologic jaundice is a yellowing of the skin, sclera, and mucous membranes that develops after the 3rd or 4th day of life because of the increased numbers of red blood cells that hemolyze after birth.

Which type of primary lesion is superficial in the epidermis, is more than 1 centimeter in diameter, and ruptures easily?

Bulla A bulla is a type of primary lesion that appears superficially in the epidermal layer of the skin. It is unilocular, or single-chambered, is greater than 1 centimeter (cm) in diameter, and ruptures easily because it is thin-walled. A cyst is an encapsulated fluid-filled cavity in the dermis or subcutaneous layer. A papule, a solid, elevated, circumscribed primary lesion less than 1 cm in diameter, appears because of superficial thickening of the epidermal layer of the skin. A macule is a flat, circumscribed primary lesion of less than 1 cm in diameter.

In which areas would the nurse assess for petechiae in a dark-skinned patient who has subacute bacterial endocarditis? Select all that apply.

Buttocks Abdomen Forearm

Which finding would the nurse expect to observe when assessing dark-skinned patients?

Cherry-red nail beds with carbon monoxide poisoning

Which skin finding would the nurse observe in a pregnant patient who has linea nigra?

Dark brown line down the abdominal midline

Which statement made by a co-worker indicates a correct understanding of skin structures and functions?

Epidermis is thin, but tough

Which assessment finding would the nurse observe in a patient with hirsutism?

Excessive hair growth on a female's face and chest This condition is caused by improper functioning of the endocrine glands or a metabolic dysfunction.

A patient has herpes zoster and presents with a group of painful vesicles. Which additional skin finding would the nurse monitor for?

Follows route of cutaneous sensory nerve pathways Herpes zoster (shingles) causes small, grouped vesicles that emerge along the route of cutaneous sensory nerve pathways, then form pustules, then crusts.

The bedridden patient has a pressure injury in which the bones are visible and there is black necrotic tissue around the edges. Which type of pressure injury would the nurse report the patient has?

Full-thickness skin/tissue loss

Which change in skin tone would the nurse observe in a light-skinned patient with anemia?

Generalized pallor Anemia in a light-skinned person can be suspected if there is generalized pallor of the skin caused by a low red blood cell count.

A patient with onychomycosis presents with nail crumbling and loosening of the nail plate. Which additional finding would the nurse monitor for?

Greenish discoloration around the nail plate Onychomycosis is a slow, persistent fungal infection that causes changes in color (green where nail plate separated from bed).

Which laboratory finding would the nurse expect in a patient who has a yellowish discoloration of the skin and sclera?

Increased serum bilirubin level The patient has jaundice, a disorder characterized by impaired liver functioning, causing the serum bilirubin levels to be increased.

Which skin diseases would the nurse be familiar with when assessing dark-skinned patients? Select all that apply.

Keloids Melasma Pseudofolliculitis

Which area would the nurse observe in a patient to determine the presence of cheilosis?

Mouth Cheilosis is a condition in which fissures occur at the corners of the mouth from excess moisture

Which condition would the nurse provide information about to a patient wanting a tattoo?

Non-TB mycobacterial infections Although professional tattooing now uses aseptic conditions, non-TB mycobacterial infections still occur.

Which distinctive assessment sign would the nurse expect to observe in a patient with thrombocytopenia?

Petechiae Petechiae are a distinctive sign of thrombocytopenia, a disease that causes bleeding and leads to microembolism formation. This type of disease is often associated with petechiae in the mucous membranes and skin. Discrete round, dark red, purple, or brown tiny punctate hemorrhages of 1 to 3 millimeters caused by bleeding from superficial capillaries are called petechiae.

The nurse imprints the thumb against the patient's tibia for 3 to 4 seconds and finds that the dent remains for a short time after removing the thumb. How would the nurse chart this finding?

Pitting edema present in lower leg

Which nail condition would a nurse observe in a patient who has paronychia?

Red, tender, and swollen nail folds It is caused either by a bacterial or fungal infection.

Which are functions of the skin? Select all that apply.

Regulates body temperature Prevents invasion of microorganisms Assists in the production of vitamin D

Which skin structure is altered when a patient reports dryness of the scalp, forehead, face, and chin?

Sebaceous glands Sebaceous glands keep the scalp, forehead, face, and chin lubricated. Sebum secreted from the sebaceous gland oils and lubricates the skin and hair and forms an emulsion with water that retards water loss from the skin.

A patient with psoriasis presents with painful patches on the elbows and knees. Which additional skin finding would the nurse monitor for?

Silver micalike scales Psoriasis is an autoimmune disease characterized by the presence of dry, silver micalike scales on the elbows and knees.

Which patient assessment would the nurse report as a normal skin finding?

Smooth, firm skin

Which information would the nurse include in a teaching session about nail physiology?

The pink color is because of vascular epithelial cells The nurse would include the following information: nails take their pink color from the underlying nail bed of the vascular epithelial cells. The lunula (rather than the matrix) is the white, opaque crescent area at the proximal end of the nail. The nails are hard plates of keratin, not collagen. Fine longitudinal ridges on the nail bed become prominent with age.

The child with impetigo presents with vesicles that have an erythematous base. Which additional assessment finding would the nurse monitor for?

Thick, honey-colored crusts Impetigo is a bacterial infection that is associated with honey-colored crusts. The lesions are moist in impetigo, not dry and flaky; dry, flaky skin can occur in hypothyroidism or xerosis. If the child has reddish-purple blotchy rashes on the skin, then the nurse would expect that the child has measles (rubeola), not impetigo. Impetigo produces pustules and vesicles, not numerous cysts.

Which microorganism causes athlete's foot?

Tinea Pedis Athlete's foot is a fungal infection that is caused by tinea pedis, or ringworm of the foot, and is characterized by the presence of small vesicles and fissures between the toes and on the sides of the feet.

Which abnormal hair condition would cause the nurse to ask about cancer and chemotherapy treatments?

Toxic alopecia The loss of hair that results from cancer and chemotherapy is known as toxic alopecia.

Which term would the nurse use to describe the white cheesy substance on the neonate's body?

Vernix caseosa thick, cheesy substance made of sebum and epithelial cells.

A patient is devoid of melanin pigment in patchy areas of the skin on the face, neck, hands, feet, and body folds. Which term would the nurse use to describe this condition?

Vitiligo

Which skin color would the nurse expect to observe in a child whose parents have been feeding the child vitamin A supplements regularly?

Yellowish-Orange The child would have yellowish-orange skin color from the excess vitamin A. This excess vitamin A is causing carotenemia

A patient with possible malignant melanoma reports that a mole has recently changed color. Which additional mole change would the nurse monitor for?

light bleeding

In which sequence would the child's rash with suspected chickenpox begin?

starts on the trunk and spreads Chickenpox is characterized by the presence of small, tight vesicles that first appear on the trunk and then spread to the face, arms, and legs. Chickenpox does not occur or spread to the soles or palms.