EAQ - CH. 9 SKIN, HAIR, NAILS

During the health history, the examiner learns that the patient had a red macular rash of the axillae and regional lymphadenopathy due to a tick bite. The examiner also discovers that patient did not undergo any treatment, and the rash disappeared after a month. What additional questions should the examiner ask the patient? Select all that apply "Do you have joint pain?" "Are you uncommonly tired?" "Have you lost your appetite?" "Do you have frequent urination?" "Have you gained excessive weight?"

"Do you have joint pain?" "Are you uncommonly tired?" "Have you lost your appetite?" Indicates that the patients is in the first stage of Lyme disease (LD). Usually the rashes fade away after 4 weeks. However, if left untreated, the patient may have disseminated disease along with anorexia, fever, chills, joint, or muscles aches.

The nurse is evaluating patient understanding of instructions for self-skin examination. Which statement by the patient would indicate a need for further clarification? "It is important to state with my face and scalp and process downward" "I need to see rather than feel for early signs of changes in moles; taking photos for comparison is important" "Assessment of areas where moles are rarely found such as my buttocks, scalps, and breast is also important to do" "I need to especially concentrate on my arms and face since dysplastic nevi are more common in these sun-exposed areas"

"I need to especially concentrate on my arms and face since dysplastic nevi are more common in these sun-exposed areas" -Dysplastic nevi are more common on the shoulders and back. NOT THE ARMS AND FACE

A 32-year-old female presents to the provider complaining of recent hair growth on the face, neck, and lower abdomen. She asks the nurse why this is occurring. Which explanation by the nurse provides the best response? "This is a normal occurrence that is common as women age" "It is caused by low levels of estrogen, which can be treated easily" "It is an autoimmune issues triggered by a genetic-environmental interaction" "It can be caused by high androgen levels, which can occur due to many causes"

"It can be caused by high androgen levels, which can occur due to many causes"

The nursing instructor is teaching a class on the layers of the skin. Which statement, if made by a student, indicates the need for further teaching? "Skin is thicker at the palm" "Epidermis is thin, but tough" "Keratin provides a brown tone to the skin" "The amount of melanin in skin varies in people"

"Keratin provides a brown tone to the skin" The melanocytes intercalated along the basal cell layer produce the pigment melanin, which gives brown tones to the skin. Keratin has no function in skin pigmentation

A nursing instructor is lecturing on nail physiology. Which statement by a nursing student indicates a need for further teaching? "Ridges on the nail plates disappear with age" "The nail matrix is bare and devoid of any cover" "The pink color is due to vascular epithelial cells" "The nail matrix is white, opaque, semilunar area"

"Ridges on the nail plates disappear with age"

An instructor is teaching nursing students about skin turgor. Which statement by the student indicated effective learning? "Turgor increases with age" "A loss of turgor is associated with fluid overload" "Skin turgor can be used to assess hydration status" "Turgor is assessed by palpating over bony prominences"

"Skin turgor can be used to assess hydration status"

During a routine examination of an infant, the parent points out a large, round, light brown patch on the infant's arm. The parent worries this could be a skin disease. What is the appropriate response by the examiner? "This is a Mongolian spot" "This is a cafe au lait spot" "That spot is caused by a bruise" "Your child may have neurofibromatosis"

"That is a cafe au lait spot" The name means "coffee with milk" because of its color. It is a normal finding in infants.

The nurse is reviewing risk factors for melanoma with a patient who presented to the provider's office for an overall skin assessment. Which risk factors would the nurse include in the discussion? Select all that apply -Skin type I or II -First-degree relative with melanoma -History of severe blistering sunburns -History of using indoor tanning devices -Long-term use of antibiotics or steroids -History of travel to developing countries

-Skin type I or II -First-degree relative with melanoma -History of severe blistering sunburns -History of using indoor tanning devices

The nurse completing an assessment on an infant being evaluated for dehydration after repeated bouts of vomiting for the past 24 hours. The nurse evaluates tissue turgor and notes that it takes 4 seconds to return to normal after the pinch. Additionally, the infant is crying, but no tears are notes and the fontanels are sunken. Which degree of dehydration would the nurse document for this infant? 5-8% loss of body weight 9-10% loss of body weight Less than 5% loss of body weight More than 10% loss of body weight

9-10% loss of body weight

The patient presents to the clinic with complaints of redness, swelling, and pain around the right thumb nail. With pressure, purulent discharge is released around the nail. The examiner anticipates the patient will be prescribed antibiotics for which condition? Scabies Beau line Acute paronychia Splinter hemorrhages

Acute paronychia

While assessing a Caucasian patient, the examiner observes that the patient's skin is white in color. Which condition may cause this skin tone? Albinism Hyperemia Polycythemia Addison disease

Albinism

During a skin assessment, the nurse notes that a patient has a mole with irregular edges. This finding reflects which aspect using the ABCDE acronym Color Borders Diameter Asymmetry

Borders

The examiner is assessing a patient in the clinic and notes several lesions. The ones still intact appear to vesicles that are greater than 1 cm in diameter. The patient reports that he had several more in the same area but they ruptured when he touched them lightly. Which term should the examiner use to document this finding? Bullae Wheals Papules Macules

Bullae A bulla is a type of primary lesion that appears superficially in the epidermal layer of the skin. It is a vesicle that is greater than 1 cm in diameter. Because it is thing walled, it ruptures easily.

While assessing a newborn, the examiner finds that the newborn has a large, oval-shaped, light brown patch on the face. Which term does the examiner use to document this finding? Mongolian spot Cafe au lait spot Erythema toxicum Harlequin color change

Cafe au lait spot

While assessing an infant, the examiner finds that the infants has yellowish-orange discoloration of the skin on the palms and the soles. Upon interacting with the child's parents, the examiner learns that infants will only eat carrots, sweet potatoes, and butternut squash. Which condition does the examiner suspect in this child? Carotenemia Acrocyanosis Cutis marmorata Cavernous hemangioma

Cartotenemia

A 50-year-old patient tells the examiner, "I have bright red, raised dots on my torso, which have grown in size and number as I got older." The examiner would provide education to the patient about which skin condition? Anasarca Toxic alopecia Alopecia areata Cherry angiomas

Cherry angiomas

After examining the nails of a patient, the examiner concludes that the patient has chronic iron deficiency anemia. Which finding supports the examiner's conclusion? Elevation of inner edge of the nails Concave shaped, spoon-like nails Tender inflammation of the nail folds Depression across the nail extending to the nail bed

Concave shaped, spoon-like nails

The nurse is completing a skin assessment for a patient being admitted to the long-term care center. During the assessment, the nurse notes several pigmented, raised, warty lesions on the patient's trunk. Which priority action should the nurse take based upon these findings? Ask if the patient has recently changed soaps or lotions Document these normal findings for future comparison Assess medication history for anticoagulant or antiplatelet therapy Contact an experienced practitioner to make an appointment for further evaluation

Contact an experienced practitioner to make an appointment for further evaluation

While caring for a newborn, the examiner notices that the newborn's skin is reddish-blue and mottles, likely due to the cool room temperature. The examiner increases the room temperature and swaddles the newborn in a blanket. After a few hours, the examiner finds that the reddish-blue discoloration has subsided. The examiner understands the patient had which condition? Acrocyanosis Carotenemia Cutis marmorata Congenital heart disease

Cutis marmorata

Which layers of skin includes the melanocytes which synthesize melanin? Dermis Epidermis Hypodermis Connective tissue

Epidermis

A patient reports a tingling sensation on the mouth and painful ulcers on the tongue and oral mucosa. The health care provider instructs the examiner to collect the sore tissue for culture. Which microorganism does the examiner expect to find in the patient's tissue specimens? Tinea corporis Tinea versicolor Varicella zoster virus Herpes simplex virus

Herpes simplex virus

While assessing a 16-year-old female patient, the examiner finds that the patient has excess hair on her face, legs, hands, and chest. Which term does the examiner use to document this finding? Hirsutism Folliculitis Tricholtillomania Traumatic alopecia

Hirsutism

The patient presents to an urgent care clinic complaining of itching and peeling of the feet. Upon assessment, the examiner notes scale-like lesions on the bottom of the feet and between the toes. The examiner scrapes the affected skin, treats the sample with potassium hydroxide, and views it under a microscope. What does the examiner anticipate seeing under the microscope? Hyphae Amoebae Clusters of cocci Rodlike bacteria with flagelae

Hyphae

The nurse is staging a pressure ulcer in the sacral area for an older patient recently admitted from home. Assessment of the wound included visible subcutaneous fat, slough in the center of the wound, and scant purulent exudate and tunneling (4 cm) at the 12 o'clock position. The nurse would classify this as which stage of ulcer? II III IV Unstageable

III

The examiner is assessing a child who has thick honey-colored crusts on the body. The child's mother tells the examiner, "Last week I found similar blisters on a boy's hand with whom my child was playing in the park." The examiner anticipates the child will be diagnoses with which infection? Impetigo Intertrigo Atopic dermatitis Measles (Rubeola)

Impetigo

The nurse is completing a skin assessment on an older adult. Which changes due to aging might the nurse expect to find upon assessment? Select all that apply. Increased subcutaneous tissue Increased epidermal permeability Collagen loss and decreased elasticity Decreased sebaceous and sweat gland activity Appearance of coarse terminal hair in the pubic areas

Increased epidermal permeability Collagen loss and decreased elasticity Decreased sebaceous and sweat gland activity

While caring for a pregnant patient, the examiner finds that the patient has redness in the palms. Which condition may cause this finding? Increased estrogen level Increased serum bilirubin level Increased serum carotene level Increased white blood cell count

Increased estrogen level

While assessing an infant, the examiner finds that the patient has a yellowish discoloration of the skin, sclera, hard palate, and the mucous membranes. What laboratory finding would the examiner expect? Increased red blood cell count Increased serum bilirubin level Decreased serum thyroxine level Decreased white blood cell count

Increased serum bilirubin level

While assessing a patient, the examiner finds the presence of a yellow-orange tinge in the palms and soles, but not in the sclera. Which laboratory finding would the examiner expect? Increased red blood cell count Increased serum bilirubin level Increased serum carotene level Increased serum thyroxine level

Increased serum carotene level

While caring for a 3 yr old child, the examiner finds a raised, bright red area of about 3 cm in diameter on the child's scalp that does not blanch on pressure. The lesion is expected to disappear in 2 to 4 years. Which condition does the examiner suspect? Telangiectasia Nevus flammeus Infantile hemangioma Cavernous hemangioma

Infantile hemangioma

A pregnant patient at 32 weeks gestation complains of generalized itching, which is more severe on the palms of her hands. Based upon this complaint, which other finding should the nurse assess for in this patient? Jaundice Melasma Telangiectasis Molluscum fibrosum gravidarum

Jaundice

The examiner is caring for a patient with acquired immunodeficiency syndrome (AIDS). The examiner notes soft, bluish purple lesions. The patient denies pain in these lesions. Suspicion of which condition should be reported to the provider? Head lice Kaposi sarcome Scalp ringworm Seborrheic dermatitis

Kaposi sarcoma

While caring for a patient with chronic lung inflammation, the examiner finds that the inner edge of patient's nail is elevated, and the distal part of the fingers look round, wider, and shiny. Which term does the examiner use to document this finding? Beau line Onycholysis Late clubbing Chronic paronychia

Late clubbing

While caring for a pregnant patient, the examiner observes that the patient has a dark brown line up and down the midline of the abdomen. Which term should the examiner use to document this finding? Chloasma Linea nigra Spider angioma Striae gravidarum

Linea nigra

The nurse is asked to complete a thorough skin assessment on a toddler with suspected physical abuse. Which physical findings does the nurse know may indicate physical abuse? Select all that apply -Lip lacerations -Patchy bald spots -Bruising over soft tissue -Presence of lesions around the mouth -Erythematous ulcerations on lower extremities

Lip lacerations Patchy bald spots Bruising over soft tissue

While assessing the skin of an adult patient, the examiner finds a birthmark that is 8 mm in diameter on the back with irregular borders. Upon questioning the patient, the examiner learns this birthmark is larger and darker that the patient remembers. These assessment findings prompt the examiner to report which possible condition to the patient's provider for further examination? Lichenification Cherry angiomas Raynaud's disease Malignant melanoma

Malignant melanoma

While assessing a 1-week-old infant, the examiner finds that the infant has white papules on the cheeks, forehead, and across the nose and the chin. Which term does the examiner use to document this finding? Milia Acrocyanosis Vernix caseosa Mongolian spots

Milia

Which patient would the nurse suspect of having chronic obstructive pulmonary disease (COPD) based upon finding of the nail assessment? Nail yellowish in color, nail base angel 175 degrees, boggy nail base Nail bed light to dark pink, nail plate smooth and flat, firm nail base Nail thickened, nail base angel 160 degrees, separation of the nail base Nail thinned, curvature of the nail plate, longitudinal ribbing in the nail bed

Nail yellowish in color, nail base angel 175 degrees, boggy nail base

The examiner is performing an admission assessment on a 65 yr old patient. Upon assessment of the toenails, the examiner notes the right great toe has yellowing of the distal nail plate and debris under the distal nail that is elevating the nail from the nail bed. However, there is no pitting of the nail. Which condition does the examiner report to the provider for further examination? Psoriasis Beau line Onychomycosis Splinter hemorrhages

Onychomycosis

A patient present to the dermatologist with complaints of recent skin issues that have developed over the past few weeks. The patient has been stressed recently and wonder if the issues are related to the stress. Upon assessment, the nurse notes dry, scaly papules and plaques on the patient's scalp, elbows, and shins. The patient reports that at night the itching keeps the patient awake. The patient has tried applying lotion, which does not seem to help. Which skin abnormality does the nurse suspect the patient may be experiencing? Psoriasis Pityriasis rosea Eczematous dermatitis Tinea (dermatophytosis)

Psoriasis

While examining the skin of a patient, the examiner finds silver mica-like scales on the patients elbows and knees. The examiner anticipates the patient will be diagnosed with which condition? Cheilosis Psoriasis Ecchymosis Candidiasis

Psoriasis

During an assessment, the examiner observes that the nail bases of the patient feel soft and spongy on palpitation. On further assessment, the examiner finds out the angle of the nail base is 180 degrees. What possible condition can the examiner anticipate? Nervousness Poor self-care Pulmonary disease Arterial insuffciency

Pulmonary disease

While assessing a child with impetigo, the examiner finds honey-colored, crustlike lesions on the child's chin. Which other type of lesion does the examiner expect to find in this child? Scales Papules Pustules Macules

Pustules

Which homeostatic processes are performed by the skin? Select all that apply. Regulates acid-based balance Regulates body temperature Regulates blood glucose level Prevents invasion of microorganisms Assists in the production of vitamin D

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

A 4-year-old patient presents to the pediatrician's office with a cough and stuffy nose; the patient's mother reports a low-grade fever. The examiner notes a papular rash on the patient's face, chest, and arms. There are no lesions in the patient's mouth, but the throat appears inflamed. The patient's father tells the examiner that the rash started yesterday and was originally flat, red, and only on the patient's face and chest. The examiner activates airborne isolation precautions based on suspicion of which condition?

Rubella

The examiner suspect jaundice in a dark-skinned patient. What locations of the body should the examiner assess to confirm this diagnosis? Select all that apply Lips Sclera Nail bed Buccal mucosa Under the tongue

Sclera Buccal mucosa Under the tongue

A patient complains of dryness of the scalp, forehead, face, and chin. What can the examiner conclude from these symptoms? Keratin is not abundantly present The melanocytes are not functioning Sebaceous secretion has been disrupted Adipose tissue deposition has been diminished

Sebaceous secretion has been disrupted

What sign or symptom would the examiner look for while assessing a patient who has chronic liver disease? Ecchymosis Venous lake Telangietasia Spider angioma

Spider angioma

While assessing a adolescent, the examiner finds reddish-brown linear streaks on the toenails. Upon interacting, the examiner learns that the adolescent was injured 2 days ago while playing soccer. Which term does the examiner use to document this finding? Scabies Beau line Acute paronychia Splinter hemorrhages

Splinter hemorrhages

The examiner is performing an admission assessment on an elderly bedridden patient who was brought to the hospital from a long-term care facility. The examiner notes a pressure ulcer on the patient's sacrum. Upon further assessment, the examiner finds that the bone is visible through the ulcer, and there is black necrotic tissue around the wound. How would the examiner stage this pressure ulcer? Stage I Stage II Stage III Stage IV

Stage IV

The 8-year-old patient presents to the clinic with a rash on the dorsal arms that is red, weeping, and intensely itchy. Reviewing the patient's chart, the examiner notes a history of asthma and allergic rhinitis. The examiner anticipates the patient will be diagnosed with which condition? The patient has impetigo The patient has intertrigo The patient has atopic dermatitis The patient has chickenpox (varicella)

The patient has atopic dermatitis

After assessing a patient who has undergone an appendectomy, the examiner documents the presence of a keloid at the surgical site. Which finding enables the examiner to reach this conclusion? The patient has depressed skin at the site of the surgery The patient has excess scare tissues at the site of the surgery The patient has thick and dry exudates at the site of the surgery The patient has thick skin with tightly packed papules at the site of the surgery

The patient has excess scar tissue at the site of the surgery

While assessing a patient, the examiner finds that the patient has raised thick areas of pigmentation, which are crusted, dark, and greasy in appearance. Upon further assessment, the examiner finds that these patched of pigmenation are noncancerous. What does the examiner interpret from these findings? The patient has acrochordons The patient has senile lentigines The patient has actinic keratosis The patient has seborrheic keratosis

The patient has seborrheic keratosis

After assessing a patient the examiner concludes that the patient has folliculitis. Which finding in the patient enables the examiner to reach this conclusion? The patient has an oval patch of hair loss along the hairline The patient has a habit of pulling and twisting his or her hair The patient has thick, yellow scales on the forehead and the scalp The patient has whiteheads with an erythematous base on the neck

The patient has whiteheads with an erythematous base on the neck

During an assessment, a patient reports that a mole on his arm has recently changed color. The patient also complains of itching and light bleeding of the mole. What can the examiner suspect from the symptoms? The patient has vitiligo The mole is a birthmark The patient has freckles The patient may have malignant melanoma

The patient may have malignant melanoma

While assessing a dark-skinned patient, the examiner believes the patient has erythema due to polycythemia. What would the examiner check in order to confirm the presence of polycythemia in this patient? The presence of reddish lips The presence of a purplish tinge on the skin The presence of cherry-red colored nail beds The presence of yellow sclera near the limbus

The presence of reddish lips

While caring for a patient with an anxiety disorder, the examiner finds that the patient has sever self-induces hair loss. Which term does the examiner use to document this condition? Folliculitis Trichotillomania Pediculosis capitis Seborrheic dermatitis

Trichotillomania

While caring for a newborn, the examiner observes a white cheesy substance on the neonate's body. Which term does the examiner use to document this finding? Lanugo Vellus hair Terminal hair Vernix caseosa

Vernix caseosa

The examiner is assessing a patient and notes patchy areas of the skin on the face, neck, hands, feet, body folds, and around orifices that are devoid of melanin pigment. What term would the examiner use to document this condition? Moles Vitiligo Freckles Birthmarks

Vitiligo

While assessing a patient, the examiner finds that the patient has symmetric bilateral, patchy, milk-white spots on the face. Suspicion of which condition does the examiner report to the provider for further examination? Vitiligo Albinism Cyanosis Erythema

Vitiligo