Chapter 13, Skin, Hair, and NailsFindings for Skin, Hair, and Nails

Question 1 of 18

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Which findings would the nurse consider normal for a middle-aged male patient?

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  • Hair present on the back and shouldersHair on the back and shoulders is an expected finding for a middle-aged male patient.
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  • Scalp hair lossScalp hair loss is an expected finding for a middle-aged male patient.
• Correct
  • Coarse terminal hair in the pubis, axillae, and beardCoarse terminal hair in the pubis, axillae, and beard is an expected finding for a middle-aged male patient.
• • Extensive gray hairExtensive gray hair is not an expected finding for a middle-aged male patient.
• • Facial hair lossFacial hair loss is not an expected finding for a middle-aged male patient.

Question 2 of 18

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Which findings would the nurse identify as normal during a skin inspection of a healthy adult patient?

• • Excessive oilinessMinimal oiliness is expected in the skin of a healthy adult patient.
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  • Uniformly tan skinNormal skin is expected to vary in color from dark brown to light tan, and it should be uniform in color.
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  • Pigmented neviNevi, or moles, are a normal finding and may be pigmented.
• • Patches of unpigmented skinUnpigmented skin is an abnormal finding in a healthy patient.

Question 3 of 18

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While inspecting the nails of a patient, the nurse asks the patient to place the dorsal surfaces of the fingertips together. The nurse expects the nail base angle to be __ degrees or less.

• • Your answer: 160Correct answer: 160The nail base angle should be 160 degrees or less. An angle of greater than 160 degrees indicates clubbing.

Question 4 of 18

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What finding would the nurse record as normal when palpating the patient’s nails?

• • BoggyA boggy nail base is unexpected and may indicate clubbing.
• • SoftA soft nail base is an unexpected finding.
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  • FirmThe patient’s nail base should feel firm when squeezed.
• • Separation of nail baseSeparation of the nail base from the bed is an unexpected finding and may indicate trauma or disease.

Question 5 of 18

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During assessment of a middle-aged adult patient, the nurse gently pinches the skin of the patient’s forearm. What would the nurse note as an expected finding?

• • BlanchingBlanching is not tested by pinching the skin.
• Correct
  • ResilienceThe skin should be resilient in response to a pinch. Failure of the skin to quickly return to place is an abnormal finding.
• • Oily residueUpon palpation, minimal perspiration or oiliness should be found.
• • Cold to touchThe skin should be cool to warm.

Question 6 of 18

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What findings would the nurse identify as normal during palpation of a patient’s nails?

• • Separation of the nail plate from the bedSeparation of the nail plate from the bed is an abnormal finding and may indicate trauma or disease.
• Correct
  • Hard textureA hard texture is a normal finding on palpation of the nails of a healthy adult.
• • Uneven thicknessThe nails of a healthy adult should be even in thickness.
• • PinkAlthough the nails should be pink, this is an inspection finding and not a palpation finding.
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  • Smooth textureA smooth texture is a normal finding on palpation of the nails of a healthy adult.

Question 7 of 18

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The apocrine glands of infants and children do not function. The nurse understands that this affects the skin of these patients in which way?

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  • Results in skin that is less oily than that of adultsThe skin of infants is less oily than that of adults as a result of nonfunctioning apocrine glands.
• • Results in rougher skinThe skin of infants is expected to be smooth, which is not a characteristic associated with nonfunctioning apocrine glands.
• • Prevents sweatingInfants are expected to sweat; however, the sweat of infants is inoffensive as a result of nonfunctioning apocrine glands.
• • Promotes coarse hair growthUnlike adults, the bodies of infants are not expected to have coarse hair, and nonfunctioning apocrine glands do not promote coarse hair growth.

Question 8 of 18

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The nurse understands that the hair covering a newborn’s body can be classified in which way?

• • CoarseA newborn is not expected to have coarse body hair.
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  • SilkyThe hair covering a newborn’s body is expected to be fine and silky.
• • PatchyThe hair covering a newborn’s body is expected to be uniform, not patchy.
• • ThickThe hair covering a newborn’s body is expected to be fine, not thick.

Question 9 of 18

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The nurse is examining the skin of a newborn and understands that which color changes are normal for this patient?

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  • MottlingTransient mottling may occur when an infant is exposed to cooler temperatures and is known as cutis marmorata.
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  • AcrocyanosisAcrocyanosis, or cyanosis of the hands and feet, is an expected finding at birth.
• • Intense and persistent yellowingA yellowing of the skin of infants suggests jaundice and may be present at birth. Intense and persistent jaundice is not normal and may indicate liver disease or infection.
• Correct
  • Deep pink areasLocalized, flat, deep pink areas are known as salmon patches and may be seen on the forehead, eyelids, upper lip, and back of the neck of infants.
• Correct
  • Hyperpigmented areasHyperpigmented patches are common in babies with dark skin.

Question 10 of 18

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Which skin examination findings would the nurse consider normal in a 75-year-old patient?

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  • DryDrier skin is typical in older adults as a result of decreased sebaceous and sweat gland activity.
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  • Thin parchment appearanceThe skin of older adults takes on the appearance of parchment because of the thinning of the epidermis.
• • Increased perspirationDecreased sweat gland activity results in decreased, rather than increased, decreased perspiration in older adults.
• Correct
  • Wrinkled epidermisThe epidermis appears wrinkled in older adults because of loss of elasticity in the dermis.
• • Yellow in colorYellowing of the skin is not a typical age-associated change in skin.

Question 11 of 18

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Which findings, related to the hair examination, would the nurse note as normal in an 80-year-old patient?

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  • Gray hairGray hair occurs with age and results from a reduction in the number of functioning melanocytes.
• • Vellus hair on naresAs adults age, fine vellus hair on the nares is replaced by coarse terminal hair.
• Correct
  • Vellus hair on scalpAs adults age, coarse terminal hair is replaced by fine vellus hair, often resulting in baldness.
• • HirsutismHirsutism, or growth of terminal hair in a male distribution pattern in women, is not an age-associated finding.
• Correct
  • Loss of axillary hairAs adults age, decreased hormone production leads to a loss of axillary and pubic hair.

Question 12 of 18

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Match the finding in older adults with the relevant cause.

• Transition from coarse terminal hair to fine vellus hair
• Decrease in sweat gland activity
• Loss of collagen and elastic fibers
• Decreased peripheral circulation

Question 13 of 18

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Match the primary skin lesion to its relevant description.

• Flat, nonpalpable, and irregularly shaped
• Elevated, circumscribed, superficial, and filled with serous fluid
• Elevated, circumscribed, encapsulated lesion filled with liquid
• A flat, circumscribed area marked by a change in color

Question 14 of 18

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Match the secondary skin lesion to its appropriate description.

• Replacement of normal skin with fibrous tissue following injury
• Crack from the epidermis to dermis
• Keratinized cells manifesting as flaky skin; may be dry or oily and varying in size
• Loss of the epidermis characterized by a hollowed-out, crusted area

Question 15 of 18

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During the skin examination, the nurse notes a liquid-filled vesicle that is elevated. What type of primary lesion does the nurse suspect?

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  • PustuleA pustule is a liquid-filled, elevated, superficial primary lesion.
• • KeloidA keloid is not liquid-filled and is a secondary lesion.
• • TumorA tumor is not liquid-filled; rather it is solid.
• • NoduleA nodule is elevated, firm, and not liquid-filled.

Question 16 of 18

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Examining a patient, the nurse notes nails with smooth, even edges, consistent thickness, and a pink coloring with a green tinge in the nail bed. Which finding would the nurse note as abnormal?

• • Smooth edgesThe nails of a healthy adult would be expected to have smooth edges.
• • Consistent thicknessThe nails of a healthy adult would be expected to have a consistent thickness.
• Correct
  • Green tingeA green tinge may indicate separation of the nail plate from the bed.
• • Even edgesThe nails of a healthy adult would be expected to have even edges.

Question 17 of 18

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Which findings would the nurse expect to assess for when evaluating a patient for suspected alopecia areata?

• • Inflammation of the paronychiumInflammation of the paronychium is a sign of paronychia (not alopecia areata), which may result from infection, and is not a condition of the hair.
• • Abnormal growth of terminal hairAbnormal growth of terminal hair in women in the male distribution pattern is a characteristic of hirsutism, not alopecia areata.
• • Painless purple skin lesionsPainless purple skin lesions are not characteristic of alopecia areata, which is a condition of the hair, rather than the skin.
• Correct
  • Sudden patchy hair loss from the scalp and faceAlopecia areata is characterized by sudden patchy hair loss, often from the scalp and face.

Question 18 of 18

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Upon inspecting a 25-year-old female patient, the nurse notes terminal hair on the patient’s upper lip, chin, and scalp, as well as fine vellus hair symmetrically distributed on the patient’s body. Which finding does the nurse note as abnormal?

• Correct
  • Terminal hair on the upper lip and chinTerminal hair on the upper lip and chin of a female adult is an abnormal finding and suggests hirsutism.
• • Terminal hair on the scalpTerminal hair on the scalp is an expected finding in a female adult.
• • Vellus hair on the bodyVellus hair on the body is an expected finding in a female adult.
• • Symmetrical distribution of hair on the bodySymmetrical distribution of hair on the body is normal in a female adult.