Pre-lecture Worksheet
Column A: Descriptor column Color Change
Pallor
Erythema
Jaundice
Cyanosis
Match the color change with the descriptor above.
Intense redness of the skin due to excess blood in the dilated superficial capillaries.
Bluish mottled color that signifies decreased perfusion.
Absence of red pink tones from the oxygenated hemoglobin in blood.
Increase in bilirubin in the blood causing a yellow color in the skin.
1. You are preparing to care for a 63 year old black male with a history of
myocardial infarction, who now presents with heart failure. What is the best
technique to assess for cyanosis?
a. Palpate the skin for increased heat.
b. Inspect the hard palate of the mouth.
c. Inspect the feet for an ashen gray look.
d. Inspect the nail beds for a dusky pale color.
2. You are caring for a 46 year old with a history of chronic alcohol abuse and
liver disease. Which site is the best technique to assess for early jaundice?
a. Sclera and hard palate
b. Nail beds
c. Lips
d. Visible skin surfaces
3. You are assessing the skin of a 56 year old during a clinic appointment. Which
technique is the best to assess for increased skin temperature?
a. A grasping with your fingertips of both the bands.
b. Laying the palmar surface of your hand on the abdomen.
c. Placing the ventral surface of your hands on the persons shins and feet.
d. Laying the dorsal surface of your hand on the persons neck.
4. During your skin assessment of a 66 year old white landscape worker, you
notice a raised thickened area of increased pigmentation of 1.5cm that looks
dark brown and greasy. What is your next most appropriate action?
a. Interpret this as seborrheic keratosis and move on with the examination.
b. Notify the physician
c. Inquire about recent exposure to toxic outdoor plants.
d. Inquire about recent exposure to deer ticks.
, 5. A 79 year old retired teacher comes to your clinic for a routine assment. The
teacher asks about small, round, flat, evenly brown macules on the backs of
the hands. After assessing the area, what is your best response?
a. “these are the result of sun exposure and do not require treatment.”
b. “these are related to sunexposure and may become cancerous.”
c. “these are skin tags that occur with older age and do no require
treatment.”
d. “I’m glad you brought this to my attention. I will refer you to biopsy.”
6. A 63 year old female with history of emphysema with a 30 year history of
smoking 1 pack a day is admitted to the hospital with the following report:
AAOX4
BP 156/78
HR 88
RR 20 BPM and unlabored
Nasal cannula: 2 L/min
Oxygen saturation: 88%
Assessment findings:
Pursed lip breathing
Tripod position
Orthopnea
Nail bed curvature > 160 degrees with bluish discoloration in all 10 digits
Capillary refill 5 seconds.
Identify the abnormal assessment findings and discuss their clinical
significance related to the primary diagnosis.
7. A 70 year old woman presents with a history of intense itching and a raised
red linear rash on one side of her upper back. These findings are consistent
with: Select all that apply.
a. A bacterial skin infection.
b. Herpes zoster infection
c. Poison ivy contact
d. History of childhood chickenpox infection.
Column A: Descriptor column Color Change
Pallor
Erythema
Jaundice
Cyanosis
Match the color change with the descriptor above.
Intense redness of the skin due to excess blood in the dilated superficial capillaries.
Bluish mottled color that signifies decreased perfusion.
Absence of red pink tones from the oxygenated hemoglobin in blood.
Increase in bilirubin in the blood causing a yellow color in the skin.
1. You are preparing to care for a 63 year old black male with a history of
myocardial infarction, who now presents with heart failure. What is the best
technique to assess for cyanosis?
a. Palpate the skin for increased heat.
b. Inspect the hard palate of the mouth.
c. Inspect the feet for an ashen gray look.
d. Inspect the nail beds for a dusky pale color.
2. You are caring for a 46 year old with a history of chronic alcohol abuse and
liver disease. Which site is the best technique to assess for early jaundice?
a. Sclera and hard palate
b. Nail beds
c. Lips
d. Visible skin surfaces
3. You are assessing the skin of a 56 year old during a clinic appointment. Which
technique is the best to assess for increased skin temperature?
a. A grasping with your fingertips of both the bands.
b. Laying the palmar surface of your hand on the abdomen.
c. Placing the ventral surface of your hands on the persons shins and feet.
d. Laying the dorsal surface of your hand on the persons neck.
4. During your skin assessment of a 66 year old white landscape worker, you
notice a raised thickened area of increased pigmentation of 1.5cm that looks
dark brown and greasy. What is your next most appropriate action?
a. Interpret this as seborrheic keratosis and move on with the examination.
b. Notify the physician
c. Inquire about recent exposure to toxic outdoor plants.
d. Inquire about recent exposure to deer ticks.
, 5. A 79 year old retired teacher comes to your clinic for a routine assment. The
teacher asks about small, round, flat, evenly brown macules on the backs of
the hands. After assessing the area, what is your best response?
a. “these are the result of sun exposure and do not require treatment.”
b. “these are related to sunexposure and may become cancerous.”
c. “these are skin tags that occur with older age and do no require
treatment.”
d. “I’m glad you brought this to my attention. I will refer you to biopsy.”
6. A 63 year old female with history of emphysema with a 30 year history of
smoking 1 pack a day is admitted to the hospital with the following report:
AAOX4
BP 156/78
HR 88
RR 20 BPM and unlabored
Nasal cannula: 2 L/min
Oxygen saturation: 88%
Assessment findings:
Pursed lip breathing
Tripod position
Orthopnea
Nail bed curvature > 160 degrees with bluish discoloration in all 10 digits
Capillary refill 5 seconds.
Identify the abnormal assessment findings and discuss their clinical
significance related to the primary diagnosis.
7. A 70 year old woman presents with a history of intense itching and a raised
red linear rash on one side of her upper back. These findings are consistent
with: Select all that apply.
a. A bacterial skin infection.
b. Herpes zoster infection
c. Poison ivy contact
d. History of childhood chickenpox infection.
