NURS 5220: Exam #1 Module 2: Ch 9, 10, 11, 12, 14, 15, 16 Questions & Answers 100%
Accurate
Mrs. Tomberg brings her 4-day-old infant to your office with a concern of a yellowish skin tone.
Which of the following statements best describes the rationale for the skin tone?
A. Increased formation of subcutaneous tissue causes a yellow hue.
B. Capillaries broken during the birth process turn the skin slightly yellow as bruises heal.
C. The yellowish color results from increased fat metabolism and heat production.
D. The infant has hyperbilirubinemia. - ANSWER-D:CorrectHyperbilirubinemia, or physiologic
jaundice, is present to a mild degree in many newborn infants. It usually starts after the first day
of life and disappears by the eighth to tenth day but may persist for as long as 3 to 4 weeks.
Intense and persistent jaundice suggests liver disease, a hemolytic process, or severe,
overwhelming infection.
Mr. Russel is a 17-year-old adolescent patient who presents with a complaint of acne. He asks
the examiner why teens have more problems with acne than children. Which of the following
would be an appropriate response?
A. "Children have better hygiene habits than adolescents because of parental guidance."
B. "Adolescents have reduced blood flow to the epidermal layer of the skin, making them more
prone to infections."
C. "At puberty, adolescents begin to secrete more oil from sebaceous glands."
,D. "Children have very little skin mass, which prevents development of acne." - ANSWER-C:
CorrectDuring adolescence, the apocrine glands enlarge and become active, causing increased
axillary sweating and sometimes body odor. Sebaceous glands increase sebum production in
response to increased hormone levels, primarily androgen, giving the skin an oily appearance
and predisposing the individual to acne.
While examining the skin of an 87-year-old woman, the nurse observes significant tenting.
Which of the following best explains that finding?
A. Small tags of skin form on the neck.
B. The skin becomes thin and takes on a parchment-like appearance.
C. The skin becomes dry with significant flaking.
D. There is a loss of adipose tissue and elasticity. - ANSWER-D:CorrectTenting occurs in the older
adult as a result of loss of adipose tissue and elasticity. The skin often appears to hang loosely
on the bony frame as a result of a general loss of elasticity, loss of underlying adipose tissue,
and years of gravitational pull.
Mr. Allen is a 66-year-old man who presents to your clinic for follow-up for his chronic
obstructive pulmonary disease (COPD). When assessing for the presence of clubbing, the
examiner specifically examines:
A. the width of the nail base.
B. the angle of the nail base.
C. the thickness of the nail.
D. the color of the nail. - ANSWER-B:CorrectThe average nail base angle should measure 160
degrees. In clubbing, the nail base is boggy and the angle increases and approaches or exceeds
180 degrees. Another method of assessment is the Schamroth technique. Clubbing is associated
with a variety of respiratory and cardiovascular diseases, cirrhosis, colitis, and thyroid disease.
Mrs. Jones presents with a complaint of a spot on her skin. Which type of lesion can develop in
an already present nevi?
,A. Malignant melanoma
B. Squamous cell carcinoma
C. Basal cell carcinoma
D. Kaposi sarcoma - ANSWER-A: CorrectMalignant melonoma is the most lethal form of skin
cancer that develops from melanocytes. Squamous cell carcinoma, basal cell carcinoma, and
Kaposi sarcoma rarely develop in an already existing nevi.
Mrs. Xavier is a 45-year-old patient who presents to your office with a complaint of a rash. On
examination, you find a herald patch (round plaque with fine superficial scaling). Which of the
following conditions identifies this finding?
A. Pityriasis rosea
B. Dermatophytosis
C. Rosacea
D. Herpes zoster - ANSWER-A:CorrectPityriasis rosea is a self-limiting inflammation of unknown
cause. The herald lesion is commonly missed, although the most common sign of this condition.
The examiner notes a large blue-black spot on the buttock of a 4-week-old black neonate. The
mother states that the infant was born with it. The examiner should recognize that this:
A. is an expected finding.
B. may indicate child abuse.
C. is related to birth trauma.
D. suggests a congenital defect. - ANSWER-A:CorrectThis finding is indicative of Mongolian
spots. Mongolian spots are irregular areas of deep blue pigmentation, usually in the sacral and
gluteal regions, and are seen predominantly in newborns of African, Native American/American
Indian, Asian, or Latin descent. They commonly appear on the back, buttocks, shoulders, and
legs of well babies and usually disappear in the preschool years.
, A skin lesion that may be associated with neurofibromatosis or pulmonary stenosis is:
A. café au lait spots.
B. nevus vasculosus.
C. port wine limb stain.
D. spider angioma. - ANSWER-A:CorrectCafé au lait spots are flat, evenly pigmented spots
varying in color from light brown to dark brown or black on dark skin, are larger than 5 mm in
diameter, and are present at birth or shortly thereafter. They may be associated with
neurofibromatosis or miscellaneous other conditions, including pulmonary stenosis, temporal
lobe dysrhythmia, and tuberous sclerosis.
Mr. Tucker is a 68-year-old man who comes to your office complaining of spots on his skin. On
examination, which lesion is an expected finding on the skin of healthy older adults?
A. Acne vulgaris
B. Cherry angioma
C. Miliaria
D. Trichotillomania - ANSWER-B: CorrectCherry angiomas are tiny, bright ruby-red, round
papules that may become brown with time. They occur in virtually everyone older than 30 years
and increase numerically with age.
The examiner notes hyperkeratosis on a patient's palms and soles. The examiner recognizes that
this:
A. may be a sign of a systemic disorder.
B. may be an indication of a congenital heart defect.
C. is commonly found among individuals with Down syndrome.
Accurate
Mrs. Tomberg brings her 4-day-old infant to your office with a concern of a yellowish skin tone.
Which of the following statements best describes the rationale for the skin tone?
A. Increased formation of subcutaneous tissue causes a yellow hue.
B. Capillaries broken during the birth process turn the skin slightly yellow as bruises heal.
C. The yellowish color results from increased fat metabolism and heat production.
D. The infant has hyperbilirubinemia. - ANSWER-D:CorrectHyperbilirubinemia, or physiologic
jaundice, is present to a mild degree in many newborn infants. It usually starts after the first day
of life and disappears by the eighth to tenth day but may persist for as long as 3 to 4 weeks.
Intense and persistent jaundice suggests liver disease, a hemolytic process, or severe,
overwhelming infection.
Mr. Russel is a 17-year-old adolescent patient who presents with a complaint of acne. He asks
the examiner why teens have more problems with acne than children. Which of the following
would be an appropriate response?
A. "Children have better hygiene habits than adolescents because of parental guidance."
B. "Adolescents have reduced blood flow to the epidermal layer of the skin, making them more
prone to infections."
C. "At puberty, adolescents begin to secrete more oil from sebaceous glands."
,D. "Children have very little skin mass, which prevents development of acne." - ANSWER-C:
CorrectDuring adolescence, the apocrine glands enlarge and become active, causing increased
axillary sweating and sometimes body odor. Sebaceous glands increase sebum production in
response to increased hormone levels, primarily androgen, giving the skin an oily appearance
and predisposing the individual to acne.
While examining the skin of an 87-year-old woman, the nurse observes significant tenting.
Which of the following best explains that finding?
A. Small tags of skin form on the neck.
B. The skin becomes thin and takes on a parchment-like appearance.
C. The skin becomes dry with significant flaking.
D. There is a loss of adipose tissue and elasticity. - ANSWER-D:CorrectTenting occurs in the older
adult as a result of loss of adipose tissue and elasticity. The skin often appears to hang loosely
on the bony frame as a result of a general loss of elasticity, loss of underlying adipose tissue,
and years of gravitational pull.
Mr. Allen is a 66-year-old man who presents to your clinic for follow-up for his chronic
obstructive pulmonary disease (COPD). When assessing for the presence of clubbing, the
examiner specifically examines:
A. the width of the nail base.
B. the angle of the nail base.
C. the thickness of the nail.
D. the color of the nail. - ANSWER-B:CorrectThe average nail base angle should measure 160
degrees. In clubbing, the nail base is boggy and the angle increases and approaches or exceeds
180 degrees. Another method of assessment is the Schamroth technique. Clubbing is associated
with a variety of respiratory and cardiovascular diseases, cirrhosis, colitis, and thyroid disease.
Mrs. Jones presents with a complaint of a spot on her skin. Which type of lesion can develop in
an already present nevi?
,A. Malignant melanoma
B. Squamous cell carcinoma
C. Basal cell carcinoma
D. Kaposi sarcoma - ANSWER-A: CorrectMalignant melonoma is the most lethal form of skin
cancer that develops from melanocytes. Squamous cell carcinoma, basal cell carcinoma, and
Kaposi sarcoma rarely develop in an already existing nevi.
Mrs. Xavier is a 45-year-old patient who presents to your office with a complaint of a rash. On
examination, you find a herald patch (round plaque with fine superficial scaling). Which of the
following conditions identifies this finding?
A. Pityriasis rosea
B. Dermatophytosis
C. Rosacea
D. Herpes zoster - ANSWER-A:CorrectPityriasis rosea is a self-limiting inflammation of unknown
cause. The herald lesion is commonly missed, although the most common sign of this condition.
The examiner notes a large blue-black spot on the buttock of a 4-week-old black neonate. The
mother states that the infant was born with it. The examiner should recognize that this:
A. is an expected finding.
B. may indicate child abuse.
C. is related to birth trauma.
D. suggests a congenital defect. - ANSWER-A:CorrectThis finding is indicative of Mongolian
spots. Mongolian spots are irregular areas of deep blue pigmentation, usually in the sacral and
gluteal regions, and are seen predominantly in newborns of African, Native American/American
Indian, Asian, or Latin descent. They commonly appear on the back, buttocks, shoulders, and
legs of well babies and usually disappear in the preschool years.
, A skin lesion that may be associated with neurofibromatosis or pulmonary stenosis is:
A. café au lait spots.
B. nevus vasculosus.
C. port wine limb stain.
D. spider angioma. - ANSWER-A:CorrectCafé au lait spots are flat, evenly pigmented spots
varying in color from light brown to dark brown or black on dark skin, are larger than 5 mm in
diameter, and are present at birth or shortly thereafter. They may be associated with
neurofibromatosis or miscellaneous other conditions, including pulmonary stenosis, temporal
lobe dysrhythmia, and tuberous sclerosis.
Mr. Tucker is a 68-year-old man who comes to your office complaining of spots on his skin. On
examination, which lesion is an expected finding on the skin of healthy older adults?
A. Acne vulgaris
B. Cherry angioma
C. Miliaria
D. Trichotillomania - ANSWER-B: CorrectCherry angiomas are tiny, bright ruby-red, round
papules that may become brown with time. They occur in virtually everyone older than 30 years
and increase numerically with age.
The examiner notes hyperkeratosis on a patient's palms and soles. The examiner recognizes that
this:
A. may be a sign of a systemic disorder.
B. may be an indication of a congenital heart defect.
C. is commonly found among individuals with Down syndrome.
