NURS 5220: EXAM #1 MODULE 2: CH 9, 10, 11, 12, 14, 15, 16 || QUESTIONS & ANSWERS | GRADE A | 100% CORRECT (2026/2027)
In which age group are milia an expected finding?
A. Newborns
B. Young children
C. Adolescents
D. Older adults ✔️A: CorrectMilia are small, whitish, discrete papules on the face; they are commonly found during the first 2 to 3 months of life.
The sebaceous glands function in an immature fashion at this age and are easily plugged by sebum. Answers b, c, and d are incorrect.
Mr. Babson is a 74-year-old man who presents to your office with a complaint of a "spot" on his chin and wants to know whether it is
cancerous. Which of the following signs or symptoms indicates a need for further medical investigation?
A. The "spot" is a reddish brown color.
B. The "spot" has been on his chin for 20 years.
C. The "spot" bleeds easily when it is touched.
D. The "spot" is slightly raised and circumscribed. ✔️C: CorrectA "spot" that bleeds easily when it is touched may be indicative of a more serious
condition like basal cell carcinoma, the most common form of skin cancer.
A 6-year-old girl has freckles over her nose and cheeks. The examiner will recall that freckles are a type of:
A. macule.
B. papule.
C. nodule.
D. patch. ✔️A:correctA macule is a flat, circumscribed area that is a change in the color of the skin usually less than 1 cm in diameter. Freckles,
flat moles, petechiae, and measles are examples of macules.
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. ✔️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." ✔️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. ✔️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. ✔️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 ✔️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 ✔️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. ✔️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. ✔️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 ✔️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.
D. is considered a normal finding. ✔️D:CorrectHyperkeratosis or callus is a superficial area that occurs on the weight-bearing areas of the feet
and on the palmar surface of the hands. Calluses are less well demarcated than corns and are usually not tender.
A patient with diabetes presents to the clinic complaining of an infected foot. On removing the patient's sock, the examiner notes an odor that
resembles rotting apples. What type of infection is this consistent with?
A. Pseudomonas infection
B. Peritonitis
C. Anaerobic infection
, D. Clostridium gas gangrene ✔️D:CorrectThe skin, like other body parts, may have odors suggesting a variety of problems: infectious, metabolic,
or neurologic. The smell of rotting apples usually indicates Clostridium gas gangrene.
Mrs. Nieland brings her toddler in for a routine office visit. She tells you that she has a new babysitter. Which finding is consistent with a
physical abuse injury in a toddler?
A. A burn to the skin with a splash pattern
B. Bruising of the skin over soft tissue
C. Bruising of the skin over a bony prominence
D. Café au lait patches ✔️B: CorrectPhysical findings in children who are physically abused include bruises, burns, lacerations, scars, bony
deformities, alopecia, retinal hemorrhages, dental trauma, and head and abdominal injuries. Bruising associated with abuse occurs over soft
tissue; toddlers and older children who bruise themselves accidentally do so over bony prominences.
Which of the following techniques helps the examiner determine whether a palpable skin mass is filled with fluid?
A. Using a Wood's lamp
B. Biopsy
C. Transillumination
D. Noting the odor of the lesion ✔️C:CorrectTransillumination may be used to determine the presence of fluid in cysts and masses. Fluid-filled
lesions will transilluminate with a red glow, whereas solid lesions will not.
Which of the following findings suggests that a patient has a fungal infection of the nail beds?
A. The nail bed is wide and thick.
B. The nail plate has a central depression, causing a spoon appearance.
C. Superficial white spots are present in the nail plate.
D. The nail plate is yellow and crumbling. ✔️D:CorrectOnychonyocosis is a fungal infection of the nail that commonly presents as a crumbling as
the fungus grows.
Which of the following are functions of the skin (select all that apply)?
A. Secrete sweat, urea, and lactic acid
B. Produce vitamin C from precursors in the skin
C. Contribute to blood pressure regulation by dilation of skin blood vessels
D. Protect against microbial/foreign substance invasion and minor physical trauma ✔️A, C, D
The skin is the first layer of protection against microbial/foreign substance invasion and minor physical trauma. It excretes sweat, urea, and
lactic acid, and it contributes to blood pressure regulation through constriction of skin blood vessels.
Physical differences between black and white Americans include which of the following?
A. Blacks have a greater incidence of pigmentary demarcation lines.
B. Whites have greater stratum lucidum.
C. Blacks synthesize reticulum fibers more readily.
In which age group are milia an expected finding?
A. Newborns
B. Young children
C. Adolescents
D. Older adults ✔️A: CorrectMilia are small, whitish, discrete papules on the face; they are commonly found during the first 2 to 3 months of life.
The sebaceous glands function in an immature fashion at this age and are easily plugged by sebum. Answers b, c, and d are incorrect.
Mr. Babson is a 74-year-old man who presents to your office with a complaint of a "spot" on his chin and wants to know whether it is
cancerous. Which of the following signs or symptoms indicates a need for further medical investigation?
A. The "spot" is a reddish brown color.
B. The "spot" has been on his chin for 20 years.
C. The "spot" bleeds easily when it is touched.
D. The "spot" is slightly raised and circumscribed. ✔️C: CorrectA "spot" that bleeds easily when it is touched may be indicative of a more serious
condition like basal cell carcinoma, the most common form of skin cancer.
A 6-year-old girl has freckles over her nose and cheeks. The examiner will recall that freckles are a type of:
A. macule.
B. papule.
C. nodule.
D. patch. ✔️A:correctA macule is a flat, circumscribed area that is a change in the color of the skin usually less than 1 cm in diameter. Freckles,
flat moles, petechiae, and measles are examples of macules.
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. ✔️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." ✔️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. ✔️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. ✔️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 ✔️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 ✔️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. ✔️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. ✔️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 ✔️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.
D. is considered a normal finding. ✔️D:CorrectHyperkeratosis or callus is a superficial area that occurs on the weight-bearing areas of the feet
and on the palmar surface of the hands. Calluses are less well demarcated than corns and are usually not tender.
A patient with diabetes presents to the clinic complaining of an infected foot. On removing the patient's sock, the examiner notes an odor that
resembles rotting apples. What type of infection is this consistent with?
A. Pseudomonas infection
B. Peritonitis
C. Anaerobic infection
, D. Clostridium gas gangrene ✔️D:CorrectThe skin, like other body parts, may have odors suggesting a variety of problems: infectious, metabolic,
or neurologic. The smell of rotting apples usually indicates Clostridium gas gangrene.
Mrs. Nieland brings her toddler in for a routine office visit. She tells you that she has a new babysitter. Which finding is consistent with a
physical abuse injury in a toddler?
A. A burn to the skin with a splash pattern
B. Bruising of the skin over soft tissue
C. Bruising of the skin over a bony prominence
D. Café au lait patches ✔️B: CorrectPhysical findings in children who are physically abused include bruises, burns, lacerations, scars, bony
deformities, alopecia, retinal hemorrhages, dental trauma, and head and abdominal injuries. Bruising associated with abuse occurs over soft
tissue; toddlers and older children who bruise themselves accidentally do so over bony prominences.
Which of the following techniques helps the examiner determine whether a palpable skin mass is filled with fluid?
A. Using a Wood's lamp
B. Biopsy
C. Transillumination
D. Noting the odor of the lesion ✔️C:CorrectTransillumination may be used to determine the presence of fluid in cysts and masses. Fluid-filled
lesions will transilluminate with a red glow, whereas solid lesions will not.
Which of the following findings suggests that a patient has a fungal infection of the nail beds?
A. The nail bed is wide and thick.
B. The nail plate has a central depression, causing a spoon appearance.
C. Superficial white spots are present in the nail plate.
D. The nail plate is yellow and crumbling. ✔️D:CorrectOnychonyocosis is a fungal infection of the nail that commonly presents as a crumbling as
the fungus grows.
Which of the following are functions of the skin (select all that apply)?
A. Secrete sweat, urea, and lactic acid
B. Produce vitamin C from precursors in the skin
C. Contribute to blood pressure regulation by dilation of skin blood vessels
D. Protect against microbial/foreign substance invasion and minor physical trauma ✔️A, C, D
The skin is the first layer of protection against microbial/foreign substance invasion and minor physical trauma. It excretes sweat, urea, and
lactic acid, and it contributes to blood pressure regulation through constriction of skin blood vessels.
Physical differences between black and white Americans include which of the following?
A. Blacks have a greater incidence of pigmentary demarcation lines.
B. Whites have greater stratum lucidum.
C. Blacks synthesize reticulum fibers more readily.
