Skin Assessment Quiz
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Questions and Answers

What is the most likely explanation for the difference in appearance of cyanosis between lighter and darker skin?

  • Lighter skin has a higher oxygen saturation in the blood, making it easier to detect cyanosis.
  • Lighter skin has a thinner epidermis, allowing the blue hue to be more readily visible.
  • Darker skin has more melanin, which makes it harder for blue light to penetrate and be reflected back. (correct)
  • Darker skin has a greater concentration of blood vessels, which makes it more difficult to detect cyanosis.

    • Which of the following is NOT a normal finding during a skin assessment?

  • Evenly colored skin tone
  • Freckles
  • Striae
  • Acanthosis nigricans (correct)

    • A patient presents with yellowing of the skin, sclera, oral mucosa, palms, and soles. Which of the following is the most likely diagnosis?

  • Cyanosis
  • Pallor
  • Acanthosis nigricans
  • Jaundice (correct)

    • What equipment is specifically used to examine the skin for fluorescence?

    <p>Wood's light (C)</p> Signup and view all the answers

    How are freckles characterized?

    <p>Flat, small macules of pigment (B)</p> Signup and view all the answers

    Which of the following is a potential cause of pallor?

    <p>Decreased oxygen saturation in the blood (B)</p> Signup and view all the answers

    Which of the following instruments is most useful for examining the texture and surface of the skin?

    <p>Magnifying glass (D)</p> Signup and view all the answers

    During a skin assessment, which tool is most suitable for evaluating the size and shape of lesions?

    <p>Centimetre ruler (B)</p> Signup and view all the answers

    When inspecting the skin for color variations, which of the following is NOT a normal finding?

    <p>Erythema (D)</p> Signup and view all the answers

    When inspecting the skin for integrity, which of the following is considered an abnormal finding?

    <p>Reddened areas (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of normal skin texture as assessed during palpation?

    <p>Rough (D), Flaky (E)</p> Signup and view all the answers

    Which of the following skin thickness characteristics could be an abnormal finding during palpation?

    <p>Thin skin (B)</p> Signup and view all the answers

    When assessing skin moisture, which of the following is a normal finding?

    <p>Dry skin (C)</p> Signup and view all the answers

    Which of the following is a potential cause for abnormal skin temperature?

    <p>Shock (C), Hypotension (D)</p> Signup and view all the answers

    When assessing skin mobility and turgor, which of the following is a normal finding?

    <p>Skin immediately returns to its original position (A)</p> Signup and view all the answers

    Based on the provided content, which of the following is NOT a normal finding when inspecting the skin?

    <p>Lesions (B)</p> Signup and view all the answers

    According to the passage, which of the following skin conditions is a result of generalized loss of pigmentation?

    <p>Albinism (B)</p> Signup and view all the answers

    When palpating the skin, which of the following is used to assess moisture?

    <p>None of the above (D)</p> Signup and view all the answers

    What is the primary objective for gathering objective data in a skin, hair, and nail assessment?

    <p>To directly observe and physically examine the patient's skin, hair, and nails. (B)</p> Signup and view all the answers

    A patient describes a rash that appears only after eating specific foods. What key assessment factor does this information provide?

    <p>Pattern (C)</p> Signup and view all the answers

    Which of these questions is NOT directly related to gathering objective data in a skin assessment?

    <p>Do you experience any itching or tenderness in specific areas? (B)</p> Signup and view all the answers

    A patient reports experiencing intense hair loss for the past month. What additional piece of information is MOST crucial to determine the potential cause?

    <p>The pattern of hair loss (e.g., shedding, breakage) (A)</p> Signup and view all the answers

    What is the MOST important reason to inquire about the patient's family history when assessing their skin?

    <p>To identify possible genetic predispositions to skin conditions. (C)</p> Signup and view all the answers

    A patient describes experiencing sudden onset of a red, itchy rash on their arms. What question would be MOST helpful in determining the possible cause?

    <p>Have you noticed any other symptoms or changes in your body along with the rash? (A)</p> Signup and view all the answers

    A patient mentions experiencing frequent headaches and a new onset of itchy scalp. What assessment factor is MOST relevant in this instance?

    <p>Associated factors (B)</p> Signup and view all the answers

    The nursing assessment of a patient's nail condition notes brittle and ridged nails. Which question would be LEAST relevant to ask the patient about their nail concerns?

    <p>When was the last time you had a manicure or nail salon treatment? (D)</p> Signup and view all the answers

    What is the term for injuries to skin and underlying tissue resulting from prolonged force on the skin?

    <p>Pressure ulcer (C)</p> Signup and view all the answers

    What describes the skin's ability to stretch and return to normal after being stretched?

    <p>Elasticity (A)</p> Signup and view all the answers

    Which term refers to a bluish cast to the skin and mucous membranes?

    <p>Cyanosis (C)</p> Signup and view all the answers

    Which term describes the paleness or lack of color observed in the skin?

    <p>Pallor (B)</p> Signup and view all the answers

    Which assessment finding indicates a generalized increase in skin fluid accumulation?

    <p>Oedema (A)</p> Signup and view all the answers

    What does the term 'turgor' refer to in skin assessment?

    <p>Skin's elasticity (B)</p> Signup and view all the answers

    What does erythema refer to in skin assessment?

    <p>Skin redness (B)</p> Signup and view all the answers

    During hair assessment, what would indicate normal findings for hair colour?

    <p>Natural hair colour varies from pale blond to black (B)</p> Signup and view all the answers

    Which of the following is considered an abnormal finding when assessing skin turgor?

    <p>The skin returns to its original position slowly after being pinched. (B)</p> Signup and view all the answers

    A patient presents with pitting edema. Which of the following findings would you expect to observe?

    <p>The skin remains indented after pressure is released. (C)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of normal skin?

    <p>Skin remains indented after pressure is released. (C)</p> Signup and view all the answers

    What term describes the ability of the skin to stretch and return to normal after being stretched?

    <p>Turgor (A)</p> Signup and view all the answers

    Which of the following is a sign of edema?

    <p>Skin that remains indented after pressure is released. (D)</p> Signup and view all the answers

    A patient with poor skin turgor is most likely experiencing:

    <p>Dehydration. (B)</p> Signup and view all the answers

    What term describes the paleness or lack of color in the skin?

    <p>Pallor (D)</p> Signup and view all the answers

    Which of the following describes the ease with which skin can be pinched?

    <p>Mobility (B)</p> Signup and view all the answers

    What is a possible indication of excessive generalized hair loss?

    <p>Hair loss caused by nutritional deficiencies (C)</p> Signup and view all the answers

    Which finding is considered abnormal during a scalp and hair assessment?

    <p>Dull, dry hair (B)</p> Signup and view all the answers

    What is the expected normal angle between the nail base and the skin?

    <p>160 degrees (A)</p> Signup and view all the answers

    Which condition may be indicated by raised lesions on the scalp?

    <p>Excessive scaliness (A)</p> Signup and view all the answers

    What abnormal finding could yellow discoloration of nails signify?

    <p>Fungal infections or psoriasis (C)</p> Signup and view all the answers

    What does a slow capillary refill time of more than 2 seconds indicate?

    <p>Potential hypoxia (B)</p> Signup and view all the answers

    What might be a sign of iron deficiency anemia in nails?

    <p>Concave nails (D)</p> Signup and view all the answers

    What normal finding is expected in nail texture assessment?

    <p>Nails are smooth and firmly attached (D)</p> Signup and view all the answers

    Which of the following could be a result of poor hygiene in nail assessment?

    <p>Dirty, broken, or jagged nails (C)</p> Signup and view all the answers

    What visual indicator could signify splinter hemorrhages in nails?

    <p>Dark lines that appear under the nail (C)</p> Signup and view all the answers

    What does excessive generalized hair loss NOT typically result from?

    <p>Normal hair shedding (B)</p> Signup and view all the answers

    What is a sign of clubbing in nails?

    <p>Spongy sensation with a 180-degree angle (B)</p> Signup and view all the answers

    What could be a potential cause of dull hair during a scalp assessment?

    <p>Chronic illness (A)</p> Signup and view all the answers

    Why is palpation important in nail assessment?

    <p>It checks for texture and consistency (C)</p> Signup and view all the answers

    Flashcards

    Onset

    When the skin condition began.

    Location

    Where the skin issue is situated, local or generalized.

    Duration

    The length of time the problem lasts or recurs.

    Severity

    How serious the skin problem is.

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    Pattern

    Factors that improve or worsen the condition.

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    Associated Factors

    Other symptoms occurring along with the skin issue.

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    Inspection

    A visual examination of the skin.

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    Palpation

    Feeling the skin condition with hands.

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    Examination Light

    A light used to illuminate the skin during assessment.

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    Skin Coloration

    Assessment for normal and abnormal skin colors.

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    Pallor

    Loss of color, resulting in pale skin without underlying pink.

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    Cyanosis

    Bluish discoloration of the skin due to poor oxygenation.

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    Jaundice

    Yellow color change of skin and mucosa indicating liver issues.

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    Acanthosis Nigricans

    Darkening and roughening of skin in localized areas, often on the neck.

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    Normal Color Variations

    Suntanned areas and freckles are normal skin color variations.

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    Vitiligo

    Depigmentation due to destruction of melanocytes, leading to light patches.

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    Elasticity

    Refers to the skin's ability to stretch and return to normal after being stretched

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    Mobility

    Describes how easily skin can be pinched

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    Turgor

    Refers to skin's elasticity and promptness of return after being pinched

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    Erythema

    Refers to skin redness

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    Pressure ulcer

    Refers injuries to skin and underlying tissue resulting from prolonged force on the skin

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    Vellus hair

    Refers to fine, prepubertal hair covering the body

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    Skin Colour Variations

    Changes in skin colour may indicate conditions like rashes or albinism.

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    Skin Integrity

    Assessment of skin's condition, especially pressure points to check for breakdown.

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    Lesions

    Abnormal growths or appearances on the skin compared to surrounding areas.

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    Skin Texture

    Assessment for smoothness or roughness of the skin's surface.

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    Skin Thickness

    Evaluates the thickness of skin; thin skin suggests issues.

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    Skin Moisture

    Assess moisture levels; normal varies by area and environment.

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    Skin Temperature

    Temperature of the skin can indicate overall health; cold suggests issues.

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    Mobility and Turgor

    Test skin elasticity by pinching it to check hydration level.

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    Skin Turgor

    The skin's ability to return to its original position after being pinched, indicating hydration level.

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    Poor Turgor

    A decreased ability of the skin to return to its original position after being pinched, often seen in dehydration.

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    Oedema

    Accumulation of fluid in body tissues causing swelling, often detected in skin assessments.

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    Normal Oedema Findings

    Skin rebounds and does not remain indented when pressure is released, indicating good skin health.

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    Abnormal Oedema Findings

    Indentations remain on the skin after pressure is released, which can indicate fluid retention issues.

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    Skin Mobility

    The ease with which skin can be pinched and returned to its original form, reflecting elasticity.

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    Oedema Grading Scale

    A scale used to classify the severity of oedema based on indentation depth.

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    Terminal Hair

    Thicker hair on scalp, body areas, varies by gender.

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    Hair Inspection

    Examine hair for amount and distribution, abnormalities.

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    Generalized Hair Loss

    Excessive hair loss may indicate various health issues.

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    Normal Scalp Findings

    Scalp is clean, dry; hair is smooth and elastic.

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    Abnormal Scalp Findings

    Excess scaliness, lesions, dull dry hair indicate issues.

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    Nail Inspection

    Examine nails for cleanliness and grooming.

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    Normal Nail Findings

    Nails should be clean, trimmed, with healthy color.

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    Pale Cyanotic Nails

    Pale or blue nails may indicate hypoxia or anemia.

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    Beau’s Lines

    Indentations in nails from acute illness or trauma.

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    Nail Clubbing

    180-degree angle at nail base indicates possible hypoxia.

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    Spoon Nails

    Concave nails can signal iron deficiency anemia.

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    Nail Texture

    Nails should be smooth and attached; abnormal is detached.

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    Capillary Refill

    Speed of pink tone returning to nail beds after pressure.

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    Palpation in Hair Assessment

    Feeling hair/scalp for cleanliness, oiliness, or lesions.

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    Hair Elasticity

    Hair's ability to stretch without breaking; indicates health.

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    Study Notes

    Motivational Activity

    • Divide into three groups (a, b, and c) based on seating.
    • Given words: SKIN, HAIR, NAIL
    • Form sentences using the letters of the words to describe them. For example, LOVE - living out valuable emotions.

    Skin, Hair & Nail Assessment

    • Unit 3: Assessment of Health Status (Systematic Approach)
    • Presented by Mrs. Keren Jones-Fraser, PhD candidate, MSCN, BSCN, Cert Ed, RN
    • Objectives of the three-hour session include:
      • Outlining client preparation for assessment.
      • Describing the normal assessment findings of skin, hair, and nails.
      • Explaining the process of assessing client skin, hair, and nails.

    Preparation

    • Ensure appropriate environment: privacy, lighting, and ventilation.
    • Have necessary equipment on hand at the start of the assessment.
    • Ensure client comfort.

    Procedure

    • Introduce self and verify client identity.
    • Explain the procedure and its importance to the client.
    • Perform hand hygiene and observe appropriate infection control procedures (e.g., donning gloves if needed).
    • Ask client to remove clothing, jewelry, and put on an examination gown. Expose only the body part to be examined.
    • Request removal of wigs, toupees, hairpieces, nail enamel, or artificial nails.
    • Position client appropriately.

    COLDSPA

    • Gather subjective data by questioning the client:
      • Character (Describe the sign/symptom, how does it feel, look, smell?).
      • Onset (When did it begin?).
      • Location (Where is it? Local or generalized?).
      • Duration (How long does it last? Does it recur?).
      • Severity (How bad is it?).
      • Pattern (What makes it better? What makes it worse?).
      • Associated factors (What other symptoms occur with it?).

    Sample Questions

    • Describe any skin problems (rashes, lesions, dryness, oiliness, drainage, bruising, swelling, or increased pigmentation).
    • What aggravates the problem?
    • What relieves the problem?
    • Has the colour, size, or shape of any birthmarks, tattoos, or moles changed?
    • Are you experiencing any pain, itching, tingling, or numbness?
    • Is there any change in your ability to feel pain, pressure, light touch, or temperature?
    • Have you ever received treatment for any skin problems (including surgery)?
    • Have you ever had allergic skin reactions to medications, plants, food, or other substances?
    • Has anyone in your family recently had an illness, rash, or other skin problem or allergy? If yes, please describe.
    • Do you spend long hours in the sun?
    • Have you ever had any hair loss or change in the condition of your hair? If yes, please describe.
    • Have you had any change in the condition or appearance of your nails? If yes, describe.
    • Are you regularly exposed to chemicals (including paint, bleach, cleaning products, petroleum)?

    Equipment Needed

    • Examination light
    • Penlight
    • Mirror for client self-examination of skin
    • Magnifying glass
    • Centimeter ruler
    • Gloves
    • Wood's light
    • Examination gown or drape

    Skin Assessment - Inspection

    • General color (Normal: even skin tone or Abnormal: pale skin without underlying pink, cyanosis, jaundice)
    • Abnormal findings: pallor, cyanosis, jaundice, acanthosis nigricans.
    • Color variations (Normal: suntanned areas or freckles, or Abnormal: vitiligo, striae, rashes, albinism, erythema)
    • Skin integrity (Normal: intact skin with no reddened areas or Abnormal: skin breakdown or reddened areas.)
    • Pressure ulcers (stages 1-4)
    • Lesions (Normal: absence of lesions, smooth skin, Abnormal: any abnormal growth or appearance compared to surrounding skin.)
    • Texture (Normal: smooth and even or Abnormal: rough, flaky)

    Skin Assessment - Palpation

    • Texture (Normal: smooth, even skin, or Abnormal: rough, flaky)
    • Thickness
      • Normal: Thin skin and/or calluses in pressure areas
      • Abnormal: Very thin skin from arterial insufficiency or steroid therapy
    • Moisture (Normal: varies with warmth of environment, or Abnormal: profuse sweating [diaphoresis], clammy skin, or decreased moisture [dehydration])
    • Temperature (Normal: warm skin, Abnormal: cold skin, hypotension or shock)
    • Mobility and Turgor (Normal: skin returns immediately to original shape, or Abnormal: slow return, poor turgor, edema)
    • Edema (grading scale 0+, 1+, 2+, 3+, and 4+).

    Hair Assessment - Inspection

    • General color and condition
      • Normal: Natural hair color, varying from pale blond to black to gray or white.
      • Abnormal: Nutritional deficiencies causing color changes (e.g., patchy gray to copper-red hair)
    • Amount and distribution (normal vs. abnormal: Vellus hair [pre-pubertal] covers whole body except soles, and palms; terminal hair in scalp, axillary, body, and public areas varies by gender)
    • Excessive generalized hair loss (due to infection, illness, nutritional deficiencies, chemotherapy, radiation treatment)

    Hair Assessment - Palpation

    • Cleanliness, dryness, or oiliness, parasites, and lesions
      • Normal: Clean, dry scalp, sparse dandruff may be visible, smooth, firm hair with some elasticity.
      • Abnormal: excessive scaliness, raised lesions, dull, dry hair, poor hygiene

    Nail Assessment - Inspection

    • Cleanliness and grooming
      • Normal: nails are clean and trimmed.
      • Abnormal: dirty, broken, or jagged nails (result from poor hygiene or occupation/hobby)
    • Colour and markings
      • Normal: pink tones, longitudinal ridging, and freckles/pigmented streaks (especially in dark-skinned clients).
      • Abnormal: pale/cyanotic nails (hypoxia/anemia), splinter hemorrhages (trauma), Beau's lines after acute illness, yellow discoloration (fungal infection/psoriasis)
    • Shape
      • Normal: 160-degree angle between the nail base and the skin.
      • Abnormal: 180+ degrees (early or late clubbing), spoon nails (concave) possibly iron deficiency anemia or hypoxia

    Nail Assessment - Palpation

    • Texture & Consistency
      • Normal: smooth, firm, firmly attached.
      • Abnormal: paronychia (nail bed inflammation), detachment of nail from nail bed
    • Capillary Refill
      • Normal: rapid pink tone return to blanched nail bed after pressure release
      • Abnormal: slow return (2+ seconds) of pink tone

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