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SHADOW HEALTH DIGITAL CLINICAL
EXPERIENCE – HAIR, SKIN, AND NAILS
ASSESSMENT ASSIGNMENT 2025 | COMPLETE
AND VERIFIED A+ GRADED EXAM SUBMISSION
WITH IN-DEPTH DOCUMENTATION, SUBJECTIVE
AND OBJECTIVE DATA, CLINICAL REASONING,
AND NURSE NOTE
What is the largest organ in the body? - -- <> ---Skin small reddish to purple macules or papules can develop anywhere in body in response to physical trauma. - -- <> ---Petechiae Purplish macules or papules result from bleeding under skin secondary to inadequate clotting mechanisms - -- <> ---Purpura Appears shiny w/ rolled pearly border; typically has telangiectasis (small spider veins) on its surface. The skin cancer grows slowly and rarely metastasizes. - -- <> ---Basal cell carcinoma second most frequently found skin cancer is related to sun exposure - -- <> ---Squamous cell carcinoma
is identified by the ABCDEs of skin cancer detection. Metastasizes quickly - -- <> ---Malignant melanoma fungus commonly found in skinfolds or generally warm and moist areas. Commonly effected sites are the axillae and groin. Wash and dry between skin folds in clinical! Need antifungal to treat. Powder and lotion wont cure. - -- <> ---Candida Estimates percentage of total body surface area burned in adults. Different areas are sectioned into numerical values related to the pictures. Note the anterior and posterior head equate 9% each - -- <> ---Wallace rule of nines Linear break in skin surface, not related to trauma - -- <> ---fissure Fluid-like, less than 1 cm diameter Ex: herpes simplex, chicken pox - -- <> ---Vesicle Ex: Partial-thickness burns, bullous impetigo
1cm in diameter (Looks like a big bulging bubble under the skin) - -- <> ---Bulla Distinct and walled-off, containing fluid or semisolid material, varies in size Looks like a knot under the skin - -- <> ---Cyst Loss of epidermal layer, usually not extending into dermis or subcutaneous layer
may appear around second trimeter and caused by hormones (brown line going vertically down a pregnant women's stomach) - -- <> ---Linea nigra Stretch marks - -- <> ---Striae Common on newborns. Teach parents not to squeeze (little wet bumps on the newborns face) - -- <> ---Milia aka mask of pregnancy. From increased hormones causing increased pigmentation (color spots on pregnant women's face) - -- <> ---Melasma fine hair that lessens closer to term (helps vernix stick to skin) - -- <> - --Lanugo Protects skin from amniotic fluid - -- <> ---Vernix Patches of skin lose pigment (looks like really big birth marks, large color spots) - -- <> ---Vitiligo Excessive collagen formation when scar is formed - -- <> ---Keloid Athletes foot - -- <> ---Tinea pedis
ring worm - -- <> ---Tinea corporis Fungal infection on the scalp - -- <> ---Tinea capitis Fungal infection of the nails - -- <> ---Tinea unguium Jock itch - -- <> ---Tinea cruris Type 1 Herpes vs. Type 2 herpes - -- <> ---Type 1 is considered above the waist and type 2 is considered below the waist, but studies shown that they can be transmitted from one to another. pin plaques with silvery scales - -- <> ---psoriasis you can see where the irritation was result from the ring she had on, what is this?
- -- <> ---contact dermatitis A nurse is teaching a group of 5th grade children about characteristics of the skin. Which of the following should she mention? Select all that apply. a) Aids in maintaining body temperature b) Involved in digestion of food c) Circulates blood throughout the body d) Protects against damage to the body from sunlight
A patient recovering from a burn injury is told by the health care provider that hair will no longer grow on the body part that was burned. The nurse realizes that this patient's burn extended into which skin layer? a) Dermis b) Distal phalanx c) Epidermis d) Subcutaneous tissue - -- <> ---Correct response: Dermis Explanation: The skin has three layers. The epidermis is the outermost layer and is comprised of dead keratinized cells and an inner layer that forms melanin and keratin. The dermis contains connective tissue and hair follicles. If the hair follicles are damaged by a burn, hair will not regrow. The subcutaneous tissue layer of the skin continues fatty tissue. The distal phalanx is a bone in the finger. The terms "generalized," "exposed surfaces," "upper arm," and "skin folds" are used to describe which major characteristic of skin lesions? a) Distribution b) Colour c) Arrangement d) Type - -- <> ---Correct response: Distribution Explanation: The given terms denote anatomic location, or distribution, of skin lesions over the body.
Upon assessing the skin, the nurse finds pustular lesions on on the face. The nurse identifies that these could be what? a) Herpes simplex b) Varicella c) Acne d) Psoriasis - -- <> ---Correct response: Acne Explanation: Pustular lesions include acne, furuncles and carbuncles. Varicella and herpes simplex are vesicular lesions and psoriasis are plaque lesions The RN should intervene and further educate the nursing assistant when observing which action? a) Assisting feeding a client ground chicken with dentures in place b) Propping a client on the side using pillows under the hip, knees, and shoulder c) Independently pulling an immobile client up in bed d) Ambulating a client using a walker in the hallway - -- <> ---Correct response: Independently pulling an immobile client up in bed Explanation: Friction/shear forces are risks to breaks in skin integrity that can occur when pulling a client up in bed alone. The nursing assistant needs to ask for assistance when repositioning an immobile client. Assisting with feeding or ambulating, and using pillows under bony prominences to prevent pressure ulcers are all appropriate nursing assistant tasks.
A stage II pressure ulcer results in a superficial skin loss of the epidermis alone or the dermis also. A stage I pressure ulcer is red in color but without skin breakdown. Stage III pressure ulcers involve the epidermis, dermis, and subcutaneous tissue. In stage IV, the muscle, bone, and other supportive tissue may be involved. During the integument health history, the nurse asks the patient about prescription medications, immunizations, and diagnosed illnesses. What will this information provide to the nurse? a) Patient's risk for skin cancer b) Patient's risk for pressure ulcer formation c) Systemic diseases that have skin manifestations d) History of physical abuse - -- <> ---Correct response: Systemic diseases that have skin manifestations Explanation: One purpose of the integumentary health history is to identify systemic diseases that have skin manifestations. Questions to determine systemic diseases that the patient may have include asking about prescribed medications, immunizations, and diagnosed illnesses. Asking about medications, immunizations, and diagnosed illnesses will not provide information about the patient's history of physical abuse, risk for skin cancer, or risk for pressure ulcer formation. What clinical manifestation of the nails should the nurse anticipate assessing in a client with iron deficiency anemia? a) Beau's lines
b) Paronychia c) Spooning d) Clubbing - -- <> ---Correct response: Spooning Explanation: Spoon nails are indicative of iron deficiency anemia. Clubbing may not be present because it is evident in people who have oxygen deficiency. Beau's lines occur after acute illness and eventually grow out. Paronychia is an infection of the nail bed and is not a characteristic feature of iron deficiency anemia. The nurse is beginning the examination of the skin of a 25-year-old teacher. She previously visited the office for evaluation of fatigue, weight gain, and hair loss. The previous clinician had a strong suspicion that the client has hypothyroidism. What is the expected moisture and texture of the skin of a client with hypothyroidism? a) Dry and smooth b) Moist and rough c) Dry and rough d) Moist and smooth - -- <> ---Correct response: Dry and rough Explanation: A client with hypothyroidism is expected to have dry and rough skin. This is a good example of how the skin can give clues to systemic diseases. A nurse inspects a client's skin and notices several flat, brown color change areas on the forearms. What is the proper term for documentation of this finding by the nurse?
The nurse should use which assessment tool to assess the client's risk for skin breakdown? a) Hendrich II b) VTE prophylaxis algorithm c) Braden Scale d) Morse Scale - -- <> ---Correct response: Braden Scale Explanation: The Braden Scale or Norton Scale, or another skin assessment tool should be used to assess for skin breakdown risk factors according to hospital standard protocol. The Hendrick II and Morse scale assess fall risk. Upon admission, clients are evaluated for venous thromboembolism (VTE) risk; but a separate skin assessment tool is used as well. A nurse is working with a 13-year-old boy who complains that he has begun to sweat a lot more than he used to. He asks the nurse where sweat comes from. The nurse knows that sweat glands are located in which layer of skin? a) Dermis b) Stratum lucidum c) Stratum corneum d) Epidermis - -- <> ---Correct response: Dermis Explanation: The dermis is a well-vascularized, connective tissue layer containing collagen and elastic fibers, nerve endings, and lymph vessels. It is also the origin of sebaceous
glands, sweat glands, and hair follicles. The epidermis, the outer layer of skin, is composed of four distinct layers: the stratum corneum, stratum lucidum, stratum granulosum, and stratum germinativum. The outermost layer consists of dead, keratinized cells that render the skin waterproof. A client presents to the health care clinic with reports of new onset of generalized hair loss for the past 2 months. The client denies the use of any new shampoos or other hair care products and claims not to be taking any new medications. The nurse should ask the client questions related to the onset of which disease process? a) Liver disease b) Crohn's disease c) Diabetes mellitus d) Hypothyroidism - -- <> ---Correct response: Hypothyroidism Explanation: Generalized hair loss can be a finding in hypothyroidism. None of the other conditions listed is associated with generalized hair loss. Diabetes is a problem with glucose regulation. Crohn's disease is an inflammatory process in the large intestines. Liver disease results in many problems with fluid regulation, metabolism of drugs, and storage of glucose. The nurse enters a client's hospital room and the client asks the nurse to raise him up in the bed. What is the nurse's best action? a) Place the client in trendelenburg so the client can slide up in bed. b) Push the client toward the head of the bed to prevent back injury.
a) Connective layer b) Epidermis c) Dermis d) Subcutaneous layer - -- <> ---Correct response: Dermis Explanation: The second layer, the dermis, functions as support for the epidermis. The dermis contains blood vessels, nerves, sebaceous glands, lymphatic vessels, hair follicles, and sweat glands, which support the nutritional needs of the epidermis and provide support for its protective function. the top layer of the skin is the dermis layer outermost skin layer, and serves as the body's first line of defense against pathogens, chemical irritants, and moisture loss. The subcutaneous layer provides insulation, storage of caloric reserves, and cushioning against external forces. Composed mainly of fat and loose connective tissue, it also contributes to the skin's mobility. The connective layer is a distracter to the question. Which area of the body should a nurse inspect for possible loss of skin integrity when performing a skin examination on a female who is obese? a) Under the breast b) Upper abdomen c) On the neck d) Anterior chest - -- <> ---Correct response: Under the breast Explanation: The nurse should inspect the area under the breast for skin integrity in obese clients. The area between the skin folds is more prone to loss of skin integrity; therefore, the presence of skin breakdown should be inspected on the skin on the limbs, under the breasts, and in the groin area. Perspiration and friction often
cause skin problems in these areas in obese clients. The areas over the chest and abdomen and on the neck are not prone to skin breakdown. A client presents to the clinic and reports numerous skin tags in the left axillary area. The client is worried about skin cancer. What can the nurse tell the client about skin tags to alleviate fear of cancer? a) Skin tags can turn into skin cancer if they are not removed b) Skin tags are an early precursor to more serious skin cancer conditions c) Skin tags are common benign skin lesions d) Skin tags need to be removed as soon as possible or they will keep growing - -- <> ---Correct response: Skin tags are common benign skin lesions Explanation: Common benign skin lesions include freckles, birth marks, skin tags, moles, and cherry angiomas. Skin tags will not turn into skin cancer and are not early precursors to other more serious skin cancer conditions. Skin tags do not keep growing if not removed. Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 258 Which of the following statements most accurately conveys an aspect of the anatomy and physiology of the skin?
c) A malignant lesion d) A sebaceous cyst - -- <> ---Correct response: A sebaceous cyst Explanation: This is a classic description of an epidermal inclusion cyst resulting from a blocked sebaceous gland. The fact that any lesion is enlarging is worrisome, but the other descriptors are so distinctive that cancer is highly unlikely. This would be an unusual location for a lymph node and these do not usually drain to the skin. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 266. A client asks a nurse to look at a raised lesion on the skin that has been present for about 5 years. Which is an "ABCD" characteristic of malignant melanoma? a) Asymmetrical shape b) Borders well demarcated c) Color is uniform d) Diameter less than 6mm - -- <> ---Correct response: Asymmetrical shape Explanation: Malignant melanomas are evaluated according to the mnemonic ABCDE: A for asymmetrical, B for irregular borders, C for color variations, D for diameter exceeding 1/8 to1/4 inch (3-4mm), and E for elevated. (less) Reference:
Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 268. Which technique should the nurse use to properly assess a client's skin turgor? a) Pinch the skin on the sternum and observe its return to the original shape. b) Pinch the skin on the abdomen and observe for color changes c) Palpate the skin around the umbilicus to assess for intactness d) Palpate the skin on the sternum to determine its flexibility - -- <> - --Correct response: Pinch the skin on the sternum and observe its return to the original shape. Explanation: The nurse should assess the skin turgor by pinching the skin on the sternum and determining how quickly the skin returns back to its original shape. Skin turgor is assessed on the sternum and not on the abdomen. Palpation is not a technique used to assess for skin turgor. (less) Reference: Weber, J., & Kelley, J. H. (2014). Health Assessment in Nursing, 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, Chapter 14: Assessing Skin, Hair, and Nails, p. 253. A nurse cares for a client of Asian decent and notices that the client sweats very little and produces no body odor. What is an appropriate action by the nurse in regards to this finding?
