NURS 612: Advanced Health Assessment - Week 4 Quiz (Skin, Hair,
Nails, Head, and Lymphatics) 2026 |Maryville
1. When examining a patient with a suspected malignant melanoma, which
characteristic is the most significant indicator of prognosis?
A. The horizontal diameter of the lesion
B. The degree of color variegation
C. The irregularity of the lesion’s border
D. The vertical depth of the lesion (Breslow depth)
Answer: D
Rationale: Breslow depth, which measures the vertical thickness of the melanoma, is the
most important prognostic factor in cutaneous melanoma.
2. A 70-year-old patient presents with dry, itchy skin. The practitioner notes
thin, parchment-like skin and increased wrinkling. This is primarily due to:
A. Increased activity of sebaceous glands
B. Loss of subcutaneous fat and decreased vascularity
C. Hyperplasia of the dermal layer
D. An increase in the turnover rate of epidermal cells
Answer: B
Rationale: Aging skin undergoes atrophy of the dermis, loss of subcutaneous fat, and
decreased vascularity and gland activity, leading to dryness and fragility.
,3. While examining a patient’s neck, the practitioner finds a firm, non-tender,
1.5 cm supraclavicular lymph node on the left side. This finding is most
suggestive of:
A. A localized viral infection
B. Chronic lymphocytic leukemia
C. Infectious mononucleosis
D. An occult abdominal or thoracic malignancy
Answer: D
Rationale: A palpable left supraclavicular node (Virchow’s node) is highly suspicious for
malignancy originating in the abdomen or thorax.
4. A patient presents with a skin lesion described as a small (0.4 cm), elevated,
circumscribed area filled with serous fluid. This is classified as a:
A. Pustule
B. Vesicle
C. Papule
D. Bulla
Answer: B
Rationale: A vesicle is a circumscribed, elevated lesion containing serous fluid, measuring
less than 1 cm. A bulla is larger than 1 cm.
5. Which physical exam technique is most appropriate for assessing the mobility
and consistency of a thyroid nodule?
A. Auscultation with the bell of the stethoscope
B. Percussion over the suprasternal notch
C. Deep palpation while the patient swallows
D. Inspection using tangential lighting only
Answer: C
, Rationale: The thyroid moves upward with swallowing. Palpation during swallowing
allows the practitioner to feel the texture, size, and mobility of the thyroid gland.
6. A patient with long-standing COPD exhibits fingernails with an angle of the
nail base greater than 180 degrees. This finding is known as:
A. Koilonychia
B. Onycholysis
C. Clubbing
D. Beau’s lines
Answer: C
Rationale: Clubbing is characterized by a straightening of the nail angle to 180 degrees or
more and a spongy feel to the nail base, often associated with chronic hypoxia.
7. The practitioner observes a ‘velvety’ hyperpigmentation in the axillae and
posterior neck of an obese adolescent. This condition is associated with:
A. Hypothyroidism
B. Vitamin B12 deficiency
C. Adrenal insufficiency
D. Insulin resistance
Answer: D
Rationale: Acanthosis nigricans is a skin condition characterized by dark, velvety patches
in body folds and is frequently associated with insulin resistance and obesity.
8. When palpating lymph nodes in a healthy adult, the practitioner would
normally expect them to be:
A. Non-palpable or small, mobile, and discrete
B. Soft, mobile, and non-tender
C. Firm, fixed, and non-tender
D. Large, rubbery, and tender
Answer: A
Nails, Head, and Lymphatics) 2026 |Maryville
1. When examining a patient with a suspected malignant melanoma, which
characteristic is the most significant indicator of prognosis?
A. The horizontal diameter of the lesion
B. The degree of color variegation
C. The irregularity of the lesion’s border
D. The vertical depth of the lesion (Breslow depth)
Answer: D
Rationale: Breslow depth, which measures the vertical thickness of the melanoma, is the
most important prognostic factor in cutaneous melanoma.
2. A 70-year-old patient presents with dry, itchy skin. The practitioner notes
thin, parchment-like skin and increased wrinkling. This is primarily due to:
A. Increased activity of sebaceous glands
B. Loss of subcutaneous fat and decreased vascularity
C. Hyperplasia of the dermal layer
D. An increase in the turnover rate of epidermal cells
Answer: B
Rationale: Aging skin undergoes atrophy of the dermis, loss of subcutaneous fat, and
decreased vascularity and gland activity, leading to dryness and fragility.
,3. While examining a patient’s neck, the practitioner finds a firm, non-tender,
1.5 cm supraclavicular lymph node on the left side. This finding is most
suggestive of:
A. A localized viral infection
B. Chronic lymphocytic leukemia
C. Infectious mononucleosis
D. An occult abdominal or thoracic malignancy
Answer: D
Rationale: A palpable left supraclavicular node (Virchow’s node) is highly suspicious for
malignancy originating in the abdomen or thorax.
4. A patient presents with a skin lesion described as a small (0.4 cm), elevated,
circumscribed area filled with serous fluid. This is classified as a:
A. Pustule
B. Vesicle
C. Papule
D. Bulla
Answer: B
Rationale: A vesicle is a circumscribed, elevated lesion containing serous fluid, measuring
less than 1 cm. A bulla is larger than 1 cm.
5. Which physical exam technique is most appropriate for assessing the mobility
and consistency of a thyroid nodule?
A. Auscultation with the bell of the stethoscope
B. Percussion over the suprasternal notch
C. Deep palpation while the patient swallows
D. Inspection using tangential lighting only
Answer: C
, Rationale: The thyroid moves upward with swallowing. Palpation during swallowing
allows the practitioner to feel the texture, size, and mobility of the thyroid gland.
6. A patient with long-standing COPD exhibits fingernails with an angle of the
nail base greater than 180 degrees. This finding is known as:
A. Koilonychia
B. Onycholysis
C. Clubbing
D. Beau’s lines
Answer: C
Rationale: Clubbing is characterized by a straightening of the nail angle to 180 degrees or
more and a spongy feel to the nail base, often associated with chronic hypoxia.
7. The practitioner observes a ‘velvety’ hyperpigmentation in the axillae and
posterior neck of an obese adolescent. This condition is associated with:
A. Hypothyroidism
B. Vitamin B12 deficiency
C. Adrenal insufficiency
D. Insulin resistance
Answer: D
Rationale: Acanthosis nigricans is a skin condition characterized by dark, velvety patches
in body folds and is frequently associated with insulin resistance and obesity.
8. When palpating lymph nodes in a healthy adult, the practitioner would
normally expect them to be:
A. Non-palpable or small, mobile, and discrete
B. Soft, mobile, and non-tender
C. Firm, fixed, and non-tender
D. Large, rubbery, and tender
Answer: A
