Question 1

What is onychomycosis and what does the nail technician do when they identify it?

Accepted Answer

Onychomycosis is a fungal infection of the nail plate — typically caused by dermatophytes — that causes yellowing, thickening, crumbling, and separation of the nail. It is contagious and requires medical (antifungal) treatment. Nail services must be refused.

Question 2

Paronychia is defined as:

Accepted Answer

Paronychia is an infection of the perionychium — the skin surrounding the nail plate. Acute paronychia is usually bacterial (Staphylococcus aureus); chronic paronychia is often fungal. Both contraindicate nail services. Redness, swelling, pain, and pus are common signs.

Question 3

What are Beau's lines?

Accepted Answer

Beau's lines are transverse grooves that cross the nail plate, indicating a temporary arrest of nail matrix function due to illness, nutritional deficiency, chemotherapy, or severe stress. They grow out with the nail and can be used to estimate when the systemic event occurred.

Question 4

Which nail condition allows nail services to be safely performed?

Accepted Answer

Leukonychia (white spots or streaks) is caused by minor trauma to the nail matrix and is not contagious or a disease state. It grows out on its own and does not contraindicate nail services. The other options listed are contagious conditions requiring referral.

Question 5

Onycholysis refers to:

Accepted Answer

Onycholysis is the painless separation of the nail plate from the nail bed, beginning at the free edge and progressing proximally. Causes include trauma, fungal infection, psoriasis, thyroid disease, and allergic reactions to nail products. Nail services may be performed if no infection is present.

Question 6

Onycholysis is the separation of the nail plate from the nail bed. Which of the following can cause this condition?

Accepted Answer

Onycholysis has multiple causes: physical trauma (repeated tapping), psoriasis (the most common systemic cause), thyroid disorders, drug reactions, excessive moisture exposure, and nail product reactions. The separation creates a space vulnerable to secondary infection.

Question 7

A client presents with yellowish-green discoloration under the nail, thickening, and a foul odor. This presentation is most consistent with:

Accepted Answer

Pseudomonas aeruginosa produces a characteristic yellow-green to dark green/black pigment (pyocyanin) and odor. It thrives in the moist space created by nail separation (onycholysis). This is contraindicated for nail services — the client must be referred for medical treatment.

Question 8

Pterygium (forward growth of the cuticle onto the nail plate) is associated with which condition?

Accepted Answer

Pterygium (dorsal pterygium) occurs when the proximal nail fold adheres to the nail plate and grows forward, often following matrix damage from lichen planus or severe trauma. It can result in permanent nail plate scarring. Nail services are contraindicated on pterygium areas.

Question 9

Beau's lines are horizontal grooves or depressions across the nail plate. What do they indicate?

Accepted Answer

Beau's lines are horizontal indentations across the nail plate caused by a temporary halt in nail matrix cell division. Common triggers include high fever, surgery, chemotherapy, nutritional deficiency, or severe systemic illness. The groove grows out as the nail recovers.

Question 10

A nail technician should refuse service and refer a client to a physician when they observe which of the following nail conditions?

Accepted Answer

New, changing, or widening dark longitudinal streaks under the nail can be a sign of subungual melanoma — a serious malignancy. Nail technicians must refer clients with suspicious pigmented nail changes to a dermatologist or physician. Nail technicians are legally prohibited from diagnosing nail diseases.

Nail Disorders and Diseases Practice Questions

More Nail Technician State Board Exam Topics