20 free NIC esthetics theory practice questions

Correct answer: C · Sterilization, since steam under pressure kills every form of microbe

CDC's disinfection and sterilization guideline describes sterilization as a process that destroys or eliminates all forms of microbial life, and it names steam under pressure as one of the principal sterilizing agents. A working autoclave cycle on cleaned tools therefore reaches sterilization. Disinfection is the level below it: CDC describes it as eliminating many or all pathogenic microorganisms on objects, except bacterial spores, so it does not describe what the autoclave achieves. Sanitation, the first of the three levels in NIC's outline, means cleaning that lowers the number of germs; it does not destroy all microbial life. Antisepsis refers to products used on living skin, and an autoclave is never used on a person. Your state's rules say which tools must be sterilized.

Look for this next time: Sterilization destroys all microbial life, including spores; disinfection stops short of bacterial spores.

Correct answer: A · They apply to every client and every service, whatever a client reports

CDC says Standard Precautions are used for all patient care: they are a baseline of common-sense practices and protective equipment, not a response to a known infection. In a spa, that means every client and every service, because a person can carry an infection without knowing it or without listing it. Waiting for an intake form to name an infection leaves the healthy-looking client unprotected. Limiting the precautions to services that might draw blood, or waiting until blood or fluid is visible, turns a baseline into a reaction after exposure has already happened. NIC's esthetics theory outline names Standard (Universal) Precautions in Scientific Concepts.

Look for this next time: Standard Precautions are the baseline for every client and service, not only for clients known to be infected.

Correct answer: D · Postpone the lip wax until the sore has healed, and avoid touching it

MedlinePlus explains that cold sores are caused by a contagious virus, herpes simplex, and that they usually appear on or around the lips. Waxing the upper lip would mean working on and next to an active sore, so the service waits until the sore has healed, and the esthetician avoids touching it in the meantime. Hard wax is still wax applied and pulled at the same spot. An antiseptic does not make an active sore safe to work around. Concealer puts a product, and then the esthetician's tools, directly on the blisters. The esthetician does not diagnose or treat the sore; questions about it go to a health care provider.

Look for this next time: An active cold sore is a contagious viral lesion: postpone services on or near it until it heals.

Correct answer: B · Section 8, Exposure controls/personal protection, listing protective gear

OSHA's Hazard Communication standard requires every safety data sheet to use 16 numbered sections in a fixed order, and Section 8 is Exposure controls/personal protection. That is where the manufacturer states the protective equipment, such as gloves and eye protection, for handling the product. Section 1 identifies the product and supplier but says nothing about what to wear. Section 11 describes toxicological information, the health effects of exposure, rather than how to prevent it. Section 13 covers disposal. The same rule requires the safety data sheet to be in English, and NIC's outline lists safety data sheets and the handling of chemicals in Scientific Concepts.

Look for this next time: For the gloves, goggles, or other gear a product needs, read Section 8 of its safety data sheet.

Correct answer: B · The eyelids, at only a fraction of a millimeter thick

The National Cancer Institute's SEER training module on the layers of the skin notes that the epidermis varies in thickness: it is only about 0.05 mm on the eyelids and about 1.5 mm on the palms and soles. So the eyelids are the thin example, and the palms and soles are the thick one, which rules out the first option. The forehead and scalp options describe what the skin there contains, active oil glands or close-set follicles, and neither feature makes the outer layer thinner. The thin eyelid epidermis is one reason makeup and skin care near the eye call for gentle pressure and bracing.

Look for this next time: The epidermis is thinnest on the eyelids (about 0.05 mm) and thickest on the palms and soles (about 1.5 mm).

Correct answer: D · The sudoriferous (sweat) glands, which let out sweat to cool the body

MedlinePlus describes hyperhidrosis as excessive, unpredictable sweating, even when it is cool or the person is at rest, and says people with it appear to have overactive sweat glands. Sudoriferous is the textbook name for sweat glands, and NIC's outline lists hyperhidrosis among the disorders of the sudoriferous gland. Sebaceous glands make oil, and their disorders, such as acne and seborrhea, form a separate list in the outline. Lymph vessels carry infection-fighting cells, as NCI's SEER module on the skin explains, and melanocytes make pigment; neither one produces sweat. The esthetician notes the condition on the record but leaves its treatment to the client's doctor.

Look for this next time: Hyperhidrosis is a disorder of the sudoriferous (sweat) glands, not the sebaceous (oil) glands.

Correct answer: A · The dermis, which holds the skin's blood vessels and sweat glands

NCI's SEER module on the layers of the skin says that regulating temperature is one of the dermis's main functions, and it lists blood vessels, hair follicles, and sweat glands among the structures the dermis contains. MedlinePlus adds that sweating helps the body stay cool. The stratum corneum is the outermost layer of the epidermis, made of continually shedding dead cells, so it does not produce sweat. The subcutaneous layer works as an insulator that conserves the body's heat, the opposite of cooling. The basal layer is where new epidermal cells divide; it has no sweat glands of its own.

Look for this next time: The dermis helps regulate temperature through the blood vessels and sweat glands it contains.

Correct answer: C · Point it out calmly and suggest that a dermatologist take a look at it

The American Academy of Dermatology's ABCDEs of melanoma start with A for asymmetry: one half of the spot is unlike the other half. The academy advises seeing a dermatologist if a mole or pigmented spot shows these signs. An esthetician recognizes the warning sign and refers, so pointing it out calmly and suggesting a dermatologist is the right call. Saying it looks like melanoma is a diagnosis, which belongs to a physician. Saying nothing withholds something the client would want to know. Exfoliating over the spot and waiting a month to compare delays the referral the academy recommends.

Look for this next time: A mole with one half unlike the other is an ABCDE warning sign: point it out and refer, without diagnosing.

Correct answer: A · Hirsutism

MedlinePlus defines hirsutism as the growth of coarse, dark hair, more typical of male-pattern growth, in areas such as the lip, chin, chest, abdomen, or back where women usually have fine hair, and it notes that too much androgen can cause it. That matches this client. NIC's outline lists hirsutism under abnormal hair growth. Hyperhidrosis is excessive sweating, a sweat gland disorder. Seborrhea and milia are on the outline's list of sebaceous gland disorders, so neither one names a hair growth problem. The physician manages the cause; the esthetician can discuss hair removal options the client's state allows.

Look for this next time: Hirsutism is coarse, dark hair in male-pattern areas on a woman, often linked to excess androgens.

Correct answer: D · The ingredients ranked from the largest amount to the smallest amount

FDA's cosmetic labeling rule, 21 CFR 701.3, requires the label to declare each ingredient in descending order of predominance, so the first ingredients are present in the largest amounts. The rule also lets a label list ingredients present at 1 percent or less without respect to order after the larger ones, and fragrance may appear simply as fragrance, which is why the stem says normally. Nothing in the rule ranks ingredients by when they were mixed, by how active they are, or by how likely they are to irritate. A client with sensitive skin may still react to an ingredient listed near the end, so the list helps her compare products rather than predict a reaction.

Look for this next time: Cosmetic ingredient lists run in descending order of predominance, with some exceptions for small amounts.

Correct answer: C · Ask the client to press a tissue on it and drop it in the trash herself

NIC's esthetics practical bulletin says NIC adopted OSHA's bloodborne pathogens standard (29 CFR 1910.1030) for blood exposure. Its steps start with avoiding all contact with blood, and when someone is bleeding, the esthetician does not touch the blood but asks the injured person to stop it with a cotton ball or tissue and throw it directly into the trash. Bandaging, discarding the gloves, placing contaminated supplies in the right container, and cleaning the hands follow. Wiping or blotting the blood herself puts her in contact with it, even through a glove. A water rinse does not disinfect the tweezers. NIC notes that blood exposure procedures are being updated with its exam revisions, so use the current version from your state or exam provider.

Look for this next time: Under NIC's blood exposure steps, the esthetician never touches the blood: the client stops it with a tissue and discards it.

Correct answer: B · Get a release in writing from her physician before treating the skin

NIC's esthetics theory outline lists a physician release among the consultation and documentation items, next to the health history and intake form, and it lists pre- and post-surgical treatments as a service area. When a client is still under a surgeon's care for the same area, the esthetician gets the physician's written release before working on that skin. Deciding that three weeks is enough healing time is a medical judgment the esthetician cannot make. A liability waiver changes the paperwork, not the risk to the client. Dropping only the massage still exposes the treated skin to cleansing, exfoliation, and masks. Your state's rules may say more about post-surgical clients.

Look for this next time: When the health history shows recent surgery or ongoing medical care, get a physician release before the service.

Correct answer: D · Hold off on waxing, since six months haven't passed since she stopped

The American Academy of Dermatology's waxing advice says not to wax if you have taken isotretinoin in the last six months. This client stopped two months ago, so she is still inside that window, and the esthetician holds off and offers to rebook once six months have passed. Stopping the medicine does not end the risk right away, which is the point of the six-month window. Hard wax is still wax, so switching products does not lift the caution. Waxing one brow as a test still waxes skin the caution covers. The esthetician records the medicine on the client's chart and leaves questions about it to her prescriber.

Look for this next time: Isotretinoin taken in the last six months is a reason not to wax, even after the client has stopped it.

Correct answer: A · Chemical, because the acid dissolves the dead skin cells on the surface

FDA notes that glycolic acid and lactic acid are the most common alpha hydroxy acids (AHAs) in cosmetic products. The American Academy of Dermatology explains that chemical exfoliation uses chemicals such as alpha and beta hydroxy acids to dissolve dead skin cells, while mechanical exfoliation uses a tool, such as a brush, pad, or sponge, or a scrub to remove them physically. So a glycolic acid treatment is chemical exfoliation. The acid does not scrub, and wiping off the product with a pad at the end does not make the treatment mechanical. Tightening pores is not how the AAD describes chemical exfoliation working.

Look for this next time: Acids such as glycolic acid exfoliate chemically by dissolving dead cells; scrubs and tools exfoliate mechanically.

Correct answer: C · Leave exfoliation out of today's service while the skin is sunburned

The American Academy of Dermatology says never to exfoliate if your skin is sunburned, or if you have open cuts or wounds. Two days after a burn, red and tender skin is still sunburned, so exfoliation stays out of this service. Lighter pressure with the scrub is still mechanical exfoliation on burned skin. An acid exfoliant is chemical exfoliation, which the same advice covers, and FDA notes that AHAs may increase the skin's sensitivity to the sun. Working only on the red areas puts the exfoliant exactly where the burn is. The esthetician can adjust the rest of the facial or rebook it.

Look for this next time: Sunburned skin is a contraindication for both mechanical and chemical exfoliation.

Correct answer: B · A broad-spectrum sunscreen, SPF 30 or higher, for UVA and UVB rays

The American Academy of Dermatology explains that broad spectrum on a label means the sunscreen protects against both UVA and UVB rays, and it recommends choosing an SPF of 30 or higher. So the advice combines both: broad spectrum and SPF 30 or more. The SPF 15 option fails on both counts, because it is below the academy's number and because the broad-spectrum label, not the SPF number, is what signals protection from both kinds of UV rays. An SPF 30 product without the broad-spectrum label may not cover UVA. Skipping sunscreen is the opposite of FDA's advice for AHA products, whose labels tell users to use a sunscreen during use and for a week afterward.

Look for this next time: Home care after exfoliation includes a broad-spectrum sunscreen, SPF 30 or higher, per the AAD.

Correct answer: C · To steady the hand so a sudden move doesn't push a tool into the eye

NIC's esthetics practical bulletin says candidates are expected to brace any time they work around the eye and mouth areas, and the theory outline lists bracing under makeup safety. FDA's eye cosmetic safety page warns that a bump or sudden stop can injure the eye, for example by scratching the cornea, with a mascara wand or other applicator. Resting the hand on the client's face keeps the tool moving with her if she flinches, which is the reason for bracing. It is not a way to judge oiliness, to position the client's head, or to stretch the eyelid, and pulling delicate eyelid skin tight is not what bracing means.

Look for this next time: Bracing anchors the working hand to the client's face so a sudden movement cannot drive a tool into the eye or mouth.

Correct answer: D · Spread it with the growth; hold the skin taut and pull fast against it

The American Academy of Dermatology's waxing steps say to spread the wax in the direction of hair growth, then hold the skin taut with one hand and quickly pull off the cloth in the opposite direction of hair growth. Spreading against the growth reverses the first step, and pulling slowly or along the growth reverses the second. Peeling the strip slowly straight upward is neither quick nor opposite to the growth. Holding the skin taut is part of the removal step, not an optional extra. Your school's and state's procedures for hard wax and for the NIC practical's simulated soft wax may add steps.

Look for this next time: Strip wax goes on in the direction of hair growth and comes off quickly against it, with the skin held taut.

Correct answer: A · The tan gives no sun protection, so she still needs to use sunscreen

FDA explains that the common sunless tanning ingredient dihydroxyacetone (DHA) is a color additive that darkens the skin, and that only sunless tanners containing sunscreen ingredients and labeled with an SPF number may provide protection from the sun. This solution has no SPF, so the tan gives her no sun protection, and she still needs sunscreen at the beach. Giving the tan an SPF value, saying it protects once developed, or saying it protects the skin it colors all treat a color change as if it were sunscreen. FDA also notes that DHA is not permitted for use in the area of the eye and lacks the safety data for approval on the lips or other mucous membranes, which is why those areas are protected during a spray tan.

Look for this next time: A sunless tan is a color, not a sunscreen: without sunscreen ingredients and an SPF, it gives no sun protection.

Correct answer: B · Use a new disposable wand for each dip, and never reuse one in the tube

FDA's eye cosmetic safety page warns that misused eye cosmetics can let bacteria or fungi grow and cause eye infections, that another person's germs may be hazardous, and that shared testers carry extra risk unless single-use applicators are used. A fresh disposable wand for every dip, never returned to the tube once used, keeps each client's germs out of the shared product. Wiping one wand on a tissue does not clean it. A personal wand redipped into the shared tube still carries that client's germs into the mascara the next client gets. Misting with alcohol is not an approach FDA describes, and NIC's outline lists disposables under makeup infection control.

Look for this next time: Use a new disposable applicator for each dip into a shared makeup product, and never put a used one back.