Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

Where does the free border of the nail plate begin?

1. At the cuticle

2. At the point distal to the hyponychium

3. At the lunula

4. At the nail bed

The correct answer is: At the point distal to the hyponychium

The free border of the nail plate begins at the point distal to the hyponychium, which is the area of skin beneath the tip of the nail where it extends past the nail bed. The hyponychium serves as a protective barrier and is located at the junction of the nail plate and the skin of the fingertip. Because the free border represents the outer edge of the nail that is visible and extends beyond the nail bed, it's correctly identified as commencing just beyond the hyponychium. The cuticle, which is often thought to be associated with the nail plate, primarily serves as a protective seal along the proximal edge of the nail, rather than where the free border starts. The lunula, the visible white crescent at the base of the nail, does not define the beginning of the free border either, as it pertains more to the growth of the nail. The nail bed is where the nail plate rests and grows from, but it does not mark the initiation of the free border. Therefore, the correct understanding is that the free border of the nail plate exclusively begins distal to the hyponychium.