Medical-Surgical: Dermatological Exam Questions with
complete Solutions A nurse is planning care for a patient who has been admitted for treatment of a malignant melanoma of the upper life without many stasis. The nurse should plan to prepare the patient for which of the following procedures? - Correct Answer surgical excision -therapeutic approach: depends on level of invasion and depth of lesion; surgical excision is Tx of choice for small, superficial lesions, deeper lesions require wide, local excision followed by skin grafting -has an extremely high incidence of metastasis
-curettage: used for small lesions that are not melanomas
-regional/topical chemotherapy: Tx of choice for localized tumors and superficial basal cell carinomas The nurse is going for a patient who has a lesion on the back of his right hand. The patient asked the nurse which type of skin cancer is the most serious. Which of the following responses by the nurse is appropriate? - Correct Answer melanomas -malignant neoplasms w/ atypical melanocytes in both epidermis, dermis, and sometimes subcutaneous cells -most lethal skin cancer, often causing metastases in bone, liver, lungs, spleen, CNS, and lymph nodes -basal cell carcinoma: most common type of skin cancer, rarely metastasizes; arise from basal cell layer of epidermis or hair follicles and generally appear on sun-exposed areas of body -actinic keratoses: premalignant; can evolve to squamous cell carcinoma, however they're not the most lethal -squamous cell carcinoma: arise from epidermis and are potentially metastatic, however they're not most lethal The nurse is assessing a patient who has a lesion on the skin. Which of the following findings as a clinical manifestation of the malignant melanoma? - Correct Answer irregularly shaped lesions w/ blue tones -can also be red or white in tone -often occur on upper back and lower legs -manifestations of actinic keratosis: rough, dry, scaly lesions 1 / 2
-manifestations of squamous cell carcinoma: firm nodule w/ crust
-manifestation of basal cell carcinoma: pearly papule w/ ulcerated center
The nurse is caring for a patient who has burn injuries to his trunk. The nurse is explaining what to expect from the prescribed hydrotherapy. Which of the following statements by the patient indicates an understanding of the teaching? - Correct Answer "i will be on a special shower table" -facilitates examination and debridement of wound during hydrotherapy; advantage of using showering technique is that it can be kept at constant temp and lowers risk of wound infection compared to tub bath -use warm water to help maintain adequate body temp -use soft washcloths or gauze to gently scrub and debride -leave small blisters intact but open larger blisters A nurse in the ED is caring for a patient who has a snakebite on her arm. Which of the following intervention should the nurse implement? - Correct Answer immobilize the limb at the level of the heart -to limit spread of venom -constrictive clothing/jewelry should be removed before swelling worsens -contraindicated: tourniquet to affected limb, use sterile scapula to incise wound, apply ice to skin over snakebite wound A nurse in the providers office is assessing a patient skin lesions. The nurse notes that the lesions are 0.5 cm (0.2 in) in size, elevated, and solid, with very distinct borders. The nurse should document the findings which of the following is commissions? - Correct Answer papules -small, solid, elevated lesion w/ distinct borders -macule: flat, variably shaped, discolored, and small, typically smaller than 10 mm in diameter; is a change in color of skin; freckles and rash associated w/ rubella are types of macules -wheals: hives; transient, elevated, irregularly shaped lesions caused by localized edema; common manifestation of allergic rxn -vesicles: circumscribed, elevated lesion or blister containing serous fluid; typically arise w/ herpes simplex, poison ivy, chickenpox
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