Nokea
A nurse is providing care for a patient who has psoriasis. The nurse is aware of the sequelae that can result from this health problem. Following the appearance of skin lesions, the nurse should prioritize what assessment?
- A. Assessment of the patients stool for evidence of intestinal sloughing
- B. Assessment of the patients apical heart rate for dysrhythmias
- C. Assessment of the patients joints for pain and decreased range of motion
- D. Assessment for cognitive changes resulting from neurologic lesions
Correct Answer: C
Rationale: Psoriasis can lead to psoriatic arthritis in up to 30% of cases, necessitating joint assessment for pain and reduced mobility. It does not affect GI, cardiac, or neurologic function.
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A patient has recently been diagnosed with advanced malignant melanoma and is scheduled for a wide excision of the tumor on her chest. In writing the plan of care for this patient, what major nursing diagnosis should the nurse include?
- A. Deficient Knowledge about Early Signs of Melanoma
- B. Chronic Pain Related to Surgical Excision and Grafting
- C. Depression Related to Reconstructive Surgery
- D. Anxiety Related to Lack of Social Support
Correct Answer: A
Rationale: Advanced melanoma suggests a lack of early detection, indicating deficient knowledge about melanoma signs. Excision does not cause chronic pain, and depression or anxiety may not be primary concerns.
A 65-year-old man presents at the clinic complaining of nodules on both legs. The man tells the nurse that his son, who is in medical school, encouraged him to seek prompt care and told him that the nodules are related to the fact that he is Jewish. What health problem should the nurse suspect?
- A. Stasis ulcers
- B. Bullous pemphigoid
- C. Psoriasis
- D. Classic Kaposis sarcoma
Correct Answer: D
Rationale: Classic Kaposis sarcoma, common in Jewish men aged 40-70, presents as nodules on the lower extremities. Stasis ulcers, bullous pemphigoid, and psoriasis have different presentations.
A patient presents at the free clinic with a black, wart-like lesion on his face, stating, Ive done some research, and Im pretty sure I have malignant melanoma. Subsequent diagnostic testing results in a diagnosis of seborrheic keratosis. The nurse should recognize what significance of this diagnosis?
- A. The patient requires no treatment unless he finds the lesion to be cosmetically unacceptable.
- B. The patients lesion will be closely observed for 6 months before a plan of treatment is chosen.
- C. The patient has one of the few dermatologic malignancies that respond to chemotherapy.
- D. The patient will likely require wide excision.
Correct Answer: A
Rationale: Seborrheic keratosis is benign and requires no treatment unless cosmetically bothersome. It is not malignant, so chemotherapy or excision is unnecessary, and observation is not required.
A patient comes to the dermatology clinic requesting the removal of a port-wine stain on his right cheek. The nurse knows that the procedure especially useful in treating cutaneous vascular lesions such as portwine stains is what?
- A. Skin graft
- B. Laser treatment
- C. Chemical face peeling
- D. Free flap
Correct Answer: B
Rationale: Laser treatment, such as argon laser, effectively treats vascular lesions like port-wine stains. Skin grafts, chemical peels, and free flaps are not suitable for this purpose.
A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants risks of basal cell carcinoma (BCC)?
- A. Teaching participants to improve their overall health through nutrition
- B. Encouraging participants to identify their family history of cancer
- C. Teaching participants to limit their sun exposure
- D. Teaching participants to control exposure to environmental and occupational radiation
Correct Answer: C
Rationale: Limiting sun exposure is the most effective way to reduce BCC risk, as UV radiation is the primary cause. Nutrition, family history, and other radiation exposures are less directly related.