Nokea
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.
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A 30-year-old male patient has just returned from the operating room after having a flap done following a motorcycle accident. The patients wife asks the nurse about the major complications following this type of surgery. What would be the nurses best response?
- A. The major complication is when the patient develops chronic pain.
- B. The major complication is when the patient loses sensation in the flap.
- C. The major complication is when the pedicle tears loose and the flap dies.
- D. The major complication is when the blood supply fails and the tissue in the flap dies.
Correct Answer: D
Rationale: Flap necrosis due to failed blood supply is the primary complication, as it leads to tissue death. Pedicle tearing is less likely, and chronic pain or sensory loss are secondary concerns.
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.
A patient requires a full-thickness graft to cover a chronic wound. How is the donor site selected?
- A. The largest area of the body without hair is selected.
- B. Any area that is not normally visible can be used.
- C. An area matching the color and texture of the skin at the surgical site is selected.
- D. An area matching the sensory capability of the skin at the surgical site is selected.
Correct Answer: C
Rationale: Donor site selection for full-thickness grafts prioritizes matching the color and texture of the surgical site to minimize scarring and ensure aesthetic compatibility.
A nurse educator is teaching a group of medical nurses about Kaposis sarcoma. What would the educator identify as characteristics of endemic Kaposis sarcoma? Select all that apply.
- A. Affects people predominantly in the eastern half of Africa
- B. Affects men more than women
- C. Does not affect children
- D. Cannot infiltrate
- E. Can progress to lymphadenopathic forms
Correct Answer: A,B,E
Rationale: Endemic Kaposis sarcoma is prevalent in eastern Africa, affects men more, and can progress to lymphadenopathic forms. It can affect children and may infiltrate.
A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating an education plan for the patient. What information should be included in this plan?
- A. Use caution when taking nonprescription medications.
- B. Avoid public places until symptoms subside.
- C. Wash skin frequently to prevent infection.
- D. Liberally apply corticosteroids as needed.
Correct Answer: A
Rationale: Nonprescription medications may exacerbate psoriasis, so caution is needed. Psoriasis is not contagious, frequent washing can worsen scaling, and overuse of corticosteroids may cause skin atrophy.