Nokea
A patient with a suspected malignant melanoma is referred to the dermatology clinic. The nurse knows to facilitate what diagnostic test to rule out a skin malignancy?
- A. Tzanck smear
- B. Skin biopsy
- C. Patch testing
- D. Skin scrapings
Correct Answer: B
Rationale: A skin biopsy is used to diagnose or rule out skin malignancies like melanoma. Tzanck smears diagnose blistering conditions, patch testing identifies allergens, and skin scrapings detect fungal infections.
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A nurse is doing a shift assessment on a group of patients after first taking report. An elderly patient is having her second dose of IV antibiotics for a diagnosis of pneumonia. The nurse notices a new rash on the patients chest. The nurse should ask what priority question regarding the presence of a reddened rash?
- A. Is the rash worse at a particular time or season?
- B. Are you allergic to any foods or medication?
- C. Are you having any loss of sensation in that area?
- D. Is your rash painful?
Correct Answer: B
Rationale: A new rash during antibiotic therapy suggests a possible allergic reaction, which could be life-threatening. Assessing for allergies is the priority over timing, sensation, or pain.
A patient presents at the dermatology clinic with suspected herpes simplex. The nurse knows to prepare what diagnostic test for this condition?
- A. Skin biopsy
- B. Patch test
- C. Tzanck smear
- D. Examination with a Woods light
Correct Answer: C
Rationale: The Tzanck smear examines cells from blistering conditions like herpes simplex. Biopsies diagnose malignancies, patch tests identify allergens, and Woods light assesses pigmentation.
A new patient presents at the clinic and the nurse performs a comprehensive health assessment. The nurse notes that the patients fingernail surfaces are pitted. The nurse should suspect the presence of what health problem?
- A. Eczema
- B. Systemic lupus erythematosus (SLE)
- C. Psoriasis
- D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: C
Rationale: Pitted nails are a hallmark of psoriasis. Eczema, SLE, and COPD do not typically cause nail pitting.
Assessment of a patients leg reveals the presence of a 1.5-cm circular region of necrotic tissue that is deeper than the epidermis. The nurse should document the presence of what type of skin lesion?
- A. Keloid
- B. Ulcer
- C. Fissure
- D. Erosion
Correct Answer: B
Rationale: An ulcer involves skin loss past the epidermis with necrotic tissue. Keloids are scar tissue, fissures are linear, and erosions are superficial.
A nurse is preparing to perform the physical assessment of a newly admitted patient. During which of the following components of the assessment should the nurse wear gloves? Select all that apply.
- A. Palpation of the patients scalp
- B. Palpation of the patients upper extremities
- C. Palpation of a rash on the patients trunk
- D. Palpation of a lesion on the patients upper back
- E. Palpation of the patients fingers
Correct Answer: C,D
Rationale: Gloves are required when palpating rashes or lesions to prevent contact with potential infectious material. Palpation of scalp, extremities, or fingers does not typically require gloves unless body fluids are present.