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26. When assessing a lesion diagnosed as malignant melanoma, the nurse most likely expects to note which of the following?
a) an irregularly shaped lesion
b) a small papule with a dry, rough scale
c) a firm, nodular lesion topped with crust
d) a pearly papule with a crater and a waxy border
27. The nurse prepares discharge instructions for a client following cryosurgery for the treatment of a malignant skin lesion. Which of the following should the nurse include in the instructions?
a) avoid showering for 7 to 10 days
b) apply ice to the site to prevent discomfort
c) apply alcohol-soaked dressings twice a day
d) clean the site with hydrogen peroxide to prevent infection
28. The clinic nurse reviews the client's chart and notes that the physician has documented a diagnosis of paronychia. Based on this diagnosis, which of the following would the nurse expect to note during the assessment?
a) red shiny skin around the nail bed
b) white taut skin in the popliteal area
c) white silvery patches on the elbows
d) swelling of the skin near the parotid gland
29. The evening nurse reviews the nursing documentation in the client's chart and notes that the day nurse has documented that the client has a stage II pressure ulcer in the sacral area. Which of the following would the nurse expect to note on assessment of the client's sacral area?
a) intact skin
b) full-thickness skin loss
c) exposed bone, tendon, or muscle
d) partial-thickness skin loss of the dermis
30.The nurse is implementing a teaching plan to a group of adolescents regarding the causes of acne. Which of the following is an appropriate nursing statement regarding the cause of this disorder?
a) acne is caused by oily skin
b) the actual cause is not known
c) acne is caused by eating chocolate
d) acne is caused as a result of exposure to heat and humidity
ANSWERS AND RATIONALE
26) A
- A melanoma is an irregularly shaped pigmented papule or plaque with a red-, white-, or blue-toned color. Basal cell carcinoma appears as a pearly papule with a central crater and rolled waxy border. Squamous cell carcinoma is a firm, nodular lesion topped with a crust or a central area of ulceration. Actinic keratosis, a premalignant lesion, appears as a small macule or papule with a dry, rough, adherent yellow or brown scale.
27) D
- Cryosurgery involves the local application of liquid nitrogen to isolated lesions and causes cell death and tissue destruction. The nurse informs the client that swelling and increased tenderness of the treated area can occur when the skin thaws. Tissue freezing is followed by hemorrhagic blister formation in 1 to 2 days. The nurse instructs the client to clean the treatment site with hydrogen peroxide to prevent secondary infection. A topical antibiotic also may be prescribed. Application of a warm, damp washcloth intermittently to the site will provide relief from any discomfort. Alcohol-soaked dressings will cause irritation. The client does not need to avoid showering.
28) A
- Paronychia, or infection around the nail, is characterized by red, shiny skin, often associated with painful swelling. These infections frequently result from trauma, picking at the nail, or disorders such as dermatitis. Often, these become secondarily infected with bacteria or fungus, which later involves the nail. Warm soaks three or four times a day may reduce pain and pressure; however, incision and drainage of the inflamed site frequently are required. Options B, C, and D are incorrect.
29) D
- In a stage II pressure ulcer, the skin is not intact. Partial-thickness skin loss of the dermis has occurred. It presents as a shallow open ulcer with a red-pink wound bed, without slough. It may also present as an intact, open or ruptured, serum-filled blister. The skin is intact in stage I. Full-thickness skin loss occurs in stage 3. Exposed bone, tendon, or muscle is present in stage 4.
30) B
- The actual cause of acne is unknown. Oily skin or the consumption of foods such as chocolate, nuts, or fatty foods are not causes of acne. Exacerbations that coincide with the menstrual cycle result from hormonal activity. Heat, humidity, and excessive perspiration may play a role in exacerbating acne but does not cause it.
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Online Nursing Practice Test about Skin Disorder (1-5)
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