medsurg exam 3 melanoma evolve and ati

A patient reports to the clinic nurse a ring-like itchy rash on the upper leg, low-grade fever, nausea, and joint pain for the past 3 weeks. What question is most important for the nurse to ask the patient? a. "Is the itching worse at night?" b. "Have you had a tick bite recently?" c. "Have you been exposed to pubic lice?" d. "Have you had unprotected sexual contact?"

b. "Have you had a tick bite recently?"

A nurse is teaching a group of clients about skin cancer. The nurse should explain that basal cell carcinoma originates from which of the following tissues? A. Subcutaneous B. Epidermis C. Dermis D. Stratum corneum

B. epidermis

A nurse is caring for a client who has regular occupational exposure to sunlight and presents for evaluation of several skin lesions. Which of the following findings should alert the nurse to the possibility of malignant melanoma? A. A pearly papule that is 0.5 cm (0.20 in) wide with raised, indistinct borders on the upper right shoulder B. Several flat, pigmented, circumscribed areas of various sizes over the bridge of the nose C. A raised, circumscribed lesion on the face that contains yellow-white purulent material D. An irregularly shaped brown lesion with light blue areas on the neck

D. An irregularly shaped brown lesion with light blue areas on the neck

A nurse is assessing a client who has a lesion on his skin. Which of the following findings is a clinical manifestation of malignant melanoma? A. Rough, dry, scaly lesion B. Firm nodule with crusting C. Pearly papule with ulcerated center D. Irregularly shaped lesion with blue tones

D. Irregularly shaped lesion with blue tones

A nurse is planning care for a client who has been admitted for the treatment of a malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures? A. Curettage B. External radiation therapy C. Regional chemotherapy D. Surgical excision

D. surgical excision

The nurse is teaching the residents of an independent living facility about preventing skin infections and infestations. What should be included in the teaching? a. Use cool compresses if an infection occurs. b. Oral antibiotics are needed for any skin changes. c. Antiviral agents will be needed to prevent outbreaks. d. Inspect skin for changes when bathing with mild soap.

d. Inspect skin for changes when bathing with mild soap.

Which patient has the highest risk of developing melanoma? a. A fair-skinned woman who uses a tanning booth regularly b. A black patient with a family history of breast and colon cancer d. A Hispanic man with psoriasis and eczema that did not respond to treatment d. An adult who had phototherapy as an infant for the treatment of hyperbilirubinemia

a. A fair-skinned woman who uses a tanning booth regularly

hich nursing intervention would be most helpful in managing a patient newly admitted with cellulitis of the right foot? a. Applying warm, moist heat b. Wrapping the foot snugly in blankets c. Keeping the foot at or below heart level d. Limiting ambulation to three times daily

a. Applying warm, moist heat

The postoperative patient has dry skin and reports pruritus on both legs. What nursing actions can help stop the itch-scratch cycle? (Select all that apply.) a. Moisturize the skin on the legs. b. Provide a warm blanket and room. c. Administer antihistamines at bedtime. d. Vigorously rub the patient's legs after bathing. e. Cleanse the legs with a saline solution twice daily.

a. Moisturize the skin on the legs. c. Administer antihistamines at bedtime.

The nurse would assess a patient admitted with cellulitis for what localized manifestation? a. Pain b. Fever c. Chills d. Malaise

a. Pain

In a patient admitted with cellulitis of the left foot, which clinical manifestation would the nurse expect to find on assessment of the left foot? a. Redness and swelling b. Pallor and poor turgor c. Cyanosis and coolness d. Edema and brown skin discoloration

a. Redness and swelling

The nurse is teaching a patient about her medications. With which medication would the nurse teach the patient to avoid prolonged sun exposure? a. Tetracycline b. Ipratropium c. Morphine sulfate d. Oral contraceptives

a. Tetracycline

A patient admitted with heart failure is diagnosed with herpes zoster and draining vesicles. Which action, if observed by the nurse, would require additional teaching for that person? a. The dietitian wears a mask when entering the patient's room. b. The patient keeps the draining vesicles covered with a dressing. c. The UAP washes hands frequently and wears gloves when in the room. d. The student nurse who takes prednisone requests a new patient assignment.

a. The dietitian wears a mask when entering the patient's room.

A patient has been diagnosed with tinea unguium (onychomycosis) under the nails but does not like the oral antifungal medication. What is the best alternate treatment the nurse should describe for her? a. nail avulsion b. anti fungal cream c. thinning of fingernails d. soaking nails in saltwater

a. nail avulsion

The patient with a stage 4 pressure injury on the coccyx will need a skin graft to close the wound. Which postoperative care should the nurse expect to use to facilitate healing? a. no straining of the grafted site b. the wound will be exposed to air c. soft tissue expansion will be done daily d. the pressure dressing will not be removed

a. no straining of the grafted site

The nurse teaches a patient with chronic kidney disease about several interventions to reduce pruritus associated with dry skin and uremia. Which statement, if made by the patient to the nurse, indicates further teaching is required? a. "I will avoid taking hot showers." b. "I can rub my skin instead of scratching." c. "Menthol can be used to numb the itch sensation." d. "A lubricating lotion right after bathing will help."

b. "I can rub my skin instead of scratching."

The patient has bleeding gums and purpura. What vitamin in these foods should be encouraged as a nutritional aid to these problems? a. Vitamin A in sweet potatoes, carrots, dark leafy greens b. Vitamin C in peppers, dark leafy greens, broccoli, and kiwi c. Vitamin D in canned salmon, sardines, fortified dairy, and eggs d. Vitamin B7 in liver, cauliflower, salmon, carrots

b. Vitamin C in peppers, dark leafy greens, broccoli, and kiwi

A patient is admitted with a diagnosis of cellulitis of the left leg and has been placed on antibiotics. Which laboratory result is the best indicator that the treatment is having a positive outcome for the patient? a. WBC of 2900/uL b. WBC of 8200/uL c. WBC of 12,700/uL d. WBC of 16,300/uL

b. WBC of 8200/μL

The nurse is caring for a patient admitted for uncontrolled seizures who also has impetigo on the face and neck. Which action is appropriate for the nurse to take? a. Put on a protective gown before entering the room. b. Wash hands for 1 to 2 minutes when leaving the room. c. Wear gloves to leave a diet menu on the patient's table. d. Wear a particulate mask when within 3 feet of the patient.

b. Wash hands for 1 to 2 minutes when leaving the room.

A community health nurse is teaching a group of clients about malignant melanoma. Which of the following traits places a client at risk for developing malignant melanoma? A. Brown eyes B. Light skin C. Black hair D. Dark skin

b. light skin

A nurse is caring for a client who has a lesion on the back of his right hand. The client asks the nurse which type of skin cancer is the most serious. Which of the following responses by the nurse is appropriate? A. Basal cell carcinoma B. Melanoma C. Actinic keratosis D. Squamous cell carcinoma

b. melanoma

he nurse is providing preoperative teaching for the patient having a facelift (rhytidectomy) surgery. Which patient response indicates the patient understands the teaching? a. "I am afraid of the pain afterwards, while it is healing." b. "I can't wait to have my forehead and lip wrinkles eliminated." c. "I have some time off work so I will not look so bad when I go back." d. "Now I can be excited to go to my fiftieth high school reunion this week."

c. "I have some time off work so I will not look so bad when I go back."

The nurse is teaching about skin cancer prevention at the community center. Which person is most at risk for developing skin cancer? a. A 67-yr-old bald man with psoriasis and type 2 diabetes. b. A 76-yr-old Hispanic man who has a latex allergy and numerous acrochordons. c. A 55-yr-old woman with fair skin and red hair and a family history of skin cancer. d. A 62-yr-old woman with chronic kidney disease who has blond hair with pale skin.

c. A 55-yr-old woman with fair skin and red hair and a family history of skin cancer.

A patient presents with a flat, dry, scaly area on the eyebrows that is treated with a chemical peel. What should the nurse include in the discharge teaching? a. Metastasis of this type of lesion is rare. b. The patient has an increased risk for melanoma. c. Recurrence of the premalignant lesion is possible. d. Untreated lesions may metastasize to regional lymph nodes.

c. Recurrence of the premalignant lesion is possible.

The nurse is performing a skin assessment for an older adult patient. What finding should the nurse immediately report to the health care provider? a. The presence of wrinkles on the face and hands. b. The patient's report of dry skin that is frequently itchy. c. The presence of an irregularly shaped mole that the patient states is new. d. The presence of veins on the back of the patient's leg that are blue and tortuous.

c. The presence of an irregularly shaped mole that the patient states is new.

The nurse assesses small, firm, reddened raised lesions with flat, rough patches on a patient that are causing intense pruritus. What question should the nurse next ask the patient? a. "Have you started any new medications?" b. "Do you have a history of seasonal allergies?" c. "Have you had any lesions such as this before?" d. "Tell me about your activities the past 2 to 7 days."

d. "Tell me about your activities the past 2 to 7 days."

A patient tells the nurse that they are afraid to use the treatment recommended for psoriasis. What is the best response by the nurse? a. "you will only know if you try and see" b. "you may need to get counseling to help you cope" c. "no treatment is medically necessary, but it could be removed" d. "topical, light therapy, and systemic medications are now available"

d. "topical, light therapy, and systemic medications are now available"

The nurse recognizes that which patient is likely to have the poorestprognosis? a. A patient with nodular ulcerative basal cell cancer. b. A patient who has been diagnosed with late squamous cell cancer. c. A patient whose is being treated for superficial squamous cell cancer. d. A patient who is newly diagnosed with stage IV malignant melanoma.

d. A patient who is newly diagnosed with stage IV malignant melanoma.

The nurse is teaching a patient about the application of a topical medication. What should the nurse include as part of the instructions? a. Avoid applying medications directly onto dressings. b. Use a tongue blade whenever the patient's skin integrity allows. c. Avoid covering skin areas where a topical medication has been applied. d. Apply a layer of medication that is just thick enough to ensure coverage.

d. Apply a layer of medication that is just thick enough to ensure coverage.

A community health nurse is teaching a group of clients about melanoma. Which of the following characteristics of lesions associated with melanoma should the nurse include in the teaching? A. One solid color B. Symmetrical shape C. <6 mm in diameter D. Irregular border

d. irregular border