Question 1

The nurse is talking to a group of young adults about decreasing the risk for skin cancer.A young woman asks the nurse about the safety of ultraviolet light tanning salons.Which response by the nurse is most appropriate?
A) "Using tanning beds without clothing contaminates skin and leads to infections."
B) "Tanning from ultraviolet light is safer than sunshine."
C) "Using sunscreen will prevent skin cancers, even in tanning beds."
D) "Skin damage from ultraviolet light is more likely than from indirect sunlight."

Accepted Answer

A) Ultraviolet light exposure greatly increases risk of skin cancer, both basal cell and melanoma types. While direct sunshine contains ultraviolet light, the amount is decreased in indirect light. The use of sunscreen can reduce the risk of cancer but not prevent it, especially in tanning beds where the ultraviolet light is intensified. That using tanning beds without clothing causes infection may or may not be true, depending on the disinfectant methods used.
B) Ultraviolet light exposure greatly increases risk of skin cancer, both basal cell and melanoma types. While direct sunshine contains ultraviolet light, the amount is decreased in indirect light. The use of sunscreen can reduce the risk of cancer but not prevent it, especially in tanning beds where the ultraviolet light is intensified. That using tanning beds without clothing causes infection may or may not be true, depending on the disinfectant methods used.
C) Ultraviolet light exposure greatly increases risk of skin cancer, both basal cell and melanoma types. While direct sunshine contains ultraviolet light, the amount is decreased in indirect light. The use of sunscreen can reduce the risk of cancer but not prevent it, especially in tanning beds where the ultraviolet light is intensified. That using tanning beds without clothing causes infection may or may not be true, depending on the disinfectant methods used.
D) Ultraviolet light exposure greatly increases risk of skin cancer, both basal cell and melanoma types. While direct sunshine contains ultraviolet light, the amount is decreased in indirect light. The use of sunscreen can reduce the risk of cancer but not prevent it, especially in tanning beds where the ultraviolet light is intensified. That using tanning beds without clothing causes infection may or may not be true, depending on the disinfectant methods used.

Question 2

A nurse is planning care for a client with sickle cell disease and chooses "Acute Pain" as the nursing diagnosis.Which intervention is inappropriate for the nurse to include in this plan of care?
A) Administer ordered analgesic medications around the clock.
B) Place patient in position of comfort.
C) Use heat or cold packs as tolerated.
D) Support the client's joints and extremities with pillows.

Accepted Answer

A) The client with sickle cell disease who is in a sickle cell crisis will likely have extreme pain. To aid in caring for this client, the nurse will administer ordered analgesic medications around the clock, place the patient in position of comfort, and support the client's joints and extremities with pillows. The use of heat or cold packs is contraindicated in the sickle cell client. Ischemic tissue is fragile and has reduced sensation, increasing the risk of burn injury from hot compresses, whereas cold compresses promote sickling.
B) The client with sickle cell disease who is in a sickle cell crisis will likely have extreme pain. To aid in caring for this client, the nurse will administer ordered analgesic medications around the clock, place the patient in position of comfort, and support the client's joints and extremities with pillows. The use of heat or cold packs is contraindicated in the sickle cell client. Ischemic tissue is fragile and has reduced sensation, increasing the risk of burn injury from hot compresses, whereas cold compresses promote sickling.
C) The client with sickle cell disease who is in a sickle cell crisis will likely have extreme pain. To aid in caring for this client, the nurse will administer ordered analgesic medications around the clock, place the patient in position of comfort, and support the client's joints and extremities with pillows. The use of heat or cold packs is contraindicated in the sickle cell client. Ischemic tissue is fragile and has reduced sensation, increasing the risk of burn injury from hot compresses, whereas cold compresses promote sickling.
D) The client with sickle cell disease who is in a sickle cell crisis will likely have extreme pain. To aid in caring for this client, the nurse will administer ordered analgesic medications around the clock, place the patient in position of comfort, and support the client's joints and extremities with pillows. The use of heat or cold packs is contraindicated in the sickle cell client. Ischemic tissue is fragile and has reduced sensation, increasing the risk of burn injury from hot compresses, whereas cold compresses promote sickling.

Question 3

A client is scheduled to have a suspected cancerous lesion removed from the arm.When planning care for this client,which outcome would be a priority?
A) The client will make nutritional changes.
B) The client will experience minimal pain after healing.
C) The client will heal without signs of infection.
D) The client will not need to make lifestyle changes.

Accepted Answer

A) Following removal of a skin lesion, the nurse directs care aimed at the prevention of infection while the skin heals. The client should not experience pain after healing and will need to make lifestyle changes to prevent further occurrences of skin cancer. Nutritional changes may or may not be needed; however, prevention of infection is the priority.
B) Following removal of a skin lesion, the nurse directs care aimed at the prevention of infection while the skin heals. The client should not experience pain after healing and will need to make lifestyle changes to prevent further occurrences of skin cancer. Nutritional changes may or may not be needed; however, prevention of infection is the priority.
C) Following removal of a skin lesion, the nurse directs care aimed at the prevention of infection while the skin heals. The client should not experience pain after healing and will need to make lifestyle changes to prevent further occurrences of skin cancer. Nutritional changes may or may not be needed; however, prevention of infection is the priority.
D) Following removal of a skin lesion, the nurse directs care aimed at the prevention of infection while the skin heals. The client should not experience pain after healing and will need to make lifestyle changes to prevent further occurrences of skin cancer. Nutritional changes may or may not be needed; however, prevention of infection is the priority.

Question 4

During a routine physical examination of a client's lungs,the nurse notes a small,fleshy bump on the client's upper chest.What should the nurse suspect as the cause of this finding on the client's skin?
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Actinic keratosis
D) Malignant melanoma

Accepted Answer

A) Basal cell carcinoma often presents as a small, fleshy bump. Squamous cell carcinoma most often appears as a flesh-colored, erythematous, indurated scaly plaque. Malignant melanoma manifests as black, brown, or multicolored nodules or plaques. Actinic keratosis is a precancerous condition. The lesion appears as a sore, rough, scaly plaque.
B) Basal cell carcinoma often presents as a small, fleshy bump. Squamous cell carcinoma most often appears as a flesh-colored, erythematous, indurated scaly plaque. Malignant melanoma manifests as black, brown, or multicolored nodules or plaques. Actinic keratosis is a precancerous condition. The lesion appears as a sore, rough, scaly plaque.
C) Basal cell carcinoma often presents as a small, fleshy bump. Squamous cell carcinoma most often appears as a flesh-colored, erythematous, indurated scaly plaque. Malignant melanoma manifests as black, brown, or multicolored nodules or plaques. Actinic keratosis is a precancerous condition. The lesion appears as a sore, rough, scaly plaque.
D) Basal cell carcinoma often presents as a small, fleshy bump. Squamous cell carcinoma most often appears as a flesh-colored, erythematous, indurated scaly plaque. Malignant melanoma manifests as black, brown, or multicolored nodules or plaques. Actinic keratosis is a precancerous condition. The lesion appears as a sore, rough, scaly plaque.

Question 5

An African-American client tells the nurse of plans to bask in the sun on an upcoming vacation.The nurse questions the client about sunscreen use.Which response indicates the client needs further education?
A) "I don't need sunscreen because I am dark-skinned already."
B) "I will avoid the sun between the peak hours of 10 am and 4 pm."
C) "I can still experience sun damage despite my dark skin tones."
D) "The melanocytes in my skin provide me with increased protection from the sun."

Accepted Answer

A) While the melanocytes in darker skin offer increased protection, the risk for skin cancer remains and sunscreen should be worn. The other client responses are correct.
B) While the melanocytes in darker skin offer increased protection, the risk for skin cancer remains and sunscreen should be worn. The other client responses are correct.
C) While the melanocytes in darker skin offer increased protection, the risk for skin cancer remains and sunscreen should be worn. The other client responses are correct.
D) While the melanocytes in darker skin offer increased protection, the risk for skin cancer remains and sunscreen should be worn. The other client responses are correct.

Question 6

A client shows the nurse a new sore on the forearm that has been increasing in size and will not heal.Which characteristics could indicate to the nurse that this sore is a malignant neoplasm? Select all that apply.
A) Invasive
B) Slow-growing
C) Localized
D) Immovable
E) Noncohesive

Accepted Answer

A) Malignant neoplasms are invasive, noncohesive, characterized by rapid growth, and not always easy to remove. They do not stop at the tissue border but invade and destroy surrounding tissues, metastasize to distant sites, and can recur. Benign neoplasms are local, cohesive, encapsulated, characterized by slow growth, and easily removed. They have well-defined borders, push other tissues out of the way, and do not recur.
B) Malignant neoplasms are invasive, noncohesive, characterized by rapid growth, and not always easy to remove. They do not stop at the tissue border but invade and destroy surrounding tissues, metastasize to distant sites, and can recur. Benign neoplasms are local, cohesive, encapsulated, characterized by slow growth, and easily removed. They have well-defined borders, push other tissues out of the way, and do not recur.
C) Malignant neoplasms are invasive, noncohesive, characterized by rapid growth, and not always easy to remove. They do not stop at the tissue border but invade and destroy surrounding tissues, metastasize to distant sites, and can recur. Benign neoplasms are local, cohesive, encapsulated, characterized by slow growth, and easily removed. They have well-defined borders, push other tissues out of the way, and do not recur.
D) Malignant neoplasms are invasive, noncohesive, characterized by rapid growth, and not always easy to remove. They do not stop at the tissue border but invade and destroy surrounding tissues, metastasize to distant sites, and can recur. Benign neoplasms are local, cohesive, encapsulated, characterized by slow growth, and easily removed. They have well-defined borders, push other tissues out of the way, and do not recur.
E) Malignant neoplasms are invasive, noncohesive, characterized by rapid growth, and not always easy to remove. They do not stop at the tissue border but invade and destroy surrounding tissues, metastasize to distant sites, and can recur. Benign neoplasms are local, cohesive, encapsulated, characterized by slow growth, and easily removed. They have well-defined borders, push other tissues out of the way, and do not recur.

Question 7

The nurse is caring for a client who has recently been diagnosed with skin cancer.The client is tearful and states,"How did I get skin cancer? I don't believe in tanning!" Which response by the nurse is indicated at this time?
A) "Can you tell me more about your feelings?"
B) "This is unusual, as skin cancer normally only occurs in sunbathers."
C) "Sun exposure can happen as we carry out our daily activities."
D) "We frequently never find out why cancer strikes."

Accepted Answer

A) Sun exposure occurs as we carry out our daily activities. Riding in the car, going in and out of buildings, and so on permit sun exposure. The client is asking for information; the other options do not provide adequate or correct information.
B) Sun exposure occurs as we carry out our daily activities. Riding in the car, going in and out of buildings, and so on permit sun exposure. The client is asking for information; the other options do not provide adequate or correct information.
C) Sun exposure occurs as we carry out our daily activities. Riding in the car, going in and out of buildings, and so on permit sun exposure. The client is asking for information; the other options do not provide adequate or correct information.
D) Sun exposure occurs as we carry out our daily activities. Riding in the car, going in and out of buildings, and so on permit sun exposure. The client is asking for information; the other options do not provide adequate or correct information.

Question 8

A client presents to the primary care clinic for an annual physical.The nurse caring for the client notes that the client's healthcare provider uses the ABCD mnemonic to assess suspicious skin lesions.What does the "D" in ABCD represent?
A) Diameter of lesion greater than 8mm
B) Distance of lesion to an additional lesion
C) Diameter of lesion greater than 6mm
D) Depth of lesion

Accepted Answer

A) The ABCD rule is used to assess suspicious lesions:
Asymmetry (One half of the nevus does not match the other half.)
Border irregularity (Edges are ragged, blurred, or notched.)
Color variation or dark black color
Diameter greater than 6 mm (size of a pencil eraser)
B) The ABCD rule is used to assess suspicious lesions:
Asymmetry (One half of the nevus does not match the other half.)
Border irregularity (Edges are ragged, blurred, or notched.)
Color variation or dark black color
Diameter greater than 6 mm (size of a pencil eraser)
C) The ABCD rule is used to assess suspicious lesions:
Asymmetry (One half of the nevus does not match the other half.)
Border irregularity (Edges are ragged, blurred, or notched.)
Color variation or dark black color
Diameter greater than 6 mm (size of a pencil eraser)
D) The ABCD rule is used to assess suspicious lesions:
Asymmetry (One half of the nevus does not match the other half.)
Border irregularity (Edges are ragged, blurred, or notched.)
Color variation or dark black color
Diameter greater than 6 mm (size of a pencil eraser)

Question 9

The nurse is caring for an older adolescent client diagnosed with malignant melanoma.Which nursing diagnoses would be appropriate when planning this client's care? Select all that apply.
A) Impaired Skin Integrity
B) Risk for Compromised Human Dignity
C) Anxiety
D) Risk for Acute Confusion
E) Disturbed Body Image

Accepted Answer

A) Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.
B) Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.
C) Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.
D) Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.
E) Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.

Question 10

An emergency department nurse is caring for a child in a sickle cell crisis.The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations? Select all that apply.
A) The client has profound pallor and fatigue.
B) The client is in extreme pain.
C) The client has profound hypotension and shock.
D) The client has a fever.
E) The client's chest CT reveals a pulmonary infarct.

Accepted Answer

A) A thrombotic sickle cell crisis is manifested by extreme pain and fever. The client in profound hypotension and shock likely has splenic sequestration as the etiology, not thrombosis. The client with a pulmonary infarct likely has Acute Chest Syndrome, not thrombosis. The client with profound pallor and fatigue likely is in an aplastic crisis, not thrombosis.
B) A thrombotic sickle cell crisis is manifested by extreme pain and fever. The client in profound hypotension and shock likely has splenic sequestration as the etiology, not thrombosis. The client with a pulmonary infarct likely has Acute Chest Syndrome, not thrombosis. The client with profound pallor and fatigue likely is in an aplastic crisis, not thrombosis.
C) A thrombotic sickle cell crisis is manifested by extreme pain and fever. The client in profound hypotension and shock likely has splenic sequestration as the etiology, not thrombosis. The client with a pulmonary infarct likely has Acute Chest Syndrome, not thrombosis. The client with profound pallor and fatigue likely is in an aplastic crisis, not thrombosis.
D) A thrombotic sickle cell crisis is manifested by extreme pain and fever. The client in profound hypotension and shock likely has splenic sequestration as the etiology, not thrombosis. The client with a pulmonary infarct likely has Acute Chest Syndrome, not thrombosis. The client with profound pallor and fatigue likely is in an aplastic crisis, not thrombosis.
E) A thrombotic sickle cell crisis is manifested by extreme pain and fever. The client in profound hypotension and shock likely has splenic sequestration as the etiology, not thrombosis. The client with a pulmonary infarct likely has Acute Chest Syndrome, not thrombosis. The client with profound pallor and fatigue likely is in an aplastic crisis, not thrombosis.

Question 11

The nurse is teaching a group of community members about preventing skin cancer.Which participant would be at the greatest risk for skin cancer?
A) A 25-year-old lifeguard at the community pool who wears sunscreen
B) A baby underneath a large beach umbrella
C) A 60-year-old farmer who wears a cap when working
D) A teenager who wears a ski outfit when skiing

Accepted Answer

A) The older adult client has had more years of living to increase the risk of skin cancer from exposure to the sun. In addition, the farmer wears a cap, but no mention is made of protectant sunscreens or long-sleeved shirts and pants. The lifeguard, baby, and teenager have lesser risk because there are physical barriers to the sun identified in each option: sunscreen, umbrella, and ski outfit.
B) The older adult client has had more years of living to increase the risk of skin cancer from exposure to the sun. In addition, the farmer wears a cap, but no mention is made of protectant sunscreens or long-sleeved shirts and pants. The lifeguard, baby, and teenager have lesser risk because there are physical barriers to the sun identified in each option: sunscreen, umbrella, and ski outfit.
C) The older adult client has had more years of living to increase the risk of skin cancer from exposure to the sun. In addition, the farmer wears a cap, but no mention is made of protectant sunscreens or long-sleeved shirts and pants. The lifeguard, baby, and teenager have lesser risk because there are physical barriers to the sun identified in each option: sunscreen, umbrella, and ski outfit.
D) The older adult client has had more years of living to increase the risk of skin cancer from exposure to the sun. In addition, the farmer wears a cap, but no mention is made of protectant sunscreens or long-sleeved shirts and pants. The lifeguard, baby, and teenager have lesser risk because there are physical barriers to the sun identified in each option: sunscreen, umbrella, and ski outfit.

Question 12

The nurse is reviewing the medical records for several clients who will be seen in the clinic today.According to the ABCD rule,which client may require removal of the skin lesion?
A) A client with a lesion that is symmetrical with an irregular border, a single color, and increased diameter
B) A client with a lesion that is symmetrical, with a smooth border, a single color, and diameter that has stayed the same
C) A client with a lesion that is asymmetrical with a regular border, two colors, and decreased diameter
D) A client with a lesion that is asymmetrical with an irregular border, two colors, and increased diameter

Accepted Answer

A) To meet all four criteria for removal of a lesion, the lesion will be asymmetrical, have irregular borders, show color change or more than one color, and have increased in diameter.
B) To meet all four criteria for removal of a lesion, the lesion will be asymmetrical, have irregular borders, show color change or more than one color, and have increased in diameter.
C) To meet all four criteria for removal of a lesion, the lesion will be asymmetrical, have irregular borders, show color change or more than one color, and have increased in diameter.
D) To meet all four criteria for removal of a lesion, the lesion will be asymmetrical, have irregular borders, show color change or more than one color, and have increased in diameter.

Question 13

During an assessment,the nurse notes leukoplakia when examining the client's mouth.The client is a smoker and explains to the nurse that it has been there for more than a month.After documenting the finding and informing the healthcare provider,what should the nurse anticipate next?
A) Antifungal medication will be prescribed.
B) A biopsy will be performed.
C) An order to provide thorough mouth care
D) A dental consult

Accepted Answer

A) Leukoplakia is a smooth irregular white patch found on the tongue, lips, cheeks, or oral mucosa that can be rubbed off with force and is considered a precursor to oral cancer. A patch that lasts more than 2 weeks is generally biopsied. Mouth care and antifungal medication would not address the possibility of oral cancer. A dental consult may be advised, but a biopsy would take priority.
B) Leukoplakia is a smooth irregular white patch found on the tongue, lips, cheeks, or oral mucosa that can be rubbed off with force and is considered a precursor to oral cancer. A patch that lasts more than 2 weeks is generally biopsied. Mouth care and antifungal medication would not address the possibility of oral cancer. A dental consult may be advised, but a biopsy would take priority.
C) Leukoplakia is a smooth irregular white patch found on the tongue, lips, cheeks, or oral mucosa that can be rubbed off with force and is considered a precursor to oral cancer. A patch that lasts more than 2 weeks is generally biopsied. Mouth care and antifungal medication would not address the possibility of oral cancer. A dental consult may be advised, but a biopsy would take priority.
D) Leukoplakia is a smooth irregular white patch found on the tongue, lips, cheeks, or oral mucosa that can be rubbed off with force and is considered a precursor to oral cancer. A patch that lasts more than 2 weeks is generally biopsied. Mouth care and antifungal medication would not address the possibility of oral cancer. A dental consult may be advised, but a biopsy would take priority.

Question 14

A nurse working in an outpatient dermatology clinic is caring for a client who has been diagnosed with a lentigo maligna.Which statement is inappropriate for the nurse to include in the client's teaching plan?
A) The lesion is also called Robertson freckle.
B) The lesion is a precursor to melanoma.
C) The lesion is a tan or black patch on the skin that looks like a freckle.
D) The lesion grows slowly, becoming mottled, dark, thick, and nodular.

Accepted Answer

A) A lentigo maligna, also called a Hutchinson freckle, is a precursor to melanoma. The lesion is a tan or black patch on the skin that looks like a freckle. The lesion grows slowly, and becomes mottled, dark, thick, and nodular.
B) A lentigo maligna, also called a Hutchinson freckle, is a precursor to melanoma. The lesion is a tan or black patch on the skin that looks like a freckle. The lesion grows slowly, and becomes mottled, dark, thick, and nodular.
C) A lentigo maligna, also called a Hutchinson freckle, is a precursor to melanoma. The lesion is a tan or black patch on the skin that looks like a freckle. The lesion grows slowly, and becomes mottled, dark, thick, and nodular.
D) A lentigo maligna, also called a Hutchinson freckle, is a precursor to melanoma. The lesion is a tan or black patch on the skin that looks like a freckle. The lesion grows slowly, and becomes mottled, dark, thick, and nodular.

Quiz 2: Cellular Regulation

The nurse is talking to a group of young adults about decreasing the risk for skin cancer.A young woman asks the nurse about the safety of ultraviolet light tanning salons.Which response by the nurse is most appropriate?

A nurse is planning care for a client with sickle cell disease and chooses "Acute Pain" as the nursing diagnosis.Which intervention is inappropriate for the nurse to include in this plan of care?

A client is scheduled to have a suspected cancerous lesion removed from the arm.When planning care for this client,which outcome would be a priority?

During a routine physical examination of a client's lungs,the nurse notes a small,fleshy bump on the client's upper chest.What should the nurse suspect as the cause of this finding on the client's skin?

An African-American client tells the nurse of plans to bask in the sun on an upcoming vacation.The nurse questions the client about sunscreen use.Which response indicates the client needs further education?

A client shows the nurse a new sore on the forearm that has been increasing in size and will not heal.Which characteristics could indicate to the nurse that this sore is a malignant neoplasm? Select all that apply.

The nurse is caring for a client who has recently been diagnosed with skin cancer.The client is tearful and states,"How did I get skin cancer? I don't believe in tanning!" Which response by the nurse is indicated at this time?

A client presents to the primary care clinic for an annual physical.The nurse caring for the client notes that the client's healthcare provider uses the ABCD mnemonic to assess suspicious skin lesions.What does the "D" in ABCD represent?

The nurse is caring for an older adolescent client diagnosed with malignant melanoma.Which nursing diagnoses would be appropriate when planning this client's care? Select all that apply.

An emergency department nurse is caring for a child in a sickle cell crisis.The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations? Select all that apply.

The nurse is teaching a group of community members about preventing skin cancer.Which participant would be at the greatest risk for skin cancer?

The nurse is reviewing the medical records for several clients who will be seen in the clinic today.According to the ABCD rule,which client may require removal of the skin lesion?

During an assessment,the nurse notes leukoplakia when examining the client's mouth.The client is a smoker and explains to the nurse that it has been there for more than a month.After documenting the finding and informing the healthcare provider,what should the nurse anticipate next?

A nurse working in an outpatient dermatology clinic is caring for a client who has been diagnosed with a lentigo maligna.Which statement is inappropriate for the nurse to include in the client's teaching plan?