A nurse is assessing a client who reports a nevus that has increased in size and an irregularly shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses?

Squamous cell carcinoma

Malignant melanoma

Kaposi's sarcoma

Basal cell carcinoma

Answer and Explanation

The Correct Answer is B

Choice A reason:
Squamous cell carcinoma typically presents as a rough, scaly, red patch, open sore, or raised growth with a central depression, often on sun-exposed areas of the body. While it can appear as a lesion that varies in color, it is not commonly associated with a nevus that has increased in size.

Choice B reason:
Malignant melanoma is associated with changes in preexisting nevi, such as an increase in size and variations in color. It often appears as a mole that changes in color, size, or feel and may have irregular edges. The description of the lesion provided by the client is characteristic of malignant melanoma, making this the correct diagnosis.

Choice C reason:
Kaposi's sarcoma is a cancer that forms in the lining of blood and lymph vessels and typically appears as patches of abnormal tissue on the skin or mucous membranes. These lesions are usually red or purple and look similar to bruises¹. They are not typically described as nevi that increase in size or lesions that vary in color.

Choice D reason:
Basal cell carcinoma often appears as a slightly transparent bump on the skin, though it can take other forms. It usually presents as a pearly white or pink bump on white skin, or a brown or black bump on darker skin, and is most often found on sun-exposed areas. It is not typically associated with a nevus that has increased in size or an irregularly shaped lesion that varies in color.

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Correct Answer is B

Explanation

Choice A reason:
A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for a healthy individual without kidney disease. In chronic kidney disease (CKD), we would expect these values to be elevated due to the kidneys' reduced ability to filter waste products from the blood.

Choice B reason:
A BUN level of 45 mg/dL and a creatinine level of 8 mg/dL are significantly higher than the normal range, which is consistent with impaired kidney function seen in CKD. These elevated levels indicate that the kidneys are not effectively filtering urea and creatinine from the blood, leading to their accumulation.

Choice C reason:
A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL could be seen in the early stages of CKD. While the creatinine level is within the normal range, the BUN level is slightly elevated, which may suggest a decline in kidney function.

Choice D reason:
A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both below the normal range. This is an unlikely finding for a patient with CKD, as kidney impairment typically leads to increased levels of these substances in the blood.

A. Use an antibiotic ointment to treat skin breakdown. B. Do not apply heat to the area of irradiation. C. Lubricate the skin with hypoallergenic lotion. D. Do not wash the area of irradiation.

Correct Answer is B

Explanation

Choice A reason:
Using an antibiotic ointment is not typically recommended as a preventive measure for skin integrity during radiation therapy. Antibiotic ointments are used to treat bacterial infections, and their use should be directed by a healthcare provider if an infection is present or there is skin breakdown.

Choice B reason:
It is important not to apply heat to the area of irradiation as heat can increase skin irritation and the risk of burns in the treated area. Patients undergoing radiation therapy are advised to avoid heat sources, including heating pads, hot water bottles, and direct sunlight, to prevent further damage to the skin.

Choice C reason:
Lubricating the skin with hypoallergenic lotion can help maintain skin integrity by keeping it moisturized. However, it is crucial to use lotions that are free of metals, alcohol, perfumes, and dyes, as these can react with radiation and cause skin irritation. Lotions should be applied after radiation therapy sessions and not immediately before treatment.

Choice D reason:
The instruction not to wash the area of irradiation is incorrect. It is essential to keep the skin clean to reduce the risk of infection. Patients should gently wash the irradiated area with lukewarm water and mild soap, and pat the area dry with a soft towel. They should avoid scrubbing or using harsh soaps that can irritate the skin.

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A nurse is assessing a client who reports a nevus that has increased in size and an irregularly shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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