A nurse is assessing a patient who presents with a scaly, crusted lesion with a central ulceration on the lower leg, as shown in the image. The lesion appears rough, firm, and does not heal despite previous treatments. The nurse suspects squamous cell carcinoma (SCC). What is the priority nursing action?

Apply an antibiotic ointment and reassess in two weeks.

Refer the patient to a dermatologist for a biopsy.

Reassure the patient that the lesion is benign and monitor for changes.

Educate the patient on proper wound care and sun protection.

Answer and Explanation

The Correct Answer is B

A. Apply an antibiotic ointment and reassess in two weeks. SCC is a form of skin cancer and requires biopsy for diagnosis. Simply applying an antibiotic and waiting could delay necessary treatment.

B. Refer the patient to a dermatologist for a biopsy. The priority action for a suspicious lesion that does not heal is to refer the patient for biopsy and further evaluation, as early detection and treatment of SCC are crucial.

C. Reassure the patient that the lesion is benign and monitor for changes. SCC can be aggressive if untreated, and assuming benignity without biopsy could result in delayed diagnosis and worsening prognosis.

D. Educate the patient on proper wound care and sun protection. While wound care and sun protection are important, the priority is obtaining a definitive diagnosis through biopsy.

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Correct Answer is B

Explanation

A. "Handwashing is not necessary since impetigo is not contagious." Impetigo is highly contagious, and proper hand hygiene is essential to prevent its spread to others.

B. “I should apply Mupirocin (Bactroban) to the affected areas as prescribed." Mupirocin (Bactroban) is the standard topical antibiotic treatment for impetigo and should be applied as prescribed to reduce bacterial colonization and promote healing.

C. “I don't need to cover the lesions; they should be left open to the air." Covering the lesions can help prevent the spread of infection by minimizing contact with contaminated surfaces.

D. “I will let my child scratch the lesions to help them dry out faster." Scratching can worsen the infection, spread bacteria to other parts of the body, and lead to secondary infections.

A. Impetigo B. Scabies C. Herpes simplex virus D. Tinea corporis

Correct Answer is A

Explanation

A. Impetigo. Impetigo is a highly contagious bacterial skin infection, often caused by Staphylococcus aureus or Streptococcus pyogenes. It is characterized by honey-colored crusted lesions, especially around the mouth and extremities.

B. Scabies. Scabies presents as intensely itchy burrows or papules, often in the web spaces of the fingers, wrists, and axillae, rather than honey-colored crusts.

C. Herpes simplex virus. Herpes simplex virus (HSV) typically causes grouped vesicular lesions on an erythematous base, not crusted honey-colored lesions.

D. Tinea corporis. Tinea corporis (ringworm) presents as red, scaly, annular lesions with central clearing, not honey-colored crusts.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to the parent of a child diagnosed with impetigo. Which of the following statements by the parent indicates a correct understanding of the treatment plan?

Correct Answer is B

Explanation

A school nurse is assessing a child who has honey-colored crusted lesions around their mouth and on their arms. The nurse should recognize this as a characteristic of which of the following skis infections?

Correct Answer is A

Explanation

A 45-year-old male patient arrives at the emergency department with partial-thickness burns on his entire right arm, the front of his right leg, and the entire front of his torso. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA) burned?

A patient is diagnosed with gout and asks the nurse how to prevent future flare-ups. Which statement by the patient indicates a correct understanding of dietary modifications for gout management?

A nurse is assessing a patient who has sustained a burn injury. The affected area is dry, white, and charred, with no pain present. Based on the classification of burns, the nurse understands this burn is:

A nurse is assessing a bedridden patient and notes a reddened area on the sacrum that does not blanch when pressed. The skin is intact. Based on this finding, which stage of pressure ulcer should the nurse document?

A nurse is assessing a client who reports burning, stabbing pain on their right thorax. The nurse notes the presence of a unilateral vesicular rash following a dermatome. Based on these findings, which of the following is the most likely diagnosis?

A patient with chronic gout is prescribed allopurinol. Which statement by the patient indicates a correct understanding of the medication's purpose?

A nurse is assessing a patient with a pressure ulcer on the heel (as shown in the image). The wound is covered with thick yellow slough, making it difficult to determine the depth of tissue damage. How should the nurse classify this wound?

A nurse is assessing a patient who reports persistent cough, night sweats, weight loss, and fatigue. The nurse suspects tuberculosis (TB). Which additional symptom would further support this diagnosis?