A nurse is collecting data from a client who has AIDS. The nurse notes that the client has multiple, widespread purplish-brown skin lesions. The nurse should suspect that the client has developed which of the following types of skin lesions?
Actinic keratosis
Kaposi's sarcoma
Actinic dermatitis
Basal cell carcinoma
The Correct Answer is B
Choice A reason: Actinic keratosis is a rough, scaly patch on the skin caused by long-term sun exposure. It is usually not purplish-brown and is more common in fair-skinned individuals. These lesions are considered pre-cancerous and can develop into squamous cell carcinoma if left untreated. The description of purplish-brown lesions in the context of an AIDS diagnosis is more indicative of Kaposi's sarcoma.
Choice B reason: Kaposi's sarcoma is a type of cancer that forms in the lining of blood and lymph vessels. It often presents as purplish-brown, red, or bluish lesions on the skin or mucous membranes and is commonly associated with AIDS. The multiple, widespread nature of the lesions described aligns with the typical presentation of Kaposi's sarcoma, making it the most likely diagnosis in this scenario.
Choice C reason: Actinic dermatitis, also known as photodermatitis, is an inflammatory reaction of the skin to sunlight. It does not typically present as purplish-brown lesions. This condition manifests as redness, swelling, and possibly blistering in sun-exposed areas. The description given is not consistent with actinic dermatitis and points more towards Kaposi's sarcoma in an AIDS client.
Choice D reason: Basal cell carcinoma does not usually present with multiple, widespread purplish-brown lesions. It is typically a localized lesion that appears as a pearly or waxy bump. The description of multiple, widespread lesions is more characteristic of Kaposi's sarcoma in clients with AIDS, making basal cell carcinoma an unlikely diagnosis in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Disseminated intravascular coagulation (DIC) is a condition characterized by both excessive clotting and excessive bleeding. The clotting cascade is inappropriately activated throughout the body, leading to the formation of numerous small blood clots in the blood vessels. These clots consume clotting factors and platelets, which can then lead to excessive bleeding. This paradoxical combination of thrombosis and bleeding is a hallmark of DIC.
Choice B reason: In DIC, platelet consumption exceeds production. The formation of numerous clots uses up platelets faster than they can be produced, which can result in thrombocytopenia and bleeding. Therefore, a progressive increase in platelet production is not an expected finding in DIC.
Choice C reason: Immediate sodium and fluid retention is not a feature of DIC. This condition primarily involves the clotting and bleeding mechanisms, not fluid balance or sodium levels.
Choice D reason: In DIC, clotting factors are consumed in the formation of numerous clots. This leads to a deficiency of clotting factors, contributing to the bleeding tendency seen in this condition. Increased clotting factors would not be expected in a patient with DIC.
Correct Answer is ["C","E"]
Explanation
Choice A reason: Massaging erythematous bony prominences can actually cause further damage to the skin and underlying tissues. It is better to relieve pressure and monitor the skin closely for any signs of breakdown.
Choice B reason: Implementing a turning schedule every 4 hours is not frequent enough. Clients with spinal cord injuries should be repositioned every 2 hours to prevent prolonged pressure on any one area and reduce the risk of skin breakdown.
Choice C reason: The correct answer is c because using pillows to keep the heels off the bed surface helps prevent pressure ulcers on the heels, which are common sites of skin breakdown in immobilized clients. This technique helps distribute pressure more evenly and reduces the risk of ulcers.
Choice D reason: Keeping environmental humidity less than 30% is not recommended, as low humidity can lead to dry and cracked skin, increasing the risk of skin breakdown. Maintaining a moderate humidity level helps keep the skin hydrated and intact.
Choice E reason: The correct answer is e because minimizing skin exposure to moisture, such as sweat, urine, or wound exudate, helps prevent maceration and skin breakdown. Using moisture-wicking materials and keeping the skin dry and clean are important measures in skin care for paralyzed clients.
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