When assessing a client diagnosed with basal cell carcinoma, which of the following findings will the nurse expect?
A blister-like pustule on the face that oozes clear fluid
A dark brown lesion that is flat
A small scaly, dry lesion on the elbow
Location on the top of the head where exposed frequently to sunlight
The Correct Answer is C
Choice A Reason: This is incorrect because a blister-like pustule on the face that oozes clear fluid may indicate impetigo, which is a bacterial skin infection, not basal cell carcinoma. Basal cell carcinoma is a type of skin cancer that arises from the basal layer of the epidermis, which is the outermost layer of the skin. Basal cell carcinoma lesions are usually not blistered or pustular, but rather smooth, shiny, or waxy.
Choice B Reason: This is incorrect because a dark brown lesion that is flat may indicate a mole, which is a benign growth of melanocytes, which are cells that produce pigment, not basal cell carcinoma. Basal cell carcinoma lesions are usually not dark brown or flat, but rather flesh-colored, pink, or red, and may have a raised or indented center.
Choice C Reason: This is correct because a small scaly, dry lesion on the elbow may indicate basal cell carcinoma. Basal cell carcinoma lesions are often small, scaly, and dry, and may bleed or crust over. They can occur anywhere on the body, but are more common on areas that are exposed to the sun, such as the face, neck, arms, or legs.
Choice D Reason: This is incorrect because location on the top of the head where exposed frequently to sunlight may indicate squamous cell carcinoma, which is another type of skin cancer that arises from the squamous layer of the epidermis, not basal cell carcinoma. Squamous cell carcinoma lesions are usually rough, scaly, or crusted, and may have a firm or hard texture. They can also occur anywhere on the body, but are more common on areas that are exposed to the sun.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: Decreased thickness of tympanic membranes is not a physiological change to hearing in older adult clients. The tympanic membranes are thin and flexible structures that vibrate in response to sound waves. The thickness of the tympanic membranes does not change significantly with age.
Choice B Reason: Decreased tinnitus is not a physiological change to hearing in older adult clients. Tinnitus is a ringing or buzzing sound in the ears that may be caused by various factors, such as noise exposure, ear infections, medications, or aging. Tinnitus may increase or decrease with age, depending on the underlying cause.
Choice C Reason: Decreased ear wax is not a physiological change to hearing in older adult clients. Ear wax is a natural substance that lubricates and protects the ear canal from dust, bacteria, and insects. Ear wax production may vary with age, but it does not affect hearing unless it accumulates and blocks the ear canal.
Choice D Reason: Decreased ability to hear high-frequency sounds is a physiological change to hearing in older adult clients. This is also known as presbycusis, which is a gradual loss of hearing that occurs as part of aging. Presbycusis affects the ability to hear high-pitched sounds, such as consonants, birdsong, or alarms.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer because bacterial meningitis is a medical emergency that requires immediate antibiotic therapy to prevent complications and death.
Choice B reason: This is incorrect because documenting intake and output is not a priority action for a child with bacterial meningitis. Fluid balance is important, but not as urgent as antibiotic administration.
Choice C reason: This is incorrect because reducing environmental stimuli is a supportive measure that can help reduce headache and photophobia, but it is not a priority action for a child with bacterial meningitis. The nurse should focus on preventing infection spread and monitoring for signs of increased intracranial pressure.
Choice D reason: This is incorrect because maintaining seizure precautions is a preventive measure that can help protect the child from injury, but it is not a priority action for a child with bacterial meningitis. The nurse should administer anticonvulsants as prescribed and observe for seizure activity, but the main goal is to treat the infection.
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