NUR 550 TEST EVALUATION QUESTIONS AND
ANSWERS SET A+
✔✔Clinical Manifestations: Signs/Symptoms - ✔✔Patient may present with one of the 5
warning signs of BCC
Persistent, non-healing sore that bleeds/oozes, especially on sun-exposed area (face,
chest, arms, legs, shoulders)
A red patch or "irritated" area that is painful or itchy (may also be without pain)
A shiny nodule or bump (can be pink, red, white, tan, black, brown)
A pink growth with elevated/rolled border and central, crusted indentation; may note
telangiectasias
A white or yellow area that is shiny/taut and has the appearance of a scar (this may
indicate invasive BCC)
✔✔Assessment Skill/Techniques
Procedure used to diagnose BCC - ✔✔Ask patients if they have noticed any changes in
their skin
If patient reports a change/new growth, further explore if patient has personal OR family
history of skin cancer (type, treatment)
During skin exam, carefully inspect/palpate any skin lesions (may require magnifying
glass)
Note and describe: type of lesion, color, texture, size, shape, location, number
Diagnosis is confirmed with biopsy
Treatment based on location, size, depth of tumor (curettage and electrodessication;
Mohs procedure; excision; pharmacologic, etc.)
✔✔3 differential diagnoses and how they differ from basal cell carcinoma -
✔✔Superficial BCC (pink patch, may have scaling)
Nodular BCC (pink papule which may have pigmentation, overlying telangiectasias
Ulcerated BCC (ulcer that does not heal, rolled border)
, Lesions that Mimic BCC Types
Actinic keratosis or squamous cell carcinoma in situ (keratotic scaling
Sebaceous hyperplasia (yellowish papule with central depression, surrounding
telangiectasias
Squamous cell carcinoma (also ulcer, firmer edges/border)
✔✔Dementia - ✔✔Definition: clinical syndrome of widespread progressive deterioration
of cognitive abilities and normal daily functioning.
An acquired condition that is characterized by a decline in at least two cognitive
domains (e.g loss of memory, attention, language, or visuospatial or executive
functioning) that is severe enough to affect social or occupational functioning.
Four primary dementia classifications have been defined according to clinical and
research criteria:
1) Alzheimer's disease (11% of Americans over 65 years, 2/3 women); 2) vascular
dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's
disease dementia.
✔✔Clinical Manifestations: Signs/Symptoms - ✔✔Age- typically affects persons over 60
Develop over months or years
No physical motor or sensory alterations until condition is advanced
Memory impairment is the predominant symptom.
Cognitive impairment can include aphasia, apraxia, agnosia, and impairment in
executive functioning.
✔✔Assessment Skill/Techniques /Labwork /Procedure used to diagnose clinical
problem - ✔✔Assessment- onset, duration, *any knowledge of previous level of
function, new medications or any medications likely to cause toxicity.
Mental Status changes notable to a specific time of day
Environmental factors- do they reside in an institution- recent outbreaks of respiratory
infections, influenza, pneumonia
Physical exam- possible causes of sepsis, skin infections, UTI
Screenings
Mini COG Assessment Instrument for Dementia- Specificity 89-96%
MMSE- Specificity 92-99%
Memory Impairment screen-Specificity 96-97%
Montreal Cognitive Assessment
Geriatric Depression Scale-
Labwork- Basic metabolic profile, Serum B12 and folic acid, CBC with differential,
urinalysis with culture and sensitivity, FTA-ABS, Lyme serology, ESR, pulse oximetry,
chest xray
Procedures- 24 hour urine, EEG, Lumbar puncture for CSF
Seek to rule out:
Depression
Drug side effects
Metabolic Disorders
ANSWERS SET A+
✔✔Clinical Manifestations: Signs/Symptoms - ✔✔Patient may present with one of the 5
warning signs of BCC
Persistent, non-healing sore that bleeds/oozes, especially on sun-exposed area (face,
chest, arms, legs, shoulders)
A red patch or "irritated" area that is painful or itchy (may also be without pain)
A shiny nodule or bump (can be pink, red, white, tan, black, brown)
A pink growth with elevated/rolled border and central, crusted indentation; may note
telangiectasias
A white or yellow area that is shiny/taut and has the appearance of a scar (this may
indicate invasive BCC)
✔✔Assessment Skill/Techniques
Procedure used to diagnose BCC - ✔✔Ask patients if they have noticed any changes in
their skin
If patient reports a change/new growth, further explore if patient has personal OR family
history of skin cancer (type, treatment)
During skin exam, carefully inspect/palpate any skin lesions (may require magnifying
glass)
Note and describe: type of lesion, color, texture, size, shape, location, number
Diagnosis is confirmed with biopsy
Treatment based on location, size, depth of tumor (curettage and electrodessication;
Mohs procedure; excision; pharmacologic, etc.)
✔✔3 differential diagnoses and how they differ from basal cell carcinoma -
✔✔Superficial BCC (pink patch, may have scaling)
Nodular BCC (pink papule which may have pigmentation, overlying telangiectasias
Ulcerated BCC (ulcer that does not heal, rolled border)
, Lesions that Mimic BCC Types
Actinic keratosis or squamous cell carcinoma in situ (keratotic scaling
Sebaceous hyperplasia (yellowish papule with central depression, surrounding
telangiectasias
Squamous cell carcinoma (also ulcer, firmer edges/border)
✔✔Dementia - ✔✔Definition: clinical syndrome of widespread progressive deterioration
of cognitive abilities and normal daily functioning.
An acquired condition that is characterized by a decline in at least two cognitive
domains (e.g loss of memory, attention, language, or visuospatial or executive
functioning) that is severe enough to affect social or occupational functioning.
Four primary dementia classifications have been defined according to clinical and
research criteria:
1) Alzheimer's disease (11% of Americans over 65 years, 2/3 women); 2) vascular
dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson's
disease dementia.
✔✔Clinical Manifestations: Signs/Symptoms - ✔✔Age- typically affects persons over 60
Develop over months or years
No physical motor or sensory alterations until condition is advanced
Memory impairment is the predominant symptom.
Cognitive impairment can include aphasia, apraxia, agnosia, and impairment in
executive functioning.
✔✔Assessment Skill/Techniques /Labwork /Procedure used to diagnose clinical
problem - ✔✔Assessment- onset, duration, *any knowledge of previous level of
function, new medications or any medications likely to cause toxicity.
Mental Status changes notable to a specific time of day
Environmental factors- do they reside in an institution- recent outbreaks of respiratory
infections, influenza, pneumonia
Physical exam- possible causes of sepsis, skin infections, UTI
Screenings
Mini COG Assessment Instrument for Dementia- Specificity 89-96%
MMSE- Specificity 92-99%
Memory Impairment screen-Specificity 96-97%
Montreal Cognitive Assessment
Geriatric Depression Scale-
Labwork- Basic metabolic profile, Serum B12 and folic acid, CBC with differential,
urinalysis with culture and sensitivity, FTA-ABS, Lyme serology, ESR, pulse oximetry,
chest xray
Procedures- 24 hour urine, EEG, Lumbar puncture for CSF
Seek to rule out:
Depression
Drug side effects
Metabolic Disorders
