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MARYVILLE NURS 623 EXAM 1 | ACTUAL EXAM
WITH VERIFIED ANSWERS & RATIONALES
Basal cell carcinoma -correct-answer-*· Flesh colored, pearly domed nodule with
overlaying telangiectatic vessels.
· Pinkish patch of skin, Later stage, central ulceration and crusting.
o Malignant tumor of the skin that originates from the basal cells of the
epidermis;
o Slow-growing and locally invasive tumor that rarely metastasizes;
o Common in 50-60 year-olds;
o Common in fair skinned but can occur in darker skin;
o Usually on head and neck but can occur anywhere;
o Early diagnosis/treatment is important as it can invade surrounding tissue;
Testing:
Biopsy
Treatment:
Simple excision:
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Electrodesiccation and curettage
Cryosurgery
Laser surgery
Mohs microsurgery - highest cure rate
Melanoma (malignant) -correct-answer-o Deadliest form of skin cancer (75% of all
skin cancer deaths)
o Arises from malignancy of epidermal melanocytes
o >90% arise from skin
o few arise from eye (uveal melanoma)
o <4% do not have primary site
o If >4 mm in depth, poor prognosis (75% mortality)
o Frequently develops in a mole with notable changes or
o Suddenly appears as a new dark spot on skin, assymetrical lesion with irregular
border, notching, and a diameter >6mm.
o Variegation in color, with admixtures of blue, red, tan, brown, black, and white.
Pneumonic:
A = asymmetry
B = border is irregular
C = colors are different in same region
D = diameter > 6 mm
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E = enlargement (evolution)
Malignant melanoma types -correct-answer-Types:
o Superficial spreading (70-85%), extensive lateral or radial growth before vertical
growth
o Nodular (15-30%), vertical growth only)
o Lentigo maligna (5%), in situ form that may persist for years before vertical
extension
o Acral lentiginous (2-8%), aggressive form most common in darker skinned
persons, especially when appearing on hands/feet
Malignant melanoma testing and management -correct-answer-Testing:
o Full body inspection
o Lesion biopsy
o Excisional biopsy is preferred
o Classification System:
o Clark/Breslow methods
o TNM (tumor, node, metastasis) pg 244
Management:
o Treatment depends on the stage of the lesion:
o Biological therapy
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o Chemotherapy
o Radiation
Surgery
Actinic Keratosis -correct-answer-Most common precancerous growth. Fair-
skinned pts aged > 40, sun exposure, men.
· Head, lips, ears, neck, hands, forearms.
· Primary lesions macules or papules poorly circumscribed. Small papules 0.5-2
mm flesh color or hyperpigmented.
· Secondary lesions erythematous, scaly with uneven surface. Pruritic, tender, or
stinging, sandpaper feel.
Treatment:
Topical therapy (5-FU) creams: Efudex, Carac
Surgical destruction (cryotherapy)
Multiple lesions blending together ______ -correct-answer-Confluent or
coalescent
Flat discoloration less than 1 cm in diameter _____ -correct-answer-Macule
MARYVILLE NURS 623 EXAM 1 | ACTUAL EXAM
WITH VERIFIED ANSWERS & RATIONALES
Basal cell carcinoma -correct-answer-*· Flesh colored, pearly domed nodule with
overlaying telangiectatic vessels.
· Pinkish patch of skin, Later stage, central ulceration and crusting.
o Malignant tumor of the skin that originates from the basal cells of the
epidermis;
o Slow-growing and locally invasive tumor that rarely metastasizes;
o Common in 50-60 year-olds;
o Common in fair skinned but can occur in darker skin;
o Usually on head and neck but can occur anywhere;
o Early diagnosis/treatment is important as it can invade surrounding tissue;
Testing:
Biopsy
Treatment:
Simple excision:
,2|Page
Electrodesiccation and curettage
Cryosurgery
Laser surgery
Mohs microsurgery - highest cure rate
Melanoma (malignant) -correct-answer-o Deadliest form of skin cancer (75% of all
skin cancer deaths)
o Arises from malignancy of epidermal melanocytes
o >90% arise from skin
o few arise from eye (uveal melanoma)
o <4% do not have primary site
o If >4 mm in depth, poor prognosis (75% mortality)
o Frequently develops in a mole with notable changes or
o Suddenly appears as a new dark spot on skin, assymetrical lesion with irregular
border, notching, and a diameter >6mm.
o Variegation in color, with admixtures of blue, red, tan, brown, black, and white.
Pneumonic:
A = asymmetry
B = border is irregular
C = colors are different in same region
D = diameter > 6 mm
,3|Page
E = enlargement (evolution)
Malignant melanoma types -correct-answer-Types:
o Superficial spreading (70-85%), extensive lateral or radial growth before vertical
growth
o Nodular (15-30%), vertical growth only)
o Lentigo maligna (5%), in situ form that may persist for years before vertical
extension
o Acral lentiginous (2-8%), aggressive form most common in darker skinned
persons, especially when appearing on hands/feet
Malignant melanoma testing and management -correct-answer-Testing:
o Full body inspection
o Lesion biopsy
o Excisional biopsy is preferred
o Classification System:
o Clark/Breslow methods
o TNM (tumor, node, metastasis) pg 244
Management:
o Treatment depends on the stage of the lesion:
o Biological therapy
, 4|Page
o Chemotherapy
o Radiation
Surgery
Actinic Keratosis -correct-answer-Most common precancerous growth. Fair-
skinned pts aged > 40, sun exposure, men.
· Head, lips, ears, neck, hands, forearms.
· Primary lesions macules or papules poorly circumscribed. Small papules 0.5-2
mm flesh color or hyperpigmented.
· Secondary lesions erythematous, scaly with uneven surface. Pruritic, tender, or
stinging, sandpaper feel.
Treatment:
Topical therapy (5-FU) creams: Efudex, Carac
Surgical destruction (cryotherapy)
Multiple lesions blending together ______ -correct-answer-Confluent or
coalescent
Flat discoloration less than 1 cm in diameter _____ -correct-answer-Macule
