Medical-Surgical: (topic;Dermatological)
EVALUATIONS and RESPONSES 2025
,EDITION 1
A nurse is planning care for a patient who has been admitted for treatment of a
malignant melanoma of the upper life without many stasis. The nurse should plan to
prepare the patient for which of the following procedures? - answer-surgical excision
-therapeutic approach: depends on level of invasion and depth of lesion; surgical
excision is Tx of choice for small, superficial lesions, deeper lesions require wide, local
excision followed by skin grafting
-has an extremely high incidence of metastasis
-curettage: used for small lesions that are not melanomas
-regional/topical chemotherapy: Tx of choice for localized tumors and superficial basal
cell carinomas
The nurse is going for a patient who has a lesion on the back of his right hand. The
patient asked the nurse which type of skin cancer is the most serious. Which of the
following responses by the nurse is appropriate? - answer-melanomas
-malignant neoplasms w/ atypical melanocytes in both epidermis, dermis, and
sometimes subcutaneous cells
-most lethal skin cancer, often causing metastases in bone, liver, lungs, spleen, CNS,
and lymph nodes
-basal cell carcinoma: most common type of skin cancer, rarely metastasizes; arise
from basal cell layer of epidermis or hair follicles and generally appear on sun-exposed
areas of body
-actinic keratoses: premalignant; can evolve to squamous cell carcinoma, however
they're not the most lethal
-squamous cell carcinoma: arise from epidermis and are potentially metastatic, however
they're not most lethal
The nurse is assessing a patient who has a lesion on the skin. Which of the following
findings as a clinical manifestation of the malignant melanoma? - answer-irregularly
shaped lesions w/ blue tones
-can also be red or white in tone
-often occur on upper back and lower legs
-manifestations of actinic keratosis: rough, dry, scaly lesions
-manifestations of squamous cell carcinoma: firm nodule w/ crust
-manifestation of basal cell carcinoma: pearly papule w/ ulcerated center
, The nurse is caring for a patient who has burn injuries to his trunk. The nurse is
explaining what to expect from the prescribed hydrotherapy. Which of the following
statements by the patient indicates an understanding of the teaching? - answer-"i will be
on a special shower table"
-facilitates examination and debridement of wound during hydrotherapy; advantage of
using showering technique is that it can be kept at constant temp and lowers risk of
wound infection compared to tub bath
-use warm water to help maintain adequate body temp
-use soft washcloths or gauze to gently scrub and debride
-leave small blisters intact but open larger blisters
A nurse in the ED is caring for a patient who has a snakebite on her arm. Which of the
following intervention should the nurse implement? - answer-immobilize the limb at the
level of the heart
-to limit spread of venom
-constrictive clothing/jewelry should be removed before swelling worsens
-contraindicated: tourniquet to affected limb, use sterile scapula to incise wound, apply
ice to skin over snakebite wound
A nurse in the providers office is assessing a patient skin lesions. The nurse notes that
the lesions are 0.5 cm (0.2 in) in size, elevated, and solid, with very distinct borders.
The nurse should document the findings which of the following is commissions? -
answer-papules
-small, solid, elevated lesion w/ distinct borders
-macule: flat, variably shaped, discolored, and small, typically smaller than 10 mm in
diameter; is a change in color of skin; freckles and rash associated w/ rubella are types
of macules
-wheals: hives; transient, elevated, irregularly shaped lesions caused by localized
edema; common manifestation of allergic rxn
-vesicles: circumscribed, elevated lesion or blister containing serous fluid; typically arise
w/ herpes simplex, poison ivy, chickenpox
A nurse is evaluating the lab values and who's in the resuscitation phase following a
major burn. Which of the following lab finding should the nurse expect? - answer-Na
132 mEq/L
Expected lab values:
-decreased Na: b/c it's trapped in interstitial space
-elevated hemoglobin: during the resuscitation phase due to loss of fluid volume
-Decreased albumin: during resuscitation phase
-elevated potassium: during resuscitation phase
EVALUATIONS and RESPONSES 2025
,EDITION 1
A nurse is planning care for a patient who has been admitted for treatment of a
malignant melanoma of the upper life without many stasis. The nurse should plan to
prepare the patient for which of the following procedures? - answer-surgical excision
-therapeutic approach: depends on level of invasion and depth of lesion; surgical
excision is Tx of choice for small, superficial lesions, deeper lesions require wide, local
excision followed by skin grafting
-has an extremely high incidence of metastasis
-curettage: used for small lesions that are not melanomas
-regional/topical chemotherapy: Tx of choice for localized tumors and superficial basal
cell carinomas
The nurse is going for a patient who has a lesion on the back of his right hand. The
patient asked the nurse which type of skin cancer is the most serious. Which of the
following responses by the nurse is appropriate? - answer-melanomas
-malignant neoplasms w/ atypical melanocytes in both epidermis, dermis, and
sometimes subcutaneous cells
-most lethal skin cancer, often causing metastases in bone, liver, lungs, spleen, CNS,
and lymph nodes
-basal cell carcinoma: most common type of skin cancer, rarely metastasizes; arise
from basal cell layer of epidermis or hair follicles and generally appear on sun-exposed
areas of body
-actinic keratoses: premalignant; can evolve to squamous cell carcinoma, however
they're not the most lethal
-squamous cell carcinoma: arise from epidermis and are potentially metastatic, however
they're not most lethal
The nurse is assessing a patient who has a lesion on the skin. Which of the following
findings as a clinical manifestation of the malignant melanoma? - answer-irregularly
shaped lesions w/ blue tones
-can also be red or white in tone
-often occur on upper back and lower legs
-manifestations of actinic keratosis: rough, dry, scaly lesions
-manifestations of squamous cell carcinoma: firm nodule w/ crust
-manifestation of basal cell carcinoma: pearly papule w/ ulcerated center
, The nurse is caring for a patient who has burn injuries to his trunk. The nurse is
explaining what to expect from the prescribed hydrotherapy. Which of the following
statements by the patient indicates an understanding of the teaching? - answer-"i will be
on a special shower table"
-facilitates examination and debridement of wound during hydrotherapy; advantage of
using showering technique is that it can be kept at constant temp and lowers risk of
wound infection compared to tub bath
-use warm water to help maintain adequate body temp
-use soft washcloths or gauze to gently scrub and debride
-leave small blisters intact but open larger blisters
A nurse in the ED is caring for a patient who has a snakebite on her arm. Which of the
following intervention should the nurse implement? - answer-immobilize the limb at the
level of the heart
-to limit spread of venom
-constrictive clothing/jewelry should be removed before swelling worsens
-contraindicated: tourniquet to affected limb, use sterile scapula to incise wound, apply
ice to skin over snakebite wound
A nurse in the providers office is assessing a patient skin lesions. The nurse notes that
the lesions are 0.5 cm (0.2 in) in size, elevated, and solid, with very distinct borders.
The nurse should document the findings which of the following is commissions? -
answer-papules
-small, solid, elevated lesion w/ distinct borders
-macule: flat, variably shaped, discolored, and small, typically smaller than 10 mm in
diameter; is a change in color of skin; freckles and rash associated w/ rubella are types
of macules
-wheals: hives; transient, elevated, irregularly shaped lesions caused by localized
edema; common manifestation of allergic rxn
-vesicles: circumscribed, elevated lesion or blister containing serous fluid; typically arise
w/ herpes simplex, poison ivy, chickenpox
A nurse is evaluating the lab values and who's in the resuscitation phase following a
major burn. Which of the following lab finding should the nurse expect? - answer-Na
132 mEq/L
Expected lab values:
-decreased Na: b/c it's trapped in interstitial space
-elevated hemoglobin: during the resuscitation phase due to loss of fluid volume
-Decreased albumin: during resuscitation phase
-elevated potassium: during resuscitation phase
