Med Surg - Exam 4 - Chapter 24 Flashcards Preview

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Flashcards in Med Surg - Exam 4 - Chapter 24 Deck (9)
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1

Which statements are true about skin and skin care (select all that apply)?
a. One of the detrimental effects of obesity on the skin is increased sweating.
b. The nutrient that is critical in maintaining and repairing the structure of the epithelial cells is vitamin C.
c. Exposure to UVA rays is believed to be the most important factor in the development of skin cancer.
d. The photosensitivity caused by various drugs can be blocked by the use of topical hydrocortisone.
e. Photosensitivity results when certain chemicals in the body cells and tissues absorb light from the sun and release energy that farms the tissues and cells.
f. When teaching a patient about the use of sunscreens that protect against exposure to both UVA and UVB rays, the nurse advises the patient to look for the inclusion of benzophenones.

a. One of the detrimental effects of obesity on the skin is increased sweating.
e. Photosensitivity results when certain chemicals in the body cells and tissues absorb light from the sun and release energy that farms the tissues and cells.
f. When teaching a patient about the use of sunscreens that protect against exposure to both UVA and UVB rays, the nurse advises the patient to look for the inclusion of benzophenones.

Vitamin A, not vitamin C, is critical in maintaining and repairing the structure of epithelial cells. Exposure to UVB rays, not UVA rays, is believed to be the most important factor in the development of skin cancer. Sunscreen, not topical hydrocortisone, can block the photosensitivity caused by various drugs.

2

Which statements characterize malignant melanomas (select all that apply)?
a. Lesion is keratotic and firm
b. Neoplastic growth of melanocytes
c. Skin cancer with highest mortality rate
d. Irregular color and asymmetric shape
e. Frequently occurs on previously damaged skin

b. Neoplastic growth of melanocytes
c. Skin cancer with highest mortality rate
d. Irregular color and asymmetric shape

Actinic and firm lesions are actinic keratosis and squamous cell carcinoma. Squamous cell carcinoma frequently occurs in previously damaged skin.

3

What is the most common skin cancer and has pearly borders?
a. Actinic keratosis
b. Basal cell carcinoma
c. Malignant melanoma
d. Squamous cell carcinoma

b. Basal cell carcinoma

Actinic keratosis is an irregularly shaped, flat, slightly erythematous papule with indistinct borders and an overlying hard keratotic scale or horn. Malignant melanoma tumors arise in melanocytes. Malignant melanoma is the deadliest skin cancer and has an increased risk in people with dysplastic nevus syndrome. Squamous cell carcinoma is a malignant neoplasm of keratinizing epidermal cells.

4

What skin condition has keratotic and firm lesions, is a precursor of squamous cell carcinoma, and is treated with topical flourouracil (5-FU)?
a. Actinic keratosis
b. Basal cell carcinoma
c. Malignant melanoma
d. Squamous cell carcinoma

a. Actinic keratosis

Basal cell carcinoma is noduloulcerative with pearly borders. Malignant melanoma tumors arise in melanocytes. Malignant melanoma is the deadlist skin cancer and has an increased risk in people with dysplastic nevus syndrome. Squamous cell carcinoma is a malignant neoplasm of keratinizing epidermal cells.

5

What characteristic is commonly seen with dysplastic nevus syndrome?
a. Associated with sun exposure
b. Precursor of squamous cell carcinoma
c. Slow-growing tumor with rare metastasis
d. Lesion has irregular color and asymmetric shape

d. Lesion has irregular color and asymmetric shape

Dysplastic nevus syndrome involves atypical moles with irregular borders and various shades of color.

6

Describe what is indicated by the ABCDEs of malignant melanoma.
A
B
C
D
E

Asymmetry: one half unlike other half
Border: irregular and poorly circumscribed
Color: varied within lesion
Diameter: larger than 6 mm
Evolving: look and appearance is changing

7

A 46-year-old African American patient is scheduled to have a basal cell carcinoma on his cheek excised in the health care provider's office. What factor is most important for the nurse to obtain in the patient's history?
a. Protected by sun exposure
b. Radiation treatment for acne
c. Prior treatments for the lesion
d. Exposure to harsh irritants such as ammonia.

b. Radiation treatment for acne

Thirty years ago, when the patient was a teenager, radiation therapy was used to treat cystic acne with the result that many of these patients now have developed basal cell carcinoma. For a person with dark skin, radiation therapy is a higher risk factor for skin cancer than exposure to the sun or other irritants.

8

The nurse plans care for a patient with a newly diagnosed malignant melanoma based on the knowledge that initial treatment may involve (select all that apply)?
a. shave biopsy.
b. Mohs' surgery.
c. surgical excision.
d. localized radiation.
e. fluorouracil (5-FU).
f. topical nitrogen mustard.

b. Mohs' surgery.
c. surgical excision.

In the early stages, surgical excision with a margin of normal skin is the initial treatment for malignant melanoma. Mohs' surgery can also be used to treatment malignant melanoma. Radiation may be used after excision for malignant melanoma, depending on staging of the disease. Topical nitrogen mustard may be used for treatment of cutaneous T-cell lymphoma.

9

A patient is a 78-year-old woman who has had chronic respiratory disease for 30 years. She weighs 212 lb (96.4 kg) and is 5 ft, 1 in (152.5 cm) tall. She has recently completed corticosteroid and antibiotic treatment for an exacerbation of her respiratory disease. Identify four specific predisposing factors for bacterial skin infection in this patient.

a. Recent corticosteroid therapy
b. Obesity
c. Chronic disease
d. Recent antibiotic therapy