A 39-year-old Hispanic woman with a history of obesity and diabetes mellitus (DM) presents with velvety darkening of the skin on the back of the neck and her axilla. Which of the following is most consistent with this presentation?
Acanthosis nigricans
Diabetic dermopathy
Scleroderma diabeticorum
Necrobiosis lipoidica
The Correct Answer is A
Choice A reason: Acanthosis nigricans is characterized by hyperpigmented, velvety plaques typically found on the neck, axillae, and other skin folds. It is strongly associated with insulin resistance and is common in individuals with obesity and type 2 diabetes.
Choice B reason: Diabetic dermopathy presents as small, round or oval, brownish atrophic patches usually on the shins. It does not involve the neck or axilla and lacks the velvety texture seen in acanthosis nigricans.
Choice C reason: Scleroderma diabeticorum involves thickening and hardening of the skin, usually on the upper back and neck, but it is less common and lacks the characteristic velvety hyperpigmentation.
Choice D reason: Necrobiosis lipoidica typically affects the lower legs and presents as yellow-brown plaques with telangiectasia and central atrophy. It is not associated with the axilla or neck and does not have a velvety appearance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Psychotic symptoms in bipolar disorder can last longer than one month, especially during severe manic or depressive episodes. The duration alone does not differentiate bipolar disorder from schizoaffective disorder.
Choice B reason: In bipolar disorder, psychotic symptoms are mood-congruent and occur exclusively during mood episodes. In contrast, schizoaffective disorder includes psychotic symptoms that persist independently of mood disturbances, which is the key distinguishing feature.
Choice C reason: Schizoaffective disorder can include both depressive and manic or hypomanic episodes. It is not limited to depressive episodes alone. The subtype (depressive type or bipolar type) depends on the nature of the mood episodes.
Choice D reason: Schizoaffective disorder often includes full-blown episodes of major depression. The presence of major depressive episodes is part of the diagnostic criteria for the depressive subtype of schizoaffective disorder.
Correct Answer is A
Explanation
Choice A reason: The copper intrauterine device (IUD) is a non-hormonal contraceptive method and is considered the safest option for women with active breast cancer. Since it does not release hormones, it avoids the risk of hormone-sensitive tumor stimulation and provides highly effective long-term contraception.
Choice B reason: Progesterone-only pills contain synthetic progestins, which may pose a risk in hormone-sensitive breast cancers. Although they are sometimes used in select cases, they are generally avoided in women with active breast cancer due to potential hormonal influence on tumor growth.
Choice C reason: Combined oral contraceptives contain both estrogen and progestin, which are contraindicated in women with breast cancer due to their potential to stimulate hormone receptor-positive tumors. This method is not safe for this patient population.
Choice D reason: Hormonal implants release progestin over time and are not recommended for women with active breast cancer. Like other hormonal methods, they may increase the risk of cancer progression in hormone-sensitive cases.
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