A 49-year-old White woman presents to the nurse practitioner with a chief complaint of a mole that has started itching and bleeding. Upon assessment, the nurse practitioner identifies the characteristics of the mole by the acronym ABCDE. Which letter of this assessment represents suspicion of a malignant melanoma?
A: asymmetry is not noted
B: border is not irregular
C: color variation (blue tones in the brown mole)
D: diameter is 1 cm
The Correct Answer is C
Choice A reason: Absence of asymmetry reduces suspicion for melanoma. Malignant lesions are often asymmetric, meaning one half does not match the other. A symmetric mole is less concerning.
Choice B reason: A regular border is typical of benign lesions. Irregular, notched, or poorly defined borders raise concern for malignancy. Since the border is not irregular, this feature does not support melanoma.
Choice C reason: Color variation, especially with blue, black, or multiple tones within a single lesion, is a hallmark of malignant melanoma. Uneven pigmentation suggests abnormal melanocyte activity and warrants further evaluation.
Choice D reason: A diameter of 1 cm is borderline. Lesions larger than 6 mm (about the size of a pencil eraser) are considered suspicious, but size alone is not diagnostic. Color variation is more specific in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Discontinuing risperidone immediately may not be necessary unless symptoms are severe or unmanageable. Clonazepam can help with akathisia, but abrupt discontinuation of antipsychotics may destabilize the patient’s psychiatric condition.
Choice B reason: Sertraline is an SSRI used for depression and anxiety, not for treating akathisia. Introducing it at this point would not address the patient’s restlessness and may complicate the clinical picture.
Choice C reason: Propranolol is effective for akathisia, but discontinuing risperidone prematurely may not be warranted. A better initial approach is to manage the side effect while continuing the antipsychotic, unless symptoms are intolerable.
Choice D reason: Akathisia is a common side effect of risperidone, especially early in treatment. Clonazepam, a benzodiazepine, can help reduce restlessness and agitation. Continuing risperidone while managing the side effect is appropriate unless symptoms worsen or persist. This approach balances symptom control with psychiatric stability.
Correct Answer is D
Explanation
Choice A reason: Structural group therapy may be beneficial for social skills and peer support but is not sufficient for managing medication nonadherence in chronic schizophrenia. It lacks the intensive, individualized outreach needed for this scenario.
Choice B reason: Inpatient hospitalization is appropriate for acute psychiatric crises, such as danger to self or others, but may not be necessary if the patient is stable and simply nonadherent. It is not a long-term solution for chronic management.
Choice C reason: Intensive outpatient programs provide structured treatment but may not offer the level of outreach and flexibility needed for patients who are resistant to care or disengaged from services.
Choice D reason: Assertive Community Treatment (ACT) is a multidisciplinary, team-based approach designed for individuals with severe mental illness who are nonadherent or difficult to engage. It includes outreach, medication management, and support in the community, making it the most appropriate choice for this client.
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