A 49-year-old White woman with brown hair and brown eyes is in disbelief when she is diagnosed with a malignant melanoma. She says she has always worn sunscreen on her yearly beach vacations. Which of the following statements by the nurse practitioner best explains the development of her malignancy?
"People with your personal characteristics of brown hair and brown eyes are at higher risk for developing malignant melanomas."
"Recent research has shown that malignant melanoma is higher in people who use sunscreen, because those people are generally out in the sun more than the general population, and sunscreen mostly blocks UVB rays, not UVA rays, which are equally as damaging."
"Higher socioeconomic status is correlated with higher rates of malignant melanoma. Going to the beach every year is an indication that you are of higher socioeconomic status."
"The water from the ocean at the beach washed off the sunscreen and you didn't reapply often enough."
The Correct Answer is B
Choice A reason: Individuals with fair skin, light hair, and light eyes are at higher risk for melanoma. However, brown hair and brown eyes are not considered high-risk features. This statement is inaccurate and may mislead the patient.
Choice B reason: This explanation reflects current understanding that sunscreen use may give a false sense of security, leading to prolonged sun exposure. Additionally, many sunscreens primarily block UVB rays, while UVA rays—which penetrate deeper into the skin—can still contribute to melanoma risk. This statement provides a scientifically grounded rationale.
Choice C reason: While there is some correlation between higher socioeconomic status and increased melanoma rates due to lifestyle factors like frequent sun exposure, this explanation is indirect and not the most accurate or helpful for the patient.
Choice D reason: Although improper sunscreen application or failure to reapply can reduce protection, this statement is speculative and lacks the broader context of UVA exposure and behavioral patterns associated with sunscreen use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Bazedoxifene is a selective estrogen receptor modulator (SERM) primarily used in postmenopausal women for osteoporosis prevention and treatment. It is not approved or recommended as first-line therapy for men with osteoporosis due to its estrogen-related mechanism of action.
Choice B reason: Risedronate is a bisphosphonate and is effective in treating osteoporosis. However, it is a specific agent within the bisphosphonate class. While it may be used, the broader class of bisphosphonates is considered first-line, allowing for individualized selection among agents like alendronate, risedronate, or zoledronic acid.
Choice C reason: Bisphosphonates are the first-line therapy for osteoporosis in men. They work by inhibiting osteoclast-mediated bone resorption, thereby increasing bone mineral density and reducing fracture risk. Their efficacy, safety profile, and long-term data support their use as the standard initial treatment.
Choice D reason: Denosumab is a monoclonal antibody that inhibits RANKL, reducing bone resorption. It is effective in treating osteoporosis and may be used in men, especially those who cannot tolerate bisphosphonates or have contraindications. However, it is considered second-line or alternative therapy, not first-line.
Correct Answer is C
Explanation
Choice A reason: While some mild viral pneumonias may resolve without antibiotics, bacterial CAP in children typically requires treatment. Delaying therapy can lead to complications such as empyema or respiratory failure.
Choice B reason: Macrolides (e.g., azithromycin) are effective against atypical pathogens like Mycoplasma pneumoniae, which are more common in older children and adolescents. However, in younger children, typical bacterial pathogens like Streptococcus pneumoniae are more prevalent, making macrolides less ideal as first-line therapy.
Choice C reason: Beta lactam antibiotics, such as amoxicillin, are the first-line treatment for CAP in children due to their efficacy against Streptococcus pneumoniae, the most common bacterial cause. They are well tolerated and widely recommended in pediatric guidelines.
Choice D reason: Cephalosporins may be used in cases of beta-lactam allergy or severe infection requiring hospitalization, but they are not typically first-line for uncomplicated CAP in otherwise healthy children.
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