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 D
Explanation
Choice A reason: Trichomonas is a sexually transmitted infection that typically causes vaginal discharge, itching, and irritation. It does not cause uterine tenderness or systemic symptoms like fever and flu-like illness in the postpartum period.
Choice B reason: A urinary tract infection may cause fever and abdominal discomfort, but it does not typically result in a tender, subinvoluted uterus or foul-smelling lochia. The symptoms described are more consistent with a uterine infection.
Choice C reason: Endometriosis is a chronic condition involving ectopic endometrial tissue, causing pelvic pain and infertility. It is not an acute postpartum infection and does not present with fever or foul-smelling discharge.
Choice D reason: Endometritis is an infection of the uterine lining, commonly occurring postpartum, especially after prolonged labor or cesarean delivery. Symptoms include uterine tenderness, fever, subinvolution, and malodorous lochia. This diagnosis best fits the clinical presentation.
Correct Answer is B
Explanation
Choice A reason: This describes osteoarthritis, not Paget’s disease. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas Paget’s disease affects bone remodeling.
Choice B reason: Paget’s disease of bone is characterized by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. The newly formed bone is structurally abnormal—larger, less dense, and more vascular—making it prone to deformity and fracture. This explains the patient’s bowing and neurological symptoms due to nerve compression.
Choice C reason: This describes rheumatoid arthritis, an autoimmune condition affecting the synovium. Paget’s disease is not autoimmune and does not primarily involve joint inflammation.
Choice D reason: While PDB does involve abnormal bone remodeling, it does not lead to decreased skeletal mass. Instead, it results in structurally unsound bone that may be enlarged but weakened.
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