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A nurse is caring for a 40-year-old female client in an outpatient clinic.

Which of the following primary skin lesions contain fluid?

Papule

Nodule

Vesicle

Pustule

Tumor

Wheal

Macule

Answer and Explanation

Correct Answer : C,D

Choice A rationale: Papules are small, raised, solid skin lesions less than 1 cm in diameter. They do not contain fluid; instead, they consist of thickened epidermis or dermal infiltrates. Papules are common in conditions like psoriasis and dermatitis, but their solid nature distinguishes them from fluid-filled lesions.

Choice B rationale: Nodules are larger, solid, raised lesions extending deeper into the dermis or subcutaneous tissue, typically more than 1 cm. They do not contain fluid but represent firm tissue masses seen in conditions such as rheumatoid nodules or lipomas.

Choice C rationale: Vesicles are small, fluid-filled lesions less than 1 cm in diameter, containing clear serous fluid. They appear as raised, translucent blisters and are characteristic of conditions like herpes simplex virus infection or contact dermatitis, matching the client’s fluid-filled itchy rash.

Choice D rationale: Pustules are raised lesions similar to vesicles but filled with purulent material (pus), indicating localized infection or inflammation. They appear white or yellow and are typical in conditions like acne or impetigo, representing a fluid-filled primary lesion.

Choice E rationale: Tumors are large solid masses that extend deeper into the dermis or subcutaneous tissues, usually more than 2 cm in diameter. They do not contain fluid and represent neoplasms or benign growths such as lipomas or cysts.

Choice F rationale: Wheals are transient, elevated, erythematous, and edematous lesions caused by dermal edema. They do not contain fluid in a cavity but represent swelling in the skin layers, typical of urticaria or allergic reactions.

Choice G rationale: Macules are flat, non-palpable skin color changes less than 1 cm in size. They do not contain fluid and are seen in conditions like freckles or petechiae.

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Correct Answer is C

Explanation

Choice A rationale

Placing the bell over only one carotid artery limits the assessment to that side. Bruits are often bilateral and may indicate systemic atherosclerosis or other vascular abnormalities; therefore, assessing both sides is crucial for a comprehensive evaluation of carotid artery integrity.

Choice B rationale

Placing the bell at the base of the client's neck, just above the clavicle, positions the stethoscope over the subclavian artery, not primarily the carotid artery. While bruits can occur in the subclavian artery, the primary location for carotid bruits is higher, directly over the carotid artery itself.

Choice C rationale

Placing the bell over the carotid artery effectively isolates the sound from potential extraneous noises originating from the lungs or heart. Instructing the client to hold their breath briefly eliminates respiratory sounds, which can interfere with the subtle, low-frequency sound of a carotid bruit, ensuring a clearer auscultatory field.

Choice D rationale

Placing the bell just above the client's sternal notch positions the stethoscope over the trachea or major vessels originating from the aortic arch, such as the brachiocephalic artery. This location is too medial and inferior to effectively auscultate for a carotid artery bruit, which is best heard laterally in the neck.

A. Periumbilical pain localizing to the right lower quadrant. B. Diffuse abdominal pain with elevated neutrophil count. C. Anorexia progressing to nausea, vomiting, and fever. D. Sudden onset of severe anxiety, fear, and concern.

Correct Answer is ["A","C"]

Explanation

Choice A rationale

Appendicitis typically begins with vague, dull, periumbilical pain. This pain then shifts and localizes to the right lower quadrant, specifically McBurney's point, as the inflammation of the appendix progresses and irritates the parietal peritoneum. This migratory pattern is a hallmark diagnostic indicator of appendicitis.

Choice B rationale

Diffuse abdominal pain is less specific for appendicitis, which characteristically localizes. While an elevated neutrophil count (normal range: 2.5-7.5 x 10^9/L or 40-75% of total WBC) is consistent with inflammation, it can be present in numerous conditions. The combination lacks the diagnostic specificity of localized pain.

Choice C rationale

Anorexia, often preceding nausea and vomiting, is a common early symptom of appendicitis. As the inflammatory process intensifies, fever (normal range: 36.5-37.5°C) often develops due to systemic inflammatory response. This progression of symptoms is a strong indicator supporting the diagnosis of appendicitis.

Choice D rationale

Sudden onset of severe anxiety, fear, and concern are psychological responses to pain or illness, not direct physiological manifestations of appendicitis. While a client may experience distress, these symptoms do not provide specific diagnostic support for the underlying inflammatory process of appendicitis.

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A nurse is caring for a 40-year-old female client in an outpatient clinic. Which of the following primary skin lesions contain fluid?

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Naxlex Comprehensive Predictor Exams

In auscultating for the presence of a carotid artery bruit, the nurse places the bell of the stethoscope at which location?

Correct Answer is C

Explanation

The nurse assesses a young adult female who was brought to the emergency department (ED) by her boyfriend because she has not been feeling well all day and he believes she is getting worse. Which finding supports the nurse's suspicion that the client is experiencing appendicitis?

Correct Answer is ["A","C"]

Explanation

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A nurse is caring for a 40-year-old female client in an outpatient clinic.

Which of the following primary skin lesions contain fluid?