A nurse is caring for a client who has suspected superficial spreading melanoma. When collecting data about the client's lesion, which of the following is an expected finding?

Purplish in color

Pain

Purulent drainage

Pruritus

Answer and Explanation

The Correct Answer is D

Rationale:

A. Superficial spreading melanoma usually presents as a variegated lesion with shades of brown, tan, or black, often with irregular borders and asymmetry. A purplish hue is not typical of this type of melanoma; lesions with purple tones may indicate vascular lesions (like hemangiomas) or rare cancers such as Kaposi sarcoma.

B. Early superficial spreading melanoma is typically painless. Pain is not a reliable indicator of early melanoma and usually only occurs if the lesion becomes ulcerated, infected, or grows deeply into the skin layers, which is more characteristic of advanced disease.

C. Melanoma is a malignant lesion, not an infection, so it does not normally produce pus. Purulent drainage would suggest a bacterial infection, abscess, or skin ulcer rather than a cancerous lesion.

D. Pruritus, or itching, is an expected finding in superficial spreading melanoma. Patients may notice mild irritation or tingling at the site of the lesion, often before any other changes are apparent. This symptom, combined with changes in size, color, shape, or the appearance of new moles, should alert the nurse to the possibility of melanoma and the need for further evaluation.

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Correct Answer is B

Explanation

Rationale:

A. Routine use of diuretics is not a standard preventative measure for chemotherapy-related renal damage. Diuretics can sometimes lead to fluid and electrolyte imbalances if used inappropriately and do not directly protect the kidneys from chemotherapy toxicity.

B. Monitoring kidney function through lab tests (e.g., serum creatinine, BUN, electrolytes) and urine output is essential because many chemotherapy agents (like cisplatin or methotrexate) are nephrotoxic. Early detection of renal impairment allows timely interventions such as dose adjustments, hydration, or medications to prevent further damage.

C. Caffeinated beverages do not provide renal protection and may increase dehydration or irritate the bladder, which can worsen kidney function. Proper hydration with water or prescribed fluids is recommended instead.

D. Giving additional nephrotoxic drugs (like certain antibiotics or NSAIDs) while the client is receiving chemotherapy increases the risk of kidney injury and should be avoided unless specifically indicated and closely monitored.

A. Serve cooked fruit with meals. B. Place the client in a room with negative-pressure airflow. C. instruct client to use an incentive spirometer every 4 hr. D. Report temperatures greater than 39.5" C (102.3" F) lasting more than 4 hr.

Correct Answer is A

Explanation

Rationale:

A. A WBC of 2,000/mm³ indicates leukopenia, which increases the risk of infection. Serving cooked fruits instead of raw fruits reduces exposure to bacteria and pathogens, as cooking kills microorganisms. This is a key infection-prevention measure for immunocompromised clients.

B. Negative-pressure rooms are used for clients with airborne infections (e.g., tuberculosis) to contain pathogens, not to protect an immunocompromised client. For a client with neutropenia, a protective isolation or positive-pressure environment is preferred to reduce exposure to pathogens.

C. Using an incentive spirometer helps prevent atelectasis and pneumonia, which is generally beneficial, but it does not directly prevent infections caused by neutropenia. It is not the priority infection-control intervention for a client with a WBC of 2,000/mm³.

D. Any elevated temperature in a neutropenic client is a medical emergency and should be reported immediately, even if lower than 39.5°C, because infection can progress rapidly. Waiting for 4 hours or for a very high fever could delay critical intervention.

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A nurse is caring for a client who has suspected superficial spreading melanoma. When collecting data about the client's lesion, which of the following is an expected finding?

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Naxlex Comprehensive Predictor Exams

Realizing that chemotherapy can result in renal damage, the nurse should:

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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A nurse is caring for a client who has suspected superficial spreading melanoma. When collecting data about the client's lesion, which of the following is an expected finding?