A nurse on a Medical-Surgical unit is caring for a client who has a suspected malignant lesion. Which of the following findings should the nurse expect when assessing the lesion? (Select all that apply.).
Lesion is brown and black in color.
Irregular borders.
Symmetrical halves.
Diameter greater than 6 mm.
Regular borders.
Correct Answer : B,D,E
Choice A rationale:
Lesion is brown and black in color - This choice does not necessarily indicate malignancy. Skin lesions can be various colors, and color alone is not a definitive indicator of malignancy. Therefore, this choice is not a reliable characteristic for assessing a suspected malignant lesion.
Choice B rationale:
Irregular borders - Irregular or uneven borders are a concerning feature of skin lesions that could suggest malignancy. Malignant lesions, such as melanoma, often have irregular, jagged, or poorly defined borders. This choice is accurate in identifying a potential sign of skin cancer.
Choice C rationale:
Symmetrical halves - Symmetry is generally associated with benign lesions, while malignant lesions often have an asymmetric appearance. A lack of symmetry is considered a characteristic of potential malignancy, making this choice appropriate.
Choice D rationale:
Diameter greater than 6 mm - Lesions with a diameter greater than 6 mm are considered a worrisome characteristic for malignancy. While the size alone is not the sole determinant, larger lesions are more likely to be assessed further for malignancy. This choice accurately identifies a significant feature for evaluation.
Choice E rationale:
Regular borders - Regular, smooth borders are generally associated with benign skin lesions. Malignant lesions tend to have irregular, jagged, or uneven borders. Identifying regular borders as a characteristic of a suspected malignant lesion is inaccurate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D - "Eating a high fiber diet will reduce my risk for developing skin cancer."
Choice A rationale:
Checking the skin monthly for any changes is a recommended practice for early detection of skin cancer. Changes in the size, color, shape, or appearance of moles or spots can be indicative of skin cancer. This statement demonstrates understanding and does not require further teaching.
Choice B rationale:
Avoiding the use of tanning booths is a crucial recommendation for preventing skin cancer. Tanning booths emit ultraviolet (UV) radiation, which significantly increases the risk of skin cancer. This statement reflects accurate knowledge and does not indicate a need for further teaching.
Choice C rationale:
Using sunscreen even on cloudy days is a sound practice to prevent skin cancer. UV rays can penetrate clouds and cause skin damage even when the sun is not directly visible. This statement shows good understanding and does not require further teaching.
Choice D rationale:
Eating a high fiber diet will reduce my risk for developing skin cancer - This statement indicates a need for further teaching. While a high fiber diet has various health benefits, it is not directly linked to reducing the risk of developing skin cancer. Skin cancer prevention primarily involves sun protection measures, avoiding tanning beds, and regular skin checks. The nurse should clarify the correct strategies for preventing skin cancer.
Correct Answer is B
Explanation
Choice A rationale:
Using an internet webpage translator might seem convenient, but it can lead to inaccuracies in communication due to language nuances and medical terminology. Direct communication with a human translator is more reliable.
Choice B rationale:
Arranging to complete the assessment with only the client and a translator present is the best option. This approach ensures accurate and confidential communication, allowing the nurse to gather essential information directly from the client without potential bias or misinterpretation from family members.
Choice C rationale:
Asking the client's husband to translate questions and answers for the client can lead to inaccurate or biased information. Additionally, it might not provide a safe environment for the client to openly share her concerns.
Choice D rationale:
Asking a male student nurse to translate for the client does not necessarily address the language barrier adequately. The gender of the translator is not the primary concern here. Ensuring effective communication through a professional translator is more important.
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