A nurse performs a skin screening for a client who has numerous skin lesions. Which lesion does the nurse evaluate first?

Beige freckles on the backs of both hands

Irregular blue mole with white specks on the lower leg

Large cluster of pustules in the right axilla

Thick, reddened papules covered by white scales.

Answer and Explanation

The Correct Answer is B

A. Beige freckles on the backs of both hands: These are typically benign and common with sun exposure. They do not usually indicate an immediate risk for malignancy and can be documented and monitored.

B. Irregular blue mole with white specks on the lower leg: Irregular, multicolored moles with asymmetry, color variation, or white specks may indicate malignant melanoma. Early identification and intervention are critical, making this lesion the highest priority for evaluation.

C. Large cluster of pustules in the right axilla: While pustules may indicate infection or inflammation, they are usually not immediately life-threatening. Assessment and treatment should follow after urgent lesions are addressed.

D. Thick, reddened papules covered by white scales: These lesions are characteristic of psoriasis, a chronic inflammatory condition. While assessment and ongoing management are needed, they are not acutely dangerous and can be evaluated after concerning lesions.

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Correct Answer is D

Explanation

A. Nitroglycerin: Nitroglycerin acts as a vasodilator that relieves chest pain by improving myocardial oxygen supply. Its adverse effects include hypotension, headache, and reflex tachycardia, but it does not cause bronchospasm or wheezing.

B. Heparin: Heparin is an anticoagulant that prevents clot formation in unstable angina. Its side effects are mainly related to bleeding and thrombocytopenia, not bronchoconstriction or airway irritation. The client’s symptoms are inconsistent with heparin-induced reactions.

C. Morphine: Morphine decreases myocardial oxygen demand by reducing preload and afterload. It may cause respiratory depression but does not cause wheezing or bronchospasm. The client’s audible wheezing suggests airway constriction rather than central respiratory suppression.

D. Propranolol: Propranolol is a non-selective beta-blocker that blocks both β1 and β2 receptors. In clients with asthma, blocking β2 receptors in the bronchi leads to bronchoconstriction and wheezing. Because the client has a history of asthma, propranolol is the most likely cause of the breathing difficulty following medication administration.

A. The lumps are smaller and less painful after starting oral contraceptives. B. Firm and movable lumps are in the upper outer breast quadrants. C. An area on the breast is hot, pink, and tender to the touch. D. The lumps get more painful before the client’s menstrual period.

Correct Answer is C

Explanation

A. The lumps are smaller and less painful after starting oral contraceptives: Improvement of symptoms with oral contraceptives is expected in fibrocystic breast changes. This reflects a positive response to treatment and does not necessitate altering the current plan of care.

B. Firm and movable lumps are in the upper outer breast quadrants: Fibrocystic breast changes commonly present as firm, mobile lumps in the upper outer quadrants of the breasts. This is consistent with the diagnosis and does not require changing the treatment plan.

C. An area on the breast is hot, pink, and tender to the touch: These symptoms suggest acute inflammation or infection, such as mastitis, rather than typical fibrocystic changes. This finding would prompt further evaluation, possible antibiotic therapy, or additional interventions, leading to a change in the treatment plan.

D. The lumps get more painful before the client’s menstrual period: Cyclical breast pain and lump tenderness related to the menstrual cycle is characteristic of fibrocystic changes. This expected pattern does not indicate a need for immediate treatment modification.

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A nurse performs a skin screening for a client who has numerous skin lesions. Which lesion does the nurse evaluate first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A 36-year-old client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

Correct Answer is C

Explanation

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