Considering the "ABCD" signs of melanoma, which off the following would be most concerning?
A mole that is smaller than 6 mm
A mole that resembles all other moles on the body
A mole with multiple colors
A mole with symmetrical borders
The Correct Answer is C
A. A mole that is smaller than 6 mm is incorrect because while size can be a factor in melanoma, smaller moles are generally less concerning. Melanomas are often larger than 6 mm, but early lesions can be smaller, so size alone is not the most alarming sign.
B. A mole that resembles all other moles on the body is incorrect because this represents the “E” or “evolution” principle in dermatology, meaning moles that are similar to surrounding moles are less likely to be malignant. Melanoma often stands out as different from other moles (the “ugly duckling” sign).
C. A mole with multiple colors is correct because the “C” in the ABCD mnemonic stands for Color. A mole with multiple shades of brown, black, tan, red, white, or blue is concerning for melanoma. Variation in color reflects abnormal melanocyte activity and irregular pigment deposition, which is a hallmark of malignant change.
D. A mole with symmetrical borders is incorrect because symmetrical moles are generally less concerning. The “B” in ABCD stands for Border, and irregular, scalloped, or poorly defined borders are a warning sign of melanoma. Symmetry is more characteristic of benign nevi.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Diabetes is incorrect because diabetes mellitus is a chronic metabolic disorder caused by insufficient insulin production or insulin resistance. It is unrelated to the acute fluid shifts or volume depletion seen in burn injuries, so it is not a complication of burns.
B. Hypovolemic shock is correct because severe burns damage the skin, which acts as a protective barrier, allowing significant fluid, plasma, and protein loss through the injured tissue. This results in a decrease in circulating blood volume, leading to reduced tissue perfusion, hypotension, tachycardia, and potential organ dysfunction. Hypovolemic shock is a life-threatening complication in the acute phase of burn injury. Early recognition and prompt fluid resuscitation using formulas like the Parkland formula are critical to restore intravascular volume, maintain organ perfusion, and prevent multi-organ failure.
C. Pneumonia is incorrect because pneumonia is primarily a respiratory complication, often arising from inhalation injury, aspiration, or prolonged immobility, rather than from fluid loss. While burn patients are at increased risk for infections due to compromised skin integrity and immune suppression, pneumonia is not the direct result of hypovolemia.
D. Heart failure is incorrect because heart failure occurs when the heart is unable to pump blood effectively due to structural or functional problems. Although severe burns can stress the cardiovascular system, the immediate threat from fluid loss is hypovolemic shock, not intrinsic heart failure.
Correct Answer is B
Explanation
A. Bacterial overgrowth of highly contagious S. aureus with development of vesicles and pruritus is incorrect because this description applies to impetigo, which is a superficial bacterial skin infection. Psoriasis is an autoimmune condition and is not contagious, so bacteria are not the primary cause.
B. Abnormal T-cell activation leading to excessive growth of keratinocytes and rapid epidermal shedding is correct because psoriasis is driven by dysregulation of the immune system. In this condition, T-cells become overactive and release cytokines that stimulate keratinocyte proliferation at an accelerated rate. Normally, keratinocytes take about 28–30 days to mature and shed, but in psoriasis, this process can occur in 3–5 days. The rapid turnover results in thickened, scaly plaques, redness, and inflammation. Chronic inflammation also contributes to the pruritus, discomfort, and erythema seen in affected areas. Triggers such as stress, infections, or certain medications may exacerbate the condition but do not cause it directly.
C. Sensitization on first exposure to an allergen with rash development on subsequent exposure is incorrect because this describes allergic contact dermatitis, where the immune system reacts to a previously encountered allergen. Psoriasis, in contrast, is autoimmune and does not require prior allergen exposure. The lesions are caused by internal immune dysregulation, not external sensitization.
D. Latent virus becomes reactivated by infection or stress, leading to development of skin lesions is incorrect because this mechanism describes viral conditions such as shingles (herpes zoster). Psoriasis is not caused by a virus, and the plaques and scales result from keratinocyte hyperproliferation due to immune dysregulation rather than viral reactivation.
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