Page 1231 - Saunders Comprehensive Review For NCLEX-RN

is diagnostic. However, a viral culture of the lesion provides the definitive diagnosis.
Herpes zoster (shingles) is caused by a reactivation of the varicella zoster virus, the
virus that causes chickenpox. A patch test is a skin test that involves the
administration of an allergen to the surface of the skin to identify specific allergies. A
biopsy would provide a cytological examination of tissue. In a Wood’s light
examination, the skin is viewed under ultraviolet light to identify superficial
infections of the skin.
Test-Taking Strategy: Focus on the subject, diagnosing herpes zoster. Recalling
that herpes zoster is caused by a virus will assist in directing you to the correct
option. Also remember that a biopsy will determine tissue type, whereas a culture
will identify an organism.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Integumentary
Health Problem: Adult Health: Integumentary: Inflammations/Infections
Priority Concepts: Clinical Judgment; Tissue Integrity
Reference: Ignatavicius, Workman, Rebar (2018), pp. 468-469.

428. Answer: 2, 3

Rationale: Melanomas are pigmented malignant lesions originating in the
melanin-producing cells of the epidermis. Melanomas cause changes in a nevus
(mole), including color and borders. This skin cancer is highly metastatic, and a
person’s survival depends on early diagnosis and treatment. Melanomas are not
painful or accompanied by sign of inflammation. Although sun exposure increases
the risk of melanoma, lesions may occur any place on the body, especially where
birthmarks or new moles are apparent.
Test-Taking Strategy: Focus on the subject, characteristics of melanoma skin
cancer. It is necessary to know the normal characteristics associated with melanoma
to answer this question correctly. Also, recalling that melanomas are highly
metastatic will assist in directing you to the correct options.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Integumentary
Health Problem: Adult Health: Cancer: Skin
Priority Concepts: Cellular Regulation; Tissue Integrity
Reference: Ignatavicius, Workman, Rebar (2018), pp. 475-476.

429. Answer: 4, 5

Rationale: Basal cell carcinoma appears as a pearly papule with a central crater
and rolled waxy border. Exposure to ultraviolet sunlight is a major risk factor. A
melanoma is an irregularly shaped pigmented papule or plaque with a red-, white-,
or blue-toned color. Actinic keratosis, a premalignant lesion, appears as a small
macule or papule with a dry, rough, adherent yellow or brown scale. Squamous cell

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