NSG 331 Exam 3 Questions With Complete Solutions
Actinic Keratosis Correct Answers ETIOLOGY/PATHO:
actinic (sun) damage, premalignant skin lesions, common in
older whites, increase in number with age
MANIFESTATIONS: flat or elevated, dry, hyperkeratoic scaly
papule, often multiple; may be rough or wart-like; rough
adherent scale on red base with returns when removed; often on
erythmatous sun-exposed area
TREATMENT/Prognosis: cryosurgery, topical application of
fluorouracil, imiquimod (Aldara) or diclofenac (Solaraze),
chemical peels, laser resurfacing, photodynamic therapy,
recurrence possible even with adequate treatment
Anticholinergics Correct Answers produce dry mouth, may
leave bad taste
-Short-acting: atrovent (temp. blurred vision with eye contact,
caution with narrow-angle glaucoma or prostatic enlargement)
-Long-Acting: spriva (blurred vision if powder gets in eyes,
must not use with Atrovent, use with SABA for quick relief,
max effect 1 week after starting, daily dose)
aspiration pneumonia Correct Answers caused by foreign
matter that is inhaled into the lungs
Assessment Abnormalities: Respiratory Correct Answers
INSPECTION:
,-abdominal paradox (inward movement of abdomen during
inspiration)
-accessory muscle use, intercostal retractions
-increased AP diameter
-clubbing
-cyanosis
-Kussmaul respirations (regular, rapid, deep respirations, fruity
odor to breath
-pursed-lip breathing
-splinting tachypnea (rate > 20 bpm)
-tripod position, inability to lie flat
PALPATION:
-altered chest movement (unequal or equal but decreased
movement)
-altered tactile fremitus
-tracheal deviation
PERCUSSION:
-dullness
-Hyperresonance
AUSCULTATION:
-absent breath sounds
-broncophony, whispered pectoriloquy,
-Coarse crackles (loud, discontinuous, low-pitched sounds
caused by air passing through airway intermittently occluded by
mucus, unstable bronchial wall)
- egphony (spoken E similar to A on auscultation because of
altered transmission of voice sounds
-fine crackles
--pleural friction rub
-stridor
-wheezes
,See page 468 for more info
Assessment for COPD Correct Answers SUBJECTIVE DATA:
-past health history: exposure to ____, recurrent respiratory tract
infections, previous hospitalizations, medications, use of O2 and
duration of use
FUNCTIONAL HEALTH PATTERNS:
-smoking
-anorexia, weight gain/loss
-increasing dyspnea and/or increase in sputum volume or
purulence, fatigue, ability to perform ADL's, feet swelling,
-elimination: constipation, gas, bloating
-sleep, sitting up while sleeping, paroxysmal nocturnal dyspnea
-HA, chest or abdominal soreness
-anxiety, depression
OBJECTIVE DATA:
-debilitation, restlessness, assumption of upright position
=cyanosis, clubbing, poor skin turgor, peripheral edema, easy
bruising, thin skin, etc.
-rapid, shallow breathing, pursed lip breathing, decrease chest
excursion and diaphragm movement, etc.
-tachycardia, dysrhythmias, jugular venous distention, etc.
-ascites, hepatomegaly (cor pulmonale)
-muscle atrophy, increased anteroposterior diameter (barrel
chest)
-abnormal ABGs (compensated respiratory acidosis),
polycythemia, pulmonary function tests, showing expiratory
airflow obstruction, etc.
, Atypical or Dysplastic Nevi Correct Answers
ETIOLOGY/PATHO: morphologically between common
acquired nevi and melanoma, may be precursor of melanoma
MANIFESTATIONS: often >5mm, irregular border, possibly
notched, frequently multiple; varying colors of tan, brown,
black, red, or pink within single mole; central part often raised
with flat edges; most common on back, but possible in common
mole sites such as scalp or buttocks
TREATMENT/PROGNOSIS: increased risk of melanoma;
careful monitoring of those with a familial tendency to
melanoma or dysplastic nevi; excisional biopsy for suspicious
lesions
Basal Cell Carcinoma Correct Answers ETIO/PATHO: change
in basal cells, no maturation or normal keratinization; continuing
division of basal cells and formation of enlarging mass; related
to excessive sun exposures, genetic skin type, x-ray radiation,
scars, and some types of nevi
MANIFESTATIONS:
-Nodular and ulcerative: small, slowly enlarging papule, borders
semi-translucent or pearly with overlying telangiectasia, erosion,
ulceration, and depression of center, normal skin markings lost
-superficial: erythematous, pearly, sharply defined, barely
elevated plaques
TREATMENT/PROGNOSIS: surgical excision,
electrodessication and curettage, cryosurgery, radiation, etc....
Actinic Keratosis Correct Answers ETIOLOGY/PATHO:
actinic (sun) damage, premalignant skin lesions, common in
older whites, increase in number with age
MANIFESTATIONS: flat or elevated, dry, hyperkeratoic scaly
papule, often multiple; may be rough or wart-like; rough
adherent scale on red base with returns when removed; often on
erythmatous sun-exposed area
TREATMENT/Prognosis: cryosurgery, topical application of
fluorouracil, imiquimod (Aldara) or diclofenac (Solaraze),
chemical peels, laser resurfacing, photodynamic therapy,
recurrence possible even with adequate treatment
Anticholinergics Correct Answers produce dry mouth, may
leave bad taste
-Short-acting: atrovent (temp. blurred vision with eye contact,
caution with narrow-angle glaucoma or prostatic enlargement)
-Long-Acting: spriva (blurred vision if powder gets in eyes,
must not use with Atrovent, use with SABA for quick relief,
max effect 1 week after starting, daily dose)
aspiration pneumonia Correct Answers caused by foreign
matter that is inhaled into the lungs
Assessment Abnormalities: Respiratory Correct Answers
INSPECTION:
,-abdominal paradox (inward movement of abdomen during
inspiration)
-accessory muscle use, intercostal retractions
-increased AP diameter
-clubbing
-cyanosis
-Kussmaul respirations (regular, rapid, deep respirations, fruity
odor to breath
-pursed-lip breathing
-splinting tachypnea (rate > 20 bpm)
-tripod position, inability to lie flat
PALPATION:
-altered chest movement (unequal or equal but decreased
movement)
-altered tactile fremitus
-tracheal deviation
PERCUSSION:
-dullness
-Hyperresonance
AUSCULTATION:
-absent breath sounds
-broncophony, whispered pectoriloquy,
-Coarse crackles (loud, discontinuous, low-pitched sounds
caused by air passing through airway intermittently occluded by
mucus, unstable bronchial wall)
- egphony (spoken E similar to A on auscultation because of
altered transmission of voice sounds
-fine crackles
--pleural friction rub
-stridor
-wheezes
,See page 468 for more info
Assessment for COPD Correct Answers SUBJECTIVE DATA:
-past health history: exposure to ____, recurrent respiratory tract
infections, previous hospitalizations, medications, use of O2 and
duration of use
FUNCTIONAL HEALTH PATTERNS:
-smoking
-anorexia, weight gain/loss
-increasing dyspnea and/or increase in sputum volume or
purulence, fatigue, ability to perform ADL's, feet swelling,
-elimination: constipation, gas, bloating
-sleep, sitting up while sleeping, paroxysmal nocturnal dyspnea
-HA, chest or abdominal soreness
-anxiety, depression
OBJECTIVE DATA:
-debilitation, restlessness, assumption of upright position
=cyanosis, clubbing, poor skin turgor, peripheral edema, easy
bruising, thin skin, etc.
-rapid, shallow breathing, pursed lip breathing, decrease chest
excursion and diaphragm movement, etc.
-tachycardia, dysrhythmias, jugular venous distention, etc.
-ascites, hepatomegaly (cor pulmonale)
-muscle atrophy, increased anteroposterior diameter (barrel
chest)
-abnormal ABGs (compensated respiratory acidosis),
polycythemia, pulmonary function tests, showing expiratory
airflow obstruction, etc.
, Atypical or Dysplastic Nevi Correct Answers
ETIOLOGY/PATHO: morphologically between common
acquired nevi and melanoma, may be precursor of melanoma
MANIFESTATIONS: often >5mm, irregular border, possibly
notched, frequently multiple; varying colors of tan, brown,
black, red, or pink within single mole; central part often raised
with flat edges; most common on back, but possible in common
mole sites such as scalp or buttocks
TREATMENT/PROGNOSIS: increased risk of melanoma;
careful monitoring of those with a familial tendency to
melanoma or dysplastic nevi; excisional biopsy for suspicious
lesions
Basal Cell Carcinoma Correct Answers ETIO/PATHO: change
in basal cells, no maturation or normal keratinization; continuing
division of basal cells and formation of enlarging mass; related
to excessive sun exposures, genetic skin type, x-ray radiation,
scars, and some types of nevi
MANIFESTATIONS:
-Nodular and ulcerative: small, slowly enlarging papule, borders
semi-translucent or pearly with overlying telangiectasia, erosion,
ulceration, and depression of center, normal skin markings lost
-superficial: erythematous, pearly, sharply defined, barely
elevated plaques
TREATMENT/PROGNOSIS: surgical excision,
electrodessication and curettage, cryosurgery, radiation, etc....
