Advanced Practice Nursing in the Care of Older Adults . F.A. Davis Company, 2014-01-
14. VitalBook file. Points Received: 2 of 2 Comments: -563888927 MultipleChoice 16 True 0 -563888927 MultipleChoice 16 Question 17. Question : A patient has a tender, firm, nodular cystic lesion on his scalp that produces cheesy discharge with foul odor. This is most likely a: Student Answer: Bacterial folliculitis Basal cell carcinoma Bullous impetigo Epidermoid cyst Instructor Explanation: With an epidermoid cyst, the patient complains of a cystic lesion that produces cheesy discharge with foul odor. The lesion is sometimes tender or painful. The lesion is nodular, round and firm, and subcutaneous; thus, it is flesh colored. The most common sites include the face, scalp, neck, upper trunk, and extremities. Goolsby Points Received: 2 of 2 Comments: -563888926 MultipleChoice 17 True 0 -563888926 MultipleChoice 17 Question 18. Question : Patient presents with complaint of a “swollen node” under his arm. The area is tender and the node has progressed in size over the past few days. Which of the following should be included in your differential diagnosis?
Student Answer: Hidradenitis suppurativa Epidermoid cyst Furuncle Both A and C Instructor Explanation: Hidradenitis suppurativa involves occlusions of hair follicles, which causes a red, fluctuant tender lesion. The site is commonly under the breast or in the axillae or groin. The clinician must differentiate this skin condition from an enlarged lymph node, which can appear similar. An enlarged lymph node is usually painless, whereas hidradenitis is usually tender. Furuncles are staphylococcal infections of hair follicles or sebaceous glands. Patients complain of pain, redness, and swelling at the affected site, commonly the axillae and groin. Goolsby Points Received: 2 of 2 Comments: -563888925 MultipleChoice 18 True 0 -563888925 MultipleChoice 18 Question 19. Question : A patient suffered a laceration of the shin three days ago, and today presents with a painful, warm, red swollen region around the area. The laceration has a purulent exudate. The clinician should recognize that the infected region is called: Student Answer: Contact dermatitis Folliculitis Hidradenitis suppurativa Cellulitis Instructor Explanation: In cellulitis, a patient often describes a history of a break in the skin from an injury, insect bite or sting, or previous procedure preceding the onset of redness, swelling, and pain at the site. The affected area is tender, swollen, reddened, and warm. Streptococcus or staphylococcal commonly causes the infection. The lower leg is a common site, usually unilateral.
Goolsby Points Received: 2 of 2 Comments: -563888924 MultipleChoice 19 True 0 -563888924 MultipleChoice 19 Question 20. Question : A woman complains of malaise and arthralgias. You note a butterfly-shaped, macular, erythematous rash across her cheeks and nose. These conditions are common in: Student Answer: Psoriasis Lichen planus Systemic lupus erythematosus Erythema nodosum Instructor Explanation: In systemic lupus erythematosus, the patient will have a range of symptoms relevant to the diagnosis, depending on the affected organs. There is often
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