Patho Patho #68

Question

The nurse is approached by a friend who has a lesion on her neck. The lesion is dark brown/ black in color. It is irregularly shaped and is described as having enlarged in size over the last few months. What advice should the nurse give in regards to this lesion?

Answers

  1. “Take a watch and wait approach and let me know if it changes.”
    • Rationale:

      This answer choice is not correct as this lesion should be evaluated as soon as possible by a dermatologist. Malignant melanoma has a high probability for metastasis to distant organs.

  2. “This looks like a benign lesion but there are topical creams that will help with any discomfort.”
    • Rationale:

      This answer choice is not correct as the description of this lesion is suspicious for malignant melanoma. Benign skin lesions are typically regularly shaped and do not change over time.

  3. “You should have that lesion evaluated by a dermatologist as soon as possible.”
    • Rationale:

      This answer choice is correct as this lesion is suspicious for malignant melanoma and should be evaluated by a dermatologist as soon as possible.

  4. “I would cover the affected area to prevent any further sun exposure.”
    • Rationale:

      This answer choice is not correct as the client should be advised to see a dermatologist as soon as possible due to the high probability for metastasis if the lesion is confirmed malignant melanoma.

Overview

The focus of this question is asking the nurse to offer education regarding a suspicious appearing lesion on a client’s neck. Given the description of the lesion, the nurse should advise to have the lesion evaluated by a dermatologist. A lesion that varies in color, is irregularly shaped, and has grown in size is suspicious for malignant melanoma and should be further assessed by a provider.

Explanation

Learning Outcomes

Malignant melanoma is a form of skin cancer that is very invasive with a high probability for metastasis. Characteristics of malignant melanoma include a lesion that contains different colors, changes in shape/size, and is irregularly shaped. This lesion should be assessed and possibly biopsied by a dermatologist as soon as possible as it is very suspicious for malignant melanoma.

Test Taking Tip

Use the ABCDE method for evaluating suspicious skin lesions: Asymmetry, Border, Color, Diameter, Evolving.

Video Rationale