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Nurse Practitioner:
doi: 10.1097/01.NPR.0000348318.30741.a2
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Skin cancer: More than skin deep

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INSTRUCTIONS Skin cancer: More than skin deep

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Skin cancer: More than skin deep

General Purpose: To provide the NP with an updated overview of the epidemiology, clinical presentation, treatment, and prevention of skin cancer. Learning Objectives: After reading the previous article and taking the following test, the NP will be able to: 1. Describe the epidemiology, pathophysiology, and clinical presentation of skin cancer 2. Discuss the diagnosis, management, and prevention of skin cancer.

1. Approximately what percentage of Americans will develop skin cancer in their lifetime?

a. 20%

b. 25%

c. 33%

d. 50%

2. Which UV light rays are more likely to cause sunburn?

a. UVA

b. UVB

c. UVC

d. UVD

3. Which UV light rays are associated with direct damage to DNA?

a. UVA

b. UVB

c. UVC

d. UVD

4. Which statement about actinic keratosis is true?

a. Lesions usually begin on non-sun exposed skin.

b. The early lesions are erythematous, scaly plaques.

c. They are precursor lesions to 10% of SCC.

d. They are precursor lesions to 10% of BCC.

5. Which statement about BCC is true?

a. It is unlikely to metastasize or become invasive.

b. It generally first appears as a dark lesion with rolled edges or an ulcerated center.

c. The lesions tend to flake off in the course of daily activities.

d. It commonly occurs on sun-exposed parts of the face, ears, scalp, shoulders, and back.

6. Which of the following is true about the occurrence of BCC?

a. It represents 85% to 95% of all skin cancers.

b. It occurs from DNA changes in melanocytes caused by UV rays.

c. It tends to occur at sites of previous trauma or injury.

d. Its recurrence rate is more than 50%.

7. SCC appears to be associated with

a. intense short-term UVA exposure.

b. cumulative long-term UVA exposure.

c. intense short-term UVB exposure.

d. cumulative long-term UVB exposure.

8. Which statement about malignant melanoma is true?

a. The majority of cases are caused by UVB exposure.

b. The majority of cases are strictly hereditary.

c. It is the most serious of all cutaneous malignancies.

d. It evolves from untreated actinic keratoses.

9. The “A” in the ABCD rule for clinical assessment of pigmented lesions stands for

a. UVA exposure.

b. asymmetry.

c. age.

d. associated trauma.

10. A favorable prognosis of malignant melanoma is entirely attributable to

a. early detection.

b. a uniform color of the lesion.

c. a lack of elevation of the lesion.

d. the symmetry of the lesion.

11. Which of the following would be considered a skin cancer in stage II?

a. a carcinoma measuring less than 2 centimeters

b. a carcinoma measuring greater than 2 centimeters

c. a carcinoma involving the structures below the skin

d. a carcinoma with lymph node involvement

12. Which staging system for malignant melanoma is based on tissue level of invasion?

a. Braden.

b. Clark.

c. Norton.

d. ACS

13. Which treatment method is 99% accurate and preserves a maximum amount of healthy skin?

a. curettage with electrodessication

b. photodynamic therapy

c. cryosurgery

d. Mohs surgery

14. Melanoma management is contingent upon all of the following except

a. histopathology.

b. invasion of lymph nodes or distant organs.

c. lesion depth.

d. lesion thickness.

15. Which is not a skin cancer risk factor among U.S. adults?

a. blistering sunburn during childhood

b. smoking

c. male gender

d. Hispanic origin

16. The SPF is a lab measure of the effectiveness of a sunscreen

a. from UVA only.

b. from UVB only.

c. from both UVA and UVB.

d. against sun poisoning.

17. Which demographic represents the highest risk for melanoma?

a. teenage girl

b. male adult younger than 50 years

c. female adult older than 50 years

d. male adult older than 50 years

18. When should sunscreen be applied before going into the sun?

a. immediately before

b. 10 minutes before

c. 15 minutes before

d. at least 20 minutes before

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