During the assessment of a 26-year-old, she states,"I have a spot on my lip I think is cancer." The nurse notes the following: a cluster of clear vesicles with an erythematous base around them located at the lip"“ skin border. The patient mentions that she just returned from Hawaii. What would be the most appropriate response by the nurse?

Correct Answer: C

Rationale: The correct answer is C because the presentation of clear vesicles with an erythematous base around them at the lip-skin border is characteristic of herpes simplex virus 1 infection, commonly known as cold sores. Given the patient's recent travel to Hawaii, exposure to the virus is likely. This infection is self-limiting and typically heals in 4 to 10 days without the need for specific treatment. Choice A is incorrect because seeing a skin specialist may not be necessary for a self-limiting viral infection. Choice B is incorrect as a biopsy is not typically indicated for a clear clinical diagnosis of herpes simplex virus infection. Choice D is incorrect as riboflavin deficiency does not present with clear vesicles and erythema at the lip-skin border.

Correct Answer: D

Rationale: The correct answer is D: A slight amount of lid lag when moving the eyes from a superior position to an inferior position. In the diagnostic positions test, when the eyes move from an extreme superior position to an inferior position, a slight amount of lid lag is expected due to the normal anatomical structure and mechanics of the eye muscles and eyelids. This lag is a normal finding and not indicative of any underlying pathology. Rationale: A: Convergence of vision in both eyes is not a normal finding in the diagnostic positions test as convergence refers to the inward movement of both eyes towards each other to maintain single binocular vision. B: Parallel movement of both eyes is not a specific finding in the diagnostic positions test. The test is designed to assess the movement of the eyes in different directions. C: Nystagmus in extreme superior gaze is not a normal finding and indicates an abnormality in eye movement coordination, not an expected finding in the diagnostic positions test.

Correct Answer: A

Rationale: The correct answer is A: clumped. Acutely infected lymph nodes typically present as clumped due to inflammation and enlargement of multiple nodes in close proximity. This clustering is a result of the immune response to the infection. Choice B: unilateral is incorrect as lymphadenopathy in acute infection can be unilateral or bilateral. Choice C: firm but freely movable is incorrect as acutely infected lymph nodes are usually tender and may not be freely movable due to inflammation. Choice D: hard and nontender is incorrect as acutely infected lymph nodes are usually tender and may not be hard.

Correct Answer: C

Rationale: The correct answer is C: Rheumatic fever. Rheumatic fever is a possible complication of untreated strep throat due to an abnormal immune response to the streptococcal infection. This can lead to inflammation in various parts of the body, particularly the heart, joints, skin, and brain. If left untreated, rheumatic fever can cause serious long-term damage to the heart valves. The other choices are incorrect because Rubella is a viral infection causing a rash, Leukoplakia is a precancerous condition of the mouth, and Scarlet fever is a bacterial infection characterized by a red rash. These conditions are not directly associated with untreated strep throat.

Correct Answer: B

Rationale: The correct answer is B: a hordeolum (stye). A hordeolum is a localized infection in the eyelid, typically caused by bacterial infection of the oil glands. In this case, the presence of a painful pustule at the lid margin, along with redness and swelling, is characteristic of a hordeolum. The pain on touch is also indicative of an infection. Choice A, a chalazion, is an inflammatory lesion caused by a blocked oil gland, but it is usually painless and not typically associated with redness or tenderness. Choice C, dacryocystitis, is an infection of the lacrimal sac, which presents with different symptoms such as tenderness over the inner corner of the eye and tearing. Choice D, blepharitis, is inflammation of the eyelid margins, but it does not typically present with a painful pustule at the lid margin.