When obtaining the health history of a 60-year-old female, the client reports noting small red lesions on her vulva. Based upon your knowledge, which of these diagnoses is most likely correct?

Correct Answer: D

Rationale: The correct diagnosis is D: Vulvar carcinoma. In a 60-year-old female with small red lesions on the vulva, vulvar carcinoma is the most likely cause due to the age group and presentation. Vulvar carcinoma commonly presents as red, white, or pigmented lesions, and its incidence increases with age. Herpes simplex (choice A) typically presents with vesicles and ulcers, not red lesions. Primary syphilis (choice B) presents with a painless chancre, while secondary syphilis (choice C) presents with a rash that typically involves the palms and soles. These choices are less likely based on the client's age, lesion appearance, and clinical findings.

Correct Answer: C

Rationale: The correct answer is C because a white blood cell count of 23,000/mm³ indicates a potential infection. Elevated WBC count is a common sign of infection as the body responds to pathogens. The other choices are incorrect because: A: Blood cultures pending do not necessarily indicate a wound infection. B: Thin, serous wound drainage is normal in some cases and does not always indicate infection. D: Decrease in wound size is a positive sign of healing, not infection. In summary, the client with an elevated WBC count should be evaluated for a wound infection due to the potential indication of an inflammatory response.

Correct Answer: A

Rationale: The correct answer is A: Cool, moist compresses. This nonpharmacologic measure helps to soothe eczematous dermatitis by reducing inflammation, itching, and discomfort. Cool compresses provide relief by constricting blood vessels and reducing swelling. Moist compresses help to hydrate the skin and prevent further irritation. Summary: B: Topical corticosteroids are pharmacologic agents used to treat eczematous dermatitis by reducing inflammation. They are not nonpharmacologic comfort measures. C: Heating pad can exacerbate eczematous dermatitis by increasing inflammation and itching. It is not recommended for this condition. D: Tepid bath with cornstarch may provide some relief for eczematous dermatitis, but cool, moist compresses are more effective in soothing the skin and reducing discomfort.

Correct Answer: C

Rationale: The correct answer is C: Full thickness. This categorization is based on the description of white and leather-like appearance, indicating complete destruction of the epidermis and dermis layers. This type of injury is characteristic of full-thickness burns, also known as third-degree burns. Partial-thickness deep burns (A) involve damage to the dermis but not the full thickness, while partial-thickness superficial burns (B) only affect the epidermis and part of the dermis. Superficial burns (D) are limited to the epidermis only. The specific description of the burns in this case clearly aligns with full-thickness burns, making choice C the most appropriate categorization.

Correct Answer: D

Rationale: The correct answer is D because staying out of the sun between 10 AM and 2 PM reduces exposure to the strongest UV rays, decreasing the risk of skin damage. A is incorrect as SPF should be at least 30. B is wrong as water-resistant sunscreens require reapplication after swimming. C is incorrect as increasing sun exposure can lead to more skin damage. In summary, option D is the most effective in reducing sun damage risk compared to the other choices.