# A nurse is preparing a client for a punch biopsy to evaluate a suspicious mole on the back. Which instruction should the nurse provide to the client regarding pre-procedure preparation?

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=540890  
> language: ko  
> subject: Adult Health

## 문제

A nurse is preparing a client for a punch biopsy to evaluate a suspicious mole on the back. Which instruction should the nurse provide to the client regarding pre-procedure preparation?

## 보기

1. Apply topical antibiotic ointment to the lesion site 24 hours before the procedure
2. Take aspirin 325 mg the morning of the procedure to prevent inflammation
3. Clean the biopsy site with soap and water on the morning of the procedure **✔ 정답**
4. Apply a heating pad to the area for 20 minutes before arriving at the clinic

**정답: 3**

## 해설

Proper skin cleansing with soap and water reduces bacterial contamination and infection risk for biopsy. Other options (topical antibiotics, aspirin, heating pad) are not standard pre-procedure instructions and may interfere with the procedure.

## 심화 해설

Clinical Judgment
This question evaluates the nurse's teaching role regarding patient preparation before a skin biopsy. The core is simple preparation for infection prevention and a safe procedure environment. Since a biopsy is an invasive procedure, keeping the site clean is the most basic and important prerequisite. Option 3 is the correct instruction to cleanse the area with soap and water on the morning of the procedure.

Memory Tip: For pre-biopsy preparation, remember "**C**lean and **S**imple." Avoid complex preparations (applying medications, heating) or actions that increase bleeding risk (taking aspirin).

KR vs US
In Korea, skin cleansing before a skin biopsy is also a basic principle. However, in the US, there is a very strong emphasis on self-care and patient education performed by the patient at home. Nurses must clearly distinguish and teach what patients should and should not do before the procedure.

## 임상 시나리오

Clinical Practice Guide
Patient education points before a skin biopsy (especially Punch Biopsy):
1.  Medication Check: Verify if the patient is taking blood thinners (aspirin, warfarin, clopidogrel, etc.) or anti-inflammatory drugs (NSAIDs), and instruct them to discontinue these as directed by the physician.
2.  Skin Preparation: On the morning of the procedure, gently wash the biopsy site with mild soap and water, and pat it dry with a clean towel. Do not apply alcohol, betadine, creams, etc., beforehand.
3.  Clothing: Recommend wearing loose-fitting clothes that allow easy access to the procedure site and will not interfere with the pressure dressing after the procedure.

Caution
When converted to a SATA (Select All That Apply) question, there is a trap that asks about "what not to do." Be careful not to confuse "what to do before the procedure" with "what to do after the procedure." Applying a topical antibiotic before the procedure is not necessary and may actually interfere with the biopsy results.

## 핵심 개념

- **Punch Biopsy** — A biopsy method that uses a circular blade (punch) to collect a small tissue sample of the full thickness of the skin (down to the dermis). Used to evaluate skin lesions such as melanoma.
- **Patient Education** — It is a core role of nurses to provide information and instructions so that patients can actively participate in their own health management and take proper measures before and after procedures.
- **Infection Prevention** — All measures to prevent pathogen invasion and infection before and after invasive procedures. Maintaining basic skin cleanliness is the first step.
- **Antiplatelet** — Drugs that inhibit platelet aggregation to prevent blood clot formation (e.g., aspirin, clopidogrel). May need to be discontinued before surgery or invasive procedures due to bleeding risk.
- **Pre-procedure Preparation** — All preparatory activities performed before a medical procedure to ensure patient safety and procedural success. This includes medication adjustments, skin preparation, maintaining NPO (nothing by mouth) status, etc.

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