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NURS550: Advanced Health Assessment and
Diagnostic Reasoning Week #6 Guided
Reading Questions with Detailed Verified
Answers
1. Identify the questions you need to ask in an skin, hair, and nails
review of systems (page 12-13 in Bates') Ans: Skin: Rashes, lumps,
sores, itching, dryness, changes in color; changes in hair or nails;
changes in size or color of moles.
Growth: Start by asking if the patient is concerned about any new
growths or rashes: "Have you noticed any changes in your skin? ... your
hair? ... your nails?" "Have you had any rashes? ... sores? ... lumps? ...
itching?" I
2. Identify the risk factors for Melanoma
FYI
is the least common skin cancer, melanoma is the most lethal due to its
high rate of metastasis and high mortality at advanced stages, causing
over 70% of skin cancer deaths.4 Ans: ☼ Personal or family history of
previous melanoma
☼ ≥50 common moles
☼ Atypical or large moles, especially if dysplastic
☼ Red or light hair
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☼ Solar lentigines (acquired brown macules on sun-exposed areas)
☼Freckles (inherited brown macules)
☼ Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning
booths
☼ Light eye or skin color, especially skin that freckles or burns easily
☼ Severe blistering sunburns in childhood
☼ Immunosuppression from human immunodeficiency virus (HIV) or from
chemotherapy
☼ Personal history of nonmelanoma skin cancer
3. Define the ABCDE's of Melanoma Ans: Asymmetry
☼ Of one side of mole compared to the other
Border irregularity
☼ Especially if ragged, notched, or blurred
Color variations
☼ More than two colors, especially blue-black, white (loss of pigment due
to regression), or red (inflammatory reaction to abnormal cells)
Diameter >6 mm
☼ Approximately the size of a pencil eraser
Evolving
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☼ Or changing rapidly in size, symptoms, or morphology
Elevated
Firm to palpation
Growing progressively over several week
a. Melanoma
HARRM Risk Factors for Melanoma
- History of previous melanoma
- Age over 50
- Regular dermatologist absent
- Mole changing
- Male gender Ans: Identification
☼ Morphology: Varies (Macules to Nodules)
☼ Configuration: Solitary
☼ Distribution: Anywhere on the skin
Subjective
☼Changing mole (size, color, shape)
b. Basal cell carcinoma Ans: Identification
☼ Morphology: Papule or nodule
☼ Configuration: Solitary
NURS550: Advanced Health Assessment and
Diagnostic Reasoning Week #6 Guided
Reading Questions with Detailed Verified
Answers
1. Identify the questions you need to ask in an skin, hair, and nails
review of systems (page 12-13 in Bates') Ans: Skin: Rashes, lumps,
sores, itching, dryness, changes in color; changes in hair or nails;
changes in size or color of moles.
Growth: Start by asking if the patient is concerned about any new
growths or rashes: "Have you noticed any changes in your skin? ... your
hair? ... your nails?" "Have you had any rashes? ... sores? ... lumps? ...
itching?" I
2. Identify the risk factors for Melanoma
FYI
is the least common skin cancer, melanoma is the most lethal due to its
high rate of metastasis and high mortality at advanced stages, causing
over 70% of skin cancer deaths.4 Ans: ☼ Personal or family history of
previous melanoma
☼ ≥50 common moles
☼ Atypical or large moles, especially if dysplastic
☼ Red or light hair
, Page | 2
☼ Solar lentigines (acquired brown macules on sun-exposed areas)
☼Freckles (inherited brown macules)
☼ Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning
booths
☼ Light eye or skin color, especially skin that freckles or burns easily
☼ Severe blistering sunburns in childhood
☼ Immunosuppression from human immunodeficiency virus (HIV) or from
chemotherapy
☼ Personal history of nonmelanoma skin cancer
3. Define the ABCDE's of Melanoma Ans: Asymmetry
☼ Of one side of mole compared to the other
Border irregularity
☼ Especially if ragged, notched, or blurred
Color variations
☼ More than two colors, especially blue-black, white (loss of pigment due
to regression), or red (inflammatory reaction to abnormal cells)
Diameter >6 mm
☼ Approximately the size of a pencil eraser
Evolving
, Page | 3
☼ Or changing rapidly in size, symptoms, or morphology
Elevated
Firm to palpation
Growing progressively over several week
a. Melanoma
HARRM Risk Factors for Melanoma
- History of previous melanoma
- Age over 50
- Regular dermatologist absent
- Mole changing
- Male gender Ans: Identification
☼ Morphology: Varies (Macules to Nodules)
☼ Configuration: Solitary
☼ Distribution: Anywhere on the skin
Subjective
☼Changing mole (size, color, shape)
b. Basal cell carcinoma Ans: Identification
☼ Morphology: Papule or nodule
☼ Configuration: Solitary
