RN Nursing · Pathophysiology · Practice question
A male construction worker, age 42, asks the nurse if a new mole on his scalp could be cancer. Based on the nurse's understanding of melanoma, the nurse should ask the patient which of the following? Select all that apply.
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✓
Has the color of lesion changed since you first noticed it?
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Did you have a tendency to freckle as a child?
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✓
Have the edges changed since it first appeared?
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Have you ever been diagnosed or treated for onychomycosis (fungal infection of the nails)?
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✓
Has the size of the mole changed since it first appeared?
Answer & explanation
Correct: Has the color of lesion changed since you first noticed it? · Have the edges changed since it first appeared? · Has the size of the mole changed since it first appeared?
Assessing a suspicious lesion for melanoma relies on the well-established ABCDE criteria: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolution (change over time). Asking whether the color has changed addresses the color and evolution criteria, since color changes in a mole are a key warning sign of malignant transformation. Asking whether the edges have changed addresses border irregularity and evolution — irregular, notched, or expanding borders are highly suspicious for melanoma. Asking whether the size has changed directly addresses both diameter and evolution, as growth in a mole is one of the most important indicators prompting biopsy. Asking about a tendency to freckle as a child is related to sun sensitivity and fair skin type, which are risk factors for melanoma in general; however, it does not assess the specific lesion characteristics and is not part of the direct ABCDE evaluation of the mole in question. A history of onychomycosis, a fungal nail infection, has no established association with melanoma risk or diagnosis and is not a relevant question when evaluating a suspicious pigmented lesion. Therefore, the three questions about color change, border change, and size change correctly reflect clinical melanoma assessment.
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