Exam 3 explore more

Question 1

When assessing the present health status of the patient, symptoms of allergies, difficulty breathing, and orthopnea could indicate?

Answer 1

respiratory disorders. The patient should be asked about the use of inhalers or oxygen at home.
Assessing the patient’s smoking history is an important aspect of the respiratory

Question 2

Assessing the patient’s smoking history is an important aspect of the respiratory assessment. This information should be recorded as?

Answer 2

the number of pack-years the individual has smoked, even if he or she has already quit.

Question 3

There are multiple environmental factors that can affect breathing. These include?

Answer 3

air pollution, allergens in the home and any filtering systems in the home, hobbies, and exposure to secondhand smoke.

Question 4

A cough may be associated with a respiratory condition or caused by other problems. The patient should be asked to describe?

Answer 4

the cough, any sputum that is produced, any other symptoms, and what measures are used to treat the cough.

Question 5

Causes of shortness of breath in a patient should be clarified. Dyspnea can be indicative of?

Answer 5

respiratory or cardiac conditions. The patient should be asked to describe what makes the difficult breathing better or worse.

Question 6

Common infectious respiratory conditions that may be encountered are?

Answer 6

acute bronchitis, pneumonia, tuberculosis, and pleural effusions. Chronic conditions include asthma, emphysema, and chronic bronchitis.

Question 7

Pneumothorax and hemothorax are most often related to a?

Answer 7

traumatic incident. These conditions can also be associated with surgical procedures.

Question 8

Inspection-Inspect for general appearance, posture and breathing effort.
Normal:
Abnormal:

Answer 8

Normal: The general appearance and posture should be relaxed. Breathing should be effortless, quiet, and rate is age appropriate.

Abnormal: Indications of respiratory distress include an appearance of apprehension with restlessness, nasal flaring, retractions, and tripod positioning

Question 9

Observe respiration for rate, breathing pattern, and chest expansion.
Normal:
Abnormal:

Answer 9

Normal: Adult passive breathing is 12-20/ minute otherwise known as eupnea. The pattern should be smooth with an even respiratory depth. Symmetric rise and expansion should occur.

Abnormal: bradypnea, tachypnea, hyperventilation, Kussmaul respirations, Biot’s, and Cheyne-Stokes patterns.

Question 10

Inspect patient’s nails, skin, and lips for color.
Normal:
Abnormal:

Answer 10

Normal: Nail beds should be pink with an angle of 160 degrees at the nail bed. Skin tones vary among individuals thereby noting the general color of the client and observing if it is consistent with skin and lip color. Note presence of pallor or cyanosis.
Abnormal: Cyanosis may be noted in a client with shortness of breath or dyspnea. Long term lung disease can cause spooning of the nail base greater than 180 degrees.

Question 11

Inspect posterior thorax for shape, symmetry, and muscle development.
Normal:
Abnormal:

Answer 11

Normal: The ribs should slope down at about 45 degrees relative to the spine. The thorax should be symmetric. The spinous processes should appear in a straight line. The scapulae should be bilaterally symmetric. Muscle development should be equal.
Abnormal: Asymmetry or unequal muscle development is abnormal. Skeletal deformities such as scoliosis or kyphosis may limit the expansion of the chest. Patients with COPD may have a barrel-shaped chest.

Question 12

Bronchovesicular breath sounds are?

Answer 12

moderate in pitch, medium in intensity, auscultated over the 1st and 2nd ICS at the sternal border, and the inspiratory and expiratory duration should be equal.

Question 13

Vesicular breath sounds are?

Answer 13

low in pitch, soft in intensity, auscultated over the peripheral lung fields, and the inspiratory phase duration is greater than the expiratory phase duration.

Question 14

Bronchial breath sounds are?

Answer 14

high in pitch, loud in intensity, auscultated over the trachea, and the duration of the inspiratory phase is less than the duration of the expiratory phase.

Question 15

Adventitious breath sounds - if heard, have the patient?

Answer 15

cough, and then repeat the auscultation to note whether the adventitious sounds changed or disappeared.

Question 16

Fine crackles

Answer 16

Fine, high-pitched crackling and popping noises (discontinuous sounds) heard during the end of inspiration; not cleared by cough.
-Clinical examples - May be heard in pneumonia, heart failure, asthma, and restrictive pulmonary diseases

Question 17

Medium crackles

Answer 17

Medium-pitched, moist sound heard about halfway through inspiration; not cleared by cough.
-Clinical examples - May be heard in pneumonia, heart failure, asthma, and restrictive pulmonary diseases but condition is worse than those with fine crackles.

Question 18

Coarse crackles

Answer 18

Low-pitched, bubbling, or gurgling sounds that start early in inspiration and extend into the first part of expiration.
Clinical examples - May be heard in pneumonia, heart failure, asthma, and restrictive pulmonary diseases; condition is worse or in terminally ill patients with diminished gag reflex; also heard in pulmonary edema and pulmonary fibrosis

Question 19

Wheeze

Answer 19

High-pitched, musical sound similar to a squeak; heard more commonly during expiration but may also be heard during inspiration; occurs in small airways.
-Clinical examples-Heard in narrowed airway diseases such as asthma

Question 20

Rhonchi

Answer 20

Low-pitched, coarse, loud, low snoring or moaning tone; actually sounds like snoring; heard primarily during expiration but may also be heard during inspiration; coughing may clear.
Clinical examples-Heard in disorders causing obstruction of the trachea or bronchus such as chronic bronchitis

Question 21

Pleural friction rub

Answer 21

Superficial, low-pitched, coarse rubbing or grating sound; sounds like two surfaces rubbing together; heard throughout inspiration and expiration; loudest over the lower anterolateral surface; not cleared by cough.
- Clinical examples-Heard in individuals with pleurisy (inflammation of the pleural surfaces)

Question 22

Inspect the anterior thorax for shape, symmetry, muscle development, and costal angel. The costal angle should be?
the anteroposterior diameter is about?

Answer 22

The costal angle should be < 90 degrees

the anteroposterior diameter is about ½ the lateral diameter or about a 1:2 ratio of AP to lateral diameter.

Question 23

Older Adults: Assessing the respiratory status of an older adult follows the same procedures as for an adult, although structural and functional differences may be noted.

Answer 23

Posterior thoracic stooping or bending or kyphosis may alter the thorax wall configuration and make thoracic expansion more difficult.

Question 24

When conducting a comprehensive assessment, the patient should be asked about the presence of diseases affecting mobility. This includes?

Answer 24

osteoporosis, arthritis, fractures, and a history of accidents or trauma.

Question 25

The point where two or more bones come together are?

Answer 25

joints. Joints are classified by the type of material between them and their degree of movement.

Question 26

- Ligaments | - Tendons

Answer 26

- Ligaments are flexible connective tissues that adhere bones to bones. - Tendons are nonelastic cords that are located at the end of muscles and attach muscles to bones.

Question 27

Common problems associated with bones are?

Answer 27

fractures and osteoporosis. Conditions associated with the joints are rheumatoid arthritis, osteoarthritis, bursitis, and gout.

Question 28

Conditions related to the spine are?

Answer 28

herniated nucleus pulposus and scoliosis. Problems linked with ligament or muscle conditions are known as carpal tunnel syndrome.

Question 29

Observe patient standing and straight from the front, back, and sides. Normal: Abnormal:

Answer 29

Normal: The body should be symmetric. The spine should be straight with expected curvatures-cervical is concave; thoracic is convex; and lumbar is concave. Abnormal: kyphosis, scoliosis, and lordosis.

Question 30

Inspect muscles for size and symmetry. Normal: Abnormal:

Answer 30

- Normal: Muscle size should appear relatively symmetric. - Abnormal: atrophy of muscle mass bilaterally may indicate lack of nerve stimulation such as spinal cord injury. Fasciculations (muscle twitching of a single muscle group) may be caused by adverse effects of drugs. Fasciculations are localized whereas spasms are more generalized.

Question 31

Palpate bones for tenderness; joints for tenderness, heat, and edema; and muscles for tenderness, heat, edema, and tone. Normal: Abnormal:

Answer 31

- Normal: Bones should be nontender on palpation. No tenderness or edema should be detected on palpation of joints or muscles. The joints and muscles should be the same temperature as the surrounding tissue. Muscles should feel firm, not hard or soft. - Abnormal: Tenderness, heat, or edema over bones, joints, or muscles may indicate tumor, inflammation, or trauma. Muscle atrophy may be evident by a decrease in muscle tone.

Question 32

Assess range of motion for major joints and adjacent muscles, for tenderness on movement, joint stability, and deformity. (know which types of movements are associated with each type of joint, refer to Table 14-1) Normal: Abnormal:

Answer 32

- Normal: There should be full range of motion actively and passively with joint stability but without tenderness, heat, edema, crepitus, deformity, or contracture. - Abnormal: crepitus which occurs after an injury; limited range of motion; increased range of motion; joint instability or deformity may indicate a number of disorders including muscle weakness, fracture, inflammation, strained ligaments, or meniscus tear.

Question 33

Observe gait for conformity, symmetry, and rhythm. Normal: Abnormal:

Answer 33

- Normal: Expected findings are conformity (ability to follow gait sequencing of both stance and swing); regular smooth rhythm; symmetry in length of leg swing; smooth swaying; and smooth, symmetric arm swing. - Abnormal: An unstable or exaggerated gait, limp, irregular stride length, arm swing that is unrelated to gait, or any other inability to maintain straight posture or asymmetry of body parts requires further assessment.

Question 34

``` Head and Neck INSPECT PALPATE OBSERVE PALPATE OBSERVE TEST ```

Answer 34

- INSPECT musculature of the face and neck for symmetry. - PALPATE each temporomandibular for movement, sounds, and tenderness. - OBSERVE jaw for range of motion. - PALPATE the neck for pain. - OBSERVE the neck for range of motion. - TEST neck muscles for strength.

Question 35

Objective: Identify findings from a musculoskeletal system assessment that would require further evaluation.

Answer 35

Rheumatoid arthritis flares | Gout

Question 36

Tissue integrity refers to the?

Answer 36

intactness and function of the skin, hair, and nails. To maintain tissue integrity, the body needs adequate nutrition and oxygenation to carry nutrients to the tissue.

Question 37

There are three main components of the skin.

Answer 37

1) The epidermis is the outermost layer and provides no blood supply. 2) The dermis is a layer which is highly vascular and regulates body temperature. It also contains sensory nerve fibers, which provide reactions to touch, pain, and temperature. 3) The hypodermis is a subcutaneous layer composed of fat. Fatty cells help with heat regulation and provide protection against injury.

Question 38

The most commonly reported skin condition is?

Answer 38

pruritus (itching). Other common findings associated with the skin are rashes, pain, discomfort, lesions, wounds, and changes in skin color or texture.

Question 39

Skin conditions common in infants and children are related to? The most common concern in the adolescent is? Significant changes occur in older adults with regard to skin and hair.

Answer 39

- children related to diaper rashes or allergens - most common concern in the adolescent is acne. - Significant changes occur in older adults with regard to skin and hair.

Question 40

Common skin conditions that may be encountered are?

Answer 40

corns, dermatitis, and psoriasis.

Question 41

Skin lesions caused by viral infections are?

Answer 41

warts, herpes simplex, herpes varicella (chickenpox), and herpes zoster (shingles).

Question 42

Lesions of a fungal nature are?

Answer 42

tinea infections and candidiasis.

Question 43

Bacterial infections can cause skin conditions such as?

Answer 43

cellulitis, impetigo, folliculitis, and abscesses.

Question 44

The most common neoplastic skin conditions are?

Answer 44

basal cell carcinoma, squamous cell carcinoma, melanoma, and Kaposi sarcoma.

Question 45

Inspect the skin for general color and uniformity of color. Normal: Abnormal:

Answer 45

- Normal: The skin color should be consistent over the body surface, with the exception of vascular areas such as the cheeks, upper chest, and genitalia, which may appear pink or have a reddish-purple tone. The normal range of skin color varies from whitish pink, to olive tones, to deep brown. Sun-exposed areas may show evidence of slightly darker pigmentation. - Abnormal: Abnormal skin color may be evidence of local or systemic disease. Common abnormal findings of particular importance include cyanosis, pallor, and jaundice. Less common findings include: 1) Hypopigmentation, also known as albinism (a complete absence of pigmentation; pale white skin tone is noted over the entire body surface). 2) Hyperpigmentation (increased melanin deposition) may be an indication of an endocrine disorder (e.g., Addison's disease) or liver disease.

Question 46

Clinical Sign: Cyanosis Light Skin Dark Skin

Answer 46

Light skin: Grayish-blue tone, especially in nail beds, earlobes, lips, mucous membranes, palms, and soles of feet Dark skin: Ashen-gray color most easily seen in the conjunctiva of the eye, oral mucous membranes, and nail beds

Question 47

Clinical sign: Ecchymosis (bruise) Light skin Dark skin

Answer 47

- Light skin: Dark red, purple, yellow, or green color, depending on age of bruise - Dark skin: Deeper bluish or black tone; difficult to see unless it occurs in an area of light pigmentation

Question 48

Clinical sign: Erythema Light skin Dark skin

Answer 48

- Light skin: Reddish tone with evidence of increased skin temperature secondary to inflammation - Dark skin: Deeper brown or purple skin tone with evidence of increased skin temperature secondary to inflammation

Question 49

Clinical sign: Jaundice Light skin Dark skin

Answer 49

- Light skin: Yellowish color of skin, sclera of eyes, fingernails, palms of hands, and oral mucosa - Dark skin: Yellowish-green color most obviously seen in sclera of eye (do not confuse with yellow eye pigmentation, which may be evident in dark-skinned patients), palms of hands, and soles of feet

Question 50

Clinical sign: Pallor Light skin Dark skin

Answer 50

- Light skin: Pale skin color that may appear white - Dark skin: Skin tone appears lighter than normal; light-skinned African Americans may have yellowish-brown skin; dark-skinned African Americans may appear ashen; specifically evident is a loss of the underlying healthy red tones of the skin

Question 51

Clinical sign: Petechiae Light skin Dark skin

Answer 51

- Light skinLesions appear as small, reddish-purple pinpoints - Dark skin: Difficult to see; may be evident in the buccal mucosa of the mouth or sclera of the eye

Question 52

Clinical sign: Rash Light skin Dark skin

Answer 52

- Light skin: May be visualized and felt with light palpation - Dark skin: Not easily visualized but may be felt with light palpation

Question 53

Clinical sign: Scar Light skin Dark skin

Answer 53

- Light skin: Narrow scar line | - Dark skin Frequently has keloid development, resulting in a thickened, raised scar

Question 54

Keloid can be a result of?

Answer 54

Result of multiple piercings

Question 55

Pigmented nevi (moles): Moles are considered an expected finding; most adults have between 10 and 40 moles scattered over the body. They are most commonly located above the waist on sun-exposed body surfaces (chest, back, arms, legs, and face). They tend to be?

Answer 55

uniformly tan to dark brown, are typically less than 5 mm in size, and may be raised or flat. The expected shape of a mole is round or oval with a clearly defined border.

Question 56

Freckles:

Answer 56

Freckles are small, flat, hyperpigmented macules that may appear anywhere on the body, particularly on sun-exposed areas of the skin. The most common locations are on the face, arms, and back.

Question 57

Patch

Answer 57

A patch is an area of darker skin pigmentation that is usually brown or tan and typically is present at birth (birthmarks). Some of these patches fade, but many do not change over time.

Question 58

Striae:

Answer 58

Striae are silver or pink “stretch marks” secondary to weight gain or pregnancy.

Question 59

Melanoma: The nurse should be familiar with abnormal characteristics of pigmented moles that might point to melanoma. Moles located below the waist or on the scalp or breast are?

Answer 59

rarely “normal” moles.

Question 60

Vitiligo is an?

Answer 60

acquired condition associated with the development of unpigmented patch or patches; it is more common in dark-skinned races and thought to be an autoimmune disorder.

Question 61

Localized areas of hyperpigmentation may be associated with?

Answer 61

endocrine disorders (pituitary, adrenal) and autoimmune disorders (systemic lupus erythematosus).

Question 62

Skin Lesions: Macule | Examples

Answer 62

- Macule - flat, circumscribed < 1 cm in diameter. | - Examples: Freckles, flat nevi (moles), petechiae, measles, scarlet fever.

Question 63

Skin lesions: Papule | Examples

Answer 63

- Papule - elevated, firm, circumscribed area < 1 cm in diameter. - Examples: Warts, elevated moles skin tags, cherry angiomas.

Question 64

Skin lesion: Patch | Example

Answer 64

- Patch - flat, nonpalpable, irregularly shaped macule > 1 cm. - Example: Vitiligo, port wine stains, Mongolian spots, and Café-au-lait spots.

Question 65

Skin lesion: Plaque | Example

Answer 65

- Plaque - elevated, firm, rough lesions with flat top > 1 cm. - Example: Psoriasis, seborrheic and actinic keratosis, eczema.

Question 66

Skin lesion: Wheal | Example

Answer 66

- Wheal - elevated, irregular shaped area of the cutaneous edema that is solid and varies in diameter. - Example: Insect bites, urticarial, allergic reactions.

Question 67

Skin lesion: Nodule | Example

Answer 67

- Nodule - elevated firm, circumscribed lesions deeper into the dermis. 1-2 cm in diameter. - Example: Dermatofibroma erythema nodusm, lipomas, hemangiomas.

Question 68

Skin lesion: Tumor | Example

Answer 68

- Tumor - elevated and solid lesions that may or may not be clear in the demarcation. They are deeper into the dermis and > 2 cm in diameter. - Example: Neoplasms, lipomas, hemangiomas.

Question 69

Skin lesion: Vesicles | Example

Answer 69

- Vesicles - elevated circumscribed, superficial, serous filled fluid lesions < 1 cm in diameter. - Example: Varicella, herpes zoster, impetigo, acute eczema.

Question 70

Skin lesion: Bulla | Example

Answer 70

- Bulla - vesicles > 1 cm. | - Example: Blisters, pemphigus vulgaris, lupus erythematosus, impetigo, and drug reactions.

Question 71

Skin lesion: Pustule | Example

Answer 71

- Pustule - elevated superficial lesions purulent fluid filled. - Example: Impetigo, acne, folliculitis, herpes simplex.

Question 72

Skin lesion: Cyst | Example

Answer 72

- Cyst - elevated, circumscribed, filled with liquid or semisolid material. - Example: Sebaceous cyst, cystic acne.

Question 73

Secondary skin lesions: Scale | Example

Answer 73

- Scale - heaped up keratinized cells, flaky skin, irregular thick or thin, dry or oily. - Example: Flaking of skin with seborrheic dermatitis following scarlet fever, dry skin, eczema, xerosis.

Question 74

Secondary skin lesion: Lichenification | Example

Answer 74

- Lichenification - rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation. - Example: Chronic dermatitis, psoriasis.

Question 75

Secondary skin lesion: Keloid | Example

Answer 75

- Keloid - irregular shaped, elevated progressively enlarging scar. Grows beyond the boundaries of the wound. - Example: Keloid formation following surgery.

Question 76

Secondary skin lesion: Scar | Example

Answer 76

- Scar - thin to thick fibrous tissue that replaces normal skin following injury or laceration. - Example: Healing wound or surgical incision.

Question 77

Secondary skin lesion: Excoriation | Example

Answer 77

- Excoriation - loss of epidermis linear hollowed out crusted area. - Example: Abrasion or scratch, scabies.

Question 78

Secondary skin lesion: Fissure | Example

Answer 78

- Fissure - linear crack or break from the epidermis to the dermis. May be moist or dry. - Example: Athlete’s foot, cracks at the corner of the mouth, chapped hands, eczema.

Question 79

Secondary skin lesion: Crust | Example

Answer 79

- Crust - dried drainage or blood, slightly elevated, variable sizes and colors. - Example: Scab on abrasion, eczema.

Question 80

Secondary skin lesion: Erosion | Example

Answer 80

- Erosion - loss of part of the epidermis, depressed moist, and glistening, following rupture of the vesicle or bulla. - Example: Varicella, variola after rupture, candidiasis, herpes simplex.

Question 81

Secondary skin lesion: Ulcer | Example

Answer 81

- Ulcer - loss of epidermis and dermis, concave, and varies in size. - Example: Pressure ulcers, stasis ulcers, syphilis chancres

Question 82

Secondary skin lesion: Atrophy | Example

Answer 82

- Atrophy - thinning of the skin surface, loss of skin markings. Skin appears translucent and paperlike. - Example: Aged skin, striae, discoid lupus erythematosus.

Question 83

Vascular lesions: Tangiectasia

Answer 83

Tangiectasia: fine, irregular red line caused by permanent dilation of a group of superficial blood vessels.

Question 84

Vascular lesions: Cherry angiomas

Answer 84

small, slightly raised, bright red area that typically appears on the face, neck, and trunk of the body. These increase in size and number with advanced age.

Question 85

A callus is an?

Answer 85

Area of excessive thickening of skin that is an expected variation associated with friction or pressure over a particular surface area. A callus is commonly found on the hands or feet.

Question 86

Abnormal skin findings: Texture: Excessive dryness, flaking, cracking, or scaling of the skin may occur secondary to environmental conditions or may be signs of?

Answer 86

systemic disease or nutritional deficiency. Look for areas of maceration, discoloration, or rashes under skinfolds

Question 87

Abnormal finding for skin temperature: Cool Skin: Generalized cool or cold skin is an abnormal finding and may be associated with?Localization of cold skin, particularly in the extremities, may be an indication of? - Hot Skin: Generalized hot skin is a reflection of?

Answer 87

cool or cold skin is an abnormal finding and may be associated with shock or hypothermia. Localization of cold skin, particularly in the extremities, may be an indication of poor peripheral perfusion. Hot Skin: Generalized hot skin is a reflection of hyperthermia. This may be associated with a fever, increased metabolic rate (e.g., hyperthyroidism), or exercise. Localized areas of skin that are hot may reflect an inflammation, infection, traumatic injury, or thermal injury such as sunburn.

Question 88

Abnormal skin: Moisture: Diaphoresis (excessive sweating) is an abnormal finding in the absence of strenuous activity. This may be a reflection of?

Answer 88

hyperthermia, extreme anxiety, pain, or shock. Excessively moist skin may often be seen with metabolic conditions such as hyperthyroidism.

Question 89

Abnormal skin finding: Mobility and Turgor: Edema, excessive scarring to the skin, or some connective tissue disorders (such as scleroderma) reduce skin mobility. Poor skin turgor is noted if “tenting” is observed or the skin slowly recedes back into place. Decreased turgor may result from?

Answer 89

dehydration or may be a finding in an individual who has experienced significant weight loss.

Question 90

Abnormal skin finding: Thickness: An increase in skin thickness is seen in patients with?

Answer 90

diabetes mellitus and is thought to be caused by abnormal collagen resulting from hyperglycemia. Excessively thin skin may take on a shiny or transparent appearance and is seen in hyperthyroidism, arterial insufficiency, and aging.

Question 91

Abnormal: Hair loss on the legs may indicate? Thinning of the eyebrows is a prominent finding in? Hirsutism (hair growth in women with an increase of hair on the face, body, and pubic area) may be a sign of an? Pubic hair distribution that deviates from typical gender patterns may indicate a?

Answer 91

Thinning of the eyebrows is a prominent finding in hypothyroidism. Hirsutism (hair growth in women with an increase of hair on the face, body, and pubic area) may be a sign of an underlying endocrine disorder. Pubic hair distribution that deviates from typical gender patterns may indicate a hormonal imbalance.

Question 92

Koilonychia (spoon nail) presents as a?

Answer 92

thin, depressed nail with the lateral edges turned upward. This is associated with anemia or may be congenital.

Question 93

Leukonychia appears as?

Answer 93

white spots on the nail plate. This is usually caused by minor trauma or manipulation of the cuticle.

Question 94

Clubbing is present when the angle of the nail base exceeds?

Answer 94

180 degrees. It is caused by proliferation of the connective tissue, resulting in an enlargement of the distal fingers. Clubbing is most commonly associated with chronic respiratory or cardiovascular disease.

Question 95

Beau's lines manifest as a?

Answer 95

groove or transverse depression running across the nail. They result from a stressor such as trauma that temporarily impairs nail formation. The groove first appears at the base of the nail by the cuticle and moves forward as the nail grows out.

Question 96

Pitting of the nail is commonly associated with?

Answer 96

psoriasis. Minor pitting may also be seen in persons with no health care problems. Examine the thickness of the nail itself. The nail should have a uniform thickness. Finally palpate the nail to ensure that the nail base feels firm and adheres to the nail bed.

Question 97

Thinning or brittleness of the nail may be?

Answer 97

secondary to poor peripheral circulation or inadequate nutrition.

Question 98

Early Signs of Melanoma - To help you remember the early signs of melanoma, use the mnemonic ABCDEF (Box 9-1)

Answer 98

A—Asymmetry (not round or oval) B—Border (poorly defined or irregular border) C—Color (uneven, variegated) D—Diameter (usually greater than 6 mm) E—Elevation (recent change from flat to raised lesion) F—Feeling (sensation of itching, tingling, or stinging within the lesion)

Question 99

Recommendations to Reduce Risk (Primary Prevention) American Cancer Society -Skin should be protected from sun exposure by:

Answer 99

- Covering with tightly woven clothing and a wide-brimmed hat. - Applying sunscreen that has sun protection factor (SPF) of 15 or higher to exposed skin (even on cloudy or hazy days). - Wearing sunglasses to protect the skin around the eyes. - Seeking shade (especially at midday) whenever possible. - Avoiding sunbathing and indoor tanning.

Question 100

Screening Recommendations (Secondary Prevention) American Cancer Society

Answer 100

Adults should examine their skin periodically; new or unusual lesions should be evaluated promptly by a health care provider. Use the ABCDEF mnemonic for evaluating lesions.

Question 101

Coining is a treatment practiced by Cambodians and Vietnamese.

Answer 101

The body is rubbed vigorously with a coin while exerting pressure until red marks appear over the bony prominence of the rib cage on the back and chest. Marks created by this treatment frequently have been mistaken as signs of abuse or mistreatment.

Question 102

Cupping is an alternative medicine therapy for arthritis, stomach aches, bruises, and paralysis.

Answer 102

Glass cups with negative pressure are applied to the skin; the negative pressure may be achieved by heating the air in the cups before application. As a result of the heat, the cup adheres to the skin and may leave a reddened area or mark. This is practiced by Latin American and Russian cultures.