A nurse is admitting a client who sustained severe burn injuries. The nurse refers to the rule of nines to determine the total body surface area of Your injury What percentage of body surface area should the nurse estimate the client has burned?

Choice A rationale: pruritus is one of the symptoms of malignant melanoma, as well as changes in the shape, size, color, or texture of a mole or other skin lesion. However, pruritus is not specific to the disease and should always serve as a clue prompting further examination.
Choice B rationale: pain is a very rare symptom in malignant melanoma especially during the early stages of the disease. However, pain may occur in advanced stages of the disease when deeper tissues have been invaded and in cases of metastasis to distant sites.
Choice C rationale: purulent discharge is an indication of an underlying infection rather than malignant melanoma.
Choice D rationale: purplish skin discoloration is common in Kaposi’s sarcoma which manifests as purplish skin nodules rather than malignant melanoma. Furthermore, it may suggest bruising or bleeding under the skin. Malignant melanoma can have various colors, such as black, brown, red, blue, or white, depending on the type and amount of melanin produced by the tumor cells.

Choice A rationale: the epidermis becomes thinner and more fragile with age hence making the skin of elderly individuals more prone to injury, bruising, and infections.
Choice B rationale: this is incorrect because the skin in old age loses its elasticity and becomes more wrinkled due to the loss of collagen and elastin fibers responsible for maintaining the elasticity of the skin.
Choice C rationale: subcutaneous tissue comprising mainly of fat and connective tissue increases with age especially in regions such as the abdomen.
Choice D rationale: blood vessels within the skin become narrower and less efficient with increasing age thus resulting in decreased blood flow and oxygen delivery to the skin.
Choice E rationale: sebum production which is responsible for skin lubrication increases with age thus making this statement incorrect.