A nurse is performing a skin assessment on a client who has a history of melanoma.

Which finding should alert the nurse to a possible malignant lesion?

Blood pressure of 90/60 mmHg

Rationale: A blood pressure of 90/60 mmHg indicates hypotension, which is a sign of septic shock and requires immediate intervention. Hypotension results from vasodilation and fluid loss due to the systemic inflammatory response to infection.

Incorrect options:

A) Temperature of 38.5°C (101.3°F) - This is a sign of fever, which is a common symptom of sepsis, but not as urgent as hypotension.

B) Heart rate of 110 beats per minute - This is a sign of tachycardia, which is a compensatory mechanism to maintain cardiac output in sepsis, but not as urgent as hypotension.

D) Respiratory rate of 22 breaths per minute - This is within the normal range for adults and does not indicate respiratory distress.

A black nodule with an irregular border and asymmetrical shape

Rationale: A black nodule with an irregular border and asymmetrical shape is consistent with the ABCDE criteria for melanoma, which are: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolving or changing appearance.

Incorrect options:

A) A brown mole with a smooth border and symmetrical shape - This is a normal finding that does not indicate malignancy.

B) A red macule with a flat surface and well-defined edges - This is likely a benign vascular lesion, such as a cherry angioma or petechiae.

D) A yellow papule with a raised surface and round edges - This is likely a benign sebaceous lesion, such as a sebaceous cyst or milia.