A nurse is performing an integumentary assessment for a client. Which of the following findings should the nurse identify as possible squamous cell carcinoma?

Choice A reason: Enlarged distal extremities are a classic sign of acromegaly due to the overproduction of growth hormone, which affects the growth plates in the bones.

Choice B reason: Coarse facial features, including a protruding jaw and brow, enlarged nose, and thickened lips, are common in acromegaly due to the excessive growth of facial bones and soft tissues.

Choice C reason: Loss of color discrimination is not typically associated with acromegaly. This symptom may be related to other conditions affecting the optic nerve or the brain.

Choice D reason: Hepatomegaly, or an enlarged liver, can occur in acromegaly as a result of increased growth factor effects on the liver.

Choice E reason: Moon face is associated with conditions that lead to corticosteroid excess, such as Cushing's syndrome, but can also appear in acromegaly due to soft tissue swelling.

Choice A reason: Neurological checks are essential after spinal surgery to monitor for any changes or deterioration in the patient's neurological status. The frequency of these checks can vary based on the patient's condition, but a common standard is to perform them every 4 hours or sooner. However, in some cases, especially immediately post operation, checks may be required more frequently, such as every 2 hours, to ensure any complications are identified and managed promptly.

Choice B reason: While mobilization is an important aspect of postsurgical care to prevent complications such as deep vein thrombosis, positioning a patient in a chair every 2 hours may not be appropriate immediately following spinal surgery. The patient's mobility and pain level must be assessed, and activities should be gradually increased as tolerated.

Choice C reason: Inspecting the spinal dressing is important to identify signs of infection or complications. However, clear drainage is not typically expected and could indicate cerebrospinal fluid leakage, which requires immediate medical attention.

Choice D reason: The term "criminal checks" is not relevant to nursing care and seems to be a typographical error. The nurse's focus should be on clinical assessments and interventions related to the patient's health status.