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NR 602 DERMATOLOGY QBANK QUESTIONS AND ANSWERS SPRING 2018
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1. A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate?

Bacterial
Viral
Parasitic
Fungal

2. A child with a sandpaper-textured rash probably has:

rubeola
strept infection
varicella
roseola

3. A 40-year-old female patient presents to the clinic with multiple, painful reddened nodules on the anterior surface of both legs. She is concerned. These are probably associated with her history of:

deep vein thrombosis.
phlebitis.
ulcerative colitis.
alcoholism.

4. A patient is is diagnosed  with tinea pedis. A microscopic examination of the sample taken from the infected area would likely demonstrate:

yphae.
yeasts.
rods or cocci.
a combination of hyphae and spores.

5. When can a child with chickenpox return to daycare?

24 hours after he is fever-free
48 hours after he is fever-free
After all lesions have crusted over 
When he no longer itches

6. A patient with a primary case of scabies was probably infected

1-3 days ago. 
1 week ago.
2 weeks ago.
3-4 weeks ago.

7. The nurse practitioner examines a patient who has had poison ivy for 3 days. She asks if she can spread it to her family members. The nurse practitioner replies:

"yes, but only before crusting has occurred."
"yes, the fluid in the blister can transmit it."
"no, transmission does not occur from the blister's contents."
"no, you are no longer contagious

8. Which chronic skin disorder primarily affects hairy areas of the body?

Seborrheic dermatitis
Atopic dermatitis
Contact dermatitis
Hydradenitis suppurativa

9. A patient with diabetes has right anterior shin edema, erythema, warmth, and tenderness to touch. This developed over the past 3 days. There is no visible pus. What is the most likely diagnosis to consider?

Deep vein thrombosis (DVT)
Buerger's disease
Cellulitis
Venous disease

10. The agent commonly used to treat patients with scabies is permethrin. How often should it applied to eradicate scabies?

Once
Once daily for 3 days
Twice daily for 3 days
Once daily for one week

11. Impetigo is characterized by:

honey-colored crusts.
silvery scales.
marble-like lesions.
wheals with pus

12. A 60-year-old patient is noted to have rounding of the distal phalanx of the fingers. What might have caused this?

Coronary artery disease
Hepatic cirrhosis
Lead toxicity
Iron deficiency anemia

13. A patient has suspected scarlet fever. He likely has a sandpaper rash and:

negative throat swab.
a positive rapid strept test.
diarrhea with abdominal cramps.
petechiae on the trunk.

14. A patient with a positive history of a tick bite about 2 weeks ago and erythema migrans has a positive ELISA for Borrelia burgdorferi. The Western blot is positive. How should he be managed?

He should receive doxycycline for Lyme disease.
He should receive penicillin for Rocky Mountain spotted fever (RMSF).
He does not have Lyme disease or RMSF.
He needs additional testing to confirm Lyme disease.

15. A patient will be taking oral terbinafine for fingernail fungus. The NP knows that:

This will cure her infection 95% of the time.
a topical antifungal will work just as well when the nail matrix is involved.
Terbinafine is a potent inhibitor of the CYP 3A4 enzymes.
toenail fungus resolves faster than fingernail fungus after treatment.

16. A skin lesion that is a solid mass is diagnosed as a:

papule

macule

Vesicles

Pustules

17. The nurse practitioner is examining a 3-month-old infant who has normal development. She has identified an alopecic area at the occiput. What should be done?

Order a TSH
Order a hydrocortisone cream for once daily application
Suspect child abuse
Encourage the caregiver to change the infant's head position

18. The most common form of skin cancer is:

squamous cell carcinoma.
basal cell carcinoma.
malignant melanoma.
cutaneous carcinoma.

19. The nurse practitioner identifies satellite lesions in a 6-month-old infant. These are:

worrisome in an infant this age
indicative of candidal infection
found in the axilla bilaterally
completely benign lesions present at birth

20. A patient who is at high risk for skin cancer should:

examine his skin monthly for changes.
be examined by a dermatologist quarterly.
use emollients regularly.
eat foods high in vitamin C.

21. An example of a premalignant lesion that develops on sun-damaged skin is:

actinic keratosis.
basal cell carcinoid.
squamous cell carcinoma.
molluscum contagiosum.

22. Which of the following areas of the body has the greatest percutaneous absorption?

Sole of the foot
Scalp
Forehead
Genitalia

23. The main difference between cellulitis and erysipelas is the:

infecting organism.
length of time that infection lasts.
treatment.
layer of skin involvement

24. Most cases of atopic dermatitis exacerbation are treated with

emollients.
topical steroids.
antihistamines.
antibiotics.

25. A 6-year-old patient with sore throat has coryza, hoarseness, and diarrhea. What is the likely etiology?

Group A Streptococcus
H. parainfluenzae
Viral etiology
Mycoplasma

26. A pregnant mother in her first trimester has a 5-year-old who has Fifth Disease. What implication does this have for the mother?

She does not have to worry about transmission to the fetus.
She may get a mild case of Fifth disease.
There is a risk of fetal death if she becomes infected.
The mother should have a fetal ultrasound today

27. A 74-year-old woman is diagnosed with shingles. The NP is deciding how to best manage her care. What should be prescribed?

An oral antiviral agent 
An oral antiviral agent plus an oral steroid
An oral antiviral agent plus a topical steroid
A topical steroid only

28. An adolescent has acne. The nurse practitioner prescribed a benzoyl peroxide product for him. What important teaching point should be given to this adolescent regarding the benzoyl peroxide?

Don't apply this product more than once daily
This often causes peeling of the skin
Photosensitivity of the skin can occur
Hypersensitivity can occur with repeated use

29. A 70-year-old is diagnosed with multiple cherry angiomas. The nurse practitioner knows that:

this is a mature capillary proliferation more common in young adults.
an angioma occurs as a single lesion.
these may bleed profusely if ruptured.
these are precursors of skin malignancies

30. A patient has seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to treat this?

Solution
Cream
Powder
Foam

31. A patient with eczema asks for a recommendation for a skin preparation to help with xerosis. What should the NP respond?

use a petroleum based product
use a hypoallergenic lotion
use any hypoallergenic product
no particular product is better than another

32. A topical treatment for basal cell carcinoma is:

sulfacetamide lotion.
5-fluorouracil.
tetracycline lotion.
trichloroacetic acid

33. The most common place for basal cell carcinoma to be found is the:

scalp.
face.
anterior shin.
upper posterior back

34. An infant is diagnosed with diaper dermatitis. Satellite lesions are visible. This should be treated with a:

moisture barrier like zinc oxide.
topical anti-fungal agent.
topical anti-bacterial agent.
low potency steroid cream.

35. A 3-year-old female had a fever of 102° F for the last 3 days. Today she woke up from a nap and is afebrile. She has a maculopapular rash. Which statement is true?

This child probably has measles.
The rash will blanch.
This is a streptococcal rash.
This could be Kawasaki disease.

36. A 71-year-old female presents with a vesicular rash that burns and itches. Shingles is diagnosed . An oral antiviral:

should be started within 72 hours of the onset of symptoms.
must be started within 96 hours of the onset of the rash.
can be started at any time after appearance of the rash.
will nearly eliminate the risk of post-herpetic neuralgia.

37. A skin disorder has a hallmark finding of silvery scales. What word below describes this common condition?

Chronic
Infectious
Contagious
Acute

38. A child has 8-10 medium brown café au lait spots > 1 cm in diameter. The differential diagnosis should include:

vitiligo.
eczema.
neurofibromatosis.
neuroblastoma.

39. A low-potency topical hydrocortisone cream would be most appropriate in a patient who has been diagnosed with:

Psoriasis
Impetigo
Atopic dermatitis
Eczema

40. A patient is found to have koilonychia. What laboratory test would be prudent to perform?

Liver function tests
CBC
Hepatitis B surface antigen
Arterial blood gases

41. A 23-year-old male appears in clinic with the following lesion on his trunk. This lesion is usually associated with:

pityriasis rosea

42. A 28-year-old has thick, demarcated plaques on her elbows. Which features are suggestive of psoriasis?

Scaly lesions on the scalp
Pruritis around the lesions
A scaly border around the plaques
Silvery scales that are not pruritic

43. Which of the following skin lesions in an older adult is a premalignant condition?

xanthelasma
chalazion
hordeolum
actinic keratosis

44. A patient presents with plaques on the extensor surface of the elbows, knees, and back. The plaques are erythematous and thick, silvery scales are present. This is likely:

plaque psoriasis
guttate psoriasis
atopic dermatitis
staph cellulitis

45. A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He complains of itching in the groin area. He is diagnosed with tinea cruris. The nurse practitioner is likely to identify:

swelling of the scrotum
macular lesions on the penis
well marginated half moon macules on the inner thigh
maceration of the scrotal folds with erythema of the penis

46. A 68-year-old female adult with pendulous breasts complains of “burning” under her right breast. The nurse practitioner observes a malodorous discharge with mild maceration under both breasts. What is this?

Intertrigo
Impetigo
Tinea corporis
Shingles

47. An example of a first-generation cephalosporin used to treat a skin infection is:

cephalexin
cefuroxime
cefdinir
ceflamore

48. A patient has a “herald patch” and is diagnosed with pityriasis rosea. Where is the “herald patch” most commonly found?

On the affected limb
On the chest
Close to the scalp
Behind one of the ears

49. A 16-year-old has been diagnosed with Lyme disease. Which drug should be used to treat him?

Doxycycline
Amoxicillin-clavulanate
Trimethroprim-sulfamethoxazole
Cephalexin

50. A 9-year-old female has presented to your clinic because of a rash on the left, upper area of her anterior trunk. She is embarrassed and very reticent to lift her blouse because her nipple will be exposed. How should the NP proceed?

Examine the patient with the area covered as much as possible
The NP should lift the blouse to expose the area for exam
Ask the accompanying caregiver to expose the area for exam
Examine all other areas of the trunk, then ask the child to lift her blouse

51. Hand-foot-and-mouth disease and herpangina:

both produce pustules on oral mucous membranes
potentially can cause orchitis in infected males
are viral infections caused by Coxsackie viruses
will only occur in the spring and summer

52. A 74-year-old male patient has sustained a laceration to his foot. His last tetanus shot was more than 10 years ago. He has completed the primary series. What should be recommended?

Tetanus toxoid only
Tetanus and diphtheria only
His primary series will protect him
Tetanus, diphtheria, and acellular pertussis (Tdap)

53. An adolescent takes isotretinoin for nodulocystic acne. She is on oral contraceptives. Both were prescribed by the dermatologist. The adolescent presents to your clinic with a sinus infection. Her temperature is 99.5° F and her blood pressure is 160/100 mmHg. How should this be managed?

Call the dermatologist to report the elevated BP
Treat the sinus infection and recheck the BP in one week
Discontinue the isotretinoin today
Discontinue the oral contraceptive today

54. Johnson is a 74-year-old who presents with a pearly-domed, nodular-looking lesion on the back of the neck. It does not hurt or itch. What is a likely etiology?

Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
Actinic keratosis

55. A 16-year-old male has nodulocystic acne. What might have the greatest positive impact in managing his acne?

Retin-A® plus minocycline
Benzoyl peroxide plus erythromycin
Isotretinoin (Accutane®)
Oral antibiotics

56. Which of the following antibiotics may increase the likelihood of photosensitivity?

Amoxicillin
Cephalosporins
Fluoroquinolones 
Macrolide

57. Which of the following lesions never blanches when pressure is applied?

Spider angioma
Spider vein
Purpura or petechiae
Cherry angioma

58. An older adult patient has been diagnosed with shingles on the right lateral aspect of her trunk. It initially appeared yesterday. It is very painful. How should she  be managed?

Treatment with a topical lidocaine patch only.
An oral antiviral agent and NSAIDs.
An oral antiviral agent and pain medication.
An oral antiviral agent, pain medication, and oral steroids

59. A young child has developed a circumferential lesion on her inner forearm. It is slightly raised, red and is pruritic. It is about 2.5 cm in diameter. This is probably related to:

a genetic disorder.
the child's new cat.
juvenile rheumatoid arthritis.
a psoriatic lesion.

60. The primary therapeutic intervention for patients who present with hives is:

steroids.
anti-histamines.
calcium channel blockers.
topical steroid cream

61. The lesions seen in a patient with folliculitis might be filled with:

blood.
pus
fluid.
serous fluid.

62. Which vehicle is least appropriate in a patient who has atopic dermatitis?

psoriasis.
impetigo.
cellulitis.
atopic dermatitis.

63. A patient has been diagnosed with scabies. What is the medication of choice to treat this?

Permethrin
Coal tar
Ketoconazole
Mupirocin

64. The American Cancer Society uses an ABCDE mnemonic to help patients develop awareness of suspicious skin lesions. What does the “B” represent?

Bleeding
Black
Border
Benign

65. A “herald patch” is a hallmark finding in which condition?

Erythema infectiosum
Pityriasis rosea
Seborrheic keratosis
Atopic dermatitis

66. A patient has used a high-potency topical steroid cream for years to treat psoriasis exacerbations when they occur. She presents today and states that this cream “just doesn’t work anymore.” What word describes this?

Rebound effect
Tachyphylaxis
Tolerance
Lichenification

67. A patient has been diagnosed with MRSA. She is allergic to sulfa. Which medication could be used to treat her?

Augmentin
Trimethoprim-sulfamethoxazole (TMPS)
Ceftriaxone
Doxycycline

68. Topical 5-fluorouracil (5-FU) is used to treat:

atopic dermatitis.
hepatitis.
thalassemia.
basal cell carcinoma.

69. A patient was burned with hot water. He has several 2-3 cm fluid-filled lesions. What are these termed?

Vesicles
Bullae
Cysts
Wheals

70. A child received a burn on his chest from a cup of hot coffee. On examination, the injured area appeared moist, red to ivory white in color, and features blisters. It is painful to touch. This burn would be classified as a:

superficial partial thickness burn

71. What finding is most characteristic of shingles? A patient reports that he found a tick on himself about 2 weeks ago. He presents today with a red circle and a white center near where he remembers the tick bite. He did not seek treatment at that time. Today he complains of myalgias and arthralgias. Which laboratory test can be used to help diagnose Lyme disease?

CBC
Lyme titer
ELISA
skin scraping

72. The best way to evaluate jaundice associated with liver disease is to observe:

blanching of the hands, feet, and nails.
the sclera, skin, and lips.
the lips, oral mucosa, and tongue.
tympanic membrane and skin only

73. The term caput succedaneum refers to:

cradle cap.
atopic dermatitis.
scalp edema.
asymmetric head shape.

74. A 4-year-old has been diagnosed with measles. The nurse practitioner identifies Koplik’s spots. These are:

penicillin.
aspirin.
ibuprofen.
sulfa.

75. A patient calls your office. He states that he just came in from the woods and discovered a tick on his upper arm. He states that he has removed the tick and the area is slightly red. What should he be advised?

No treatment is needed.
He should be prescribed doxycycline.
He needs a topical scrub to prevent Lyme Disease.
He should come to the office for a ceftriaxone injection.

76. A wound has the following characteristics; partial thickness loss of dermis, a shallow open ulcer with red/pink bed, and no evidence of sloughing. What stage of pressure ulcer does this describe?

Stage I

Stage II

Stage III

Stage IV

77. A patient has been in the sun for the past few weeks and has developed darkened skin and numerous 3-6 mm light-colored, flat lesions on his trunk. What is the likely etiology?

Tinea corporis
Tinea unguium
Tinea versicolor
Human papilloma virus

78. What advice should be given to a parent who has a child with Fifth Disease?

This commonly causes pruritis in young children
He can return to school when the rash has disappeared
Acetaminophen should be avoided in this child
A parent may experience joint aches and pains

79. A 6-year-old has been diagnosed with Lyme disease. Which drug should be used to treat him?

penicillin
aspirin
ibuprofen
sulfa

80. A patient presents with small vesicles on the lateral edges of his fingers and intense itching. On close inspection, there are small vesicles on the palmar surface of the hand. What is this called?

Seborrheic dermatitis
Dyshidrotic dermatitis
Herpes zoster
Varicella zoster

81. A patient has 10 cm of well demarcated erythema on his lower leg that is raised and warm to touch. He had an abrupt onset of lower leg pain, and fever that began 36 hours ago. What is this?

Cellulitis

Erysipelas

Impetigo

An allergic reaction

82. What is the proper technique to safely remove a tick from a human?

Pull it off with tweezers
Use petroleum jelly
Use isopropyl alcohol
Use a hot match

83. A skin lesion fluoresces under a Wood’s lamp. What microscopic finding is consistent with this?

Clue cells
Herpes simplex
Spores
Leukocytes

84. A 23-year-old male appears in clinic with the following nonpruritic lesion on his trunk. He first noticed this about 3 days ago. The lesion is probably:

a herald patch

85. A patient presents to the minor care area of the emergency department after being bitten by a dog. The patient states that the dog had a tag around his neck and had been seen roaming around the neighborhood for days before the patient was bitten. The dog did not exhibit any odd behavior. How should this be managed? Patients with atopic dermatitis are likely to exhibit: Which test is NOT suitable to diagnose shingles if the clinical presentation is questionable?

If the bites are only minor, do not mention rabies prophylaxis to the patient
Give the patient tetanus immunization only. Don't call animal control.
Clean the wounds, provide tetanus and rabies prophylaxis
Report the bite to animal control and administer appropriate medical care

86. A patient exhibits petechiae on both lower legs but has no other complaints. How should the NP proceed?

Refer to hematology
Order a CBC
Order blood cultures
Stop aspirin and re-assess in one week

87. A 9-year-old has diagnosed with chickenpox. A drug that should be avoided in him is:

penicillin.
aspirin.
ibuprofen.
sulfa.

 

 

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NR 602 DERMATOLOGY QBANK QUESTIONS AND ANSWERS SPRING 2018
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1. A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? Bacterial Viral Parasitic Fungal 2. A child with a sandpaper-textured rash probably has: rubeola strept infection varicella roseola 3. A 40-year-old female patient presents to the clinic with multiple, painful reddened nodules on the anterior surface of both legs. She is concerned. These are probably associated with her history of: deep vein thrombosis. phlebitis. ulcerative colitis. alcoholism. 4. A patient is is diagnosed with tinea pedis. A microscopic examination of the sample taken from the infected area would likely demonstrate: yphae. yeasts. rods or cocci. a combination of hyphae and spores. 5. When can a child with chickenpox return to daycare? 24 hours after he is fever-free 48 hours after he is fever-free After all lesions have crusted over When he no longer itches 6. A patient with a primary case of scabies was probably infected 1-3 days ago. 1 week ago. 2 weeks ago. 3-4 weeks ago. 7. The nurse practitioner examines a patient who has had poison ivy for 3 days. She asks if she can spread it to her family members. The nurse practitioner replies: "yes, but only before crusting has occurred." "yes, the fluid in the blister can transmit it." "no, transmission does not occur from the blister's contents." "no, you are no longer contagious 8. Which chronic skin disorder primarily affects hairy areas of the body? Seborrheic dermatitis Atopic dermatitis Contact dermatitis Hydradenitis suppurativa 9. A patient with diabetes has right anterior shin edema, erythema, warmth, and tenderness to touch. This developed over the past 3 days. There is no visible pus. What is the most likely diagnosis to consider? Deep vein thrombosis (DVT) Buerger's disease Cellulitis Venous disease 10. The agent commonly used to treat patients with scabies is permethrin. How often should it applied to eradicate scabies? Once Once daily for 3 days Twice daily for 3 days Once daily for one week 11. Impetigo is characterized by: honey-colored crusts. silvery scales. marble-like lesions. wheals with pus 12. A 60-year-old patient is noted to have rounding of the distal phalanx of the fingers. What might have caused this? Coronary artery disease Hepatic cirrhosis Lead toxicity Iron deficiency anemia 13. A patient has suspected scarlet fever. He likely has a sandpaper rash and: negative throat swab. a positive rapid strept test. diarrhea with abdominal cramps. petechiae on the trunk. 14. A patient with a positive history of a tick bite about 2 weeks ago and erythema migrans has a positive ELISA for Borrelia burgdorferi. The Western blot is positive. How should he be managed? He should receive doxycycline for Lyme disease. He should receive penicillin for Rocky Mountain spotted fever (RMSF). He does not have Lyme disease or RMSF. He needs additional testing to confirm Lyme disease. 15. A patient will be taking oral terbinafine for fingernail fungus. The NP knows that: This will cure her infection 95% of the time. a topical antifungal will work just as well when the nail matrix is involved. Terbinafine is a potent inhibitor of the CYP 3A4 enzymes. toenail fungus resolves faster than fingernail fungus after treatment. 16. A skin lesion that is a solid mass is diagnosed as a: papule macule Vesicles Pustules 17. The nurse practitioner is examining a 3-month-old infant who has normal development. She has identified an alopecic area at the occiput. What should be done? Order a TSH Order a hydrocortisone cream for once daily application Suspect child abuse Encourage the caregiver to change the infant's head position 18. The most common form of skin cancer is: squamous cell carcinoma. basal cell carcinoma. malignant melanoma. cutaneous carcinoma. 19. The nurse practitioner identifies satellite lesions in a 6-month-old infant. These are: worrisome in an infant this age indicative of candidal infection found in the axilla bilaterally completely benign lesions present at birth 20. A patient who is at high risk for skin cancer should: examine his skin monthly for changes. be examined by a dermatologist quarterly. use emollients regularly. eat foods high in vitamin C. 21. An example of a premalignant lesion that develops on sun-damaged skin is: actinic keratosis. basal cell carcinoid. squamous cell carcinoma. molluscum contagiosum. 22. Which of the following areas of the body has the greatest percutaneous absorption? Sole of the foot Scalp Forehead Genitalia 23. The main difference between cellulitis and erysipelas is the: infecting organism. length of time that infection lasts. treatment. layer of skin involvement 24. Most cases of atopic dermatitis exacerbation are treated with emollients. topical steroids. antihistamines. antibiotics. 25. A 6-year-ol...
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