NSG 623/624 Exam 1
Rena, age 27, had her spleen removed after a MVA. You are seeing her in the office for the first time since her discharge from the hospital. She asks you how her surgery will affect her in the future. How do you respond? A. "You may have difficulty salvaging iron from old red blood cells for reuse." B. "Your red blood cell production will be slowed." C. "You'll have difficulty storing the nutritional agents needed to make red blood cells." D. "Your lymphatic system may have difficulty transporting lymph fluid to the blood vessels."
A. "You may have difficulty salvaging iron from old red blood cells for reuse."
The most common human papillomavirus types associated with cutaneous, nongenital warts include: A. 1, 2, and 4. B. 6 and 11. C. 16 and 18. D. 32 and 36.
A. 1, 2, and 4.
You see a kindergartner with impetigo and advise that she can return ____ hours after initiating effective antimicrobial therapy. A. 24 B. 48 C. 72 D. 96
A. 24
You see a 33-year-old male with a minor dog bite on his hand. The examination reveals a superficial wound on the left palm. The dog is up-to-date on immunizations. In deciding whether to initiate antimicrobial therapy, you consider that ______ of dog bites become bacterially infected. A. 5% B. 20% C. 50% D. 75%
A. 5%
A first-degree burn is: A. Affected skin blanches with ease. B. Surface is raw and moist. C. Affected area is white and leathery.
A. Affected skin blanches with ease.
Physiological changes in the immune system of older adults include: A. An increase in immunoglobulin A and G antibodies. B. A high rate of T-lymphocyte proliferation. C. An increase in the number of cytotoxic T cells. D. An increase in CD8, which affects regulation of the immune system.
A. An increase in immunoglobulin A and G antibodies.
The ABCDEs of melanoma identification include which of the following? A. Asymmetry: One half does not match the other half. B. Border: The borders are regular; they are not ragged, notched, or blurred. C. Color (pigmentation) is uniform. D. Diameter: The diameter is 5 mm.
A. Asymmetry: One half does not match the other half.
Lyme disease is caused by the bacterium: A. Borrelia burgdorferi. B. Bacillus anthracis. C. Corynebacterium striatum. D. Treponema pallidum.
A. Borrelia burgdorferi.
Clients with AIDS typically experience a neurological symptomatic triad consisting of: A. Cognitive, motor, and behavioral changes. B. Seizures, paresthesia, and dysesthesia. C. Kaposi's sarcoma, cryptococcal meningitis, and depression. D. Seizures, depression, and paresthesia.
A. Cognitive, motor, and behavioral changes.
Clients with AIDS typically experience the neurological symptomatic triad consisting of: A. Cognitive, motor, and behavioral changes. B. Seizures, depression, and paresthesias. C. Seizures, paresthesias, and dysesthesias. D. Kaposi's sarcoma, cryptococcal meningitis, and depression.
A. Cognitive, motor, and behavioral changes.
Which is the best test to perform to spot an iron-deficiency anemia early before it progresses to full-blown anemia? A. Ferritin. B. Reticulocytes. C. Hemoglobin. D. Hematocrit.
A. Ferritin.
Which of the following statements is most accurate regarding cellulitis? A. Insect bites, abrasion, or other skin trauma can be the origin of cellulitis. B. Cellulitis most often occurs on the chest and abdomen. C. Necrosis is a common complication of cellulitis. D. Cellulitis often occurs spontaneously without any identifiable skin wound.
A. Insect bites, abrasion, or other skin trauma can be the origin of cellulitis.
Which is a true statement regarding psoriasis? A. It can be exacerbated by stress. B. It is highly contagious. C. It is usually worse in the summer. D. All clients have accompanying pruritis.
A. It can be exacerbated by stress.
Pernicious anemia is a result of? A. Not enough intrinsic factor. B. Not enough iron. C. Not enough folic acid. D. Not enough vitamin D.
A. Not enough intrinsic factor.
Tina, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? A. Obtain a lead level. B. Instruct Tina's parents to increase the amount of milk in her diet. C. Start Tina on ferrous sulfate (Feosol) and check the CBC in 6 weeks. D. Recheck the CBC during this visit.
A. Obtain a lead level.
A 70-year-old client with herpes zoster has a vesicle on the tip of the nose. This may indicate: A. Ophthalmic zoster. B. Herpes simplex. C. Kaposi's sarcoma. D. Orf and milker's nodules.
A. Ophthalmic zoster.
The "herald patch" is present in almost all cases of: A. Pityriasis rosea. B. Psoriasis. C. Impetigo. D. Rubella.
A. Pityriasis rosea.
Despite successful primary prophylaxis, which infection remains a common AIDS-defining diagnosis? A. Pneumocystis jiroveci pneumonia (PCP) B. Cryptococcosis C. Cryptosporidiosis D. Candidiasis
A. Pneumocystis jiroveci pneumonia (PCP)
Sidney, age 72, has just been diagnosed with temporal arteritis. What do you prescribe? A. Systemic corticosteroids B. Topical corticosteroids C. Antibiotics D. Antifungal preparations
A. Systemic corticosteroids
The following statements are all true regarding herpes zoster except which one? A. The typical lesion are bullae. B. It is due to reactivation of the latent varicella virus. C. It is usually more severe in immunocompromised individuals. D. Infection of the trigeminal nerve ophthalmic branch can cause corneal blindness.
A. The typical lesion are bullae.
In an adult with BMI greater than 40 kg/m2 who is being treated with TMP-SMX for CA-MRSA, the recommended dose is two tablets BID. A. True B. False
A. True
Skin lesions associated with actinic keratoses can be described as: A. a slightly rough, pink or flesh-colored lesion in a sun-exposed area. B. a well-defined, slightly raised, red, scaly plaque in a skinfold. C. a blistering lesion along a dermatome. D. a crusting lesion along flexor aspects of the fingers.
A. a slightly rough, pink or flesh-colored lesion in a sun-exposed area.
When prescribing pulse dosing with itraconazole for the treatment of fingernail fungus, the clinician realizes that: A. a transient increase in hepatic enzymes is commonly seen with its use. B. drug-induced leukopenia is a common problem. C. the patient needs to be warned about excessive bleeding because of the drug's antiplatelet effect. D. its use is contraindicated in the presence of iron-deficiency anemia.
A. a transient increase in hepatic enzymes is commonly seen with its use.
In a 13-year-old female patient with mild acne and who experiences an inadequate response to benzoyl peroxide treatment, an appropriate treatment option would be to: A. add a topical retinoid. B. add an oral antibiotic. C. consider isotretinoin. D. consider hormonal therapy.
A. add a topical retinoid.
An oral antimicrobial option for the treatment of methicillin-sensitive S. aureus includes all of the following except: A. amoxicillin. B. dicloxacillin. C. cephalexin. D. cefadroxil.
A. amoxicillin.
Anthralin (Drithocreme) is helpful in treating psoriasis because it has what kind of activity? A. antimitotic B. exfoliative C. vasoconstrictor D. humectant
A. antimitotic
Which of the following medications is likely to cause the most sedation? A. chlorpheniramine B. cetirizine C. fexofenadine D. loratadine
A. chlorpheniramine
You have initiated therapy for an 18-year-old man with acne vulgaris and have prescribed doxycycline. He returns in 3 weeks, complaining that his skin is "no better." Your next action is to: A. counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved. B. discontinue the doxycycline and initiate minocycline therapy. C. advise him that antibiotics are likely not an effective treatment for him and should not be continued. D. add a second antimicrobial agent such trimethoprim-sulfamethoxazole.
A. counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved.
A 24-year-old woman presents with hive-form linear lesions that develop over areas where she has scratched. These resolve within a few minutes. This most likely represents: A. dermographism. B. contact dermatitis. C. angioedema. D. allergic reaction.
A. dermographism.
Which of the following is the best treatment option for cellulitis when risk of infection with a methicillin-resistant pathogen is considered low? A. dicloxacillin B. amoxicillin C. metronidazole D. trimethoprim-sulfamethoxazole.
A. dicloxacillin
Which of the following do you expect to find in the assessment of the person with urticaria? A. eosinophilia B. low erythrocyte sedimentation rate C. elevated thyroid-stimulating hormone level D. leukopenia
A. eosinophilia
A 78-year-old resident of a long-term care facility complains of generalized itchiness at night that disturbs her sleep. Her examination is consistent with scabies. Which of the following do you expect to find on examination? A. excoriated papules on the interdigital area B. annular lesions over the buttocks C. vesicular lesions in a linear pattern D. honey-colored crusted lesions that began as vesicles
A. excoriated papules on the interdigital area
One of the most common trigger agents for contact dermatitis is: A. exposure to nickel. B. use of fabric softener. C. bathing with liquid body wash. D. eating spicy foods.
A. exposure to nickel.
An 88-year-old, community-dwelling man who lives alone has limited mobility because of osteoarthritis. Since his last office visit 2 months ago, he has lost 5% of his body weight and has developed angular cheilitis. You expect to find the following on examination: A. fissuring and cracking at the corners of the mouth B. marked erythema of the hard and soft palates C. white plaques on the lateral borders of the buccal mucosa D. raised, painless lesions on the gingival
A. fissuring and cracking at the corners of the mouth
A 38-year-old woman with advanced human immunodeficiency virus (HIV) disease presents with a chief complaint of a painful, itchy rash over her trunk. Examination reveals linear vesicular lesions that do not cross the midline and are distributed over the posterior thorax. This presentation is most consistent with: A. herpes zoster. B. dermatitis herpetiformis. C. molluscum contagiosum. D. impetigo.
A. herpes zoster.
Tzanck smear that is positive for giant multinucleated cells was taken from a lesion caused by: A. herpesvirus. B. S. aureus. C. streptococci. D. allergic reaction.
A. herpesvirus.
A significant rabies risk is associated with a bite from all of the following except: A. humans. B. foxes. C. bats. D. skunks.
A. humans.
The mechanism of action of imiquimod is as a/an: A. immunomodulator. B. antimitotic. C. keratolytic. D. irritant.
A. immunomodulator.
The mechanism of action of pimecrolimus (Elidel) in the treatment of atopic dermatitis is as a/an: A. immunomodulator. B. antimitotic. C. mast cell activator. D. exfoliant.
A. immunomodulator.
You see a 36-year-old man with no chronic health problems who presents with two furuncles, each around 4 cm in diameter, on the right anterior thigh. These lesions have been present for 3 days, slightly increasing in size during this time. He has no fever or other systemic symptoms. You advise the following: A. incision and drainage of the lesion B. a systemic antibiotic empirically C. a topical antibiotic D. aspiration of the lesion contents and prescription of a systemic antibiotic based on culture results
A. incision and drainage of the lesion
Treatment options in postherpetic neuralgia include all of the following except: A. injectable methylprednisolone. B. oral pregabalin. C. oral nortriptyline. D. topical lidocaine.
A. injectable methylprednisolone.
Characteristics of onychomycosis include all of the following except: A. it is readily diagnosed by clinical examination. B. nail hypertrophy. C. brittle nails. D. fingernails respond more readily to therapy than toenails.
A. it is readily diagnosed by clinical examination.
Which of the following is not a potential adverse effect with long-term high-potency topical corticosteroid use? A. lichenification B. telangiectasia C. skin atrophy D. adrenal suppression
A. lichenification
The use of which of the following medications contributes to the development of acne vulgaris? A. lithium B. propranolol C. sertraline D. clonidine
A. lithium
Which of the following represents the most effective method of cancer screening? A. skin examination B. stool for occult blood C. pelvic examination D. chest radiography
A. skin examination
Signs that bed bugs are present in a home include all of the following except: A. small drops of fresh blood on floorboards. B. blood smears on bed sheets. C. presence of light brown exoskeletons. D. dark specks found along mattress seams.
A. small drops of fresh blood on floorboards.
Patients with rosacea are recommended to use daily: A. sunscreen. B. astringents. C. exfoliant. D. antimicrobial cream.
A. sunscreen.
You see a 34-year-old man with atopic dermatitis localized primarily on the arms who complains of severe itching. The condition becomes worse at night and interferes with his sleep. You recommend: A. taking a bedtime dose of antihistamine. B. taking a bedtime dose of acetaminophen. C. taking a hot shower prior to bedtime. D. applying a warm compress to the affected areas 30 minutes prior to bedtime.
A. taking a bedtime dose of antihistamine.
When prescribing itraconazole (Sporanox), the NP considers that: A. the drug is a cytochrome P-450 3A4 inhibitor. B. one pulse cycle is recommended for fingernail treatment, and two cycles are needed for toenail therapy. C. continuous therapy is preferred in the presence of hepatic disease. D. taking the drug on an empty stomach enhances the efficacy of the product.
A. the drug is a cytochrome P-450 3A4 inhibitor.
First-line treatment of impetigo with less than 5 lesions of 1-2 centimeters in diameter on the legs in a 9-year-old girl is: A. topical mupirocin. B. topical neomycin. C. oral cefixime. D. oral doxycycline.
A. topical mupirocin.
Match the following descriptions to the correct lesion or distribution name. loss of epidermis and dermis A. ulcer B. atrophy C. fissure D. reticular
A. ulcer
A possible adverse effect with the use of a first-generation antihistamine such as diphenhydramine in an 80-year-old man is: A. urinary retention. B. hypertension. C. tachycardia. D. urticaria.
A. urinary retention.
In counseling a patient with seborrheic dermatitis on the scalp about efforts to clear lesions, you advise her to: A. use ketoconazole shampoo. B. apply petroleum jelly nightly to the affected area. C. coat the area with high-potency corticosteroid cream three times a week. D. expose the lesions periodically to heat by carefully using a hair dryer.
A. use ketoconazole shampoo.
All of the following organisms have been implicated in the development of rosacea except: A. viruses. B. bacteria. C. yeast. D. mites.
A. viruses.
Match the following descriptions to the correct lesion or distribution name. circumscribed area of skin edema A. wheal B. pustule C. patch D. plaque
A. wheal
An urticarial lesion is usually described as a: A. wheal. B. plaque. C. patch. D. papule
A. wheal.
A burn that is about twice as large as an adult's palmar surface of the hand including the fingers encompasses a BSA of approximately ____%. A. 1 B. 2 C. 3 D. 4
B. 2
How many grams of a topical cream or ointment are needed for a single application to the hands? A. 1 B. 2 C. 3 D. 4
B. 2
When prescribing fluconazole, the NP considers that it is a cytochrome P-450: A. 3A4 inhibitor. B. 2CP inhibitor. C. 2D6 inducer. D. 1A2 inducer.
B. 2CP inhibitor.
How many grams of a topical cream or ointment are needed for a single application to the entire body? A. 10 to 30 B. 30 to 60 C. 60 to 90 D. 90 to 120
B. 30 to 60
Samantha is being given platelets because of acute leukemia. One "pack" of platelets should raise her count by how much? A. 2,000 to 4,000 mm3 B. 5,000 to 8,000 mm3 C. 9,000 to 12,000 mm3 D. About 15,000 mm3
B. 5,000 to 8,000 mm3
Treatment options for actinic keratoses include topical: A. vitamin D derivative cream. B. 5-fluorouracil. C. acyclovir. D. doxepin.
B. 5-fluorouracil.
You examine a patient with a red, tender thermal burn that has excellent capillary refill involving the entire surface of the anterior right thigh. The estimated involved body surface area (BSA) is approximately: A. 5%. B. 9%. C. 13%. D. 18%.
B. 9%.
What does a shift to the left or left shift mean? A. A rise in monocytes. B. A rise in neutrophils. C. A rise in basophils. D. A rise in lymphocytes.
B. A rise in neutrophils.
Select a statement that is true about the erythrocyte sedimentation rate (ESR)? A. It is useful in detecting pancreatic cancer. B. A rise in the ESR is a normal part of aging. C. It is diagnostic for rheumatoid arthritis. D. It is a very specific indicator of inflammation.
B. A rise in the ESR is a normal part of aging.
Under which of the following circumstances is the reticulocyte count elevated? A. Aplastic anemia. B. Acute blood loss. C. Poisonings. D. Iron-deficiency anemia.
B. Acute blood loss.
A 64-year-old man with seborrhea mentions that his skin condition is "better in the summer when I get outside more and much worse in the winter." You respond: A. Sun exposure is a recommended therapy for the treatment of this condition. B. Although sun exposure is noted to improve the skin lesions associated with seborrhea, its use as a therapy is potentially associated with an increased rate of skin cancer. C. The lower humidity in the summer months noted in many areas of North America contributes to the improvement in seborrheic lesions .D. Use high-potency topical corticosteroids during the winter months, tapering these off for the summer months.
B. Although sun exposure is noted to improve the skin lesions associated with seborrhea, its use as a therapy is potentially associated with an increased rate of skin cancer.
Tobacco has been linked to which of the following types of cancer? A. Colon cancer B. Bladder cancer C. Prostate cancer D. Cervical cancer
B. Bladder cancer
Justin, an obese 42-year-old, cut his right leg 3 days ago while climbing a ladder. Today his right lower leg is warm, reddened, and painful without a sharply demarcated border. What do you suspect? A. Diabetic neuropathy B. Cellulitis C. Peripheral vascular disease D. The beginning of a stasis ulcer
B. Cellulitis
Which of the following increases the risk of pancreatic cancer? A. A high-carbohydrate diet B. Cigarette smoking, diabetes, and a high-fat diet C. Diabetes and lack of activity D. Yo-yo dieting
B. Cigarette smoking, diabetes, and a high-fat diet
Which of the following is recommended treatment for erythema migrans or early Lyme disease? A. Dicloxacillin 500 mg po bid X 10 days B. Doxycycline 100 mg po bid X 21 days C. Erythromycin 333mg po tid X 10 days D. Ciprofloxacin 250 mg po bid X 14 days
B. Doxycycline 100 mg po bid X 21 days
All CA-MRSA strains are capable of causing necrotizing infection. A. True B. False
B. False
CA-MRSA is most commonly spread from one person to another via airborne pathogen transmission. A. True B. False
B. False
If a skin and soft tissue infection does not improve in 48 to 72 hours with antimicrobial therapy, infection with a resistant pathogen is virtually the only cause. A. True B. False
B. False
Most acute-onset necrotic skin lesions reported in North America are caused by spider bites. A. True B. False
B. False
Skin lesions infected by community-acquired MRSA (CA-MRSA) often occur spontaneously on intact skin. A. True B. False
B. False
The mechanism of resistance of MRSA is via the production of beta-lactamase. A. True B. False
B. False
Which of the following is an X-linked recessive disorder commonly seen in African American men? A. Sickle cell anemia B. Glucose-6-phosphate dehydrogenase deficiency C. Pyruvate kinase deficiency D. Bernard-Soulier syndrome
B. Glucose-6-phosphate dehydrogenase deficiency
Abe, age 57, has just been given a diagnosis of herpes zoster. He asks you about exposure to others. You tell him that: A. Once he has been on the medication for a full 24 hours, he is no longer contagious. B. He should stay away from children and pregnant women who have not had chickenpox. C. He should wait until the rash is completely gone before going out in crowds. D. He should be isolated from all persons except his wife.
B. He should stay away from children and pregnant women who have not had chickenpox.
Your client, George, age 60, presents with pruritus and complains of lymphadenopathy in his neck. He also complains of night sweats and has noticed a low-grade fever. He has not lost any weight and otherwise feels well. He is widowed and has been dating a new woman recently. On physical examination, you find enlarged supraclavicular nodes. You suspect: A. Lung cancer. B. Hodgkin's lymphoma. C. A lingering viral infection from a bout of flu he had 6 weeks ago. D. Non-Hodgkin's lymphoma.
B. Hodgkin's lymphoma.
Which of the following types of cellulitis is referred to as "flesh-eating bacteria"? A. Erysipelas B. Necrotizing fasciitis C. Periorbital cellulitis D. Peripheral vascular cellulitis
B. Necrotizing fasciitis
Sherri's blood work returns with a decreased mean cell volume (MCV) and a decreased mean cellular hemoglobin concentration (MCHC). What should you do next? A. Order a serum folate level. B. Order a serum iron, TIBC, and serum ferritin level. C. Order a serum ferritin. D. Order a serum iron and total iron binding capacity (TIBC).
B. Order a serum iron, TIBC, and serum ferritin level.
A common infective agent in domestic pet cat bites is: A. viridans streptococcus species. B. Pasteurella multocida. C. Bacteroides species. D. Haemophilus influenzae.
B. Pasteurella multocida.
Hemolytic anemia may be an inherited condition. Which of the following is not an inherited condition related to hemolytic anemia? A. Hereditary spherocytosis B. Pernicious anemia C. Glucose-6-phosphate dehydrogenase deficiency D. Sickle cell anemia
B. Pernicious anemia
Mrs. Hubbard, age 45, is complaining of generalized morning stiffness especially in both her wrists and hands. It is much worse in the morning and lasts for a few hours. She also complains of fatigue and generalized body aches that have been present for the past few months. Which of the following is most likely? A. Gout B. Rheumatoid arthritis C. Osteoporosis D. Osteoarthritis
B. Rheumatoid arthritis
A patient is complaining of severe pruritus that is worse at night. Several family members have the same symptoms. Upon examination, areas of excoriated papules are noted on some of the interdigital webs of both hands and the axillae. This is most consistent with: A. Contact dermatitis. B. Scabies. C. Larva migrans. D. Impetigo.
B. Scabies.
Which type of hemangioma in a newborn occurs on the nape of the neck and is usually not noticeable when it becomes covered by hair? A. Nevus flammeus (port-wine stain) B. Stork's beak mark C. Strawberry hemangioma D. Cavernous hemangioma
B. Stork's beak mark
What is the most common rosacea trigger? A. Skin care products B. Sun exposure C. Cold weather D. Alcohol
B. Sun exposure
A second-degree burn is: A. Affected skin blanches with ease. B. Surface is raw and moist. C. Affected area is white and leathery.
B. Surface is raw and moist.
Sandra, age 69, is complaining of dry skin. What do you advise her to do? A. Bathe every day. B. Use tepid water and a mild cleansing cream. C. Use a dehumidifier. D. Decrease the oral intake of fluids.
B. Use tepid water and a mild cleansing cream.
A linear arrangement along a nerve distribution is a description of which type of skin lesion? A. Annular B. Zosteriform C. Keratotic D. Linear
B. Zosteriform
Who is the best candidate for isotretinoin (Accutane) therapy? A. a 17-year-old patient with pustular lesions and poor response to benzoyl peroxide B. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect C. a 14-year-old patient with open and closed comedones and a family history of "ice pick" scars D. an 18-year-old patient with inflammatory lesions and improvement with tretinoin (Retin-A)
B. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect
A 72-year-old woman presents with a newly formed, painless, pearly, ulcerated nodule with an overlying telangiectasis on the upper lip. This most likely represents: A. an actinic keratosis. B. a basal cell carcinoma. C. a squamous cell carcinoma. D. molluscum contagiosum.
B. a basal cell carcinoma.
Which of the following is not a recommended option to make cosmetic improvements for phymatous rosacea? A. laser peel B. ablative laser surgery C. surgical shave technique D. mechanical dermabrasion
B. ablative laser surgery
Your priority in caring for Tom, the aforementioned patient, is to: A. administer a rapidly acting oral antihistamine. B. administer parenteral epinephrine. C. initiate vasopressor therapy. D. administer a parenteral systemic corticosteroid.
B. administer parenteral epinephrine.
Preferred antimicrobials for the treatment of adults with Lyme disease include all of the following except: A. a tetracycline. B. an aminoglycoside. C. a cephalosporin. D. a penicillin.
B. an aminoglycoside.
To enhance the potency of a topical corticosteroid, the prescriber recommends that the patient apply the preparation: A. to dry skin by gentle rubbing. B. and cover with an occlusive dressing. C. before bathing. D. with an emollient
B. and cover with an occlusive dressing.
In counseling a patient with atopic dermatitis, you suggest all of the following can be used to alleviate symptoms of a flare except: A. the use of oral antihistamines. B. applying a heating pad on the affected region for 30 minutes. C. the use of topical corticosteroids. D. applying cool, wet dressings made from a clean cloth and water to the affected area.
B. applying a heating pad on the affected region for 30 minutes.
Which of the following findings is often found in a person with stage 2 Lyme disease? A. peripheral neuropathic symptoms B. atrioventricular heart block C. conductive hearing loss D. macrocytic anemia
B. atrioventricular heart block
Match the following descriptions to the correct lesion or distribution name. loss of skin markings and full skin thickness A. ulcer B. atrophy C. fissure D. reticular
B. atrophy
When advising the patient about scabies contagion, you inform her that: A. mites can live for many weeks away from the host. B. close personal contact with an infected person is usually needed to contract this disease. C. casual contact with an infected person is likely to result in infestation. D. bedding used by an infected person must be destroyed.
B. close personal contact with an infected person is usually needed to contract this disease.
Match the following descriptions to the correct lesion or distribution name. multiple lesions blending together: A. atrophy B. confluent or coalescent C. annular D. lichenification
B. confluent or coalescent
When caring for an adult with an outbreak of shingles, you advise that: A. there is no known treatment for this condition. B. during outbreaks, the chickenpox (varicella) virus is shed. C. although they are acutely painful, the lesions heal well without scarring or lingering discomfort. D. this condition commonly strikes young and old alike.
B. during outbreaks, the chickenpox (varicella) virus is shed.
Which of the following best describes seborrheic dermatitis lesions? A. flaking lesions in the antecubital and popliteal spaces B. greasy, scaling lesions in the nasolabial folds C. intensely itchy lesions in the groin folds D. silvery lesions on the elbows and knees
B. greasy, scaling lesions in the nasolabial folds
The likely causative organisms of nonbullous impetigo in a 6-year-old child include: A. H. influenzae and S. pneumoniae. B. group A streptococcus and S. aureus. C. M. catarrhalis and select viruses. D. P. aeruginosa and select fungi.
B. group A streptococcus and S. aureus.
Risk factors for malignant melanoma include: A. Asian ancestry. B. history of blistering sunburn. C. family history of psoriasis vulgaris. D. presence of atopic dermatitis.
B. history of blistering sunburn.
You see a 28-year-old man who is having an anaphylactic reaction following a bee sting and is experiencing trouble breathing. Your initial response is to administer: A. oral antihistamine. B. injectable epinephrine. C. supplemental oxygen. D. vasopressor therapy.
B. injectable epinephrine.
Pernicious anemia is usually caused by: A. dietary deficiency of vitamin B12. B. lack of production of intrinsic factor by the gastric mucosa. C. RBC enzyme deficiency. D. a combination of micronutrient deficiencies caused by malabsorption.
B. lack of production of intrinsic factor by the gastric mucosa.
When counseling a person who has a 2-mm verruca-form lesion on the hand, you advise that: A. bacteria are the most common cause of these lesions. B. lesions usually resolve without therapy in 12 to 24 months. C. there is a significant risk for future dermatologic malignancy. D. surgical excision is the treatment of choice.
B. lesions usually resolve without therapy in 12 to 24 months.
Oral antimicrobial treatments recommended for rosacea include all of the following except: A. metronidazole. B. levofloxacin. C. erythromycin. D. doxycycline.
B. levofloxacin.
A 14-year-old male presents with acne consisting of 25 comedones and 20 inflammatory lesions with no nodules. This patient can be classified as having: A. mild acne. B. moderate acne. C. severe acne. D. very severe acne.
B. moderate acne.
The use of lindane (Kwell) to treat scabies is discouraged because of its potential for: A. hepatotoxicity. B. neurotoxicity. C. nephrotoxicity. D. pancreatitis.
B. neurotoxicity.
A woman was treated as an inpatient for a serious soft tissue infection with parenteral linezolid and now is being seen on day 3 of her illness and is being discharged to home. She is feeling better and appears by examination to be clinically improved. Culture results reveal MRSA, sensitive to trimethoprim-sulfamethoxazole, linezolid, daptomycin, vancomycin, and clindamycin and resistant to cephalothin and erythromycin. Her antimicrobial therapy should be completed with: A. oral cephalexin. B. oral trimethoprim-sulfamethoxazole. C. parenteral vancomycin. D. oral linezolid.
B. oral trimethoprim-sulfamethoxazole.
Which of the following conditions is unlikely to result in anemia of chronic disease? A. rheumatoid arthritis B. peripheral vascular disease C. chronic renal insufficiency D. osteomyelitis
B. peripheral vascular disease
Match the following descriptions to the correct lesion or distribution name. raised lesion, larger than 1 cm, may be same or different color from the surrounding skin A. patch B. plaque C. macule D. ulcer
B. plaque
Psoriatic lesions arise from: A. decreased skin exfoliation. B. rapid skin cell turnover, leading to decreased maturation and keratinization. C. inflammatory changes in the dermis. D. lichenification.
B. rapid skin cell turnover, leading to decreased maturation and keratinization.
Match the following descriptions to the correct lesion or distribution name. netlike cluster A. fissure B. reticular C. wheal D. patch
B. reticular
Common clinical conditions included in the atopy subgroup of type I hypersensitivity reactions include all of the following except: A. allergic rhinitis. B. rosacea. C. atopic dermatitis. D. allergic gastroenteropathy.
B. rosacea.
The spectrum of antimicrobial activity of mupirocin (Bactroban) includes: A. primarily gram-negative organisms. B. select gram-positive organisms. C. Pseudomonas species and anaerobic organisms. D. only organisms that do not produce beta-lactamase.
B. select gram-positive organisms.
Which of the following represents the most important diagnostic test for the patient in the previous question? A. complete blood cell count with white blood cell differential B. serum testing for Borrelia burgdorferi infection C. computed tomography (CT) scan of the head with contrast enhancement D. serum protein electrophoresis
B. serum testing for Borrelia burgdorferi infection
Risk factors for the development of postherpetic neuralgia include: A. age younger than 50 years at the time of the outbreak. B. severe prodromal symptoms. C. lumbar location of lesions. D. low volume of lesions.
B. severe prodromal symptoms.
A 56-year-old truck driver presents with a new nodular, opaque lesion with nondistinct borders on his left forearm. This most likely represents a(n): A. actinic keratosis. B. squamous cell carcinoma. C. basal cell carcinoma. D. malignant melanoma.
B. squamous cell carcinoma.
When prescribing erythropoietin supplementation, the NP considers that: A. the adrenal glands are its endogenous source. B. the addition of micronutrient supplementation needed for erythropoiesis is advisable. C. its use is as an adjunct in treating thrombocytopenia. D. with its use, the RBC life span is prolonged.
B. the addition of micronutrient supplementation needed for erythropoiesis is advisable.
A common site for atopic dermatitis in an infant is: A. the diaper area. B. the face. C. the neck. D. the posterior trunk.
B. the face.
You see a 42-year-old woman with a cluster of red, itchy spots on her left arm. She informs you that she recently stayed at a hotel that she later discovered was infested with bed bugs. You advise her that: A. she should immediately begin a regimen of oral antibiotics. B. the reaction is usually self-limiting and should resolve in 1 to 2 weeks. C. given that bed bug bites are usually not itchy, an alternative diagnosis should be considered. D. she should wash all of her clothes in cold water.
B. the reaction is usually self-limiting and should resolve in 1 to 2 weeks.
When counseling a patient about the use of tacrolimus (Protopic) or pimecrolimus (Elidel), you mention that: A. this is the preferred atopic dermatitis treatment in infants. B. there is a possibility of increased cancer risk with its use. C. the product is used interchangeably with topical corticosteroids. D. the product is a potent antihistamine.
B. there is a possibility of increased cancer risk with its use.
For severe, recalcitrant psoriasis that affects more than 30% of the body, all of the following treatments are recommended except: A. methotrexate. B. topical anthralin (Drithocreme). C. tumor necrosis factor (TNF) modulators. D. cyclosporine.
B. topical anthralin (Drithocreme).
Which of the following is recommended for preventing a burn wound infection? A. topical corticosteroid B. topical silver sulfadiazine C. oral erythromycin D. oral moxifloxacin
B. topical silver sulfadiazine
When prescribing tretinoin (Retin-A), the NP advises the patient to: A. use it with benzoyl peroxide to minimize irritating effects. B. use a sunscreen because the drug is photosensitizing. C. add a sulfa-based cream to enhance antiacne effects. D. expect a significant improvement in acne lesions after approximately 1 week of use.
B. use a sunscreen because the drug is photosensitizing.
Clinical features of bullous impetigo include: A. intense itch. B. vesicular lesions. C. dermatomal pattern. D. systemic symptoms such as fever and chills.
B. vesicular lesions.
You examine a patient with psoriasis vulgaris and expect to find the following lesions: A. lichenified areas in flexor areas B. well-demarcated plaques on the knees C. greasy lesions throughout the scalp D. vesicular lesions over the upper thorax
B. well-demarcated plaques on the knees
You teach Mitch about his tinea pedis. Which of the following statements indicates he doesn't understand your directions? A. "I should wash my socks with bleach." B. "I should use an antifungal powder twice a day." C. "I should wear rubber shoes in the shower to prevent transmission to others." D. "I should dry between my toes every day."
C. "I should wear rubber shoes in the shower to prevent transmission to others."
Stage 3 Lyme disease, characterized by joint pain and neuropsychiatric symptoms, typically occurs how long after initial infection? A. 1 month B. 4 months C. 1 year D. 5 years
C. 1 year
How many grams of a topical cream or ointment are needed for a single application to an arm? A. 1 B. 2 C. 3 D. 4
C. 3
The gold standard for definitive diagnosis of sickle cell anemia is: A. A reticulocyte count. B. The sickle cell test. C. A hemoglobin electrophoresis. D. A peripheral blood smear.
C. A hemoglobin electrophoresis.
Tanisha, a 24-year-old African American mother of four young children, presents in the clinic today with varicella. She states that three of her children also have it and that her eruption started less than 24 hours ago. Which of the following may shorten the course of Tanisha's disease? A. Calamine lotion B. Cool baths C. Acyclovir (Zovirax) D. Corticosteroids
C. Acyclovir (Zovirax)
A third-degree burn is: A. Affected skin blanches with ease. B. Surface is raw and moist. C. Affected area is white and leathery.
C. Affected area is white and leathery.
A nurse practitioner is teaching a client how to use permethrin 1% cream rinse (Nix) for treatment of pediculosis capitis. What is the most important information that should be given to the client? A. The shampoo should not be used again, because it is toxic and may be absorbed systemically and cause acute respiratory problems. B. It is not necessary to treat other members of the family or launder bedding or clothing. C. After hair is shampooed and towel-dried, apply permethrin 1% creme rinse to scalp and hair, and leave this on for 10 minutes before rinsing. D. Shampoo hair daily for 1 week with permethrin 1%.
C. After hair is shampooed and towel-dried, apply permethrin 1% creme rinse to scalp and hair, and leave this on for 10 minutes before rinsing.
5.The primary reason we screen newborns for sickle cells disease is to: A. Present the parents with the option for genetic screening in the future. B. Test siblings if it is proved that the newborn has sickle cell disease. C. Allow for the prevention of septicemia with prophylactic medication. D. Prevent a sickle cell crisis.
C. Allow for the prevention of septicemia with prophylactic medication.
Thin, spoon-shaped nails are usually seen in: A. Trauma. B. A fungal infection. C. Anemia. D. Psoriasis.
C. Anemia.
Which of the following laboratory studies is used to determine if a client has had hepatitis? A. Serum protein B. Protein electrophoresis C. Antibody testing D. Globulin levels
C. Antibody testing
Which of the following is positive in a large percentage of patients with systemic lupus erythematosus? A. Antiparietal antibody B. Immunoglobulin C. Antinuclear antibody (ANA) D. Rheumatoid factor
C. Antinuclear antibody (ANA)
What is the most important thing a woman can do to have youthful, attractive skin? A. Keep well hydrated. B. Use sunscreen with an SPF of at least 45. C. Avoid smoking. D. Use mild, defatted or glycerin soaps.
C. Avoid smoking.
What is the most effective treatment for urticaria? A. An oral antihistamine B. Dietary management C. Avoidance of the offending agent D. A glucocorticosteroid
C. Avoidance of the offending agent
Balanitis is associated with: A. Diabetes. B. Macular degeneration. C. Candida infection of the penis. D. Measles.
C. Candida infection of the penis.
A common cause of angular cheilitis is infection by: A. Escherichia coli. B. Streptococcus pneumoniae. C. Candida species. D. Aspergillus species.
C. Candida species.
Elizabeth, 83, presents with a 3-day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in the at site. What do you suspect? A. Varicella B. Rubella C. Herpes zoster D. Syphilis
C. Herpes zoster
Your client, age 60, presents with pruritus and complains of lymphadenopathy in his neck. He also complains of night sweats and has noticed a low-grade fever. He has not lost any weight and otherwise feels well. He is widowed and has been dating recently. On physical exam you notice enlarged supraclavicular nodes. You suspect? A. A lingering viral infection from a bout of flu he had 6 weeks ago. B. Lung cancer. C. Hodgkin's lymphoma. D. Non-Hodgkin's lymphoma.
C. Hodgkin's lymphoma.
Which of the following would not be recommended to prevent Lyme disease when visiting a Lyme-endemic area? A. Wear long pants and long-sleeved shirts. B. Use insect repellent. C. If a tick bite occurs, wait until after consulting a healthcare provider before removing the insect. D. If a tick bite occurs and the tick is engorged, administer a single 200-mg dose of doxycycline.
C. If a tick bite occurs, wait until after consulting a healthcare provider before removing the insect.
Type I hypersensitivity reactions, such as atopic dermatitis, involve the action of which antibodies binding to receptor sites on mast cells? A. IgG B. IgM C. IgE D. IgA
C. IgE
Type I hypersensitivity reaction is mediated through: A. TNF-α binding to T cells. B. IgG antibodies binding to T cells. C. IgE antibodies binding to mast cells. D. IL-10 binding to basophils.
C. IgE antibodies binding to mast cells.
Your client, Jackson, has decreased lymphocytes. You suspect: A. Bacterial infection. B. Viral infection. C. Immunodeficiency. D. Parasitic infection.
C. Immunodeficiency.
Thalassemia is caused by: A. Blood loss. B. Impaired production of all blood-forming elements. C. Increased destruction of red blood cells. D. Autoimmune antibodies.
C. Increased destruction of red blood cells.
Which of the following represents the most accurate patient information when using permethrin (Elimite) for treating scabies? A. To avoid systemic absorption, the medication should be applied over the body and rinsed off within 1 hour. B. The patient should notice a marked reduction in pruritus within 48 hours of using the product. C. Itch often persists for a few weeks after successful treatment. D. It is a second-line product in the treatment of scabies.
C. Itch often persists for a few weeks after successful treatment.
Multiple myeloma is a plasma cell malignancy in which the bone marrow is replaced, and there is bone destruction and paraprotein formation. Myeloma is a disease of older adults overall (median age at presentation, 65 years). Common presenting symptoms include: A. Nausea, vomiting, and chronic cough. B. Fatigue and splenomegaly. C. Low back pain and hypercalcemia. D. Nausea, vomiting, and fatigue.
C. Low back pain and hypercalcemia.
Caroline, an older adult, is homeless and has iron-deficiency anemia. She smokes and drinks when she can and has an ulcer. Which of the following is not one of the risk factors of iron-deficiency anemia? A. Age older than 60. B. Ulcer disease. C. Smoking. D. Poverty.
C. Smoking.
A client with HIV infection has a CD4 count of 305 and an HIV RNA level of 13,549. The client is asymptomatic. What is your course of action? A. Negotiate with your client a time to start therapy. B. Recheck the laboratory results in 1 month. If the counts remain like this, start treatment. C. Start therapy now because the client's CD4 count is less than 500, and the HIV RNA level is greater than 10,000. D. Wait to start therapy until the client becomes asymptomatic.
C. Start therapy now because the client's CD4 count is less than 500, and the HIV RNA level is greater than 10,000.
Johnny, age 12, just started taking amoxicillin for otitis media. His mother said that he woke up this morning with a rash on his trunk. What is your first action? A. Prescribe systemic antihistamines. B. Prescribe a short course of systemic steroids. C. Stop the amoxicillin. D. Continue the drug; this reaction on the first day is normal.
C. Stop the amoxicillin.
Margaret, age 32, comes to the clinic. She has painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect? A. Lymphocytoma cutis B. Relapsing polychondritis C. Systemic lupus erythematosus D. An allergic reaction
C. Systemic lupus erythematosus
Biological agents to treat psoriasis, such as infliximab and etanercept, work by blocking the action of: A. IL-9. B. CD4. C. TNF-α D. IgG.
C. TNF-α
Buddy, age 12, presents with annular lesions with a scaly border and central clearing on his trunk. What do you suspect? A. Psoriasis B. Erythema multiforme C. Tinea corporis D. Syphilis
C. Tinea corporis
Why is ultraviolet light therapy used to treat psoriasis? A. To dry the lesions B. To kill the bacteria C. To decrease the growth rate of epidermal cells D. To kill the fungi
C. To decrease the growth rate of epidermal cells
A 29-year-old woman has a sudden onset of right-sided facial asymmetry. She is unable to close her right eyelid tightly or frown or smile on the affected side. Her examination is otherwise unremarkable. This likely represents paralysis of cranial nerve: A. III. B. IV. C. VII. D. VIII.
C. VII.
One of the mechanisms of action of a topical corticosteroid preparation is as: A. an antimitotic. B. an exfoliant. C. a vasoconstrictor. D. a humectant.
C. a vasoconstrictor.
Psoriasis vulgaris is a chronic skin disease caused by: A. bacterial colonization. B. absence of melanin. C. accelerated mitosis. D. type I hypersensitivity reaction.
C. accelerated mitosis.
Seborrheic dermatitis is likely caused by: A. accelerated mitosis of skin cells. B. colonization of skin by Staphylococcus aureus. C. an inflammatory reaction to Malassezia species on skin. D. exposure to excessive UV radiation.
C. an inflammatory reaction to Malassezia species on skin.
The most important aspect of skin care for individuals with atopic dermatitis is: A. frequent bathing with antibacterial soap. B. consistent use of medium-potency to high-potency topical steroids. C. application of lubricants. D. treatment of dermatophytes.
C. application of lubricants.
First-line therapy for acne vulgaris with closed comedones includes: A. oral antibiotics. B. isotretinoin. C. benzoyl peroxide. D. hydrocortisone cream.
C. benzoyl peroxide.
Definitive diagnosis of skin cancer requires: A. skin examination. B. CT scan. C. biopsy. D. serum antigen testing.
C. biopsy.
Antihistamines exhibit therapeutic effect by: A. inactivating circulating histamine. B. preventing the production of histamine. C. blocking activity at histamine receptor sites. D. acting as a procholinergic agent.
C. blocking activity at histamine receptor sites.
A 62-year-old woman presents 2 days after noticing a "bug bite" on her left forearm. Examination reveals a warm, red, edematous area with sharply demarcated borders. The patient is otherwise healthy with no fever. This most likely represents: A. contact dermatitis. B. an allergic reaction. C. cellulitis. D. erysipelas.
C. cellulitis.
An impetigo lesion that becomes deeply ulcerated is known as: A. cellulitis. B. erythema. C. ecthyma. D. empyema.
C. ecthyma.
During type I hypersensitivity reactions, histamine released from degraded mast cells cause all of the following except: A. vasodilation. B. mucous gland stimulation. C. enhanced sebum production. D. tissue swelling.
C. enhanced sebum production.
You write a prescription for a topical agent and anticipate the greatest rate of absorption when it is applied to the: A. palms of the hands. B. soles of the feet. C. face. D. abdomen.
C. face.
Match the following descriptions to the correct lesion or distribution name. narrow linear crack into epidermis, exposing dermis A. ulcer B. atrophy C. fissure D. macule
C. fissure
A 24-year-old man arrives at the walk-in center. He reports that he was bitten in the thigh by a raccoon while walking in the woods. The examination reveals a wound that is 1 cm deep on his right thigh. The wound is oozing bright red blood. Your next best action is to: A. administer high-dose parenteral penicillin. B. initiate antibacterial prophylaxis with amoxicillin. C. give rabies immune globulin and rabies vaccine. D. suture the wound after proper cleansing.
C. give rabies immune globulin and rabies vaccine.
The most common causative organisms in cellulitis are: A. Escherichia coli and Haemophilus influenzae. B. Bacteroides species and other anaerobes. C. group A beta-hemolytic streptococci and S. aureus. D. pathogenic viruses.
C. group A beta-hemolytic streptococci and S. aureus.
Which of the following is the least potent topical corticosteroid? A. betamethasone dipropionate 0.1% (Diprosone) B. clobetasol propionate 0.05% (Cormax) C. hydrocortisone 2.5% D. fluocinonide 0.05% (Lidex)
C. hydrocortisone 2.5%
In the treatment of acne vulgaris, which lesions respond best to topical antibiotic therapy? A. open comedones B. cysts C. inflammatory lesions D. superficial lesions
C. inflammatory lesions
You see a 28-year-old man who was involved in a fight approximately 1 hour ago with another person. The patient states, "He bit me in the arm." Examination of the left forearm reveals an open wound consistent with this history. Your next best action is to: A. obtain a culture and sensitivity of the wound site. B. refer for rabies prophylaxis. C. irrigate the wound and débride as needed. D. close the wound with adhesive strips.
C. irrigate the wound and débride as needed.
Nonchemical means to eliminate bed bugs can include all of the following except: A. vacuuming crevices. B. washing bedding and other items in hot water. C. isolating the infested area from any hosts for at least 2 weeks. D. running bedding and other items in a dryer on high heat for 20 minutes.
C. isolating the infested area from any hosts for at least 2 weeks.
The zoster vaccine (Zostavax) is a(n): A. inactivated/killed virus vaccine. B. conjugate vaccine containing a virus-like particle (VLP). C. live, attenuated vaccine. D. inactivated toxin vaccine.
C. live, attenuated vaccine.
Match the following descriptions to the correct lesion or distribution name. flat discoloration less than 1 cm in diameter A. patch B. plaque C. macule D. wheal
C. macule
The use of sunscreen has minimal impact on reducing the risk of which type of skin cancer? A. squamous cell carcinoma B. basal cell carcinoma C. malignant melanoma D. all forms of skin cancer
C. malignant melanoma
Topical therapies for the treatment of rosacea include all of the following except: A. metronidazole cream. B. azelaic acid gel. C. medium-potency corticosteroid cream. D. benzoyl peroxide.
C. medium-potency corticosteroid cream.
Oral antifungal treatment options for onychomycosis include all of the following except: A. itraconazole. B. fluconazole. C. metronidazole. D. terbinafine.
C. metronidazole.
In diagnosing onychomycosis, the NP considers that: A. nails often have a single midline groove. B. pitting is often seen. C. microscopic examination reveals hyphae. D. Beau lines are present.
C. microscopic examination reveals hyphae.
A 28-year-old woman presents to your practice with chief complaint of a cat bite sustained on her right ankle. Her pet cat had bitten her after she inadvertently stepped on its paw while she was in her home. Her cat is 3 years old, is up-to-date on immunizations, and does not go outside. Physical examination reveals pinpoint superficial puncture wounds on the right ankle consistent with the presenting history. She washed the wound with soap and water immediately and asks if she needs additional therapy. Treatment for this patient's cat bite wound should include standard wound care with the addition of: A. oral erythromycin. B. topical bacitracin. C. oral amoxicillin-clavulanate. D. parenteral rifampin.
C. oral amoxicillin-clavulanate.
The human papillomavirus responsible for nongenital warts is mainly passed through: A. contact with infected surfaces. B. exposure to saliva from infected person. C. person-to-person contact. D. exposure to infected blood.
C. person-to-person contact.
Common triggers for anaphylaxis include exposure to certain types of all of the following except: A. medications. B. food. C. pet dander. D. insect bites.
C. pet dander.
Match the following descriptions to the correct lesion or distribution name. vesicle-like lesion with purulent content A. reticular B. wheal C. pustule D. patch
C. pustule
What is the most effective protection against shingles? A. previous episode of chickenpox as a child B. prior episode of shingles C. receipt of varicella-zoster immunization D. avoiding children and daycare centers
C. receipt of varicella-zoster immunization
A patient presents with a painful, blistering thermal burn involving the first, second, and third digits of his right hand. The most appropriate plan of care is to: A. apply an anesthetic cream to the area and open the blisters. B. apply silver sulfadiazine cream (Silvadene) to the area followed by a bulky dressing. C. refer the patient to burn specialty care. D. wrap the burn loosely with a nonadherent dressing and prescribe an analgesic agent.
C. refer the patient to burn specialty care.
In counseling a patient with scabies, the NP recommends all of the following methods to eliminate the mite from bedclothes and other items except: A. wash items in hot water. B. run items through the clothes dryer for a normal cycle. C. soak items in cold water for at least 1 hour. D. place items in a plastic storage bag for at least 1 week.
C. soak items in cold water for at least 1 hour.
First-line therapy for angular cheilitis therapy includes the use of: A. metronidazole gel. B. hydrocortisone cream. C. topical nystatin. D. oral ketoconazole.
C. topical nystatin.
In counseling a patient on the use of topical products to treat nail fungal infections, the NP considers that: A. nail lacquers, such as ciclopirox olamine 8% solution (Penlac), offer similar effectiveness to oral antifungals. B. some herbal products, such as tea tree oil, can be an effective alternative to oral agents. C. topical products have limited penetration through the nail matrix to reach the site of infection. D. cream-based products are more effective than gel-based products in treating nail fungal infections.
C. topical products have limited penetration through the nail matrix to reach the site of infection.
Barbie, age 27, had her spleen removed after an automobile accident. You are seeing her in the office for the first time since her discharge from the hospital. She asks you how her surgery will affect her in the future. How do you respond? A. "Your red blood cell production will be slowed." B. "Your lymphatic system may have difficulty transporting lymph fluid to the blood vessels." C. "You'll have difficulty storing the nutritional agents needed to make red blood cells." D. "You may have difficulty salvaging iron from old red blood cells for reuse."
D. "You may have difficulty salvaging iron from old red blood cells for reuse."
To transmit the bacterium that causes Lyme disease, an infected tick must feed on a human host for at least: A. 5 minutes. B. 30 minutes. C. 2 hours. D. 24 hours.
D. 24 hours.
Macrocytic normochromic anemias are caused by: A. An infection or tumor. B. A nutritional deficiency of iron. C. Acute blood loss. D. A deficiency of folic acid.
D. A deficiency of folic acid.
First-line treatment for acne vulgaris with closed comedones includes: A. Hydrocortisone cream. B. Isotretinion. C. Oral antibiotics. D. Benzoyl peroxide.
D. Benzoyl peroxide.
Gram-negative bacteria that commonly cause burn wound infections include all of the following except: A. P. aeruginosa. B. E. coli C. K. pneumoniae D. H. influenzae
D. H. influenzae
You have diagnosed Tom with contact dermatitis on the left side of the face secondary to poison ivy. You would recommend? A. Hydrocortisone cream 1% bid until healed B. Clotrimazole cream bid for 2 weeks C. Washing with antibacterial soap bid to reduce risk of secondary infection until healed D. Halcinonide 1% ointment bid for 2 weeks
D. Halcinonide 1% ointment bid for 2 weeks
Leonard is an 18-year-old man who has been taking isotretinoin (Accutane) for the treatment of acne for the past 2 months. Which of the following is the most important question for the clinician to ask at his follow-up office visit? A. Are you having any problems remembering to take your medication? B. Have you noticed any dry skin around your mouth since you started using Accutane? C. Do you notice any improvement in your skin? D. Have you noticed any recent changes in your mood?
D. Have you noticed any recent changes in your mood?
A mother brings to the clinic her 3-year-old daughter, who presents with dry red patches on her face around the eyes. The mother has observed her daughter constantly rubbing the area, which has caused swelling around the eyes. Physical examination is consistent with atopic dermatitis. The NP considers that this is a diagnosis that: A. requires a skin culture to confirm contributing bacterial organisms. B. should be supported by a biopsy of the affected area. C. necessitates obtaining peripheral blood eosinophil level D. Is usually made by clinical assessment alone
D. Is usually made by clinical assessment alone
Recommended nonpharmacological options to treat actinic keratosis include all of the following except: A. chemical peel. B. cryotherapy. C. laser resurfacing. D. Mohs micrographic surgery.
D. Mohs micrographic surgery.
Tinea unguium is also known as: A. Tinea capitis. B. Pityriasis versicolor. C. Tinea manuum. D. Onychomycosis
D. Onychomycosis
Your client, Ms. Jones, has an elevated platelet count. You suspect: A. Systemic lupus erythematosus. B. Infectious mononucleosis. C. Disseminated intravascular coagulation (DIC). D. Splenectomy.
D. Splenectomy.
You suspect that your new client Doug has hepatitis C, although he is currently asymptomatic. Your suspicion is based on his medical history, which includes which of the following factors that has been identified as a red flag for this disease? A. Lactose intolerance B. Frequent sore throats and upper respiratory infections C. A history of mononucleosis at age 17 D. Unsafe sexual behaviors
D. Unsafe sexual behaviors
Among the following, who is at greatest risk of developing seborrheic dermatitis? A. a 15-year-old boy residing in a rural setting B. a 34-year-old woman who smokes 2 PPD C. a 48-year-old male truck driver D. a 72-year-old man with Parkinson disease
D. a 72-year-old man with Parkinson disease
When examining a mole for malignant melanoma, all of the following characteristics can indicate a melanoma except: A. asymmetry with nonmatching sides. B. color is not uniform. C. a recently formed lesion. D. a lesion that has been present for at least 2 years.
D. a lesion that has been present for at least 2 years.
Match the following descriptions to the correct lesion or distribution name. in a ring formation A. wheal B. patch C. macule D. annular
D. annular
A skin biopsy results indicate the presence of malignant melanoma for a 53-year-old woman. You recommend: A. excision of the entire lesion. B. electrodissection with curettage. C. initiating treatment with topical cancer chemotherapy. D. consultation with a skin cancer expert to direct next best action.
D. consultation with a skin cancer expert to direct next best action.
Analgesia options for a patient with shingles can include all of the following except: A. topical lidocaine gel 5% with oral acetaminophen. B. Burow's solution with a high-potency oral NSAID. C. Burow's solution with an oral opioid. D. fentanyl transdermal patch and a topical medium-potency corticosteroid on the affected area.
D. fentanyl transdermal patch and a topical medium-potency corticosteroid on the affected area.
A common site for atopic dermatitis in an adult is on the: A. dorsum of the hand. B. face. C. neck. D. flexor surfaces.
D. flexor surfaces.
You see a 67-year-old man with seborrheic dermatitis that has failed to respond to treatment with ketoconazole shampoo. An appropriate second-line treatment option can include all of the following except: A. oral fluconazole. B. a topical immune modulator. C. topical propylene glycol. D. high-potency topical corticosteroid.
D. high-potency topical corticosteroid.
Common clinical manifestations of anaphylaxis can include all of the following except: A. upper airway edema. B. itch without rash. C. dizziness with syncope. D. hypertension.
D. hypertension.
Match the following descriptions to the correct lesion or distribution name. skin thickening usually found over pruritic or friction areas A. macule B. plaque C. annular D. lichenification
D. lichenification
Risk factors for angular cheilitis in adults include all of the following except: A. advanced age. B. HIV infection. C. alteration of facial vertical dimension due to loss of teeth. D. obesity.
D. obesity.
You prescribe a topical medication and want it to have maximum absorption, so you choose the following vehicle: A. gel B. lotion C. cream D. ointment
D. ointment
You see a 52-year-old woman who was bitten by a rat while opening a Dumpster. The examination reveals a wound approximately 1 cm deep that is oozing bright red blood. Treatment of this patient should include standard wound care with the addition of: A. rabies immune globulin. B. rabies vaccine. C. oral ciprofloxacin. D. oral amoxicillin-clavulanate.
D. oral amoxicillin-clavulanate.
Nonsurgical options for the treatment of squamous and basal cell carcinoma include all of the following except: A. cryotherapy. B. electrodissection with curettage. C. topical cancer chemotherapy. D. oral hydroxyurea.
D. oral hydroxyurea.
Match the following descriptions to the correct lesion or distribution name. flat discoloration greater than 1 cm in diameter A. reticular B. wheal C. pustule D. patch
D. patch
In a 22-year-old woman using isotretinoin (Accutane) therapy, the NP ensures follow-up to monitor for all of the following tests except: A. hepatic enzymes B. triglyceride measurements C. pregnancy test D. platelet count
D. platelet count
The use of TNF modulators for the treatment of psoriasis is associated with an increased risk for: A. gastrointestinal disorders. B. nephrotoxicity. C. QTc prolongation. D. reactivation of latent tuberculosis.
D. reactivation of latent tuberculosis.
Which of the following findings is often found in a person with stage 1 Lyme disease? A. peripheral neuropathic symptoms B. high-grade atrioventricular heart block C. Bell's palsy D. single painless annular lesion
D. single painless annular lesion
Treatment options in generalized psoriasis vulgaris include all of the following except: A. psoralen with ultraviolet A light (PUVA) therapy. B. methotrexate. C. cyclosporine. D. systemic corticosteroids.
D. systemic corticosteroids.
46.All of the following statements are true regarding skin reactions to bed bugs except: A. skin reactions are more common with repeated exposure to bed bug bites. B. skin reactions can typically involve papules, macules, or wheals. C. allergic reactions can be treated with topical corticosteroids. D. systemic skin reactions frequently occur following an initial exposure to bed bug bites.
D. systemic skin reactions frequently occur following an initial exposure to bed bug bites.
The most common sites for squamous and basal cell carcinoma include: A. palms of hands and soles of feet. B. pelvic and lumbar regions. C. the abdomen. D. the face and scalp.
D. the face and scalp.
All of the following characteristics about bed bugs are true except: A. they can be found in furniture, carpeting, and floorboards. B. their peak feeding time is at dawn. C. during feeding, they are attracted to body heat and carbon dioxide. D. they prefer to harbor unsanitary environments.
D. they prefer to harbor unsanitary environments.
Shingles most commonly involve the dermatomes of the: A. legs and pubic area. B. face. C. upper arms and shoulders. D. thorax.
D. thorax.
Which of the following is an oral antimicrobial option for the treatment of a community-acquired methicillin-resistant S. aureus cutaneous infection? A. amoxicillin B. dicloxacillin C. cephalexin D. trimethoprim-sulfamethoxazole
D. trimethoprim-sulfamethoxazole
A 49-year-old man presents with a skin lesion suspicious for malignant melanoma. You describe the lesion as having: A. deep black−brown coloring throughout. B. sharp borders. C. a diameter of 3 mm or less. D. variable pigmentation.
D. variable pigmentation.
