Med Surg Exam 3 Actual Exam Newest / Med Surg Exam 3 Practice Exam / Med
Surg Exam 3 Preparation With 150 Questions And Correct Answers | Already
Graded A+
Question 1
Which statement best describes the pathophysiology of psoriasis?
A) A contagious bacterial infection of the dermis
B) A chronic autoimmune condition resulting in overproduction of keratin
C) A viral eruption occurring along a specific dermatome
D) An allergic reaction to systemic antibiotics
E) A fungal overgrowth caused by excessive moisture
Correct Answer: B) A chronic autoimmune condition resulting in overproduction of keratin
Rationale: Psoriasis is a chronic, non-contagious autoimmune skin disorder. The primary
mechanism is the hyperproliferation of keratinocytes. Normal skin cells take about a
month to replace themselves, but in psoriasis, this process occurs in just a few days, leading
to the buildup of thick, scaly plaques.
Question 2
A patient with psoriasis is found to have abdominal obesity, high triglycerides, and elevated
fasting blood sugar. This cluster of findings is known as:
A) Cushing’s Syndrome
B) Metabolic Syndrome
C) Addison’s Disease
D) Raynaud’s Phenomenon
E) Hypovolemic Shock
Correct Answer: B) Metabolic Syndrome
Rationale: Psoriasis is increasingly recognized as a systemic inflammatory condition. It is
strongly associated with metabolic syndrome, which includes hypertension, central obesity,
dyslipidemia, and insulin resistance. Patients with psoriasis have a higher risk of
developing Type 2 diabetes and cardiovascular disease.
Question 3
In which of the following areas would a nurse most likely expect to find psoriatic lesions?
A) Sole of the foot and armpits
B) Elbows, knees, and scalp
C) Inside the mouth and on the tongue
D) Only on the palms of the hands
E) Behind the ears exclusively
Correct Answer: B) Elbows, knees, and scalp
Rationale: Psoriasis commonly affects the extensor surfaces of the body. Typical sites of
involvement include the elbows, knees, scalp, sacrum, trunk, and the lateral aspects of the
, 2
extremities. These lesions appear as red papules that coalesce into plaques covered with
silvery scales.
Question 4
A nurse is teaching a patient about phototherapy with UV light for psoriasis. What is a critical
safety point to include?
A) UV therapy prevents the need for topical medications
B) Phototherapy decreases the risk of all types of cancer
C) This treatment increases the patient’s risk of skin cancer
D) The patient should apply high-potency steroids immediately before UV exposure
E) UV light is only effective for arterial ulcers, not psoriasis
Correct Answer: C) This treatment increases the patient’s risk of skin cancer
Rationale: While phototherapy (UVB or PUVA) is an effective treatment for moderate-to-
severe psoriasis because it slows down the rapid growth of skin cells, repeated exposure to
ultraviolet radiation increases the long-term risk of developing skin cancers, including
squamous cell and basal cell carcinoma.
Question 5
When providing skin care education to a patient with psoriasis, the nurse should instruct the
patient to:
A) Vigorously scratch the lesions to remove scales
B) Apply high-potency corticosteroids to the face daily
C) Avoid scratching or picking at the lesions
D) Use hot water during every shower to soften the patches
E) Stop all medications once the skin appears clear
Correct Answer: C) Avoid scratching or picking at the lesions
Rationale: Scratching or picking at psoriatic lesions can lead to the Koebner phenomenon,
where new lesions develop at the site of skin trauma. It also increases the risk of secondary
bacterial infections. Patients should also be warned not to use high-potency steroids on the
face as the skin there is thin and prone to atrophy.
Question 6
Which protein is the principal component of hair, skin, and nails, and is overproduced in
psoriasis?
A) Albumin
B) Collagen
C) Keratin
D) Hemoglobin
E) Myoglobin
, 3
Correct Answer: C) Keratin
Rationale: Keratin is a tough, fibrous protein that provides structure and protection to the
skin and its appendages. In psoriasis, the immune system triggers an inflammatory
response that causes keratinocytes to mature too quickly and pile up on the skin surface.
Question 7
A "chronic wound" is defined as one that:
A) Heals within 48 hours of injury
B) Is caused exclusively by surgical incisions
C) Fails to progress to healing in a timely manner
D) Only occurs in pediatric patients
E) Results from a single blunt force trauma
Correct Answer: C) Fails to progress to healing in a timely manner
Rationale: Chronic wounds are those that do not follow the normal sequence of repair or
fail to heal within the expected timeframe (usually 3 months). They often remain "stuck" in
the inflammatory phase of healing due to factors like poor perfusion, infection, or
underlying disease like diabetes.
Question 8
Which of the following characteristics is typical of an arterial ulcer?
A) Irregular borders and located on the inner ankle
B) Large, shallow, and highly edematous
C) Small, round "punched out" appearance with smooth borders
D) Surrounded by leathery, brown-pigmented skin
E) Usually painless even when deep
Correct Answer: C) Small, round "punched out" appearance with smooth borders
Rationale: Arterial ulcers result from ischemia (lack of oxygenated blood). They typically
have a "punched out" look, smooth margins, a pale wound base, and are located on the
toes or lateral malleolus. They are often very painful, especially when the legs are elevated.
Question 9
What is the primary cause of venous stasis ulcers?
A) Narrowing of the carotid arteries
B) Inadequate venous drainage and high pressure in the veins
C) Excessive intake of Vitamin K
D) Prolonged use of compression stockings
E) Overproduction of insulin
Correct Answer: B) Inadequate venous drainage and high pressure in the veins
Rationale: Venous ulcers occur when valves in the leg veins fail (venous insufficiency),
, 4
causing blood to pool in the lower legs. This increases hydrostatic pressure, forcing fluid
and red blood cells into the surrounding tissue, which eventually breaks down into a
shallow, irregular ulcer.
Question 10
A nurse observes a wound on the inner ankle that is shallow, has irregular borders, and is
surrounded by edematous, brown-stained skin. The nurse suspects:
A) An arterial ulcer
B) A diabetic foot ulcer
C) A venous stasis ulcer
D) A stage 1 pressure injury
E) Psoriasis of the ankle
Correct Answer: C) A venous stasis ulcer
Rationale: Venous ulcers are characteristically located near the medial malleolus (inner
ankle). The "hemosiderin staining" (brownish discoloration) is caused by the breakdown of
red blood cells that have leaked into the tissue due to chronic venous hypertension.
Question 11
Intermittent claudication is a classic symptom of which condition?
A) Congestive Heart Failure
B) Chronic Venous Insufficiency
C) Peripheral Arterial Disease (PAD)
D) Epilepsy
E) Venous Stasis Ulcers
Correct Answer: C) Peripheral Arterial Disease (PAD)
Rationale: Intermittent claudication is ischemic muscle pain that is caused by a consistent
level of exercise (such as walking a certain distance) and is relieved by rest. It occurs
because the narrowed arteries cannot supply enough oxygen to the muscles during activity.
Question 12
Which finding is most consistent with Peripheral Arterial Disease (PAD)?
A) Brawny, leathery skin on the calves
B) Warm, reddened skin with bounding pulses
C) Shiny, thin skin with hair loss on the legs
D) Heavy edema and itching
E) Rapid capillary refill of less than 1 second
Correct Answer: C) Shiny, thin skin with hair loss on the legs
Rationale: In PAD, chronic ischemia leads to trophic changes in the skin. The skin becomes
Surg Exam 3 Preparation With 150 Questions And Correct Answers | Already
Graded A+
Question 1
Which statement best describes the pathophysiology of psoriasis?
A) A contagious bacterial infection of the dermis
B) A chronic autoimmune condition resulting in overproduction of keratin
C) A viral eruption occurring along a specific dermatome
D) An allergic reaction to systemic antibiotics
E) A fungal overgrowth caused by excessive moisture
Correct Answer: B) A chronic autoimmune condition resulting in overproduction of keratin
Rationale: Psoriasis is a chronic, non-contagious autoimmune skin disorder. The primary
mechanism is the hyperproliferation of keratinocytes. Normal skin cells take about a
month to replace themselves, but in psoriasis, this process occurs in just a few days, leading
to the buildup of thick, scaly plaques.
Question 2
A patient with psoriasis is found to have abdominal obesity, high triglycerides, and elevated
fasting blood sugar. This cluster of findings is known as:
A) Cushing’s Syndrome
B) Metabolic Syndrome
C) Addison’s Disease
D) Raynaud’s Phenomenon
E) Hypovolemic Shock
Correct Answer: B) Metabolic Syndrome
Rationale: Psoriasis is increasingly recognized as a systemic inflammatory condition. It is
strongly associated with metabolic syndrome, which includes hypertension, central obesity,
dyslipidemia, and insulin resistance. Patients with psoriasis have a higher risk of
developing Type 2 diabetes and cardiovascular disease.
Question 3
In which of the following areas would a nurse most likely expect to find psoriatic lesions?
A) Sole of the foot and armpits
B) Elbows, knees, and scalp
C) Inside the mouth and on the tongue
D) Only on the palms of the hands
E) Behind the ears exclusively
Correct Answer: B) Elbows, knees, and scalp
Rationale: Psoriasis commonly affects the extensor surfaces of the body. Typical sites of
involvement include the elbows, knees, scalp, sacrum, trunk, and the lateral aspects of the
, 2
extremities. These lesions appear as red papules that coalesce into plaques covered with
silvery scales.
Question 4
A nurse is teaching a patient about phototherapy with UV light for psoriasis. What is a critical
safety point to include?
A) UV therapy prevents the need for topical medications
B) Phototherapy decreases the risk of all types of cancer
C) This treatment increases the patient’s risk of skin cancer
D) The patient should apply high-potency steroids immediately before UV exposure
E) UV light is only effective for arterial ulcers, not psoriasis
Correct Answer: C) This treatment increases the patient’s risk of skin cancer
Rationale: While phototherapy (UVB or PUVA) is an effective treatment for moderate-to-
severe psoriasis because it slows down the rapid growth of skin cells, repeated exposure to
ultraviolet radiation increases the long-term risk of developing skin cancers, including
squamous cell and basal cell carcinoma.
Question 5
When providing skin care education to a patient with psoriasis, the nurse should instruct the
patient to:
A) Vigorously scratch the lesions to remove scales
B) Apply high-potency corticosteroids to the face daily
C) Avoid scratching or picking at the lesions
D) Use hot water during every shower to soften the patches
E) Stop all medications once the skin appears clear
Correct Answer: C) Avoid scratching or picking at the lesions
Rationale: Scratching or picking at psoriatic lesions can lead to the Koebner phenomenon,
where new lesions develop at the site of skin trauma. It also increases the risk of secondary
bacterial infections. Patients should also be warned not to use high-potency steroids on the
face as the skin there is thin and prone to atrophy.
Question 6
Which protein is the principal component of hair, skin, and nails, and is overproduced in
psoriasis?
A) Albumin
B) Collagen
C) Keratin
D) Hemoglobin
E) Myoglobin
, 3
Correct Answer: C) Keratin
Rationale: Keratin is a tough, fibrous protein that provides structure and protection to the
skin and its appendages. In psoriasis, the immune system triggers an inflammatory
response that causes keratinocytes to mature too quickly and pile up on the skin surface.
Question 7
A "chronic wound" is defined as one that:
A) Heals within 48 hours of injury
B) Is caused exclusively by surgical incisions
C) Fails to progress to healing in a timely manner
D) Only occurs in pediatric patients
E) Results from a single blunt force trauma
Correct Answer: C) Fails to progress to healing in a timely manner
Rationale: Chronic wounds are those that do not follow the normal sequence of repair or
fail to heal within the expected timeframe (usually 3 months). They often remain "stuck" in
the inflammatory phase of healing due to factors like poor perfusion, infection, or
underlying disease like diabetes.
Question 8
Which of the following characteristics is typical of an arterial ulcer?
A) Irregular borders and located on the inner ankle
B) Large, shallow, and highly edematous
C) Small, round "punched out" appearance with smooth borders
D) Surrounded by leathery, brown-pigmented skin
E) Usually painless even when deep
Correct Answer: C) Small, round "punched out" appearance with smooth borders
Rationale: Arterial ulcers result from ischemia (lack of oxygenated blood). They typically
have a "punched out" look, smooth margins, a pale wound base, and are located on the
toes or lateral malleolus. They are often very painful, especially when the legs are elevated.
Question 9
What is the primary cause of venous stasis ulcers?
A) Narrowing of the carotid arteries
B) Inadequate venous drainage and high pressure in the veins
C) Excessive intake of Vitamin K
D) Prolonged use of compression stockings
E) Overproduction of insulin
Correct Answer: B) Inadequate venous drainage and high pressure in the veins
Rationale: Venous ulcers occur when valves in the leg veins fail (venous insufficiency),
, 4
causing blood to pool in the lower legs. This increases hydrostatic pressure, forcing fluid
and red blood cells into the surrounding tissue, which eventually breaks down into a
shallow, irregular ulcer.
Question 10
A nurse observes a wound on the inner ankle that is shallow, has irregular borders, and is
surrounded by edematous, brown-stained skin. The nurse suspects:
A) An arterial ulcer
B) A diabetic foot ulcer
C) A venous stasis ulcer
D) A stage 1 pressure injury
E) Psoriasis of the ankle
Correct Answer: C) A venous stasis ulcer
Rationale: Venous ulcers are characteristically located near the medial malleolus (inner
ankle). The "hemosiderin staining" (brownish discoloration) is caused by the breakdown of
red blood cells that have leaked into the tissue due to chronic venous hypertension.
Question 11
Intermittent claudication is a classic symptom of which condition?
A) Congestive Heart Failure
B) Chronic Venous Insufficiency
C) Peripheral Arterial Disease (PAD)
D) Epilepsy
E) Venous Stasis Ulcers
Correct Answer: C) Peripheral Arterial Disease (PAD)
Rationale: Intermittent claudication is ischemic muscle pain that is caused by a consistent
level of exercise (such as walking a certain distance) and is relieved by rest. It occurs
because the narrowed arteries cannot supply enough oxygen to the muscles during activity.
Question 12
Which finding is most consistent with Peripheral Arterial Disease (PAD)?
A) Brawny, leathery skin on the calves
B) Warm, reddened skin with bounding pulses
C) Shiny, thin skin with hair loss on the legs
D) Heavy edema and itching
E) Rapid capillary refill of less than 1 second
Correct Answer: C) Shiny, thin skin with hair loss on the legs
Rationale: In PAD, chronic ischemia leads to trophic changes in the skin. The skin becomes
