NR 667: WEEK 2: PRACTICE EXAM QUESTIONS WITH
VERIFIED ANSWERS.
1) A 27-year-old male patient, who works as a janitor, presents with a 6-month
history of an intermittent rash on his hands. History reveals itching and occasional
burning. Examination reveals irregularly-distributed scaly maculopapular
erythematous patches extending from the dorsum of the hand several inches up
the forearms, and dry palms with no nail involvement. The most likely diagnosis
is:
A) contact dermatitis.
B) eczema.
C) scabies infestation.
D) psoriasis. -- Answer ✔✔ contact dermatitis.
2) A 35-year-old woman presents with a new, darkly pigmented lesion on her back
that she noticed a few months ago. The lesion is asymmetrical, has irregular
borders, and varies in color. What is the most appropriate next step in
management?
A) Perform an excisional biopsy
B) Perform a shave biopsy
C) Reassure the patient and advise regular monitoring
D) Perform a punch biopsy -- Answer ✔✔ Perform an excisional biopsy
,3) What is the most likely diagnosis for an elderly patient with GI cancer who
presents with skin pallor, conjunctival pallor, palpitations, and weakness?
A) Autoimmune hemolytic anemia
B) Iron deficiency anemia
C) Peptic ulcer disease
D) Gastroesophageal reflux disease -- Answer ✔✔ Iron deficiency anemia
4) A Caucasian male patient with fair skin and green eyes is at a particularly high risk
for which of the following serious skin conditions?
A) Skin cancer
B) Sunburn
C) Wrinkles
D) Keratoacanthoma -- Answer ✔✔ Skin cancer
5) An adult female presents with right leg pain and rash. The patient exhibits
significant swelling of the right lower extremity from the ankle to the end of the
upper thigh, erythema, induration, and weeping lesions in the anterior lower leg.
The patient "picked at" the affected area, and its condition progressed to the
current state over a period of 1 week. Over the past 2 days, the swelling and pain
have increased greatly. BP=86/50, P=104, R=24/min, and T=101.2 degrees F (38.4
degrees C); BMI=45.9. The nurse practitioner should:
A) Refer for immediate evaluation in the emergency dept
B) Prescribe cephalexin (Keflex), 500mg every 6 hours
C) Prescribe trimethoprim-sulfamethoxazole 160mg/800mg (Bactrim DS),
every 12 hours
D) Refer to an infectious disease specialist -- Answer ✔✔ Refer for
immediate evaluation in the emergency dept
6) Your patient presents with a red, well-differentiated, raised circular lesion on
their nose which has a bloody-appearing central appearance. Which type of lesion
does this likely represent?
A) Squamous cell carcinoma
B) Actinic keratosis
C) Cherry hemangioma
, D) Basal cell carcinoma -- Answer ✔✔ Basal cell carcinoma
7) Your 58-year-old male patient identifies a bothersome 2cm lesion on his forehead
during your admission exam which is right where his baseball caps hit and cause
discomfort. You identify it as a seborrheic keratosis. Which of the following
represents the most effective strategy for removal?
A) Shave biopsy
B) Punch biopsy
C) Elliptical excision
D) Local wide excision -- Answer ✔✔ Shave biopsy
8) What is the most common form of skin cancer?
A) Basal cell carcinoma
B) Keratoacanthoma
C) Squamous cell carcinoma
D) Malignant melanoma -- Answer ✔✔ Basal cell carcinoma
9) A 30-year-old woman presents with a history of recurrent herpes simplex virus
(HSV) infections on her lips. She wants to know how to manage future outbreaks.
What is the most appropriate initial management for recurrent HSV?
A) Oral antivirals at the onset of symptoms
B) Daily oral antiviral prophylaxis
C) Immunotherapy
D) Topical antibiotics during outbreaks -- Answer ✔✔ Oral antivirals at
the onset of symptoms
10) You are admitting an otherwise healthy 67-year-old female patient with a leading
diagnosis of hypotension. She has a history of palmar dyshidrotic eczema who has
been taking mometasone ointment for over a month. She reports stopping this
medication a few days prior to admission. With this information, what is the likely
diagnosis of her admission?
A) Suppression of the HPA axis causing an Addisonian crisis
B) Acute heart failure
, C) Dehydration
D) Suppression of the adrenal glands causing Cushing syndrome -- Answer
✔✔ Suppression of the HPA axis causing an Addisonian crisis
11) A high school football player presents Monday morning after sustaining an injury
Friday night. The injuring play involved a tackle to the lateral right leg. The player
walked off the field but was unable to play the rest of the game and has been in
pain and limping since. In assessing for a medical meniscus and lateral meniscus
injury, the nurse practitioner should perform the:
A) McMurray test
B) Lachman test
C) PSOAS test
D) Thomas test -- Answer ✔✔ McMurray test
12) The patient undergoing a cardiac arrest after a recent fracture should be
considered for which of the following potential causes of pulseless electrical
activity?
A) Pericarditis
B) Hyperglycemia
C) Fat embolism
D) Hyponatremia -- Answer ✔✔ Fat embolism
13) A 50-year-old woman with a history of osteoporosis presents for a routine
check-up. What is the most appropriate medication to prevent further bone loss?
A) Bisphosphonates
B) Estrogen therapy
C) Vitamin D supplements
D) Calcium supplements -- Answer ✔✔ Bisphosphonates
14) The most specific test for gout is:
A) Serum purine level
B) Synovial fluid with monosodium urate crystals
C) Normalized uric acid level after a trial of allopurinol (Zyloprim)
VERIFIED ANSWERS.
1) A 27-year-old male patient, who works as a janitor, presents with a 6-month
history of an intermittent rash on his hands. History reveals itching and occasional
burning. Examination reveals irregularly-distributed scaly maculopapular
erythematous patches extending from the dorsum of the hand several inches up
the forearms, and dry palms with no nail involvement. The most likely diagnosis
is:
A) contact dermatitis.
B) eczema.
C) scabies infestation.
D) psoriasis. -- Answer ✔✔ contact dermatitis.
2) A 35-year-old woman presents with a new, darkly pigmented lesion on her back
that she noticed a few months ago. The lesion is asymmetrical, has irregular
borders, and varies in color. What is the most appropriate next step in
management?
A) Perform an excisional biopsy
B) Perform a shave biopsy
C) Reassure the patient and advise regular monitoring
D) Perform a punch biopsy -- Answer ✔✔ Perform an excisional biopsy
,3) What is the most likely diagnosis for an elderly patient with GI cancer who
presents with skin pallor, conjunctival pallor, palpitations, and weakness?
A) Autoimmune hemolytic anemia
B) Iron deficiency anemia
C) Peptic ulcer disease
D) Gastroesophageal reflux disease -- Answer ✔✔ Iron deficiency anemia
4) A Caucasian male patient with fair skin and green eyes is at a particularly high risk
for which of the following serious skin conditions?
A) Skin cancer
B) Sunburn
C) Wrinkles
D) Keratoacanthoma -- Answer ✔✔ Skin cancer
5) An adult female presents with right leg pain and rash. The patient exhibits
significant swelling of the right lower extremity from the ankle to the end of the
upper thigh, erythema, induration, and weeping lesions in the anterior lower leg.
The patient "picked at" the affected area, and its condition progressed to the
current state over a period of 1 week. Over the past 2 days, the swelling and pain
have increased greatly. BP=86/50, P=104, R=24/min, and T=101.2 degrees F (38.4
degrees C); BMI=45.9. The nurse practitioner should:
A) Refer for immediate evaluation in the emergency dept
B) Prescribe cephalexin (Keflex), 500mg every 6 hours
C) Prescribe trimethoprim-sulfamethoxazole 160mg/800mg (Bactrim DS),
every 12 hours
D) Refer to an infectious disease specialist -- Answer ✔✔ Refer for
immediate evaluation in the emergency dept
6) Your patient presents with a red, well-differentiated, raised circular lesion on
their nose which has a bloody-appearing central appearance. Which type of lesion
does this likely represent?
A) Squamous cell carcinoma
B) Actinic keratosis
C) Cherry hemangioma
, D) Basal cell carcinoma -- Answer ✔✔ Basal cell carcinoma
7) Your 58-year-old male patient identifies a bothersome 2cm lesion on his forehead
during your admission exam which is right where his baseball caps hit and cause
discomfort. You identify it as a seborrheic keratosis. Which of the following
represents the most effective strategy for removal?
A) Shave biopsy
B) Punch biopsy
C) Elliptical excision
D) Local wide excision -- Answer ✔✔ Shave biopsy
8) What is the most common form of skin cancer?
A) Basal cell carcinoma
B) Keratoacanthoma
C) Squamous cell carcinoma
D) Malignant melanoma -- Answer ✔✔ Basal cell carcinoma
9) A 30-year-old woman presents with a history of recurrent herpes simplex virus
(HSV) infections on her lips. She wants to know how to manage future outbreaks.
What is the most appropriate initial management for recurrent HSV?
A) Oral antivirals at the onset of symptoms
B) Daily oral antiviral prophylaxis
C) Immunotherapy
D) Topical antibiotics during outbreaks -- Answer ✔✔ Oral antivirals at
the onset of symptoms
10) You are admitting an otherwise healthy 67-year-old female patient with a leading
diagnosis of hypotension. She has a history of palmar dyshidrotic eczema who has
been taking mometasone ointment for over a month. She reports stopping this
medication a few days prior to admission. With this information, what is the likely
diagnosis of her admission?
A) Suppression of the HPA axis causing an Addisonian crisis
B) Acute heart failure
, C) Dehydration
D) Suppression of the adrenal glands causing Cushing syndrome -- Answer
✔✔ Suppression of the HPA axis causing an Addisonian crisis
11) A high school football player presents Monday morning after sustaining an injury
Friday night. The injuring play involved a tackle to the lateral right leg. The player
walked off the field but was unable to play the rest of the game and has been in
pain and limping since. In assessing for a medical meniscus and lateral meniscus
injury, the nurse practitioner should perform the:
A) McMurray test
B) Lachman test
C) PSOAS test
D) Thomas test -- Answer ✔✔ McMurray test
12) The patient undergoing a cardiac arrest after a recent fracture should be
considered for which of the following potential causes of pulseless electrical
activity?
A) Pericarditis
B) Hyperglycemia
C) Fat embolism
D) Hyponatremia -- Answer ✔✔ Fat embolism
13) A 50-year-old woman with a history of osteoporosis presents for a routine
check-up. What is the most appropriate medication to prevent further bone loss?
A) Bisphosphonates
B) Estrogen therapy
C) Vitamin D supplements
D) Calcium supplements -- Answer ✔✔ Bisphosphonates
14) The most specific test for gout is:
A) Serum purine level
B) Synovial fluid with monosodium urate crystals
C) Normalized uric acid level after a trial of allopurinol (Zyloprim)
