NSG 3250 Adult Health I Exam 2
Advanced Review Manual for Galen
College Students Including Quizzes
and Rationales 2026/2027
Question 1:
A patient presents to the clinic with painful burning vesicles on the upper lip that later
rupture and crust over. Which viral infection should the nurse most strongly suspect?
A. Herpes zoster
B. Herpes simplex virus type 1
C. Impetigo
D. Candidiasis
Correct Answer: B. Herpes simplex virus type 1
Rationale: Herpes simplex virus type 1 (HSV-1) commonly causes oral lesions known
as cold sores or fever blisters. Patients frequently report a prodromal burning or
tingling sensation prior to vesicle formation. The lesions usually rupture and crust
over before healing. Herpes zoster follows a dermatomal pattern, impetigo causes
honey-colored crusted lesions due to bacterial infection, and candidiasis presents with
fungal plaques or itching rather than painful vesicles.
Question 2:
A patient reports painful genital ulcers accompanied by crusted blisters and burning
discomfort. Which condition is most consistent with these findings?
A. Syphilis
B. Herpes simplex virus type 2
C. Human papillomavirus
D. Contact dermatitis
Correct Answer: B. Herpes simplex virus type 2
Rationale: HSV-2 is the primary cause of genital herpes and typically presents with
painful vesicles or ulcerative lesions in the genital area. These lesions may rupture
and crust over. Syphilitic chancres are usually painless, human papillomavirus causes
genital warts rather than ulcers, and contact dermatitis produces itching and
inflammation rather than grouped vesicles.
,2026/2027
Question 3:
A nurse explains to a patient that herpes simplex virus remains dormant in which
location after the initial infection?
A. Bone marrow
B. Peripheral sensory ganglia
C. Epidermal tissue only
D. Lymphatic vessels
Correct Answer: B. Peripheral sensory ganglia
Rationale: HSV establishes latency within sensory nerve ganglia, especially the
trigeminal ganglion in HSV-1 infections. The virus can reactivate during stress,
illness, or immunosuppression. Bone marrow and lymphatic vessels are not reservoirs
for HSV latency, and the virus does not remain solely within epidermal tissue.
Question 4:
A patient who had chickenpox as a child develops painful grouped vesicles along the
trunk in a dermatomal distribution. Which condition should the nurse suspect?
A. Psoriasis
B. Cellulitis
C. Herpes zoster
D. Contact dermatitis
Correct Answer: C. Herpes zoster
Rationale: Herpes zoster, or shingles, results from reactivation of the varicella-zoster
virus that remains dormant after chickenpox infection. The disease is characterized by
painful vesicular eruptions distributed along a dermatome. Psoriasis causes scaly
plaques, cellulitis causes diffuse inflammation, and contact dermatitis is associated
with allergen exposure.
Question 5:
Which statement best describes the cause of shingles?
A. Fungal infection of the epidermis
B. Reactivation of dormant varicella-zoster virus
C. Initial exposure to herpes simplex virus
D. Bacterial infection of hair follicles
Correct Answer: B. Reactivation of dormant varicella-zoster virus
,2026/2027
Rationale: Shingles occurs when the varicella-zoster virus reactivates years after a
primary chickenpox infection. The virus remains dormant in sensory ganglia until
reactivation occurs, often due to aging or immunosuppression. The condition is not
fungal, bacterial, or caused by HSV infection.
Question 6:
A newborn is noted to have thick white patches inside the mouth that are difficult to
remove. Which condition should the nurse suspect?
A. Oral candidiasis
B. Leukoplakia
C. Herpes simplex infection
D. Impetigo
Correct Answer: A. Oral candidiasis
Rationale: Oral candidiasis, or thrush, is caused by Candida albicans and commonly
affects newborns. The infection presents as white plaques on the tongue and oral
mucosa. These lesions may bleed if scraped. Herpes simplex causes painful vesicles,
leukoplakia is more common in adults, and impetigo affects the skin rather than the
oral cavity.
Question 7:
A patient presents with genital itching and a thick white “cottage cheese-like”
discharge. Which diagnosis is most likely?
A. Herpes simplex virus
B. Bacterial vaginosis
C. Candidiasis
D. Gonorrhea
Correct Answer: C. Candidiasis
Rationale: Vaginal candidiasis commonly presents with intense itching, irritation, and
thick white discharge resembling cottage cheese. Candida albicans is the most
common causative organism. Herpes simplex causes painful ulcers, bacterial
vaginosis produces thin gray discharge with odor, and gonorrhea often presents with
purulent discharge.
Question 8:
A child presents with highly contagious honey-colored crusted lesions around the
nose and mouth. Which condition should the nurse suspect?
, 2026/2027
A. Impetigo
B. Psoriasis
C. Seborrheic dermatitis
D. Herpes zoster
Correct Answer: A. Impetigo
Rationale: Impetigo is a superficial bacterial skin infection caused by Staphylococcus
aureus or Streptococcus pyogenes. It is characterized by honey-colored crusted
lesions, particularly around the nose and mouth in children. Psoriasis produces silvery
plaques, seborrheic dermatitis causes oily scaling, and herpes zoster follows
dermatomes.
Question 9:
A nurse is educating a patient newly diagnosed with genital herpes. Which statement
by the nurse is most accurate?
A. “The infection can only spread when lesions are visible.”
B. “There is a permanent cure for herpes simplex.”
C. “The virus may still spread even without active lesions.”
D. “Antiviral therapy completely eliminates transmission risk.”
Correct Answer: C. “The virus may still spread even without active lesions.”
Rationale: HSV can spread through asymptomatic viral shedding even when no
lesions are present. Antiviral therapy reduces outbreaks and transmission risk but does
not cure the infection. Education on safe sex and transmission prevention is critical.
Question 10:
A patient asks why shingles developed years after recovering from chickenpox.
Which response is best?
A. “The infection was caused by a new fungal exposure.”
B. “Your chickenpox virus remained inactive and later reactivated.”
C. “Shingles only develops after bacterial infections.”
D. “This condition occurs only in children.”
Correct Answer: B. “Your chickenpox virus remained inactive and later
reactivated.”
Rationale: Varicella-zoster virus remains dormant in sensory ganglia after chickenpox
infection and can reactivate later in life as shingles. Age, stress, and
immunosuppression increase risk. The disease is viral, not bacterial or fungal.
Question 11: