NR 506 FNP Board Examination with ALL the Answers Latest Update 2022 (100% correct)

• Basal Cell Cancer: Question description and the fact that it doesn’t have any tx (Hints: Waxy, pearly, telangiectasia, ulcer center lesion Basal cell- most prevalent skin cancer, pearly domed nodule with overlying telangiectatic vessels, maybe plaque, maybe papule, may see central ulceration and crusting, deepest layer of the epidermis, Dx gold standard biopsy, TX chemo or immunotherapy • Actinic Keratosis: Question about description (Scaly red to yellow located in sun exposed area: precancerous Actinic keratosis- rough flat, dry, crusty, erythematous papules or plaques, scaly patch of red or brown skin caused by years of sun exposure, evolving carcinoma, precursor to squamous cell carcinoma, Dx biopsy, refer to dermatology, TX topical 5 fluoracil 5-FU, cryotherapy, • Melanoma question: Know ABCDE ABCDE- asymmetry, border is irregular, color variegation, diameter .6mm size greater than pencil eraser, elevation above skin level • Squamous cell- skin cancer develops in the outer layer of the skin, lower lip common location, nodule, indistinct margins, surface is firm, scaly, irregular, and may bleed easily, may metastasize • Postherpetic neuralgia PHN- prophylaxis is TCA-Elavil Shingles • Cellulitis- deep tissue, gram positive, gradual course over days, TX PCN, macrolide • Erysipelas-(strept infection)- acute onset, well demarcated and above the skin, TX pcn or macrolide • MRSA- TX Bactrim or tetracyclines • Papule – solid elevated mass up to 1 cm • Macule- flat small like a freckle • Vesicle – filled with serous fluid and less than 1 cm • Bullae- fluid filled and larger than 1 cm, can be found with 2nd degreeburns • Xerosis- dry skin, use petroleum-based product, not lotions • Psoriasis- pruritic erythematous plaque covered with fine silvery white scales, scalp and elbows TX topical steroids • Shingles- chicken pox, reactivation of varicella zoster virus involves single dermatome, less likely several dermatomes, finding prodrome- itching burning photophobia fever headache malaise, acute phase dermatomal rash 3-4 days, unilateral, pain, possible severe, macupapular rash progresses to vesicles then pustules 3-4 days, may appear for a week, convalescent phase- 2-3 week rash resolves, pain Dx viral culture, polymerase chain reaction PCR, TX acyclovir, zostrix cream, gabapentin amitriptyline • Varicella: Chicken pox, starts on the FACE, spreads to trunk, arms and scalp. Prodrome of fever, pharyngitis, malaise., followed by 24, eruption of puritic vesicular lesions. Exanthem, erthematous puritic maculars develop to papules and fluid filled vesicles”drewdrops on a rose petal” Hairline and spread • Shingles: herpes zoster: varicella virus infection: elderly. One dermatone • Spider bite- TX abx on wound, cold packs nsaids • Dog bite- treat with analgesia (Tylenol, nsaids, Demerol), Augmentin/doxycycline/Bactrim, wound cleaning with soap and water, betadine, local anesthesia (lidocaine), irrigated with 2000ml normal saline, betadine, wound debridement, facial bites should be closed with sutures only, pack wound, tetanus immunization, antibiotic therapy, • Lyme disease- erythema migrans, (Borrelia burgdorferi) bulls eye rash, start within 72 hours of exposure, TX with doxycycline or amoxicillin, or azithromycin Dx two step test EIA and then western blot • Lupus- multisystem autoimmune disease, characterized by remission and exacerbations, affects organs, skin kidney, heart, and blood vessels, face butterfly rash, avoid sunlight exposure, photosensitivity TX refer to rheumatologist, topical and oral steroids, avoid sun and cover skin Less seen in Caucasians • Pityriasis rosea- exanthem, Christmas tree pattern rash, herald patch, normally on trunk, and limbs, oval erythematous-squamous scaly lesion. Pityriasis=bran, rosea=pink, last 5weeks • Anthrax-bacterial infection, from animals, spores inhaled, caused dark scabs difficult to breath. TX doxycycline/ fluoroquinolones (Cipro) • Tinea versicolor- trunk and extremities sun spots, lighten areas over darker skin • Tinea corporis-(ringworm) arms/legs or body, fungal, Tx: mupirocin ointment • Tinea cruris- jock itch • Tinea capitas- skin or scalp • Tinea pedis-athletes foot • Psoriasis- cause pitting in finger nails • Erthema Multiforme- Bulls Eye Rash.Infection. erythematous macule evolves into a papuleSX: skin, mouth lesions that ave pink-red center surrounded by pale ring border, can be painful and puritic. Hands. Bulla on lips vesicle filled large lesions, Causes:herpes simplex, or sulfa rhe