MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
1. Basics with skin conditions: •Alopecia
•Rash
•Pruritus
•Uticaria
•Pigmentation change
Skin lesion—New vs. Change
2. HPI questions for skin problems: Duration of symptoms
Precipitating factors
•Medications
•Food
•Occupation
•Outdoors
•Hobbies/Sport participation
•Exposure to insects
•Jewelry/metals/chemicals
•Family history
Is it:
Local or systemic
Pruritus- all day or worse at night
Uticaria - duration
Pigmented changes
3. Pigmentation/Changes of the skin Diff diagnosis: Nevi- brown, beige or
pink(< 5mm)
Melanoma
Related to pregnancy- melasma (mask of pregnancy)
Addison disease
Side effect of medication- steroid therapy
4. skin lesions: Macule - flat, nonpalpable (freckle, petechia)
Papule - PALPABLE, solid elevation of skin (elevated nevus)
Nodule - elevated solid mass, deeper and firmer than papule (wart)
Tumor - solid mass deep in subcutaneous tissue (epithelioma)
Wheal - irregularly shaped, elevated area (hive, mosquito bite
,MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
Vesicle - elevation of skin with serous (clear) fluid
Pustule - similar to vesicle but filled with pus (acne)
Ulcer - deep loss of skin (venous statis ulcer)
Atophy - thinning of skin
Bullae-Clear fluid-filled blisters > 10 mm in diameter. These may be caused by
burns, bites, irritant or allergic contact dermatitis, and drug reactions.
5. primary versus secondary skin lesions: Primary skin lesions are those which
develop as a direct result of the disease process.
Secondary lesions are those which evolve from primary lesions or develop as a
consequence of the patient's activities.
6. Parasitic Skin Infections: scabies and lice
7. Scabies: Highly contagious infestation that occurs mainly in children, young
adults, health care workers, and institutionalized persons of all ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas of
body most attractive to mites. Itching, excoriation, , crusting, and scaling may be
present making it hard to see scabies.
Diagnostics:Ink burrow test
8. Scabies treatment: Permethrin 5% cream (Remember you have 5 fingers)-
leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
9. Lice treatment: Permethrin 1% leave on for 10 mins then rinse. May repeat in
7 days if needed.
,MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
10. Fungal skin infections: · Candidiasis- bright, beefy red rash treat with topical
antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective,
educate patient.
· Fungal infections survive on keratin, so considered superficial.
· Pathogens: Epidermophyton, trichophyton, microsporum.
· Those at risk are DM and immunocompromised.
· Diagnostics: KOH
11. Tinea corporis
(Ringworm of body): Hx of erythematous round and elevated pruritic lesion that
grows in size & starts to clear in the center
Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1%
12. Tinea capitus (ringworm of head): Children common. Painless bald spot,
may have kerion that looks like honeycomb, inflammation. Boggy mass containing
broken hairs and oozing purulent material from follicular orifices
Systemic antifungals - Griseofulvin BID for 2-4 months or 2 weeks after negative
cultures. Teratogenic - use 2nd method of contraception.
OR terbinafine cream
13. Tinea versicolor (skin, AKA pityriasis versicolor): Round or oval lesions of
hypo or hyperpigmentation macule, located mainly on back chest, arms, some-
times neck/face. Sometimes very fine scales seen. Agent P oribiculare causes
round, pityrosporum ovale causes oval
Clotrimazole 1% cream and solution BID up to 4 weeks
14. Bacterial infections of the skin: · Impetigo
· highly contagious
Cellulitis
· Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin,
· PCN allergy use Erythromycin.
· non purulent assume staph aureus
, MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
Purulent cellulitis
· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
15. Impetigo: Honey crusted plaques, usually on face
Bullous: begin as small vesicles that rupture easily with serous fluid turning into
crust
Nonbullous, vesticulopustular: thick, adherent lesions, dirty yellow-colored crust
with erythematous margins
Treatment:
Clean lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin).
With no treatment, it is self-limiting 2-3 wks
16. follilculitis: Staphylococcus. Multiple small papules on erythematous base,
can be large yellow white tender pustules in adults. Common in places hair is
present, widespread is characteristic, bumpy rash, no itching.
Treatment:
Only if becomes infected. Large lesions cleansed with weak soap solution, followed
by soaking with saline or aluminum subacetate BID. TAO can be used BID for 5
days. Oral ABT 1st gen cephalo. if resistant
17. Localized cellulitis: The typical lesion of cellulitis is wide, diffuse area of
erythematous skin that is warm and tender to palpation. Infection is occasionally
accompanied by severe edema. Systemic symptoms such as fever, chills, and
malaise may also be present.
CAUSES- Diabetic patient or other immunocompromised patients. Any break in the
skin. Skin breaks from surgical incisions, skin tears, wounds, trauma, insect bites
or stings, and animal or human bites. PREEXISTING conditions- stasis ulcers,
dermatitides, viral skin infections, superficial bacterial infections, and bolus disease
all have the risk for secondary infections.
Subjective- tender, warm, erythematous areas of skin usually on face, neck, and
extremities. Usually report an insect bite or some form of skin break. If recurrent
cellulitis may deny any trauma or injury.
Objective- Lower leg most common site of infection .If lower extremity cellulites
should look for SS of tinea pedis (Athletes foot) infection can be point of entry for
ANSWERS A+ GRADED 2023
1. Basics with skin conditions: •Alopecia
•Rash
•Pruritus
•Uticaria
•Pigmentation change
Skin lesion—New vs. Change
2. HPI questions for skin problems: Duration of symptoms
Precipitating factors
•Medications
•Food
•Occupation
•Outdoors
•Hobbies/Sport participation
•Exposure to insects
•Jewelry/metals/chemicals
•Family history
Is it:
Local or systemic
Pruritus- all day or worse at night
Uticaria - duration
Pigmented changes
3. Pigmentation/Changes of the skin Diff diagnosis: Nevi- brown, beige or
pink(< 5mm)
Melanoma
Related to pregnancy- melasma (mask of pregnancy)
Addison disease
Side effect of medication- steroid therapy
4. skin lesions: Macule - flat, nonpalpable (freckle, petechia)
Papule - PALPABLE, solid elevation of skin (elevated nevus)
Nodule - elevated solid mass, deeper and firmer than papule (wart)
Tumor - solid mass deep in subcutaneous tissue (epithelioma)
Wheal - irregularly shaped, elevated area (hive, mosquito bite
,MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
Vesicle - elevation of skin with serous (clear) fluid
Pustule - similar to vesicle but filled with pus (acne)
Ulcer - deep loss of skin (venous statis ulcer)
Atophy - thinning of skin
Bullae-Clear fluid-filled blisters > 10 mm in diameter. These may be caused by
burns, bites, irritant or allergic contact dermatitis, and drug reactions.
5. primary versus secondary skin lesions: Primary skin lesions are those which
develop as a direct result of the disease process.
Secondary lesions are those which evolve from primary lesions or develop as a
consequence of the patient's activities.
6. Parasitic Skin Infections: scabies and lice
7. Scabies: Highly contagious infestation that occurs mainly in children, young
adults, health care workers, and institutionalized persons of all ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas of
body most attractive to mites. Itching, excoriation, , crusting, and scaling may be
present making it hard to see scabies.
Diagnostics:Ink burrow test
8. Scabies treatment: Permethrin 5% cream (Remember you have 5 fingers)-
leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
9. Lice treatment: Permethrin 1% leave on for 10 mins then rinse. May repeat in
7 days if needed.
,MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
10. Fungal skin infections: · Candidiasis- bright, beefy red rash treat with topical
antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective,
educate patient.
· Fungal infections survive on keratin, so considered superficial.
· Pathogens: Epidermophyton, trichophyton, microsporum.
· Those at risk are DM and immunocompromised.
· Diagnostics: KOH
11. Tinea corporis
(Ringworm of body): Hx of erythematous round and elevated pruritic lesion that
grows in size & starts to clear in the center
Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1%
12. Tinea capitus (ringworm of head): Children common. Painless bald spot,
may have kerion that looks like honeycomb, inflammation. Boggy mass containing
broken hairs and oozing purulent material from follicular orifices
Systemic antifungals - Griseofulvin BID for 2-4 months or 2 weeks after negative
cultures. Teratogenic - use 2nd method of contraception.
OR terbinafine cream
13. Tinea versicolor (skin, AKA pityriasis versicolor): Round or oval lesions of
hypo or hyperpigmentation macule, located mainly on back chest, arms, some-
times neck/face. Sometimes very fine scales seen. Agent P oribiculare causes
round, pityrosporum ovale causes oval
Clotrimazole 1% cream and solution BID up to 4 weeks
14. Bacterial infections of the skin: · Impetigo
· highly contagious
Cellulitis
· Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin,
· PCN allergy use Erythromycin.
· non purulent assume staph aureus
, MARYVILLE NURS 623 EXAM 1 VERIFIED QUESTIONS AND
ANSWERS A+ GRADED 2023
Purulent cellulitis
· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
15. Impetigo: Honey crusted plaques, usually on face
Bullous: begin as small vesicles that rupture easily with serous fluid turning into
crust
Nonbullous, vesticulopustular: thick, adherent lesions, dirty yellow-colored crust
with erythematous margins
Treatment:
Clean lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin).
With no treatment, it is self-limiting 2-3 wks
16. follilculitis: Staphylococcus. Multiple small papules on erythematous base,
can be large yellow white tender pustules in adults. Common in places hair is
present, widespread is characteristic, bumpy rash, no itching.
Treatment:
Only if becomes infected. Large lesions cleansed with weak soap solution, followed
by soaking with saline or aluminum subacetate BID. TAO can be used BID for 5
days. Oral ABT 1st gen cephalo. if resistant
17. Localized cellulitis: The typical lesion of cellulitis is wide, diffuse area of
erythematous skin that is warm and tender to palpation. Infection is occasionally
accompanied by severe edema. Systemic symptoms such as fever, chills, and
malaise may also be present.
CAUSES- Diabetic patient or other immunocompromised patients. Any break in the
skin. Skin breaks from surgical incisions, skin tears, wounds, trauma, insect bites
or stings, and animal or human bites. PREEXISTING conditions- stasis ulcers,
dermatitides, viral skin infections, superficial bacterial infections, and bolus disease
all have the risk for secondary infections.
Subjective- tender, warm, erythematous areas of skin usually on face, neck, and
extremities. Usually report an insect bite or some form of skin break. If recurrent
cellulitis may deny any trauma or injury.
Objective- Lower leg most common site of infection .If lower extremity cellulites
should look for SS of tinea pedis (Athletes foot) infection can be point of entry for
