NURS 651 EXAM 1 MARYVILLE UNIVERSITY LATEST
ACTUAL EXAM 75 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |ALREADY GRADED A+
12 month old male
Past 3 months increased erythema and pruritus
scratches all night, sheets bloody in the am
family history of allergic rhinitis and asthma - ANSWER: Acute atopic dermatitis
treatment for acute atopic dermatitis - ANSWER: Daily lukewarm bath 5-20min, mild
or no soap.
pat dry after bath, add emollient, ie. aquaphor
Repeat emollient with each diaper change
Topical steroids first line, least potent first
calcineurini inhibitors to face (tacrolimus, and pimecrolimus)
Consider bleach baths and wet wraps
14 year old female, healthy
Itchy rash on stomach and feet
dryness, erythema, irritated
Tried to treat with topical steroids at home, moisturizer and lots of bath and body
works creams - ANSWER: Contact dermatitis
Treatment for contact dermatitis - ANSWER: Remove offending agent ( nickel allergy
to jeans buttons, rubber from latex flip flops)
Clean area, treat with emoillents
Topical steroids
will not recur if agent is avoided
can occur from poison ivy, latex, fragrances
11 year old female healthy
developed rash over last week
intense pruritic circular raised papular rash - ANSWER: Insect bites due to bed bugs
Information about bed bugs - ANSWER: Visible to naked eye, small
Wingless
Yellow to reddish oval shaped, prominent eyes
Mostly night feeders, attracted to warm blooded animals and humans
Life cycle: egg 4-5 days, nymph state 5 stages, adult 1 year,
Can survive 1 year without feeding
Hide in luggage, mattresses, box springs, clothing
Signs and symptoms of bed bug insect bites - ANSWER: Erythemous papule with or
wheal 2-5mm with punctuate center
Most common reaction small inflamed
Itchy bump where each bite occurred ( resolves in 1-2 weeks if not exposed further)
, can become widespread bullies rash
Other factors of when to consider bed bug diagnosis - ANSWER: recent travel,
pruritic papule noted on awakening, skin reaction with linear configuration
Treatment of bed bugs - ANSWER: professional pest management
all mattresses should be checked for dark stains usually around the head of bed, use
scraper to remove.
bag all stuffed animals for 3 days at freeze at 18 degrees or below. Or high heat at
122 degrees
Prevention of Bed bugs - ANSWER: Check all hotel mattresses on arrival for small
dark stains around head of bed.
Keep luggage up and away from bed.
Clothes worn in hotel room should be bagged and sealed.
Use caution with garage sale items.
5 year old boy known food allergy to milk, egg and peanut. At birthday party came to
mom, itchy, coughing and sneezing. Child given Benadryl and brought to your office,
Diffuse generalized hives, papular and erythema areas. - ANSWER: Uritcaria and
angioedema in setting of anaphylaxis
Treatment for Urticaria and angioedema in setting of anaphylaxis - ANSWER:
Administer EPI and activate EMS
Give Albuterol only after EPI given
Monitor VS and airway compromise
EPI can be repeated for persistent s/s or return of S/s
12 yr old female with persistent rash on upper arms, cheeks and upper thighs gets
worse with age and cold weather. Fine pearly papular rash, with some excoriated
lesions, no bleeding or drainage. Skin feels rough, History of allergic rhinitis. -
ANSWER: Keratosis Pilaris
Signs and symptoms of Keratosis Pilaris - ANSWER: Appears like skin of plucked
chicken or goosebumps
Genetic disorder of keratinization of hair follicles
Very common, benign condition
Described as a condition of childhood and teens
Usually improves with age
Can flare in adolescence
Treatment of keratosis pilaris - ANSWER: Prevent skin dryness, mild soaps
Avoid hot baths or showers
Mild=treat with OTC moisturizers
Moderate= treat with topical keratolytics
Preparations with salicylic acid, or lactic acid will help soften and flatten papule.
ACTUAL EXAM 75 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |ALREADY GRADED A+
12 month old male
Past 3 months increased erythema and pruritus
scratches all night, sheets bloody in the am
family history of allergic rhinitis and asthma - ANSWER: Acute atopic dermatitis
treatment for acute atopic dermatitis - ANSWER: Daily lukewarm bath 5-20min, mild
or no soap.
pat dry after bath, add emollient, ie. aquaphor
Repeat emollient with each diaper change
Topical steroids first line, least potent first
calcineurini inhibitors to face (tacrolimus, and pimecrolimus)
Consider bleach baths and wet wraps
14 year old female, healthy
Itchy rash on stomach and feet
dryness, erythema, irritated
Tried to treat with topical steroids at home, moisturizer and lots of bath and body
works creams - ANSWER: Contact dermatitis
Treatment for contact dermatitis - ANSWER: Remove offending agent ( nickel allergy
to jeans buttons, rubber from latex flip flops)
Clean area, treat with emoillents
Topical steroids
will not recur if agent is avoided
can occur from poison ivy, latex, fragrances
11 year old female healthy
developed rash over last week
intense pruritic circular raised papular rash - ANSWER: Insect bites due to bed bugs
Information about bed bugs - ANSWER: Visible to naked eye, small
Wingless
Yellow to reddish oval shaped, prominent eyes
Mostly night feeders, attracted to warm blooded animals and humans
Life cycle: egg 4-5 days, nymph state 5 stages, adult 1 year,
Can survive 1 year without feeding
Hide in luggage, mattresses, box springs, clothing
Signs and symptoms of bed bug insect bites - ANSWER: Erythemous papule with or
wheal 2-5mm with punctuate center
Most common reaction small inflamed
Itchy bump where each bite occurred ( resolves in 1-2 weeks if not exposed further)
, can become widespread bullies rash
Other factors of when to consider bed bug diagnosis - ANSWER: recent travel,
pruritic papule noted on awakening, skin reaction with linear configuration
Treatment of bed bugs - ANSWER: professional pest management
all mattresses should be checked for dark stains usually around the head of bed, use
scraper to remove.
bag all stuffed animals for 3 days at freeze at 18 degrees or below. Or high heat at
122 degrees
Prevention of Bed bugs - ANSWER: Check all hotel mattresses on arrival for small
dark stains around head of bed.
Keep luggage up and away from bed.
Clothes worn in hotel room should be bagged and sealed.
Use caution with garage sale items.
5 year old boy known food allergy to milk, egg and peanut. At birthday party came to
mom, itchy, coughing and sneezing. Child given Benadryl and brought to your office,
Diffuse generalized hives, papular and erythema areas. - ANSWER: Uritcaria and
angioedema in setting of anaphylaxis
Treatment for Urticaria and angioedema in setting of anaphylaxis - ANSWER:
Administer EPI and activate EMS
Give Albuterol only after EPI given
Monitor VS and airway compromise
EPI can be repeated for persistent s/s or return of S/s
12 yr old female with persistent rash on upper arms, cheeks and upper thighs gets
worse with age and cold weather. Fine pearly papular rash, with some excoriated
lesions, no bleeding or drainage. Skin feels rough, History of allergic rhinitis. -
ANSWER: Keratosis Pilaris
Signs and symptoms of Keratosis Pilaris - ANSWER: Appears like skin of plucked
chicken or goosebumps
Genetic disorder of keratinization of hair follicles
Very common, benign condition
Described as a condition of childhood and teens
Usually improves with age
Can flare in adolescence
Treatment of keratosis pilaris - ANSWER: Prevent skin dryness, mild soaps
Avoid hot baths or showers
Mild=treat with OTC moisturizers
Moderate= treat with topical keratolytics
Preparations with salicylic acid, or lactic acid will help soften and flatten papule.
