NR602 / NR-602 Midterm Exam (2023 / 2024): Primary Care of the Childbearing & Childrearing Family Practicum – Chamberlain.

NR602 / NR-602 Midterm Exam (Latest 2023 / 2024): Primary Care of the Childbearing & Childrearing Family Practicum – Chamberlain. 1. J.D. is a postterm infant with lesions of varying morphology including wheals, vesicles, and pustules on her trunk. You suspect J.D. has: a. Cutis marmorata b. Erythema toxicum neonatorum c. Milia d. Contact dermatitis 2. In order to confirm your diagnosis of J.D., you order a Wright's stained smear. If your diagnosis is correct, what are the expected results of the smear? a. Presence of eosinophils b. Presence of neutrophils c. Presence of keratinous material d. Presence of staphylococcus bacteria 3. In addition to monitoring the skin for any changes, what is the best management for J.D.? a. Topical antibiotics on lesions b. Topical steroids on lesions c. A moisturizer on lesions d. No treatment necessary since J.D.'s condition will resolve spontaneously in 5 to 7 days 4. You examine C.C., a newborn, and observe numerous white papular lesions on the cheeks, forehead, and nose. You suspect either milia or neonatal acne. Which physical finding helps to confirm a diagnosis of milia? a. Papular lesions are intermixed with pale yellow macules b. Papular lesions have an erythematous circular ring at the base c. Papular lesions are surrounded by lacy-blue area witherythematous mottling d. Papular lesions, yellow in color, are observed on the hard palate 5. Newborn K.T. is three-weeks premature and you observe a macular erythematous lacy appearance to her skin when you undress her. K.T. has which condition? a. Cutis marmorata b. Erythema toxicum neonatorum c. Salmon patch d. Nevus flammeus 6. In addition to monitoring the skin for any changes, what is the best management for K.T.? a. Keep K.T. warm b. Decrease the environmental temperature c. Use a moisturizer on affected skin areas d. Do nothing, as condition will resolve spontaneously in 5 to 7 days without intervention 7. Newborn W.R. has a vascular lesion that will not fade as she gets older. What is your diagnosis? a. Salmon patch b. Capillary hemangioma c. Café au lait d. Port-wine stain (nevus flammeus) 8. W.R.'s parents are concerned about her appearance and the psychological effect on their daughter as she becomes aware of her condition. In educating the parents, you tell them about several options. Which of the following is not an appropriate management or treatment consideration for W.R.? a. Application of topical steroids to the affected area to prevent pruritus b. Camouflage affected areas with cosmetics c. Pulsed laser treatment of affected area d. Counseling for psychological concerns9. Which condition is thought to be more apparent in darkerskinned individuals or during the summer months? a. Tinea corporis b. Psoriasis c. Pityriasis alba d. Pityriasis rosea 10. J.R., an eight-year-old boy, has scaly, hyperpigmented lesions in a "fir tree" distribution, predominately on his trunk. One lesion on the buttocks is larger than all the other lesions and measures 4 cm in diameter. What is your likely diagnosis? a. Psoriasis b. Eczema c. Pityriasis alba d. Pityriasis rosea 11. What symptom is commonly experienced in J.R.'s condition? a. Pruritus b. Pain at site of lesions c. Nausea d. Headache 12. What management would you not recommend for J.R. with his condition? a. Cool bath or cool compresses to lesions b. Topical steroids to lesions c. Oral antibiotics d. Monitored and controlled daily sunlight exposure 13. You have diagnosed D.L. with acute atopic dermatitis. Which of the following is not correct regarding the incidence of this condition? a. D.L. is most likely an infant b. D.L. has a greater chance of developing asthma later in childhood than the average individual c. D.L. has a greater chance of developing malignantmelanoma in adulthood than the average individual d. D.L. has a condition associated with familial predisposition 14. Which of the following management measures or treatments would you not recommend for D.L.? a. Topical steroids to affected areas b. Wet compresses to affected skin areas c. Maintain a dry, warm environment d. Eliminate all substances that dry the skin 15. In addition to having atopic dermatitis, you have diagnosed D.L. with a secondary bacterial infection at the site of several lesions. What is the best management for the infection? a. Topical antibiotics to affected areas b. Oral antibiotics c. Hot compresses to affected areas d. Monitored and controlled daily sun exposure until lesions resolve 16. You see B.D. for the first time at age six weeks. B.D. has a bright red, raised, rubbery lesion of irregular shape and 2 cm in diameter on the occiput. What condition do you suspect B.D. has? a. Malignant melanoma b. Port-wine stain c. Capillary hemangioma d. Burn 17. Which of the following is not characteristic of the lesion B.D. has? a. It was not present at birth, however, B.D.'s mother noticed site was blanched b. It will continue to grow for the first 9 to 12 months of B.D.'s life c. It will begin to gradually resolve when B.D. is between 12 to 15 months d. It is expected to completely resolve by the time B.D. is ten years old18. You notice 10 macular tan lesions of varying sizes on D.D. and refer him for a medical evaluation to rule out neurofibromatosis or Albright's syndrome. What kind of lesion does D.D. have? a. Malignant melanoma b. Café au lait spots c. Mongolian spots d. Vitiligo 19. What is characteristic of the lesion that D.D. has? a. More common in Caucasians than dark-skinned individuals b. More common in males than females c. Lesions can be present at birth, however, more lesions may develop at any age d. Lesions usually fade spontaneously and completely resolve in adult life 20. You suspect that A.F., age nine years, has either pityriasis alba or vitiligo. Which of the following would not confirm the diagnosis of pityriasis alba? a. A.F.'s skin would be normally pigmented except for areas of depigmentation b. A.F.'s skin would have one or more scaly areas of hypopigmentation c. A.F. complains of mild itching in areas of hypopigmentation d. A.F.'s lesions became more pronounced when she was exposed to sunlight 21. A.F. was diagnosed with pityriasis alba. Which of the following is proper management of A.F.'s condition? a. Bland moisturizers to reduce over drying b. Topical steroids to the affected areas c. Expose affected areas to short periods of sunlight each day d. Burow's wet compresses to affected areas 22. Patient education is a major part of the PNP's role. What would you teach A.F. and her parent regarding the progress and prognosis of pityriasis alba?a. A.F. will continue to develop lesions for the rest of her life b. A.F.'s condition should fade appreciably in three to four months c. A.F.'s condition is permanent and affected areas will not repigment d. A.F.'s condition will resolve completely, however, the affected areas can become slightly reddened when exposed to sunlight 23. Malignant melanoma is a form of much dreaded skin cancer. Which of the following is not characteristic of this condition? a. Occurs in all ethnic groups but more commonly in lightskinned individuals b. Severe sunburn or excessive exposure to sunlight before the age of ten years predisposes developing melanoma later in childhood or in adult life c. Spreads through the lymphatic system and invades other distant skin surfaces and organs d. Spreads primarily by invading skin surfaces that surround the major lesion 24. Which of the following does not characterize the lesion of malignant melanoma? a. Irregular asymmetrical nodule with blurred borders b. Raised with distinct symmetrical borders c. Uneven coloring in which blue, black, brown, tan, and red may all be present in the same lesion d. Bleeding, ulceration in later stages 25. Patient education regarding prevention of malignant melanoma is essential. Which of the following is not considered best prevention education? a. Avoid sunlight, especially during the hours of 9:00 a.m. and 1:00 p.m. b. Avoid sun tanning lamps c. Use cover-up clothing, hats, and sunglassesd. Use sun blocks that protect against ultraviolet exposure with 30 SPF 26. You suspect M.N. as having chronic psoriasis. Which of the following is characteristic of her lesions if she has psoriasis vulgaris? a. Scaly erythematous patches and plaques 3 to 10 mm in diameter b. Round or oval in shape c. Large scaly silver-white plaque 5 to 10 cm in diameter d. Located mainly on her trunk 27. M.N.'s condition of psoriasis is common in approximately 33% of children. Which of the following is not correct regarding the etiology or incidence of this condition? a. Occurs more commonly in dark-skinned ethnic individuals b. Associated with constant rubbing or trauma to exposed affected areas such as elbows c. Associated with overproduction of epithelial cells d. Associated with epithelial cells that migrate to the skin surface much more quickly than normal 28. What would you not advise regarding the management or treatment of M.N.'s condition? a. Excise lesions b. Apply topical steroids c. Apply mineral oil and moisturizers d. Expose to monitored short periods of sunlight 29. You have diagnosed Jale as having contact dermatitis. Which symptom is most characteristic of his condition? a. Headache b. Difficulty breathing c. Pruritus at site of affected areas d. Pain at site of affected areas30. Which of the following is not characteristic of Jale's condition? a. He has hypersensitivity to a substance within his environment when direct contact is made b. He may experience a delayed reaction of several days with reexposure to an allergen c. His dermatitis may be caused by direct contact with topical medications, soaps, cosmetics, fabrics, and plants d. Typical response is redness and edema at the site of contact which may progress to papules and vesicles 31. What would you not recommend as management and treatment of Jale's condition? a. Skin testing during the acute episode to determine if Jale has an allergy b. Cool compresses of Burow's solution to affected areas c. Topical steroids to affected areas for five days d. Oral antihistamines 32. You diagnose Kelli, age seven months, with diaper dermatitis. Which of the following should not be included in the differential diagnosis? a. Atopic dermatitis b. Child abuse c. Contact dermatitis d. Pityriasis alba 33. What management measure would you not prescribe to treat Kelli's condition? a. Oral antihistamines b. Lubricants such as petroleum jelly to mildly affected areas c. Low potency topical steroids to severely affected areas with erythema and papules d. Topical antibiotics to severely affected areas with ulcerations34. What would not be an appropriate recommendation to prevent Kelli from having subsequent episodes of diaper dermatitis? a. Expose diaper area to air several times each day b. Increase oral fluids using orange juice to dilute urine c. Make diaper changes immediately after soiling d. Use a double rinse of vinegar and water for home-laundered diapers 35. Seborrhea dermatitis is common in both infants and adolescents. Which of the following is not correct of this condition? a. Can cause irritating pigment changes to include hyperpigmentation and hypopigmentation b. Is associated with an overproduction of sebum in areas abundant with sebaceous glands c. The condition in infants is known as "cradle cap" in which lesions have erythematous base with yellow crusted areas and greasy scales d. The condition in adolescents is known as acne with comedomes, papular and pustular lesions 36. What is the best treatment of seborrhea in the infant? a. Mineral oil to loosen crusts prior to washing affected areas with a nonperfumed baby shampoo b. Topical antibiotics c. Oral antibiotics in severe cases d. Oral steroids for severe cases 37. You are evaluating F.P., age three years, who acutely sustained a burn when she pulled a pan of boiling water onto herself within the past hour. Since burns are classified according to the depth of injury to the skin layers and the amount of area involved, how would you rate the burn if 5% of her body surfaceis burned involving the epidermis and upper part of the dermis? a. She has a minor first and second degree burn b. She has a major second degree burn c. She has a major full thickness burn d. She has major first and second degree burns 38. F.P.'s burn should appear: a. Dry, with mild edema and erythema b. Dry whitish areas that blanch with pressure c. Dry whitish to brownish areas with edema d. Moist with edema, erythema, and a few vesicles 39. What is the best treatment for F.P.'s burn? a. Warm compresses to affected areas and mild analgesic for discomfort b. Topical emollients to affected areas c. Topical steroids to affected areas d. Refer for urgent treatment in an ED 40. Jerry has been diagnosed as having folliculitis, an inflammatory condition involving the pilosebaceous follicle. What is the most common cause of this condition? a. Microsporum canis tinea b. Pox virus c. Staphylococcus aureus d. Streptococcus group A 41. Jerry has a condition that most commonly occurs on which body surface? a. Neck and scalp b. Upper arms c. Chest and abdomen d. Legs42. You order a culture and the results confirm that Jerry's condition is caused by the most common organism for this condition. What treatment do you prescribe? a. Oral penicillin b. Dicloxacillin c. Tinactin d. Tretinoin 43. Sandra, age twelve years, has several vesicles and honeycolored crusted lesions on her face above the right nares. She has a history of having had a scratch in the same area several days ago. What condition do you suspect? a. Acne b. Impetigo c. Herpes simplex d. Eczema 44. Judy, age fifteen years, has been diagnosed as having acne. Which of the following is not true of this condition? a. Poor hygiene is the primary cause of acne b. Associated with increased androgenic hormonal activity c. Females can have a "cyclic" component to their acne d. Severe acne having a later onset in puberty is more common among males 45. Judy has a history of remission and exacerbation of acne that has followed the pattern of menses for two years. However, the condition over the last six months has worsened to a moderate degree of severity and has been chronic and persistent. You prescribe antibiotic therapy. Which of the following antibiotics would you not consider? a. Topical clindamycin b. Oral erythromycinc. Oral minocycline d. Oral tetracycline 46. K.C., age thirteen years, has several firm, small (2 mm), white or skin-colored umbilicated papules on her neck. The lesions have been present for three months and have increased in number. What is your diagnosis? a. Acne b. Molluscum contagiosum c. Warts d. Cellulitis 47. What is the cause of K.C.'s condition? a. Microsporum canis tinea b. Pox virus c. Staphylococcus aureus d. Streptococcus group A 48. Which treatment would you not recommend for K.C.'s condition? a. Curettage lesions b. Oral antibiotics c. Observation d. Topical Imiquimod 49. Paul has four superficial lesions on his anterior lower abdomen of one week duration. The lesions are 4 cm in diameter, scaly, irregular shaped plaques with skin-colored centers and erythematous borders. The affected areas are slightly pruritic. What condition do you suspect Paul has? a. Psoriasis b. Eczema c. Tinea corporis d. Pityriasis rosea50. You performed two tests to confirm your diagnosis of Paul's condition. The KOH scraping was positive for the presence of hyphae. The Wood's lamp did not fluoresce the lesions. You are sure that Paul's condition was not caused by which organism? a. Epidermophyton floccosum b. Microsporum canis c. Trichophyton tonsurans d. Trichophyton rubrum 51. You see Paul after eight weeks of treatment with a topical antifungal preparation. The original lesions have almost resolved, however, the condition has worsened with the development of several other larger lesions on the abdomen and groin area. Which of the following would you not consider? a. Oral antifungal medication, griseofulvin b. Topical antibiotic preparation c. Continue with the topical antifungal applications d. Educate again regarding not sharing personal items 52. Dale, age 7 years, is complaining of pain and burning on his right leg where you observe two small red puncture marks surrounded by a blanched area with an erythematous border. He had been playing with his dog all morning outside in a grassy wooded area near his home and was wearing shorts. You suspect he has been bitten by which insect? a. Mosquito b. Bee c. Recluse spider d. Black widow spider 53. Which of the following is not true of insect stings from bees, wasps, and fire ants? a. Greater reaction of hypersensitivity occurs most often with the initial exposure than with subsequent exposuresb. For mild reactions, cool compresses to the site of injury is the usual management c. Occurs more often during the spring and summer months d. Most stings occur in self-defense when the nonaggressive insect feels threatened or irritated 54. You diagnose W.A. with scabies. Which of the following is not characteristic of this condition? a. He has several erythematous papular, pustular, and crusted lesions on his face b. He has several excoriated scratched areas around the umbilicus and waist area c. He has several linear curved lines approximately 4 mm in length with a papule at the proximal end linear line d. He complains of severe pruritus which is worse at night 55. Which of the following is not recommended as a management and treatment strategy for W.A.? a. Put nonwashable items in a plastic bag and store for one week b. Prescribe topical antifungal applications c. Prescribe topical antiparasitics d. Prescribe topical steroids and/or oral antihistamines for pruritus 56. Pediculosis is a highly communicable, common condition in children. Which of the following is not correct of pediculosis humanus? a. Caused by an insect that does not fly or jump b. Gravid females lay ova in seams of clothing c. Likes hairy areas of the body better than the non-hairy body surfaces d. Same medication used for scabies may be used to effectively eradicate this condition57. Hypersensitivity may occur to a variety of substances causing a variety of reactions. It is important to determine if the body's hypersensitivity reaction will cause erythema multiforme condition. Which of the following is not typical of the erythema multiforme reaction? a. Target "bulls-eye" lesion with a necrotic center surrounded by a pale macular middle area and then by an erythematous peripheral ring b. Itching at site of affected skin areas c. Pain at site of affected areas, especially in the oral cavity d. Lesions which all have the same morphology on the trunk 58. You see D.Y. in your clinic and suspect she has a form of erythema multiforme. Erythema multiforme minor must be differentiated from erythema multiforme major. Which of the following is the most important confirming evidence for making a diagnosis of erythema multiforme major? a. Presence of deeper lesions within the dermis b. Presence of lesions on the exposed areas of the body c. Presence of pustules indicating a secondary infectious process d. Occurrence of prodromal systemic symptoms of fever, malaise, sore throat, headache, nausea, and/or vomiting 59. You suspect D.Y. has erythema multiforme major. What treatment or management is most indicated? a. Prescribe topical antibiotics due to secondary infection b. Prescribe topical steroids to lesions for pruritus c. Refer for medical evaluation d. No treatment is indicated as condition will resolve spontaneously in one week 60. Urticaria is a hypersensitivity allergic reaction to a variety of substances and agents. You suspect W.P. has urticaria due to the typical morphology of lesions on her trunk and arms which are:a. Erythematous papules b. Vesicles c. Pustules d. Wheals 61. During W.P.'s acute episode of urticaria which of the following is not considered an appropriate management or treatment measure? a. Oral antibiotics to prevent secondary infection b. Oral antihistamines for pruritus c. Topical steroids to affected areas to reduce the immune response d. Cool compresses to affected areas