NSG 6020 3p Exam Verified Questions And Answers 100% Correct
Question 1
A nurse practitioner is performing a musculoskeletal assessment on an older adult client. The
practitioner notes the presence of hard, bony enlargements on the distal interphalangeal joints of
the fingers. These are known as:
A) Bouchard's nodes
B) Heberden's nodes
C) Tophi
D) Rheumatoid nodules
E) Ganglion cysts
Correct Answer: B) Heberden's nodes
Rationale: Heberden's nodes are bony prominences that form on the most distal joints of
the fingers (distal interphalangeal joints). They are a classic and common finding in
osteoarthritis, a form of degenerative joint disease.
Question 2
A 25-year-old female presents with fatigue, weight gain, and hair loss. Based on a strong
suspicion of hypothyroidism, what skin characteristics would the nurse practitioner expect to
find during the examination?
A) Warm and moist
B) Smooth and soft
C) Dry and rough
D) Oily and diaphoretic
E) Thin and translucent
Correct Answer: C) Dry and rough
Rationale: Hypothyroidism is a state of decreased metabolic activity. This leads to reduced
sweat and sebum production, resulting in skin that is characteristically dry, rough, and cool
to the touch.
Question 3
When evaluating a patient with joint pain, which one of the following symptoms is most
consistent with an inflammatory process, such as rheumatoid arthritis, rather than a
noninflammatory process like osteoarthritis?
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A) Pain that worsens with activity and is relieved by rest.
B) Presence of bony enlargements (nodes).
C) Morning stiffness that resolves in less than 30 minutes.
D) Swelling, warmth, redness, and tenderness of the joint.
E) An absence of systemic symptoms.
Correct Answer: D) Swelling, warmth, redness, and tenderness of the joint.
Rationale: While tenderness can be a symptom, the combination of swelling (tumor),
warmth (calor), redness (rubor), and tenderness (dolor) are the cardinal signs of
inflammation. These are characteristic of inflammatory arthritis and are less common in
noninflammatory joint disease.
Question 4
An older adult presents with several flattened, skin-colored papules covered by a hard, dry scale
on his forehead and arms. The lesions feel rough, like sandpaper. What is the most likely
diagnosis?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Squamous cell carcinoma
E) Solar lentigo
Correct Answer: C) Actinic keratosis
Rationale: Actinic keratosis is a precancerous skin lesion that develops on sun-exposed
areas. It is typically a rough, scaly, and hard papule or plaque. Because it has the potential
to progress to squamous cell carcinoma, it requires treatment or monitoring.
Question 5
A patient complains of diffuse pain that is worse in the neck, shoulders, and low back. The
examination reveals multiple specific tender points on palpation of muscles, but no joint swelling
and normal muscle strength. These findings are most characteristic of:
A) Rheumatoid arthritis
B) Polymyalgia rheumatica
C) Fibromyalgia
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D) Myofascial pain syndrome
E) Osteoarthritis
Correct Answer: C) Fibromyalgia
Rationale: Fibromyalgia is a chronic pain syndrome characterized by widespread
musculoskeletal pain, fatigue, and the presence of multiple "tender points" on physical
examination. It is not an inflammatory or autoimmune disease, so joint swelling is absent.
Question 6
A new patient and several family members are complaining of intense itching that worsens at
night. The examination reveals excoriated papules and burrows in the interdigital web spaces and
axillae. These findings are classic for:
A) Atopic dermatitis (eczema)
B) Psoriasis
C) Scabies
D) Pediculosis (lice)
E) Urticaria (hives)
Correct Answer: C) Scabies
Rationale: Scabies is a contagious skin infestation by the mite Sarcoptes scabiei. The intense
pruritus (especially at night) and the characteristic location of the burrows and papules in
areas like the finger webs, wrists, and axillae are hallmark signs. The fact that multiple
family members are affected also points to a contagious infestation.
Question 7
An older woman is concerned about her risk for osteoporosis. Which factor from her history is a
recognized risk factor for the disease?
A) Menopause at age 53.
B) Obesity.
C) African American ethnicity.
D) Delayed menarche (first period at age 16).
E) A history of multiple pregnancies.
, [Type here]
Correct Answer: D) Delayed menarche (first period at age 16).
Rationale: Osteoporosis risk is related to lifetime estrogen exposure, as estrogen is
protective of bone density. Delayed menarche and early menopause both shorten the total
time of estrogen exposure, thereby increasing the risk for developing osteoporosis.
Question 8
During a routine visit, the nurse practitioner notices several flat, reddish-purple lesions on an
older adult's forearms. They are tender on examination. What is the most appropriate initial
action?
A) Immediately refer the patient to a dermatologist.
B) Reassure the patient that these are normal age spots.
C) Document the finding and plan to re-evaluate at the next visit.
D) Ask the patient how they might have acquired these lesions.
E) Obtain a skin biopsy of one of the lesions.
Correct Answer: D) Ask the patient how they might have acquired these lesions.
Rationale: These lesions are consistent with senile purpura, which are common, benign
bruises that occur in older adults due to the fragility of their dermal capillaries. They often
result from minor trauma. Before making any assumptions or ordering tests, the best first
step is to gather more history from the patient about any recent bumps or injuries.
Question 9
A 58-year-old man presents with bilateral back pain that has been worsening over 2 months and
now awakens him at night. Which of the following findings would be LEAST concerning in this
patient?
A) The pain awakens him from sleep.
B) The pain has been steadily increasing.
C) The pain is bilateral.
D) The patient has a history of cancer.
E) The patient is over 50 years old.
Correct Answer: C) The pain is bilateral.
Rationale: Night pain, progressive pain, age >50, and a history of cancer are all "red flags"
for a serious underlying cause of back pain (like malignancy or infection). Bilateral pain,
Question 1
A nurse practitioner is performing a musculoskeletal assessment on an older adult client. The
practitioner notes the presence of hard, bony enlargements on the distal interphalangeal joints of
the fingers. These are known as:
A) Bouchard's nodes
B) Heberden's nodes
C) Tophi
D) Rheumatoid nodules
E) Ganglion cysts
Correct Answer: B) Heberden's nodes
Rationale: Heberden's nodes are bony prominences that form on the most distal joints of
the fingers (distal interphalangeal joints). They are a classic and common finding in
osteoarthritis, a form of degenerative joint disease.
Question 2
A 25-year-old female presents with fatigue, weight gain, and hair loss. Based on a strong
suspicion of hypothyroidism, what skin characteristics would the nurse practitioner expect to
find during the examination?
A) Warm and moist
B) Smooth and soft
C) Dry and rough
D) Oily and diaphoretic
E) Thin and translucent
Correct Answer: C) Dry and rough
Rationale: Hypothyroidism is a state of decreased metabolic activity. This leads to reduced
sweat and sebum production, resulting in skin that is characteristically dry, rough, and cool
to the touch.
Question 3
When evaluating a patient with joint pain, which one of the following symptoms is most
consistent with an inflammatory process, such as rheumatoid arthritis, rather than a
noninflammatory process like osteoarthritis?
,[Type here]
A) Pain that worsens with activity and is relieved by rest.
B) Presence of bony enlargements (nodes).
C) Morning stiffness that resolves in less than 30 minutes.
D) Swelling, warmth, redness, and tenderness of the joint.
E) An absence of systemic symptoms.
Correct Answer: D) Swelling, warmth, redness, and tenderness of the joint.
Rationale: While tenderness can be a symptom, the combination of swelling (tumor),
warmth (calor), redness (rubor), and tenderness (dolor) are the cardinal signs of
inflammation. These are characteristic of inflammatory arthritis and are less common in
noninflammatory joint disease.
Question 4
An older adult presents with several flattened, skin-colored papules covered by a hard, dry scale
on his forehead and arms. The lesions feel rough, like sandpaper. What is the most likely
diagnosis?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Squamous cell carcinoma
E) Solar lentigo
Correct Answer: C) Actinic keratosis
Rationale: Actinic keratosis is a precancerous skin lesion that develops on sun-exposed
areas. It is typically a rough, scaly, and hard papule or plaque. Because it has the potential
to progress to squamous cell carcinoma, it requires treatment or monitoring.
Question 5
A patient complains of diffuse pain that is worse in the neck, shoulders, and low back. The
examination reveals multiple specific tender points on palpation of muscles, but no joint swelling
and normal muscle strength. These findings are most characteristic of:
A) Rheumatoid arthritis
B) Polymyalgia rheumatica
C) Fibromyalgia
,[Type here]
D) Myofascial pain syndrome
E) Osteoarthritis
Correct Answer: C) Fibromyalgia
Rationale: Fibromyalgia is a chronic pain syndrome characterized by widespread
musculoskeletal pain, fatigue, and the presence of multiple "tender points" on physical
examination. It is not an inflammatory or autoimmune disease, so joint swelling is absent.
Question 6
A new patient and several family members are complaining of intense itching that worsens at
night. The examination reveals excoriated papules and burrows in the interdigital web spaces and
axillae. These findings are classic for:
A) Atopic dermatitis (eczema)
B) Psoriasis
C) Scabies
D) Pediculosis (lice)
E) Urticaria (hives)
Correct Answer: C) Scabies
Rationale: Scabies is a contagious skin infestation by the mite Sarcoptes scabiei. The intense
pruritus (especially at night) and the characteristic location of the burrows and papules in
areas like the finger webs, wrists, and axillae are hallmark signs. The fact that multiple
family members are affected also points to a contagious infestation.
Question 7
An older woman is concerned about her risk for osteoporosis. Which factor from her history is a
recognized risk factor for the disease?
A) Menopause at age 53.
B) Obesity.
C) African American ethnicity.
D) Delayed menarche (first period at age 16).
E) A history of multiple pregnancies.
, [Type here]
Correct Answer: D) Delayed menarche (first period at age 16).
Rationale: Osteoporosis risk is related to lifetime estrogen exposure, as estrogen is
protective of bone density. Delayed menarche and early menopause both shorten the total
time of estrogen exposure, thereby increasing the risk for developing osteoporosis.
Question 8
During a routine visit, the nurse practitioner notices several flat, reddish-purple lesions on an
older adult's forearms. They are tender on examination. What is the most appropriate initial
action?
A) Immediately refer the patient to a dermatologist.
B) Reassure the patient that these are normal age spots.
C) Document the finding and plan to re-evaluate at the next visit.
D) Ask the patient how they might have acquired these lesions.
E) Obtain a skin biopsy of one of the lesions.
Correct Answer: D) Ask the patient how they might have acquired these lesions.
Rationale: These lesions are consistent with senile purpura, which are common, benign
bruises that occur in older adults due to the fragility of their dermal capillaries. They often
result from minor trauma. Before making any assumptions or ordering tests, the best first
step is to gather more history from the patient about any recent bumps or injuries.
Question 9
A 58-year-old man presents with bilateral back pain that has been worsening over 2 months and
now awakens him at night. Which of the following findings would be LEAST concerning in this
patient?
A) The pain awakens him from sleep.
B) The pain has been steadily increasing.
C) The pain is bilateral.
D) The patient has a history of cancer.
E) The patient is over 50 years old.
Correct Answer: C) The pain is bilateral.
Rationale: Night pain, progressive pain, age >50, and a history of cancer are all "red flags"
for a serious underlying cause of back pain (like malignancy or infection). Bilateral pain,
