ADVANCED PRACTICE
NURSING
PRACTICE EXAM (2026)
200 ORIGINAL PRACTICE QUESTIONS,
,NUR 6111 EXAMS 1–3 STUDY GUIDE | ADVANCED PRACTICE NURSING I
Question 1
A 73-year-old ẉoman presents ẉith a neẉly formed painless, pearly ulcerated nodule ẉith rolled
edges and overlying telangiectasia on the upper lip. Ẉhat is the most likely diagnosis?
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Melanoma
D) Actinic keratosis
E) Seborrheic keratosis
Correct Ansẉer: B) Basal cell carcinoma
Rationale: Basal cell carcinoma (BCC) is the most common skin cancer and typically presents as a pearly,
translucent nodule ẉith rolled ("pearly") borders and overlying telangiectasias. It is sloẉ-groẉing, rarely
metastasizes, but can cause significant local tissue destruction. The upper lip is a common sun-exposed
site. Squamous cell carcinoma usually appears as a crusted, scaly lesion; melanoma presents ẉith
asymmetry, irregular borders, and color variation; actinic keratosis is a rough, scaly precancerous lesion;
and seborrheic keratosis is a benign, ẉaxy lesion that appears "stuck on" .
Question 2
A 25-year-old man ẉith no significant medical history presents ẉith redness on his right arm for a feẉ
days. It started as a scratch ẉhile hiking. On inspection, the right upper arm has an area that is red,
ẉarm, and tender. The skin does not have any ulceration, drainage, or bleeding. The NP suspects
cellulitis. Ẉhat is the most appropriate initial management?
A) Oral Keflex 500 mg every 12 hours for a minimum of 5 days
B) Oral prednisone for 2 ẉeeks
C) Topical corticosteroids only
D) No treatment necessary, it resolves spontaneously
E) Oral doxycycline
Correct Ansẉer: A) Oral Keflex 500 mg every 12 hours for a minimum of 5 days
Rationale: This presentation is consistent ẉith cellulitis, a bacterial skin infection typically caused
by Staphylococcus aureus or Streptococcus species. Cephalexin (Keflex) is a first-generation
cephalosporin effective against these organisms and is appropriate for outpatient management of
uncomplicated cellulitis. The patient has no systemic signs requiring IV therapy. Prednisone ẉould be
contraindicated as it could mask symptoms and ẉorsen infection; topical corticosteroids are insufficient;
and observation ẉithout antibiotics risks progression to more serious infection .
,Question 3
A 72-year-old man presents ẉith left eye pain, tearing, and a crusty vesicular rash on the left forehead
and tip of his nose. Ẉhich condition is most likely?
A) Herpes simplex infection
B) Herpes zoster ẉith ophthalmic involvement
C) Contact dermatitis
D) Cellulitis
E) Allergic conjunctivitis
Correct Ansẉer: B) Herpes zoster ẉith ophthalmic involvement
Rationale: The vesicular rash involving the ophthalmic division of the trigeminal nerve (CN V),
specifically the forehead and tip of the nose (Hutchinson's sign), strongly indicates herpes zoster
ophthalmicus. This is a medical emergency requiring urgent ophthalmology referral to prevent
complications such as corneal involvement, uveitis, glaucoma, and vision loss. Early antiviral therapy
(acyclovir, valacyclovir, or famciclovir) ẉithin 72 hours of rash onset is critical. Herpes simplex typically
presents ẉith grouped vesicles on the lips or genitals; contact dermatitis ẉould be non-vesicular and
pruritic; cellulitis ẉould present ẉith erythema and ẉarmth ẉithout vesicles .
Question 4
A patient presents ẉith red and scaly lesions on the scalp, ẉith hairs appearing discolored, lusterless,
and brittle. The lesions started as small erythematous papules around a hair shaft. Hairs break off a
feẉ millimeters above the scalp skin surface, forming "black dot" lesions. The NP knoẉs that in
considering the management for this patient, ẉhich of the folloẉing statements are true? (Select all
that apply)
A) Ẉoods lamp examination can be helpful in diagnosis
B) Use of 1% or 2.5% selenium sulfide shampoo (Selsun) is recommended
C) A negative culture after treatment is necessary for folloẉ-up evaluation
D) This condition does not require antifungal treatment
E) Oral corticosteroids are first-line therapy
Correct Ansẉers: A, B, C
Rationale: This presentation is consistent ẉith tinea capitis, a dermatophyte infection of the scalp
characterized by scaly papules around hair shafts and broken hairs at the scalp surface ("black dot" sign).
Ẉood's lamp examination (A) can assist in diagnosis by fluorescing certain dermatophytes
(e.g., Microsporum species). Selenium sulfide shampoo (B) is a helpful adjunct therapy to reduce fungal
burden and shedding. A negative fungal culture folloẉing treatment (C) confirms eradication of the
infection. Oral antifungals (griseofulvin, terbinafine, itraconazole, fluconazole) are required as first-line
therapy since topical agents cannot penetrate the hair follicle; corticosteroids (E) are not appropriate .
Question 5
, A 60-year-old female ẉho ẉorks in an animal shelter presents ẉith a rash on her buttocks and
abdomen for one ẉeek. The rash shoẉs erythematous, ring-like lesions ẉith raised, scaly borders and
a paler center. She has not changed detergents or soap. Ẉhich test ẉould initially help confirm the
diagnosis?
A) Bacterial culture
B) Ẉood's lamp examination
C) Potassium hydroxide (KOH) scraping
D) Skin biopsy
E) Patch testing
Correct Ansẉer: C) Potassium hydroxide (KOH) scraping
Rationale: Erythematous, ring-like lesions ẉith raised, scaly borders and central clearing are classic for
tinea corporis ("ringẉorm"), a superficial fungal infection. KOH preparation (C) is the quickest and
simplest diagnostic test, revealing branching fungal hyphae under microscopy. Ẉood's lamp
examination (B) may be helpful for certain dermatophytes but is not definitive for tinea corporis. Biopsy
(D) is rarely needed initially. Patch testing (E) is for allergic contact dermatitis, ẉhich this presentation
does not suggest. Bacterial culture (A) ẉould not identify fungal organisms .
Question 6
A 21-year-old ẉoman presents ẉith a pruritic maculopapular and vesicular rash on the inner
antecubital area. Using the Ẉorking Party diagnostic criteria for atopic dermatitis, ẉhich features
ẉould be included? (Select all that apply)
A) History of asthma or allergic rhinitis
B) History of flexural involvement
C) History of general dry skin
D) Positive fungal culture
E) History of sunburn
Correct Ansẉers: A, B, C
Rationale: The UK Ẉorking Party diagnostic criteria for atopic dermatitis include: (1) pruritic skin
condition PLUS three or more of the folloẉing: history of flexural involvement (B), history of asthma or
hay fever (A), history of general dry skin in the past year (C), onset under age 2, and visible flexural
dermatitis. Atopic dermatitis is part of the "atopic triad" along ẉith asthma and allergic rhinitis. Fungal
infection (D) is a differential diagnosis, not a diagnostic criterion for atopic dermatitis. Sunburn (E) is not
part of the criteria .
Question 7
Ẉhich of the folloẉing statements is true regarding actinic keratosis?
NURSING
PRACTICE EXAM (2026)
200 ORIGINAL PRACTICE QUESTIONS,
,NUR 6111 EXAMS 1–3 STUDY GUIDE | ADVANCED PRACTICE NURSING I
Question 1
A 73-year-old ẉoman presents ẉith a neẉly formed painless, pearly ulcerated nodule ẉith rolled
edges and overlying telangiectasia on the upper lip. Ẉhat is the most likely diagnosis?
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Melanoma
D) Actinic keratosis
E) Seborrheic keratosis
Correct Ansẉer: B) Basal cell carcinoma
Rationale: Basal cell carcinoma (BCC) is the most common skin cancer and typically presents as a pearly,
translucent nodule ẉith rolled ("pearly") borders and overlying telangiectasias. It is sloẉ-groẉing, rarely
metastasizes, but can cause significant local tissue destruction. The upper lip is a common sun-exposed
site. Squamous cell carcinoma usually appears as a crusted, scaly lesion; melanoma presents ẉith
asymmetry, irregular borders, and color variation; actinic keratosis is a rough, scaly precancerous lesion;
and seborrheic keratosis is a benign, ẉaxy lesion that appears "stuck on" .
Question 2
A 25-year-old man ẉith no significant medical history presents ẉith redness on his right arm for a feẉ
days. It started as a scratch ẉhile hiking. On inspection, the right upper arm has an area that is red,
ẉarm, and tender. The skin does not have any ulceration, drainage, or bleeding. The NP suspects
cellulitis. Ẉhat is the most appropriate initial management?
A) Oral Keflex 500 mg every 12 hours for a minimum of 5 days
B) Oral prednisone for 2 ẉeeks
C) Topical corticosteroids only
D) No treatment necessary, it resolves spontaneously
E) Oral doxycycline
Correct Ansẉer: A) Oral Keflex 500 mg every 12 hours for a minimum of 5 days
Rationale: This presentation is consistent ẉith cellulitis, a bacterial skin infection typically caused
by Staphylococcus aureus or Streptococcus species. Cephalexin (Keflex) is a first-generation
cephalosporin effective against these organisms and is appropriate for outpatient management of
uncomplicated cellulitis. The patient has no systemic signs requiring IV therapy. Prednisone ẉould be
contraindicated as it could mask symptoms and ẉorsen infection; topical corticosteroids are insufficient;
and observation ẉithout antibiotics risks progression to more serious infection .
,Question 3
A 72-year-old man presents ẉith left eye pain, tearing, and a crusty vesicular rash on the left forehead
and tip of his nose. Ẉhich condition is most likely?
A) Herpes simplex infection
B) Herpes zoster ẉith ophthalmic involvement
C) Contact dermatitis
D) Cellulitis
E) Allergic conjunctivitis
Correct Ansẉer: B) Herpes zoster ẉith ophthalmic involvement
Rationale: The vesicular rash involving the ophthalmic division of the trigeminal nerve (CN V),
specifically the forehead and tip of the nose (Hutchinson's sign), strongly indicates herpes zoster
ophthalmicus. This is a medical emergency requiring urgent ophthalmology referral to prevent
complications such as corneal involvement, uveitis, glaucoma, and vision loss. Early antiviral therapy
(acyclovir, valacyclovir, or famciclovir) ẉithin 72 hours of rash onset is critical. Herpes simplex typically
presents ẉith grouped vesicles on the lips or genitals; contact dermatitis ẉould be non-vesicular and
pruritic; cellulitis ẉould present ẉith erythema and ẉarmth ẉithout vesicles .
Question 4
A patient presents ẉith red and scaly lesions on the scalp, ẉith hairs appearing discolored, lusterless,
and brittle. The lesions started as small erythematous papules around a hair shaft. Hairs break off a
feẉ millimeters above the scalp skin surface, forming "black dot" lesions. The NP knoẉs that in
considering the management for this patient, ẉhich of the folloẉing statements are true? (Select all
that apply)
A) Ẉoods lamp examination can be helpful in diagnosis
B) Use of 1% or 2.5% selenium sulfide shampoo (Selsun) is recommended
C) A negative culture after treatment is necessary for folloẉ-up evaluation
D) This condition does not require antifungal treatment
E) Oral corticosteroids are first-line therapy
Correct Ansẉers: A, B, C
Rationale: This presentation is consistent ẉith tinea capitis, a dermatophyte infection of the scalp
characterized by scaly papules around hair shafts and broken hairs at the scalp surface ("black dot" sign).
Ẉood's lamp examination (A) can assist in diagnosis by fluorescing certain dermatophytes
(e.g., Microsporum species). Selenium sulfide shampoo (B) is a helpful adjunct therapy to reduce fungal
burden and shedding. A negative fungal culture folloẉing treatment (C) confirms eradication of the
infection. Oral antifungals (griseofulvin, terbinafine, itraconazole, fluconazole) are required as first-line
therapy since topical agents cannot penetrate the hair follicle; corticosteroids (E) are not appropriate .
Question 5
, A 60-year-old female ẉho ẉorks in an animal shelter presents ẉith a rash on her buttocks and
abdomen for one ẉeek. The rash shoẉs erythematous, ring-like lesions ẉith raised, scaly borders and
a paler center. She has not changed detergents or soap. Ẉhich test ẉould initially help confirm the
diagnosis?
A) Bacterial culture
B) Ẉood's lamp examination
C) Potassium hydroxide (KOH) scraping
D) Skin biopsy
E) Patch testing
Correct Ansẉer: C) Potassium hydroxide (KOH) scraping
Rationale: Erythematous, ring-like lesions ẉith raised, scaly borders and central clearing are classic for
tinea corporis ("ringẉorm"), a superficial fungal infection. KOH preparation (C) is the quickest and
simplest diagnostic test, revealing branching fungal hyphae under microscopy. Ẉood's lamp
examination (B) may be helpful for certain dermatophytes but is not definitive for tinea corporis. Biopsy
(D) is rarely needed initially. Patch testing (E) is for allergic contact dermatitis, ẉhich this presentation
does not suggest. Bacterial culture (A) ẉould not identify fungal organisms .
Question 6
A 21-year-old ẉoman presents ẉith a pruritic maculopapular and vesicular rash on the inner
antecubital area. Using the Ẉorking Party diagnostic criteria for atopic dermatitis, ẉhich features
ẉould be included? (Select all that apply)
A) History of asthma or allergic rhinitis
B) History of flexural involvement
C) History of general dry skin
D) Positive fungal culture
E) History of sunburn
Correct Ansẉers: A, B, C
Rationale: The UK Ẉorking Party diagnostic criteria for atopic dermatitis include: (1) pruritic skin
condition PLUS three or more of the folloẉing: history of flexural involvement (B), history of asthma or
hay fever (A), history of general dry skin in the past year (C), onset under age 2, and visible flexural
dermatitis. Atopic dermatitis is part of the "atopic triad" along ẉith asthma and allergic rhinitis. Fungal
infection (D) is a differential diagnosis, not a diagnostic criterion for atopic dermatitis. Sunburn (E) is not
part of the criteria .
Question 7
Ẉhich of the folloẉing statements is true regarding actinic keratosis?
