AGNP Dermatological question
A high school athlete who is on the wrestling team complains of multiple bumps on his
lower left arm. The patient denies pruritus, pain, or discomfort from the lesions. During
the skin exam, the nurse practitioner notices multiple smooth domed papules that are 2
to 5 mm in diameter with central umbilication. Which diagnosis is most likely?
A.Molluscum contagiosum
B.Acne vulgaris
C.Verruca vulgaris
D.Basal cell carcinoma - answerA. Molluscum contagiosum is caused by the poxvirus. It
is highly contagious and spreads by autoinoculation, skin-to-skin contact, sexual
contact, and sharing towels. It is a self-limited infection in immunocompetent patients. It
resolves in 6 to 12 months. Advise healthy patients that it is a self-limited infection. Acne
does not appear on the lower left arm. Verruca vulgaris is the common wart; in this
case, the appearance is not wartlike. It also does not look like basal cell cancer (pearly
edges, telangiectasia, papule, or central ulceration).
An adult Black male presents with blood under the nail of the great toe that involves
approximately 50% of the nail area. He reports dropping a hammer accidentally on his
toe about 5 hours ago. Which of the following is the recommended treatment?
A.Biopsy to rule out melanoma
B.No treatment is needed
C.Trephination
D.Nail removal - answerC. Trephination is the name of a procedure in which a small
hole is drilled on top of the nail so that the blood can drain. An 18-gauge needle or a
large paperclip (straighten one end) is used and heated with a flame from a lighter. If
the blood is not drained, it will result in permanent ischemic damage to the nail bed,
which can lead to permanent loss of the toenail.
All of the following pharmacologic agents are indicated for the treatment of plaque
psoriasis, except:
A.Topical corticosteroids
B.Vitamin D analogs
C.Ultraviolet light therapy
D.Oral antibiotics - answerD. Oral antibiotics are not used to treat plaque psoriasis (the
most common type of psoriasis), because it is not caused by bacterial infection. Topical
corticosteroids, vitamin D analogs (calcipotriene ointment), and ultraviolet light therapy
(UVB light) are methods used to treat psoriasis.
4.6% complete
Question
Which of the following is considered as a precursor lesion of squamous cell skin
cancer?
, A.Atopic dermatitis
B.Actinic keratosis
C.Seborrheic keratosis
D.Nevi - answerB. Actinic keratosis (AK) is the precursor lesion of squamous cell
carcinoma of the skin. It is caused by chronic sunlight exposure or chronic indoor
tanning (UV rays). Several to many lesions are common. It is located in sun-exposed
areas, such as the face, the dorsum of the arms and hands, and the chest. It appears
like a small dry, scaly-to-rough patch of skin that does not go away, and it may bleed
with trauma. Only about 5% to 10% of AK will turn into skin cancer, but it can become
invasive. Atopic dermatitis and eczema are pruritic and appear in hands, knees, and
other classic areas. Seborrheic keratosis looks like soft warts pasted on the skin; most
are located on the back and can range in color from tan to black. It does not itch or hurt
and is benign.
Molluscum contagiosum is caused by:
A.Herpesvirus
B.Poxvirus
C.Staphylococcus aureus
D.Haemophilus influenzae - answerB. Poxvirus
Molluscum contagiosum is caused by a poxvirus infection of the skin.
Which debridement method works best for wounds with minimal to no discharge?
A.Autolytic debridement
B.Sharp debridement
C.Jet lavage debridement
D.Enzymatic debridement - answerA. In autolytic debridement, the wound is covered
with hydrogel sheet, alginate sheet, or semiocclusive transparent film, which retains the
enzymes produced by the wound. It works best in wounds with minimal to no discharge.
In sharp debridement, the necrotic tissue is cut with a scalpel or sharp scissors. Water
is used to clean and debride in jet lavage debridement, and proteolytic enzymes are
applied to the wound in enzymatic debridement.
The nurse practitioner is evaluating a cat-bite wound on a patient's hand. There is no
redness or purulent discharge. The patient received a tetanus booster 4 years ago.
Which of the following is the correct action to take?
A.Clean the wound with soap and water and apply a topical antibiotic and a Band-Aid
B.Because the wound is clean and does not appear infected, there is no need for
antibiotics
C.Give the patient a tetanus booster using the Tdap form of the vaccine
D.Clean the wound with soap and water and prescribe amoxicillin-clavulanate
(Augmentin) 500 mg PO BID × 10 days - answerSolution: D
Clean the wound with soap and water and prescribe amoxicillin-clavulanate
(Augmentin) 500 mg PO BID × 10 days
Cat bites are more likely to become infected than dog bites, and this bite is located on
an extremity. These facts justify the prescription of Augmentin 500 mg PO BID × 10
days for the patient. This incident falls within the 5-year time period in which the
A high school athlete who is on the wrestling team complains of multiple bumps on his
lower left arm. The patient denies pruritus, pain, or discomfort from the lesions. During
the skin exam, the nurse practitioner notices multiple smooth domed papules that are 2
to 5 mm in diameter with central umbilication. Which diagnosis is most likely?
A.Molluscum contagiosum
B.Acne vulgaris
C.Verruca vulgaris
D.Basal cell carcinoma - answerA. Molluscum contagiosum is caused by the poxvirus. It
is highly contagious and spreads by autoinoculation, skin-to-skin contact, sexual
contact, and sharing towels. It is a self-limited infection in immunocompetent patients. It
resolves in 6 to 12 months. Advise healthy patients that it is a self-limited infection. Acne
does not appear on the lower left arm. Verruca vulgaris is the common wart; in this
case, the appearance is not wartlike. It also does not look like basal cell cancer (pearly
edges, telangiectasia, papule, or central ulceration).
An adult Black male presents with blood under the nail of the great toe that involves
approximately 50% of the nail area. He reports dropping a hammer accidentally on his
toe about 5 hours ago. Which of the following is the recommended treatment?
A.Biopsy to rule out melanoma
B.No treatment is needed
C.Trephination
D.Nail removal - answerC. Trephination is the name of a procedure in which a small
hole is drilled on top of the nail so that the blood can drain. An 18-gauge needle or a
large paperclip (straighten one end) is used and heated with a flame from a lighter. If
the blood is not drained, it will result in permanent ischemic damage to the nail bed,
which can lead to permanent loss of the toenail.
All of the following pharmacologic agents are indicated for the treatment of plaque
psoriasis, except:
A.Topical corticosteroids
B.Vitamin D analogs
C.Ultraviolet light therapy
D.Oral antibiotics - answerD. Oral antibiotics are not used to treat plaque psoriasis (the
most common type of psoriasis), because it is not caused by bacterial infection. Topical
corticosteroids, vitamin D analogs (calcipotriene ointment), and ultraviolet light therapy
(UVB light) are methods used to treat psoriasis.
4.6% complete
Question
Which of the following is considered as a precursor lesion of squamous cell skin
cancer?
, A.Atopic dermatitis
B.Actinic keratosis
C.Seborrheic keratosis
D.Nevi - answerB. Actinic keratosis (AK) is the precursor lesion of squamous cell
carcinoma of the skin. It is caused by chronic sunlight exposure or chronic indoor
tanning (UV rays). Several to many lesions are common. It is located in sun-exposed
areas, such as the face, the dorsum of the arms and hands, and the chest. It appears
like a small dry, scaly-to-rough patch of skin that does not go away, and it may bleed
with trauma. Only about 5% to 10% of AK will turn into skin cancer, but it can become
invasive. Atopic dermatitis and eczema are pruritic and appear in hands, knees, and
other classic areas. Seborrheic keratosis looks like soft warts pasted on the skin; most
are located on the back and can range in color from tan to black. It does not itch or hurt
and is benign.
Molluscum contagiosum is caused by:
A.Herpesvirus
B.Poxvirus
C.Staphylococcus aureus
D.Haemophilus influenzae - answerB. Poxvirus
Molluscum contagiosum is caused by a poxvirus infection of the skin.
Which debridement method works best for wounds with minimal to no discharge?
A.Autolytic debridement
B.Sharp debridement
C.Jet lavage debridement
D.Enzymatic debridement - answerA. In autolytic debridement, the wound is covered
with hydrogel sheet, alginate sheet, or semiocclusive transparent film, which retains the
enzymes produced by the wound. It works best in wounds with minimal to no discharge.
In sharp debridement, the necrotic tissue is cut with a scalpel or sharp scissors. Water
is used to clean and debride in jet lavage debridement, and proteolytic enzymes are
applied to the wound in enzymatic debridement.
The nurse practitioner is evaluating a cat-bite wound on a patient's hand. There is no
redness or purulent discharge. The patient received a tetanus booster 4 years ago.
Which of the following is the correct action to take?
A.Clean the wound with soap and water and apply a topical antibiotic and a Band-Aid
B.Because the wound is clean and does not appear infected, there is no need for
antibiotics
C.Give the patient a tetanus booster using the Tdap form of the vaccine
D.Clean the wound with soap and water and prescribe amoxicillin-clavulanate
(Augmentin) 500 mg PO BID × 10 days - answerSolution: D
Clean the wound with soap and water and prescribe amoxicillin-clavulanate
(Augmentin) 500 mg PO BID × 10 days
Cat bites are more likely to become infected than dog bites, and this bite is located on
an extremity. These facts justify the prescription of Augmentin 500 mg PO BID × 10
days for the patient. This incident falls within the 5-year time period in which the
