LEIK FNP ACTUAL STUDY GUIDE ANSWERS AND
QUESTIONS SET A+
✔✔Which of the following diagnoses are typically seen with melasma?
a. Pregnancy
b. Obesity
c. Basel cell carcinoma
d. Melanoma - ✔✔a
Melasma is also known as "mask of pregnancy". Bilater brown-to-tan colored stains
located on the upper cheeks, malar area, forehead, and chin in some women who are
pregnant or taking oral contraceptive pills.
✔✔A nurse practitioner notes that a patient has hypopigmentation with irregular shapes
on the face, arms, and abdomen of a patient. Which of the following diagnoses does the
patient likely have?
a. Xerosis
b. Nevi
c. Acanthosis nigricans
d. Vitiligo - ✔✔d
Vitiligo are white patches of skin with iregular shapes that gradually develop and spread
over time. It is chronic and progressive and can be located on any part of the body.
Autoimmune diseases are a risk factor. Advise patient to wear sunscreen. Can be
mentally difficult for body image.
✔✔A type 2 diabetic patient comes to the clinic due to thickening of skin behind the
neck and on the axilla. The skin appears to be velvety. What is the most likely
diagnosis?
a. Acanthosis nigricans
b. Acrochordon
c. Vitiligo
d. Seborrheic keratoses - ✔✔a
,Diffuse velvety thickening of the skin usually located behind the neck and on the axilla.
Often associated with diabetes, metabolic syndrome, obesity, and cancer of the GI tract.
Acrochordon are skin tags. Vitaligo are white patches of skin with irregular shapes.
Seborrheic keratoses are soft, wart-like, flesy growth that have a "pasted" on
appearance.
✔✔A nurse practitioner diagnoses a patient with cutaneous candidiasis in her axilla
area. The least appropriate medication to prescribe to this patient is:
a. Mometasone furoate 0.1% (Elocon ointment)
b. Nystatin (Mycostatin®, Nilstat®)
c. Terbinafine (Lamisil)
d. Ketoconazole (Daktarin Gold 2%) - ✔✔a
Avoid steroids in cases of suspected fungal infections because it will worsen the
infection. The other three medications are all used to treat various fungal infections.
✔✔Pinpoint areas of bleeding in the skin when scales from a psoriatic plaque are
removed is also known as:
a. Koebner phenomenon
b. Auspitz sign
c. Guttate psoriasis
d. Serpiginous - ✔✔b
Serpiginous are rashes that are shaped like a snake (larva migrans). Koebner
phenomenon are new psoriatic plaques form over areas of skin trauma. Guttate
psoriasis is a severe form of psoriasis resulting from strep A infection.
✔✔Which of the following statements are true?
a. Seborrheic keratosis are precancerous precursors to squamous cell carcinoma.
b. Seborrheic keratosis are precancerous precursors to basal cell carcinoma.
c. Actinic keratosis are precancerous precursors to squamous cell carcinoma.
d. Actinic keratosis are precancerous precursors to basal cell carcinoma. - ✔✔c
Actinic keratoses are precancerous precursor to squamous cell carcinoma. Older adults
with fair skin, light-colored hair, blue eyes who are white skin and a history of sun
exposure are at the highest incidence of skin cancer.
✔✔A 73 year old female patient comes to the clinic with complains of numerous dry,
round, and pink lesions on her upper back that are scaly and will not heal after scabbing
over. The nurse practitioner's next step would be?
a. Refer to dermatologist for biopsy
b. Biopsy area during that visit
c. Advise the patient to wear a bandaid and use a disinfectant on area until area heals
d. Advise the patient to wear sunscreen at all times - ✔✔a
,The gold standard diagnoses includes refer the patient to dermatology for a biopsy of
actinic keratoses, especially since the lesion will not heal. A patient should be educated
to wear sunscreen at all times but that will not impact the current problem.
✔✔A patient comes to the clinic today with complaints of a "sun rash". She noticed the
rash began after swimming in the pool with her daughter. The patient does not have any
other complaints. Upon assessment the nurse practitioner notes multiple
hypopigmented round macules on the chest, shoulder, and back. A KOH slide reveals
hyphae and spores. The most appropriate treatment option for this patient is:
a. Hydrocortisone 2.5%
b. Ketoconazole (Nizoral)
c. Tazarotene
d. Nystatin cream - ✔✔b
The patient presents with classic symptoms of tinea versicolor. It typically appears after
skin becomes tan from sun exposure. The treatment includes antifungals such a
ketoconazole, terbinafine (lamisil) cream. Tazarotene is a retinoid.
✔✔Which of the following is considered high-potency (group 2) topical steroid?
a. Hydrocortisone 1%
b. Halcinonide (Halog)
c. Triamcinolone acetonide
d. Methylprednisolone (Medrol) - ✔✔b
Halcinanide (Haldog) is a medium-potency steroid. Hydrocortisone 1% is lowest
potency (group 7), triamcinolone acetonide is a medium potency steroid (group 4).
✔✔Which of the follow can occur, especially in infants and children, after using potent to
ultrapotent topical steroids except?
a. Hypothalamic pituitary adrenal suppression
b. Telangiectasia
c. Hypopigmentation
d. Dermatophytoses - ✔✔d
Dermatophytoses is an infection of superficial keratinized tissue by tinea organism. HPA
suppression may occur with excessive or prolonged use (>2 weeks).
✔✔What is the preferred treatment option for HIV-seropostivie patiens with moderate to
severe oropharyngeal candida?
a. Oral flucanazole
b. Oral steroid
c. Topical anti-fungal
d. Topical steroid - ✔✔a
, Oral flucanazole is preferred systemic antifungal in HIV-seropositive patients with
oropharyngeal candida (which is the most common opportunistic infection).
✔✔The nurse practitioner is seeing a 41 year old male patient for a dog bite on his left
lower leg. The nurse practitioner knows that the most likely organism that has caused
purulent cellulitis is:
a. Streptococci
b. Staph aureus
c. Pasteurella multocida
d. V. vulnificus - ✔✔b
The most likely organism to cause a purulent form of cellulitis is staph aureus (gram
positive). Most non purulent form of cellulitis is usually doe to streptococci or
staphlococcal. V. vulnificus is organism due to exposure of wound to brackish to
saltwater.
✔✔A patient comes to the clinic with complaints of nausea and diarrhea. He notes that
he began to feel sick after eating raw oysters yesterday afternoon. The nurse
practitioner assumes which of the following organisms may be responsibile?
a. Staph aureus
b. Pasteurella multicida
c. V. vulnificus
d. Pseudomonas aeruginosa - ✔✔c
Exposure of wound to brackish to saltwater (or eating raw clams/oysters) from the Gulf
Coast or Chesapeake Bay can cause bacterial infection. it is the leading cause of
shellfish death in the US. 50% mortality rate from v. vulnificus septicemia.
✔✔A 21 year old patient comes to the clinic after getting into a physical altercation at a
bar the night before. He claims that he kicked and punch the other person. His right
hard is swollen, red, and tender to the touch. What should the nurse practitioner do
next?
a. Order x-ray of hand
b. Refer to ED
c. Refer to orthopedics
d. Suggest NSAIDS and ice - ✔✔b
Clenched-fist injuries should be referred to ED for treatment due to their high risk of
infection to joints.
✔✔A 23 year old female patient comes to the clinic with 2-3 cm furuncles in her right
axilla area, on right elbow, and right forearm. She denies any change in lifestyle or
eating habits. The furuncles are round, red bumps that are hot and tender to the touch.
How should the nurse practitioner first proceed?
a. Advice using warm compress BID
QUESTIONS SET A+
✔✔Which of the following diagnoses are typically seen with melasma?
a. Pregnancy
b. Obesity
c. Basel cell carcinoma
d. Melanoma - ✔✔a
Melasma is also known as "mask of pregnancy". Bilater brown-to-tan colored stains
located on the upper cheeks, malar area, forehead, and chin in some women who are
pregnant or taking oral contraceptive pills.
✔✔A nurse practitioner notes that a patient has hypopigmentation with irregular shapes
on the face, arms, and abdomen of a patient. Which of the following diagnoses does the
patient likely have?
a. Xerosis
b. Nevi
c. Acanthosis nigricans
d. Vitiligo - ✔✔d
Vitiligo are white patches of skin with iregular shapes that gradually develop and spread
over time. It is chronic and progressive and can be located on any part of the body.
Autoimmune diseases are a risk factor. Advise patient to wear sunscreen. Can be
mentally difficult for body image.
✔✔A type 2 diabetic patient comes to the clinic due to thickening of skin behind the
neck and on the axilla. The skin appears to be velvety. What is the most likely
diagnosis?
a. Acanthosis nigricans
b. Acrochordon
c. Vitiligo
d. Seborrheic keratoses - ✔✔a
,Diffuse velvety thickening of the skin usually located behind the neck and on the axilla.
Often associated with diabetes, metabolic syndrome, obesity, and cancer of the GI tract.
Acrochordon are skin tags. Vitaligo are white patches of skin with irregular shapes.
Seborrheic keratoses are soft, wart-like, flesy growth that have a "pasted" on
appearance.
✔✔A nurse practitioner diagnoses a patient with cutaneous candidiasis in her axilla
area. The least appropriate medication to prescribe to this patient is:
a. Mometasone furoate 0.1% (Elocon ointment)
b. Nystatin (Mycostatin®, Nilstat®)
c. Terbinafine (Lamisil)
d. Ketoconazole (Daktarin Gold 2%) - ✔✔a
Avoid steroids in cases of suspected fungal infections because it will worsen the
infection. The other three medications are all used to treat various fungal infections.
✔✔Pinpoint areas of bleeding in the skin when scales from a psoriatic plaque are
removed is also known as:
a. Koebner phenomenon
b. Auspitz sign
c. Guttate psoriasis
d. Serpiginous - ✔✔b
Serpiginous are rashes that are shaped like a snake (larva migrans). Koebner
phenomenon are new psoriatic plaques form over areas of skin trauma. Guttate
psoriasis is a severe form of psoriasis resulting from strep A infection.
✔✔Which of the following statements are true?
a. Seborrheic keratosis are precancerous precursors to squamous cell carcinoma.
b. Seborrheic keratosis are precancerous precursors to basal cell carcinoma.
c. Actinic keratosis are precancerous precursors to squamous cell carcinoma.
d. Actinic keratosis are precancerous precursors to basal cell carcinoma. - ✔✔c
Actinic keratoses are precancerous precursor to squamous cell carcinoma. Older adults
with fair skin, light-colored hair, blue eyes who are white skin and a history of sun
exposure are at the highest incidence of skin cancer.
✔✔A 73 year old female patient comes to the clinic with complains of numerous dry,
round, and pink lesions on her upper back that are scaly and will not heal after scabbing
over. The nurse practitioner's next step would be?
a. Refer to dermatologist for biopsy
b. Biopsy area during that visit
c. Advise the patient to wear a bandaid and use a disinfectant on area until area heals
d. Advise the patient to wear sunscreen at all times - ✔✔a
,The gold standard diagnoses includes refer the patient to dermatology for a biopsy of
actinic keratoses, especially since the lesion will not heal. A patient should be educated
to wear sunscreen at all times but that will not impact the current problem.
✔✔A patient comes to the clinic today with complaints of a "sun rash". She noticed the
rash began after swimming in the pool with her daughter. The patient does not have any
other complaints. Upon assessment the nurse practitioner notes multiple
hypopigmented round macules on the chest, shoulder, and back. A KOH slide reveals
hyphae and spores. The most appropriate treatment option for this patient is:
a. Hydrocortisone 2.5%
b. Ketoconazole (Nizoral)
c. Tazarotene
d. Nystatin cream - ✔✔b
The patient presents with classic symptoms of tinea versicolor. It typically appears after
skin becomes tan from sun exposure. The treatment includes antifungals such a
ketoconazole, terbinafine (lamisil) cream. Tazarotene is a retinoid.
✔✔Which of the following is considered high-potency (group 2) topical steroid?
a. Hydrocortisone 1%
b. Halcinonide (Halog)
c. Triamcinolone acetonide
d. Methylprednisolone (Medrol) - ✔✔b
Halcinanide (Haldog) is a medium-potency steroid. Hydrocortisone 1% is lowest
potency (group 7), triamcinolone acetonide is a medium potency steroid (group 4).
✔✔Which of the follow can occur, especially in infants and children, after using potent to
ultrapotent topical steroids except?
a. Hypothalamic pituitary adrenal suppression
b. Telangiectasia
c. Hypopigmentation
d. Dermatophytoses - ✔✔d
Dermatophytoses is an infection of superficial keratinized tissue by tinea organism. HPA
suppression may occur with excessive or prolonged use (>2 weeks).
✔✔What is the preferred treatment option for HIV-seropostivie patiens with moderate to
severe oropharyngeal candida?
a. Oral flucanazole
b. Oral steroid
c. Topical anti-fungal
d. Topical steroid - ✔✔a
, Oral flucanazole is preferred systemic antifungal in HIV-seropositive patients with
oropharyngeal candida (which is the most common opportunistic infection).
✔✔The nurse practitioner is seeing a 41 year old male patient for a dog bite on his left
lower leg. The nurse practitioner knows that the most likely organism that has caused
purulent cellulitis is:
a. Streptococci
b. Staph aureus
c. Pasteurella multocida
d. V. vulnificus - ✔✔b
The most likely organism to cause a purulent form of cellulitis is staph aureus (gram
positive). Most non purulent form of cellulitis is usually doe to streptococci or
staphlococcal. V. vulnificus is organism due to exposure of wound to brackish to
saltwater.
✔✔A patient comes to the clinic with complaints of nausea and diarrhea. He notes that
he began to feel sick after eating raw oysters yesterday afternoon. The nurse
practitioner assumes which of the following organisms may be responsibile?
a. Staph aureus
b. Pasteurella multicida
c. V. vulnificus
d. Pseudomonas aeruginosa - ✔✔c
Exposure of wound to brackish to saltwater (or eating raw clams/oysters) from the Gulf
Coast or Chesapeake Bay can cause bacterial infection. it is the leading cause of
shellfish death in the US. 50% mortality rate from v. vulnificus septicemia.
✔✔A 21 year old patient comes to the clinic after getting into a physical altercation at a
bar the night before. He claims that he kicked and punch the other person. His right
hard is swollen, red, and tender to the touch. What should the nurse practitioner do
next?
a. Order x-ray of hand
b. Refer to ED
c. Refer to orthopedics
d. Suggest NSAIDS and ice - ✔✔b
Clenched-fist injuries should be referred to ED for treatment due to their high risk of
infection to joints.
✔✔A 23 year old female patient comes to the clinic with 2-3 cm furuncles in her right
axilla area, on right elbow, and right forearm. She denies any change in lifestyle or
eating habits. The furuncles are round, red bumps that are hot and tender to the touch.
How should the nurse practitioner first proceed?
a. Advice using warm compress BID
