NU 518: Advanced Nursing Assessment Exam 3
Study Guide – Complete Actual Exam Questions
with 100% Verified Correct Answers and
Detailed Informative Rationales | Latest Update -
2026/2027 | Already Graded A+
Question 1
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for
a regular skin check-up. She has just returned from her annual dig site in Greece.
She has fair skin and reddish-blonde hair. She has a family history of melanoma.
She has many freckles scattered across her skin. From this description, which of
the following is not a risk factor for melanoma in this patient?
A. Age
B. Hair color
C. Actinic lentigines
D. Heavy sun exposure
Answer: A
Rationale: Age is not a specific risk factor for melanoma in this patient.
Melanoma can occur at any age, though risk increases with age. The patient's fair
skin, reddish-blonde hair, family history of melanoma, and heavy sun exposure
(from archaeological digs in Greece and living in Arizona) are all significant risk
factors. Actinic lentigines (liver spots) are also associated with sun damage and
increased melanoma risk. The patient's age of 35 is not a risk factor compared to
these other factors.
Question 2
You are speaking to an 8th grade class about health prevention and are preparing to
discuss the ABCDEs of melanoma. Which of the following descriptions correctly
defines the ABCDEs?
A. A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6
mm; E = evolution
[1]
,B. A = asymmetry; B = irregular borders; C = color changes, especially blue; D =
diameter >6 mm; E = evolution
C. A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E =
evolution
D. A = asymmetry; B = regular borders; C = color changes, especially orange; D =
diameter >6 mm; E = evolution
Answer: B
Rationale: The ABCDEs of melanoma are: A = Asymmetry (one half does not
match the other); B = Border irregularity (edges are ragged, notched, or blurred); C
= Color variation (different shades of brown, black, and sometimes red, white, or
blue); D = Diameter >6 mm (larger than a pencil eraser); E = Evolution (changes
in size, shape, color, or symptoms over time). Option B is the only one that
correctly lists these criteria. Actinic keratoses are precursors to squamous cell
carcinoma, not melanoma.
Question 3
You are beginning the examination of the skin on a 25-year-old teacher. You have
previously elicited that she came to the office for evaluation of fatigue, weight
gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the
expected moisture and texture of the skin of a patient with hypothyroidism?
A. Moist and smooth
B. Moist and rough
C. Dry and smooth
D. Dry and rough
Answer: D
Rationale: Hypothyroidism causes decreased metabolic rate, leading to dry, rough,
and coarse skin. The skin also becomes cool, pale, and puffy (myxedema). This is
due to decreased sebum production and reduced sweating. Moist and smooth skin
would be seen in hyperthyroidism, not hypothyroidism.
Question 4
A 28-year-old patient comes to the office for evaluation of a rash. At first there
was only one large patch, but then more lesions erupted suddenly on the back and
torso; the lesions itch. On physical examination, you note that the pattern of
eruption is like a Christmas tree and that there are a variety of erythematous
[2]
,papules and macules on the cleavage lines of the back. Based on this description,
what is the most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema
Answer: A
Rationale: Pityriasis rosea is characterized by an initial "herald patch" (a single
large lesion) followed by a secondary eruption of smaller lesions in a "Christmas
tree" distribution along the cleavage lines of the back. The lesions are typically
erythematous papules and macules that may itch. Tinea versicolor presents with
hypopigmented or hyperpigmented patches, not a Christmas tree pattern. Psoriasis
presents with well-demarcated silvery scales. Atopic eczema is chronic and pruritic
with flexural distribution.
Question 5
A 19-year-old construction worker presents for evaluation of a rash. He notes that
it started on his back with a multitude of spots and is also on his arms, chest, and
neck. It itches a lot. He does sweat more than before because being outdoors is part
of his job. On physical examination, you note dark tan patches with a reddish cast
that has sharp borders and fine scales, scattered more prominently around the upper
back, chest, neck, and upper arms as well as under the arms. Based on this
description, what is your most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema
Answer: B
Rationale: Tinea versicolor is a fungal infection caused by Malassezia furfur,
which is associated with increased sweating and heat. It presents with sharply
bordered, finely scaled patches that may be hypopigmented or hyperpigmented.
The distribution on the upper trunk, back, and arms is typical. Pityriasis rosea has a
herald patch and Christmas tree pattern. Psoriasis has silvery scales. Atopic eczema
is chronic with flexural involvement.
[3]
, Question 6
A 68-year-old retired farmer comes to your office for evaluation of a skin lesion.
On the right temporal area of the forehead, you see a flattened papule the same
color as his skin, covered by a dry scale that is round and feels hard. He has several
more of these scattered on the forehead, arms, and legs. Based on this description,
what is your most likely diagnosis?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Squamous cell carcinoma
Answer: A
Rationale: Actinic keratosis is a premalignant lesion caused by sun exposure. It
presents as a flattened, scaly, rough papule that feels like sandpaper. It is most
commonly found on sun-exposed areas (face, forehead, arms). Seborrheic keratosis
is a benign, waxy, "stuck-on" lesion. Basal cell carcinoma typically has a pearly
border with telangiectasias. Squamous cell carcinoma may present as an ulcerated
or crusted lesion.
Question 7
A 58-year-old gardener comes to your office for evaluation of a new lesion on her
upper chest. The lesion appears to be "stuck on" and is oval, brown, and slightly
elevated with a flat surface. It has a rough, wartlike texture on palpation. Based on
this description, what is your most likely diagnosis?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Squamous cell carcinoma
Answer: B
Rationale: Seborrheic keratosis is a benign skin lesion that appears "stuck on" and
has a waxy, warty texture. It is commonly oval or round, brown, and slightly
elevated. It is not premalignant and does not require treatment unless irritated.
Actinic keratosis is rough and scaly, not "stuck on." Basal cell and squamous cell
carcinomas are malignant.
Question 8
[4]
Study Guide – Complete Actual Exam Questions
with 100% Verified Correct Answers and
Detailed Informative Rationales | Latest Update -
2026/2027 | Already Graded A+
Question 1
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for
a regular skin check-up. She has just returned from her annual dig site in Greece.
She has fair skin and reddish-blonde hair. She has a family history of melanoma.
She has many freckles scattered across her skin. From this description, which of
the following is not a risk factor for melanoma in this patient?
A. Age
B. Hair color
C. Actinic lentigines
D. Heavy sun exposure
Answer: A
Rationale: Age is not a specific risk factor for melanoma in this patient.
Melanoma can occur at any age, though risk increases with age. The patient's fair
skin, reddish-blonde hair, family history of melanoma, and heavy sun exposure
(from archaeological digs in Greece and living in Arizona) are all significant risk
factors. Actinic lentigines (liver spots) are also associated with sun damage and
increased melanoma risk. The patient's age of 35 is not a risk factor compared to
these other factors.
Question 2
You are speaking to an 8th grade class about health prevention and are preparing to
discuss the ABCDEs of melanoma. Which of the following descriptions correctly
defines the ABCDEs?
A. A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6
mm; E = evolution
[1]
,B. A = asymmetry; B = irregular borders; C = color changes, especially blue; D =
diameter >6 mm; E = evolution
C. A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E =
evolution
D. A = asymmetry; B = regular borders; C = color changes, especially orange; D =
diameter >6 mm; E = evolution
Answer: B
Rationale: The ABCDEs of melanoma are: A = Asymmetry (one half does not
match the other); B = Border irregularity (edges are ragged, notched, or blurred); C
= Color variation (different shades of brown, black, and sometimes red, white, or
blue); D = Diameter >6 mm (larger than a pencil eraser); E = Evolution (changes
in size, shape, color, or symptoms over time). Option B is the only one that
correctly lists these criteria. Actinic keratoses are precursors to squamous cell
carcinoma, not melanoma.
Question 3
You are beginning the examination of the skin on a 25-year-old teacher. You have
previously elicited that she came to the office for evaluation of fatigue, weight
gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the
expected moisture and texture of the skin of a patient with hypothyroidism?
A. Moist and smooth
B. Moist and rough
C. Dry and smooth
D. Dry and rough
Answer: D
Rationale: Hypothyroidism causes decreased metabolic rate, leading to dry, rough,
and coarse skin. The skin also becomes cool, pale, and puffy (myxedema). This is
due to decreased sebum production and reduced sweating. Moist and smooth skin
would be seen in hyperthyroidism, not hypothyroidism.
Question 4
A 28-year-old patient comes to the office for evaluation of a rash. At first there
was only one large patch, but then more lesions erupted suddenly on the back and
torso; the lesions itch. On physical examination, you note that the pattern of
eruption is like a Christmas tree and that there are a variety of erythematous
[2]
,papules and macules on the cleavage lines of the back. Based on this description,
what is the most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema
Answer: A
Rationale: Pityriasis rosea is characterized by an initial "herald patch" (a single
large lesion) followed by a secondary eruption of smaller lesions in a "Christmas
tree" distribution along the cleavage lines of the back. The lesions are typically
erythematous papules and macules that may itch. Tinea versicolor presents with
hypopigmented or hyperpigmented patches, not a Christmas tree pattern. Psoriasis
presents with well-demarcated silvery scales. Atopic eczema is chronic and pruritic
with flexural distribution.
Question 5
A 19-year-old construction worker presents for evaluation of a rash. He notes that
it started on his back with a multitude of spots and is also on his arms, chest, and
neck. It itches a lot. He does sweat more than before because being outdoors is part
of his job. On physical examination, you note dark tan patches with a reddish cast
that has sharp borders and fine scales, scattered more prominently around the upper
back, chest, neck, and upper arms as well as under the arms. Based on this
description, what is your most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema
Answer: B
Rationale: Tinea versicolor is a fungal infection caused by Malassezia furfur,
which is associated with increased sweating and heat. It presents with sharply
bordered, finely scaled patches that may be hypopigmented or hyperpigmented.
The distribution on the upper trunk, back, and arms is typical. Pityriasis rosea has a
herald patch and Christmas tree pattern. Psoriasis has silvery scales. Atopic eczema
is chronic with flexural involvement.
[3]
, Question 6
A 68-year-old retired farmer comes to your office for evaluation of a skin lesion.
On the right temporal area of the forehead, you see a flattened papule the same
color as his skin, covered by a dry scale that is round and feels hard. He has several
more of these scattered on the forehead, arms, and legs. Based on this description,
what is your most likely diagnosis?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Squamous cell carcinoma
Answer: A
Rationale: Actinic keratosis is a premalignant lesion caused by sun exposure. It
presents as a flattened, scaly, rough papule that feels like sandpaper. It is most
commonly found on sun-exposed areas (face, forehead, arms). Seborrheic keratosis
is a benign, waxy, "stuck-on" lesion. Basal cell carcinoma typically has a pearly
border with telangiectasias. Squamous cell carcinoma may present as an ulcerated
or crusted lesion.
Question 7
A 58-year-old gardener comes to your office for evaluation of a new lesion on her
upper chest. The lesion appears to be "stuck on" and is oval, brown, and slightly
elevated with a flat surface. It has a rough, wartlike texture on palpation. Based on
this description, what is your most likely diagnosis?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Squamous cell carcinoma
Answer: B
Rationale: Seborrheic keratosis is a benign skin lesion that appears "stuck on" and
has a waxy, warty texture. It is commonly oval or round, brown, and slightly
elevated. It is not premalignant and does not require treatment unless irritated.
Actinic keratosis is rough and scaly, not "stuck on." Basal cell and squamous cell
carcinomas are malignant.
Question 8
[4]
