NR 511 Week 2 Mastery Exam – Latest 2026/2027
Edition | 120 Questions & Answers with Rationales
| Complete Study Guide
SECTION 1: DERMATOLOGY (Questions 1–20)
1. A 25-year-old male presents with genital pruritus. Examination shows small,
erythematous, excoriated papules in the pubic hair; no mites are seen. There is no
penile discharge or constitutional symptoms. What is the most likely diagnosis?
A. Pediculosis
B. Gonorrhea
C. Chlamydia
D. Scabies
Correct Answer: A
Rationale: The presentation of genital pruritus with erythematous excoriated papules
confined to the pubic hair is classic for pediculosis pubis (pubic lice). The absence of
discharge and systemic symptoms makes gonorrhea and chlamydia unlikely; scabies
usually produces more widespread involvement with identifiable burrows in interdigital webs
and wrists.
2. A patient presents with a rash that looks like the patient was “slapped on the
cheeks.” This is the hallmark of which disease?
A. Rubella
,B. Rocky Mountain spotted fever
C. Erythema infectiosum (Fifth disease)
D. Measles
Correct Answer: C
Rationale: The “slapped-cheek” rash is the classic presentation of erythema infectiosum
(Fifth disease), caused by parvovirus B19. Rubella produces a diffuse maculopapular rash,
and Rocky Mountain spotted fever typically begins with a maculopapular rash that becomes
petechial.
3. A 22-year-old college student presents with a rash after spending several nights in
a hotel hot tub. Examination reveals multiple erythematous papules and pustules.
What is the most likely diagnosis?
A. Folliculitis
B. Cellulitis
C. Erysipelas
D. Herpes simplex
Correct Answer: A
Rationale: Hot-tub exposure is a classic risk factor for Pseudomonas folliculitis, which
presents as erythematous papules and pustules in areas covered by swimwear. Cellulitis
and erysipelas are deeper, spreading infections, and herpes simplex produces grouped
vesicles.
4. A 45-year-old woman has a pruritic, erythematous, scaly rash in the intertriginous
areas under the breasts. What is the most likely diagnosis?
A. Tinea corporis
B. Candidal intertrigo
C. Psoriasis
D. Contact dermatitis
,Correct Answer: B
Rationale: Candidal intertrigo commonly occurs in warm, moist skin folds (under breasts,
axillae, groin) and presents as beefy-red erythema with satellite pustules. Tinea corporis
usually has an annular border; psoriasis has silvery scale on extensor surfaces.
5. A 60-year-old man presents with a slowly growing, pearly nodule with
telangiectasias on the nose. What is the most likely diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Melanoma
D. Actinic keratosis
Correct Answer: B
Rationale: Basal cell carcinoma classically appears as a pearly, translucent nodule with
surface telangiectasias, often on sun-exposed areas such as the nose. Squamous cell
carcinoma is more scaly and ulcerated; melanoma is pigmented and asymmetric.
6. Which of the following is the most common reversible cause of conductive hearing
loss?
A. Acoustic neuroma
B. Cerumen impaction
C. Meniere’s disease
D. Temporal bone fracture
Correct Answer: B
Rationale: Cerumen impaction is the most frequent reversible cause of conductive hearing
loss. Acoustic neuroma and Meniere’s disease cause sensorineural loss, and
temporal-bone fracture may cause conductive loss but is less common and often
irreversible.
, 7. A 30-year-old woman presents with an annular, scaly plaque on the arm. KOH
examination shows septate hyphae. What is the treatment of choice?
A. Topical corticosteroid
B. Topical antifungal (e.g., terbinafine)
C. Oral antibiotic
D. Topical antiviral
Correct Answer: B
Rationale: Tinea corporis is a dermatophyte infection that responds to topical antifungals
such as terbinafine. Corticosteroids may worsen the infection, and antibiotics/antivirals are
ineffective against fungi.
8. A 70-year-old man has a history of recurrent herpes zoster in the same dermatome.
What is the most appropriate next step?
A. Reassure and treat symptomatically
B. Refer for HIV testing
C. Start long-term antiviral prophylaxis
D. Obtain a skin biopsy
Correct Answer: B
Rationale: Recurrent herpes zoster in the same dermatome should prompt evaluation for
underlying immunodeficiency, including HIV testing. Long-term prophylaxis is not standard
for immunocompetent patients.
9. Which of the following is a first-line treatment for scabies in a 2-month-old infant?
A. Permethrin 5 % cream
B. Lindane
C. Oral ivermectin
D. Benzyl benzoate
Correct Answer: A
Edition | 120 Questions & Answers with Rationales
| Complete Study Guide
SECTION 1: DERMATOLOGY (Questions 1–20)
1. A 25-year-old male presents with genital pruritus. Examination shows small,
erythematous, excoriated papules in the pubic hair; no mites are seen. There is no
penile discharge or constitutional symptoms. What is the most likely diagnosis?
A. Pediculosis
B. Gonorrhea
C. Chlamydia
D. Scabies
Correct Answer: A
Rationale: The presentation of genital pruritus with erythematous excoriated papules
confined to the pubic hair is classic for pediculosis pubis (pubic lice). The absence of
discharge and systemic symptoms makes gonorrhea and chlamydia unlikely; scabies
usually produces more widespread involvement with identifiable burrows in interdigital webs
and wrists.
2. A patient presents with a rash that looks like the patient was “slapped on the
cheeks.” This is the hallmark of which disease?
A. Rubella
,B. Rocky Mountain spotted fever
C. Erythema infectiosum (Fifth disease)
D. Measles
Correct Answer: C
Rationale: The “slapped-cheek” rash is the classic presentation of erythema infectiosum
(Fifth disease), caused by parvovirus B19. Rubella produces a diffuse maculopapular rash,
and Rocky Mountain spotted fever typically begins with a maculopapular rash that becomes
petechial.
3. A 22-year-old college student presents with a rash after spending several nights in
a hotel hot tub. Examination reveals multiple erythematous papules and pustules.
What is the most likely diagnosis?
A. Folliculitis
B. Cellulitis
C. Erysipelas
D. Herpes simplex
Correct Answer: A
Rationale: Hot-tub exposure is a classic risk factor for Pseudomonas folliculitis, which
presents as erythematous papules and pustules in areas covered by swimwear. Cellulitis
and erysipelas are deeper, spreading infections, and herpes simplex produces grouped
vesicles.
4. A 45-year-old woman has a pruritic, erythematous, scaly rash in the intertriginous
areas under the breasts. What is the most likely diagnosis?
A. Tinea corporis
B. Candidal intertrigo
C. Psoriasis
D. Contact dermatitis
,Correct Answer: B
Rationale: Candidal intertrigo commonly occurs in warm, moist skin folds (under breasts,
axillae, groin) and presents as beefy-red erythema with satellite pustules. Tinea corporis
usually has an annular border; psoriasis has silvery scale on extensor surfaces.
5. A 60-year-old man presents with a slowly growing, pearly nodule with
telangiectasias on the nose. What is the most likely diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Melanoma
D. Actinic keratosis
Correct Answer: B
Rationale: Basal cell carcinoma classically appears as a pearly, translucent nodule with
surface telangiectasias, often on sun-exposed areas such as the nose. Squamous cell
carcinoma is more scaly and ulcerated; melanoma is pigmented and asymmetric.
6. Which of the following is the most common reversible cause of conductive hearing
loss?
A. Acoustic neuroma
B. Cerumen impaction
C. Meniere’s disease
D. Temporal bone fracture
Correct Answer: B
Rationale: Cerumen impaction is the most frequent reversible cause of conductive hearing
loss. Acoustic neuroma and Meniere’s disease cause sensorineural loss, and
temporal-bone fracture may cause conductive loss but is less common and often
irreversible.
, 7. A 30-year-old woman presents with an annular, scaly plaque on the arm. KOH
examination shows septate hyphae. What is the treatment of choice?
A. Topical corticosteroid
B. Topical antifungal (e.g., terbinafine)
C. Oral antibiotic
D. Topical antiviral
Correct Answer: B
Rationale: Tinea corporis is a dermatophyte infection that responds to topical antifungals
such as terbinafine. Corticosteroids may worsen the infection, and antibiotics/antivirals are
ineffective against fungi.
8. A 70-year-old man has a history of recurrent herpes zoster in the same dermatome.
What is the most appropriate next step?
A. Reassure and treat symptomatically
B. Refer for HIV testing
C. Start long-term antiviral prophylaxis
D. Obtain a skin biopsy
Correct Answer: B
Rationale: Recurrent herpes zoster in the same dermatome should prompt evaluation for
underlying immunodeficiency, including HIV testing. Long-term prophylaxis is not standard
for immunocompetent patients.
9. Which of the following is a first-line treatment for scabies in a 2-month-old infant?
A. Permethrin 5 % cream
B. Lindane
C. Oral ivermectin
D. Benzyl benzoate
Correct Answer: A
