NUR631-Advanced Health Assessment Test 1 Q & A
GRADED A+
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) tinea versicolor
fungal infection so sweating and increased moisture led to this
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) actinic keratosis
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) seborrheic keratosis
"stuck on"
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the
hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the
ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin
condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage
to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a
pressure ulcer. What is the stage of this ulcer?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4 - ANSWER-C) stage 3
full thickness skin loss with damage to subcutaneous tissue
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or
twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in
braids. On physical examination, you note a clearly demarcated, round patch of hair loss
without visible scaling or inflammation. There are no hair shafts visible. Based on this
description, what is your most likely diagnosis?
A) Alopecia areata
B) Trichotillomania
C) Tinea capitis
D) Traction alopecia - ANSWER-A) alopecia areata
A mother brings her 11 month old to you because her mother-in-law and others have told her
that her baby is jaundiced. She is eating and growing well and performing the developmental
milestones she should for her age. On examination you indeed notice a yellow tone to her skin
from head to toe. Her sclerae are white. To which area should your next questions be related?
A) Diet
,B) Family history of liver diseases
C) Family history of blood diseases
D) Ethnicity of the child - ANSWER-A) diet
A new mother is concerned that her child occasionally "turns blue." On further questioning, she
mentions that this is at her hands and feet. She does not remember the child's lips turning blue.
She is otherwise eating and growing well. What would you do now?
A) Reassure her that this is normal
B) Obtain an echocardiogram to check for structural heart disease and consult cardiology
C) Admit the child to the hospital for further observation
D) Question the validity of her story - ANSWER-A) reassure her that this is normal
peripheral cyanosis when cold
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure
to ill people or other agents in the environment. He has a slight fever in the office. The rash
consists of small, bright red marks. When they are pressed, the red color remains. What should
you do?
A) Prescribe a steroid cream to decrease inflammation.
B) Consider admitting the patient to the hospital.
C) Reassure the parents and the patient that this should resolve within a week.
D) Tell him not to scratch them, and follow up in 3 days. - ANSWER-B) consider admitting patient
to hospital
non-blanchable means there is pinpoint bleeding under the skin
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It
has been there for about a year and is getting larger. He says his wife has been able to squeeze
out a cheesy-textured substance on occasion. He worries this may be cancer. When gently
pinched from the side, a prominent dimple forms in the middle of the mass. What is most
likely?
A) An enlarged lymph node
, B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion - ANSWER-B) a sebaceous cyst
A young man comes to you with an extremely pruritic rash over his knees and elbows which has
come and gone for several years. It seems to be worse in the winter and improves with some
sun exposure. On examination, you notice scabbing and crusting with some silvery scale, and
you are observant enough to notice small "pits" in his nails. What would account for these
findings?
A) Eczema
B) Pityriasis rosea
C) Psoriasis
D) Tinea infection - ANSWER-C) psoriasis
For which of the following patients would a comprehensive health history be appropriate?
A) A new patient with the chief complaint of "I sprained my ankle"
B) An established patient with the chief complaint of "I have an upper respiratory infection"
C) A new patient with the chief complaint of "I am here to establish care"
D) A new patient with the chief complaint of "I cut my hand" - ANSWER-c) a new patient with
the CC of "I am here to establish care"
the patient is new to the provider so a comprehensive health history is needed
The components of the health history include all of the following except which one?
A) Review of systems
B) Thorax and lungs
C) Present illness
D) Personal and social items - ANSWER-B) thorax and lungs
GRADED A+
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) tinea versicolor
fungal infection so sweating and increased moisture led to this
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) actinic keratosis
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) seborrheic keratosis
"stuck on"
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the
hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the
ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin
condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage
to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a
pressure ulcer. What is the stage of this ulcer?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4 - ANSWER-C) stage 3
full thickness skin loss with damage to subcutaneous tissue
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or
twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in
braids. On physical examination, you note a clearly demarcated, round patch of hair loss
without visible scaling or inflammation. There are no hair shafts visible. Based on this
description, what is your most likely diagnosis?
A) Alopecia areata
B) Trichotillomania
C) Tinea capitis
D) Traction alopecia - ANSWER-A) alopecia areata
A mother brings her 11 month old to you because her mother-in-law and others have told her
that her baby is jaundiced. She is eating and growing well and performing the developmental
milestones she should for her age. On examination you indeed notice a yellow tone to her skin
from head to toe. Her sclerae are white. To which area should your next questions be related?
A) Diet
,B) Family history of liver diseases
C) Family history of blood diseases
D) Ethnicity of the child - ANSWER-A) diet
A new mother is concerned that her child occasionally "turns blue." On further questioning, she
mentions that this is at her hands and feet. She does not remember the child's lips turning blue.
She is otherwise eating and growing well. What would you do now?
A) Reassure her that this is normal
B) Obtain an echocardiogram to check for structural heart disease and consult cardiology
C) Admit the child to the hospital for further observation
D) Question the validity of her story - ANSWER-A) reassure her that this is normal
peripheral cyanosis when cold
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure
to ill people or other agents in the environment. He has a slight fever in the office. The rash
consists of small, bright red marks. When they are pressed, the red color remains. What should
you do?
A) Prescribe a steroid cream to decrease inflammation.
B) Consider admitting the patient to the hospital.
C) Reassure the parents and the patient that this should resolve within a week.
D) Tell him not to scratch them, and follow up in 3 days. - ANSWER-B) consider admitting patient
to hospital
non-blanchable means there is pinpoint bleeding under the skin
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It
has been there for about a year and is getting larger. He says his wife has been able to squeeze
out a cheesy-textured substance on occasion. He worries this may be cancer. When gently
pinched from the side, a prominent dimple forms in the middle of the mass. What is most
likely?
A) An enlarged lymph node
, B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion - ANSWER-B) a sebaceous cyst
A young man comes to you with an extremely pruritic rash over his knees and elbows which has
come and gone for several years. It seems to be worse in the winter and improves with some
sun exposure. On examination, you notice scabbing and crusting with some silvery scale, and
you are observant enough to notice small "pits" in his nails. What would account for these
findings?
A) Eczema
B) Pityriasis rosea
C) Psoriasis
D) Tinea infection - ANSWER-C) psoriasis
For which of the following patients would a comprehensive health history be appropriate?
A) A new patient with the chief complaint of "I sprained my ankle"
B) An established patient with the chief complaint of "I have an upper respiratory infection"
C) A new patient with the chief complaint of "I am here to establish care"
D) A new patient with the chief complaint of "I cut my hand" - ANSWER-c) a new patient with
the CC of "I am here to establish care"
the patient is new to the provider so a comprehensive health history is needed
The components of the health history include all of the following except which one?
A) Review of systems
B) Thorax and lungs
C) Present illness
D) Personal and social items - ANSWER-B) thorax and lungs
