SARAH MICHELLE AANP BOARD EXAM
STRUCTURED LEARNING GUIDE
©A 23-year-old patient who is pregnant presents with erythema migrans
on their left lower leg. Which of the following is the best treatment
option for this patient?
A. Doxycycline (Vibramycin)
B. Azithromycin (Zithromax)
C. Levofloxacin
D. Amoxicillin - This patient has Lyme disease, which commonly
presents with erythema migrans, a bullseye-shaped lesion at the site of
the tick bite. Amoxicillin (D) is only recommended for patients with
Lyme disease who are pregnant. Children and adults who are not
pregnant should be treated with doxycycline (Vibramycin) (A).
Azithromycin (Zithromax) (B) and levofloxacin (C) are not preferred
treatments for Lyme disease.
©A parent presents with their two young children, both of whom have
erythematous papules and burrows around their ankles and some
tracking lines between their toes. Which of the following would be the
best treatment for this condition?
A. Griseofulvin
,B. Permethrin
C. Terbinafine
D. Mebendazole (Emverm) - This vignette offers a classic description of
scabies, which is treated with permethrin (B). Scabies commonly
presents between the fingers and toes, as well as around the lower ankles
and feet. Scabies often affects everyone in the household at once.
Griseofulvin (A) and terbinafine (C) are both antifungal medications
commonly used to treat tinea infections. Mebendazole (Emverm) (D) is
commonly used to treat enterobiasis, or pinworms.
©A patient presents for care related to a lesion on their trunk that the
nurse practitioner believes is caused by a dermatophyte infection. What
is the best diagnostic test?
A. Potassium hydroxide preparation
B. Fluorescein staining
C. Scabies preparation
D. Punch biopsy - Tinea infections are caused by dermatophytes and are
easily diagnosed using a potassium hydroxide preparation (A).
Fluorescein staining (B) is useful in detecting corneal scratches or
foreign objects in the eye. A scabies preparation (C) would not be useful
for a suspected dermatophyte infection. A punch biopsy (D) is
commonly used to assess tissue for certain types of cancer and would
not be necessary for a suspected tinea infection.
,©Which description best describes the rash associated with herpes
zoster?
A. A red, blotchy rash that begins on the face and spreads to the rest of
the body
B. Painful lumps and abscesses typically found on the groin and axillae
C. Painful, clustered vesicles around the lips
D. A painful, unilateral, localized, vesicular rash that runs along a
dermatome - The description of a painful, unilateral, localized, vesicular
rash that runs along a dermatome (D) is the classic description of herpes
zoster. A red blotchy rash that begins on the face and spreads to the rest
of the body (A) describes the rash associated with measles. Hidradenitis
suppurativa presents with painful lumps and abscesses, typically found
on the groin and axillae (B). Herpes simplex virus type 1 will typically
present with painful, clustered vesicles around the lips (C).
©The nurse practitioner is discussing next steps in treatment of acne
with a 16-year-old patient and their parent. The patient has not been
responding to their current treatment regimen of tretinoin (Retin-A)
combined with a benzoyl peroxide preparation. Which of the following
is the best next step in treatment?
A. Oral doxycycline (Vibramycin)
B. Oral cephalexin (Keflex)
C. Azelaic acid (Finacea)
, D. A referral to dermatology for oral isotretinoin (Accutane) - Acne
treatment usually begins with a combination of topical retinoids, such as
tretinoin (Retin-A), benzoyl peroxide preparations, and topical
antibiotics. After trialing these methods, the clinician could consider an
oral antibiotic, typically from the tetracycline class, such as doxycycline
(Vibramycin) (A). Cephalosporins (B) are not first-line treatments for
acne. While azelaic acid (Finacea) (C) is sometimes used for conditions
such as acne or rosacea, it is not considered first line for the treatment of
acne. A referral to dermatology for isotretinoin (Accutane) (D) is
typically considered the last step in acne management.
©The nurse practitioner is evaluating a patient who presents with a
superficial, erythematous rash with well-demarcated borders on the
anterior aspect of the left lower leg. Which of the following is the most
appropriate treatment option for this patient?
A. Trimethoprim-sulfamethoxazole (Bactrim DS)
B. Doxycycline (Vibramycin)
C. Ciprofloxacin (Cipro)
D. Amoxicillin - The likely diagnosis is erysipelas, or superficial
cellulitis. The key finding in this question is that the erythema has a
well-demarcated border. Erysipelas is best treated with a penicillin, such
as amoxicillin (D), or cephalosporin, such as cephalexin (Keflex). There
is not currently a known MRSA infection at this time. Therefore,
trimethoprim-sulfamethoxazole (Bactrim DS) (A) and doxycycline
(Vibramycin) (B) are not indicated. Ciprofloxacin (Cipro) (C) is not
STRUCTURED LEARNING GUIDE
©A 23-year-old patient who is pregnant presents with erythema migrans
on their left lower leg. Which of the following is the best treatment
option for this patient?
A. Doxycycline (Vibramycin)
B. Azithromycin (Zithromax)
C. Levofloxacin
D. Amoxicillin - This patient has Lyme disease, which commonly
presents with erythema migrans, a bullseye-shaped lesion at the site of
the tick bite. Amoxicillin (D) is only recommended for patients with
Lyme disease who are pregnant. Children and adults who are not
pregnant should be treated with doxycycline (Vibramycin) (A).
Azithromycin (Zithromax) (B) and levofloxacin (C) are not preferred
treatments for Lyme disease.
©A parent presents with their two young children, both of whom have
erythematous papules and burrows around their ankles and some
tracking lines between their toes. Which of the following would be the
best treatment for this condition?
A. Griseofulvin
,B. Permethrin
C. Terbinafine
D. Mebendazole (Emverm) - This vignette offers a classic description of
scabies, which is treated with permethrin (B). Scabies commonly
presents between the fingers and toes, as well as around the lower ankles
and feet. Scabies often affects everyone in the household at once.
Griseofulvin (A) and terbinafine (C) are both antifungal medications
commonly used to treat tinea infections. Mebendazole (Emverm) (D) is
commonly used to treat enterobiasis, or pinworms.
©A patient presents for care related to a lesion on their trunk that the
nurse practitioner believes is caused by a dermatophyte infection. What
is the best diagnostic test?
A. Potassium hydroxide preparation
B. Fluorescein staining
C. Scabies preparation
D. Punch biopsy - Tinea infections are caused by dermatophytes and are
easily diagnosed using a potassium hydroxide preparation (A).
Fluorescein staining (B) is useful in detecting corneal scratches or
foreign objects in the eye. A scabies preparation (C) would not be useful
for a suspected dermatophyte infection. A punch biopsy (D) is
commonly used to assess tissue for certain types of cancer and would
not be necessary for a suspected tinea infection.
,©Which description best describes the rash associated with herpes
zoster?
A. A red, blotchy rash that begins on the face and spreads to the rest of
the body
B. Painful lumps and abscesses typically found on the groin and axillae
C. Painful, clustered vesicles around the lips
D. A painful, unilateral, localized, vesicular rash that runs along a
dermatome - The description of a painful, unilateral, localized, vesicular
rash that runs along a dermatome (D) is the classic description of herpes
zoster. A red blotchy rash that begins on the face and spreads to the rest
of the body (A) describes the rash associated with measles. Hidradenitis
suppurativa presents with painful lumps and abscesses, typically found
on the groin and axillae (B). Herpes simplex virus type 1 will typically
present with painful, clustered vesicles around the lips (C).
©The nurse practitioner is discussing next steps in treatment of acne
with a 16-year-old patient and their parent. The patient has not been
responding to their current treatment regimen of tretinoin (Retin-A)
combined with a benzoyl peroxide preparation. Which of the following
is the best next step in treatment?
A. Oral doxycycline (Vibramycin)
B. Oral cephalexin (Keflex)
C. Azelaic acid (Finacea)
, D. A referral to dermatology for oral isotretinoin (Accutane) - Acne
treatment usually begins with a combination of topical retinoids, such as
tretinoin (Retin-A), benzoyl peroxide preparations, and topical
antibiotics. After trialing these methods, the clinician could consider an
oral antibiotic, typically from the tetracycline class, such as doxycycline
(Vibramycin) (A). Cephalosporins (B) are not first-line treatments for
acne. While azelaic acid (Finacea) (C) is sometimes used for conditions
such as acne or rosacea, it is not considered first line for the treatment of
acne. A referral to dermatology for isotretinoin (Accutane) (D) is
typically considered the last step in acne management.
©The nurse practitioner is evaluating a patient who presents with a
superficial, erythematous rash with well-demarcated borders on the
anterior aspect of the left lower leg. Which of the following is the most
appropriate treatment option for this patient?
A. Trimethoprim-sulfamethoxazole (Bactrim DS)
B. Doxycycline (Vibramycin)
C. Ciprofloxacin (Cipro)
D. Amoxicillin - The likely diagnosis is erysipelas, or superficial
cellulitis. The key finding in this question is that the erythema has a
well-demarcated border. Erysipelas is best treated with a penicillin, such
as amoxicillin (D), or cephalosporin, such as cephalexin (Keflex). There
is not currently a known MRSA infection at this time. Therefore,
trimethoprim-sulfamethoxazole (Bactrim DS) (A) and doxycycline
(Vibramycin) (B) are not indicated. Ciprofloxacin (Cipro) (C) is not
