NUR 6121 EXAM 3 – ADVANCED PRACTICE NURSING II |WILLIAM
PATERSON UNIVERSITY COLLEGE OF NURSING
2026/2027 ACADEMIC YEAR MSN AND ADVANCED PRACTICE
NURSING STUDENTS
TOPICS COVERED:
- Dermatological Disorders
- Genitourinary Conditions
- Mental Health Disorders
- Women's Health
- Hematological and Immune Disorders
- Emergency Problems
- Health Screening and Health Promotion
- Legal, Political, and Ethical Considerations
- Alternative and Complementary Therapies
- Special Populations (LGBTQ+, Older Adults, Young Adults)
SECTION 1: DERMATOLOGICAL DISORDERS (Questions 1–25)
1. A 45-year-old patient presents with a pruritic, erythematous rash on the flexor
surfaces of the elbows and knees. The lesions are well-demarcated, scaly plaques.
What is the most likely diagnosis?
A. Atopic dermatitis
B. Psoriasis
C. Contact dermatitis
D. Tinea corporis
Answer: B. Psoriasis
Rationale: Psoriasis typically presents with well-demarcated, erythematous, scaly
plaques on extensor surfaces (elbows, knees) and can be pruritic. Atopic
dermatitis commonly affects flexor surfaces but is less well-demarcated. Contact
dermatitis is usually acute and associated with exposure. Tinea corporis is a fungal
infection with annular lesions.
2. A 32-year-old woman complains of a painful, burning rash on her right torso
that
1
,appeared 3 days ago. On examination, you see grouped vesicles on an
erythematous
base in a dermatomal distribution. What is the most appropriate initial
treatment?
A. Oral acyclovir
B. Topical hydrocortisone
C. Oral antihistamines
D. Wet compresses only
Answer: A. Oral acyclovir
Rationale: This is herpes zoster (shingles). Antiviral therapy (acyclovir,
valacyclovir,
or famciclovir) is indicated to reduce duration and severity, especially if started
within 72 hours of rash onset. Topical steroids and antihistamines are adjunctive
but not primary.
3. Which of the following is a characteristic finding in acne vulgaris?
A. Comedones (open and closed)
B. Pruritic papules on the trunk
C. Hyperpigmented macules on the face
D. Scaling and fissuring of the palms
Answer: A. Comedones (open and closed)
Rationale: Acne vulgaris is characterized by non-inflammatory comedones
(blackheads and whiteheads) and inflammatory papules, pustules, and nodules.
Pruritic papules suggest scabies; hyperpigmented macules suggest post-
inflammatory changes; scaling palms suggest eczema or psoriasis.
4. A 60-year-old male with a history of sun exposure presents with a pearly,
telangiectatic nodule on his nose that has been slowly growing. It bleeds easily
with minor trauma. What is the most likely diagnosis?
A. Actinic keratosis
B. Basal cell carcinoma
C. Squamous cell carcinoma
D. Melanoma
2
,Answer: B. Basal cell carcinoma
Rationale: Basal cell carcinoma commonly presents as a pearly, telangiectatic
nodule on sun-exposed areas, with a history of easy bleeding. Actinic keratosis is
scaly and rough. Squamous cell carcinoma is often hyperkeratotic. Melanoma is
pigmented and irregular.
5. A patient presents with a pruritic, annular lesion with central clearing on the
forearm. The lesion has a raised, scaly border. KOH prep is positive. What is the
diagnosis?
A. Tinea corporis
B. Nummular eczema
C. Erythema migrans
D. Granuloma annulare
Answer: A. Tinea corporis
Rationale: Tinea corporis (ringworm) presents with annular lesions with central
clearing and a scaly border; KOH prep shows hyphae. Nummular eczema is coin-
shaped and not fungal. Erythema migrans is a target-like lesion from Lyme
disease. Granuloma annulare is asymptomatic and has no scale.
6. Which of the following is the first-line treatment for mild to moderate atopic
dermatitis?
A. Topical corticosteroids
B. Oral corticosteroids
C. Topical calcineurin inhibitors
D. Antihistamines
Answer: A. Topical corticosteroids
Rationale: Topical corticosteroids are the mainstay for acute flares of atopic
dermatitis. Topical calcineurin inhibitors (e.g., tacrolimus) are second-line for
sensitive areas. Oral corticosteroids are reserved for severe cases. Antihistamines
help with pruritus but are not primary treatment.
7. A 25-year-old patient develops erythematous, scaly patches on the scalp with
silvery scales and a positive Auspitz sign. What is the most likely diagnosis?
3
, A. Seborrheic dermatitis
B. Psoriasis
C. Tinea capitis
D. Lichen planus
Answer: B. Psoriasis
Rationale: Psoriasis on the scalp presents with silvery scales and Auspitz sign
(pinpoint bleeding when scale is removed). Seborrheic dermatitis has greasy,
yellow scales. Tinea capitis causes hair loss and black dots. Lichen planus is
pruritic, violaceous, and polygonal.
8. A patient presents with multiple skin tags and acanthosis nigricans. Which
condition should you screen for?
A. Diabetes mellitus
B. Hyperthyroidism
C. Adrenal insufficiency
D. Vitamin D deficiency
Answer: A. Diabetes mellitus
Rationale: Acanthosis nigricans and skin tags are associated with insulin resistance
and type 2 diabetes. Screening for diabetes is indicated.
9. A 70-year-old patient has a non-healing ulcer on the lower leg with irregular,
rolled borders and no pain. What is the most concerning diagnosis?
A. Venous stasis ulcer
B. Arterial ulcer
C. Marjolin's ulcer (squamous cell carcinoma)
D. Diabetic ulcer
Answer: C. Marjolin's ulcer (squamous cell carcinoma)
Rationale: A non-healing ulcer with rolled borders and no pain in an older patient
should raise suspicion for malignancy, especially squamous cell carcinoma arising
in chronic wounds. Venous ulcers are painful and have sloping edges; arterial
ulcers are painful and punched-out; diabetic ulcers are neuropathic.
10. What is the most common bacterial cause of cellulitis?
4
PATERSON UNIVERSITY COLLEGE OF NURSING
2026/2027 ACADEMIC YEAR MSN AND ADVANCED PRACTICE
NURSING STUDENTS
TOPICS COVERED:
- Dermatological Disorders
- Genitourinary Conditions
- Mental Health Disorders
- Women's Health
- Hematological and Immune Disorders
- Emergency Problems
- Health Screening and Health Promotion
- Legal, Political, and Ethical Considerations
- Alternative and Complementary Therapies
- Special Populations (LGBTQ+, Older Adults, Young Adults)
SECTION 1: DERMATOLOGICAL DISORDERS (Questions 1–25)
1. A 45-year-old patient presents with a pruritic, erythematous rash on the flexor
surfaces of the elbows and knees. The lesions are well-demarcated, scaly plaques.
What is the most likely diagnosis?
A. Atopic dermatitis
B. Psoriasis
C. Contact dermatitis
D. Tinea corporis
Answer: B. Psoriasis
Rationale: Psoriasis typically presents with well-demarcated, erythematous, scaly
plaques on extensor surfaces (elbows, knees) and can be pruritic. Atopic
dermatitis commonly affects flexor surfaces but is less well-demarcated. Contact
dermatitis is usually acute and associated with exposure. Tinea corporis is a fungal
infection with annular lesions.
2. A 32-year-old woman complains of a painful, burning rash on her right torso
that
1
,appeared 3 days ago. On examination, you see grouped vesicles on an
erythematous
base in a dermatomal distribution. What is the most appropriate initial
treatment?
A. Oral acyclovir
B. Topical hydrocortisone
C. Oral antihistamines
D. Wet compresses only
Answer: A. Oral acyclovir
Rationale: This is herpes zoster (shingles). Antiviral therapy (acyclovir,
valacyclovir,
or famciclovir) is indicated to reduce duration and severity, especially if started
within 72 hours of rash onset. Topical steroids and antihistamines are adjunctive
but not primary.
3. Which of the following is a characteristic finding in acne vulgaris?
A. Comedones (open and closed)
B. Pruritic papules on the trunk
C. Hyperpigmented macules on the face
D. Scaling and fissuring of the palms
Answer: A. Comedones (open and closed)
Rationale: Acne vulgaris is characterized by non-inflammatory comedones
(blackheads and whiteheads) and inflammatory papules, pustules, and nodules.
Pruritic papules suggest scabies; hyperpigmented macules suggest post-
inflammatory changes; scaling palms suggest eczema or psoriasis.
4. A 60-year-old male with a history of sun exposure presents with a pearly,
telangiectatic nodule on his nose that has been slowly growing. It bleeds easily
with minor trauma. What is the most likely diagnosis?
A. Actinic keratosis
B. Basal cell carcinoma
C. Squamous cell carcinoma
D. Melanoma
2
,Answer: B. Basal cell carcinoma
Rationale: Basal cell carcinoma commonly presents as a pearly, telangiectatic
nodule on sun-exposed areas, with a history of easy bleeding. Actinic keratosis is
scaly and rough. Squamous cell carcinoma is often hyperkeratotic. Melanoma is
pigmented and irregular.
5. A patient presents with a pruritic, annular lesion with central clearing on the
forearm. The lesion has a raised, scaly border. KOH prep is positive. What is the
diagnosis?
A. Tinea corporis
B. Nummular eczema
C. Erythema migrans
D. Granuloma annulare
Answer: A. Tinea corporis
Rationale: Tinea corporis (ringworm) presents with annular lesions with central
clearing and a scaly border; KOH prep shows hyphae. Nummular eczema is coin-
shaped and not fungal. Erythema migrans is a target-like lesion from Lyme
disease. Granuloma annulare is asymptomatic and has no scale.
6. Which of the following is the first-line treatment for mild to moderate atopic
dermatitis?
A. Topical corticosteroids
B. Oral corticosteroids
C. Topical calcineurin inhibitors
D. Antihistamines
Answer: A. Topical corticosteroids
Rationale: Topical corticosteroids are the mainstay for acute flares of atopic
dermatitis. Topical calcineurin inhibitors (e.g., tacrolimus) are second-line for
sensitive areas. Oral corticosteroids are reserved for severe cases. Antihistamines
help with pruritus but are not primary treatment.
7. A 25-year-old patient develops erythematous, scaly patches on the scalp with
silvery scales and a positive Auspitz sign. What is the most likely diagnosis?
3
, A. Seborrheic dermatitis
B. Psoriasis
C. Tinea capitis
D. Lichen planus
Answer: B. Psoriasis
Rationale: Psoriasis on the scalp presents with silvery scales and Auspitz sign
(pinpoint bleeding when scale is removed). Seborrheic dermatitis has greasy,
yellow scales. Tinea capitis causes hair loss and black dots. Lichen planus is
pruritic, violaceous, and polygonal.
8. A patient presents with multiple skin tags and acanthosis nigricans. Which
condition should you screen for?
A. Diabetes mellitus
B. Hyperthyroidism
C. Adrenal insufficiency
D. Vitamin D deficiency
Answer: A. Diabetes mellitus
Rationale: Acanthosis nigricans and skin tags are associated with insulin resistance
and type 2 diabetes. Screening for diabetes is indicated.
9. A 70-year-old patient has a non-healing ulcer on the lower leg with irregular,
rolled borders and no pain. What is the most concerning diagnosis?
A. Venous stasis ulcer
B. Arterial ulcer
C. Marjolin's ulcer (squamous cell carcinoma)
D. Diabetic ulcer
Answer: C. Marjolin's ulcer (squamous cell carcinoma)
Rationale: A non-healing ulcer with rolled borders and no pain in an older patient
should raise suspicion for malignancy, especially squamous cell carcinoma arising
in chronic wounds. Venous ulcers are painful and have sloping edges; arterial
ulcers are painful and punched-out; diabetic ulcers are neuropathic.
10. What is the most common bacterial cause of cellulitis?
4
