NUR 621 MODULE 3 EXAM STUDY GUIDE — UTICA
COLLEGE
Health Promotion & Primary Care I | 2026 Update
| Complete Solutions
Welcome to your Module 3 Study Guide. As your professor, I expect you to do more than just
memorize facts; I expect you to think like advanced practice nurses. Dermatology in primary
care requires sharp visual assessment, precise differential diagnosis, and the ability to
recognize the "red flag" that mandates an emergent referral. Master this guide, and you will
dominate this exam.
PART A: SKIN & SOFT TISSUE INFECTIONS DRILL (Questions 1–8)
1. A 45-year-old patient presents with a well-demarcated, diffuse area of erythema on the left
lower extremity. The area is warm, tender, and edematous. There is no open wound or
drainage. What is the most likely diagnosis?
A) Necrotizing fasciitis
B) Cellulitis
C) Diabetic ulcer
D) Kaposi's sarcoma
Correct Answer: B) Cellulitis
Rationale: Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissue
characterized by wide, diffuse erythema, warmth, tenderness, and edema.
High-Yield Pearl: Memorize the classic triad of cellulitis: Erythema + Warmth + Edema.
Absence of an open sore rules out a primary ulcer.
2. Which of the following clinical presentations is most highly suspicious for necrotizing
fasciitis, requiring immediate surgical consultation?
,A) Diffuse erythema with well-defined borders
B) Localized open sore with a necrotic base
C) Severe pain out of proportion to physical findings, rapid progression, and systemic toxicity
D) Purple-red nodules that are non-tender to palpation
Correct Answer: C) Severe pain out of proportion to physical findings, rapid progression, and
systemic toxicity
Rationale: Necrotizing fasciitis is a life-threatening emergency. "Pain out of proportion" is the
hallmark clinical clue distinguishing it from simple cellulitis.
High-Yield Pearl: On the exam, if you see "pain out of proportion," think necrotizing fasciitis.
Do not hesitate; escalate care immediately.
3. A patient with a history of HIV presents with asymptomatic, violaceous, round nodules on
the lower extremities. There is no warmth or tenderness. What is the most likely diagnosis?
A) Cellulitis
B) Kaposi's sarcoma
C) Necrotizing fasciitis
D) Diabetic ulcer
Correct Answer: B) Kaposi's sarcoma
Rationale: Kaposi's sarcoma is a vascular tumor associated with HHV-8 in
immunocompromised patients (like HIV/AIDS). It presents as purple-red nodules or plaques
and lacks the acute warmth/tenderness of an infection.
High-Yield Pearl: "Violaceous" + "HIV" + "Non-tender" = Kaposi's sarcoma.
4. A 60-year-old diabetic patient presents with a localized, deep open sore on the plantar
surface of the foot surrounded by a callus. Unlike cellulitis, this lesion is best described as:
A) A wide, diffuse area of erythema
B) A localized open sore without diffuse erythema
C) A rapidly spreading zone of ecchymosis
, D) A vascular tumor
Correct Answer: B) A localized open sore without diffuse erythema
Rationale: Diabetic ulcers are localized wounds, usually on pressure points (plantar surface),
caused by neuropathy and microvascular disease. They are distinct from the diffuse erythema
of cellulitis.
High-Yield Pearl: Differentiate by distribution: Cellulitis is diffuse; Diabetic ulcer is localized.
5. When initiating empiric treatment for uncomplicated cellulitis in a healthy adult, the FNP
should target which primary pathogens?
A) Staphylococcus and Streptococcus species
B) Pseudomonas aeruginosa and E. coli
C) Fungal species
D) Human Herpesvirus 8 (HHV-8)
Correct Answer: A) Staphylococcus and Streptococcus species
Rationale: Staph and Strep are the primary causative organisms of cellulitis. Empiric coverage
(e.g., cephalexin, dicloxacillin) must cover these.
High-Yield Pearl: If the patient has risk factors for MRSA (history of MRSA, IV drug use,
abscess), you must add MRSA coverage (e.g., doxycycline, TMP-SMX, or linezolid).
6. A patient returns to the clinic 48 hours after starting antibiotics for cellulitis. The FNP notes
the erythema has expanded by 2 cm, and the patient now has a fever of 101.5°F. What is the
next best action?
A) Reassure the patient that antibiotics take 72 hours to work
B) Discontinue the current antibiotic and prescribe a topical antifungal
C) Assess for MRSA risk factors, consider broadening antibiotic coverage, and evaluate for
deeper infection
D) Refer to oncology for suspected Kaposi's sarcoma
Correct Answer: C) Assess for MRSA risk factors, consider broadening antibiotic coverage, and
evaluate for deeper infection
COLLEGE
Health Promotion & Primary Care I | 2026 Update
| Complete Solutions
Welcome to your Module 3 Study Guide. As your professor, I expect you to do more than just
memorize facts; I expect you to think like advanced practice nurses. Dermatology in primary
care requires sharp visual assessment, precise differential diagnosis, and the ability to
recognize the "red flag" that mandates an emergent referral. Master this guide, and you will
dominate this exam.
PART A: SKIN & SOFT TISSUE INFECTIONS DRILL (Questions 1–8)
1. A 45-year-old patient presents with a well-demarcated, diffuse area of erythema on the left
lower extremity. The area is warm, tender, and edematous. There is no open wound or
drainage. What is the most likely diagnosis?
A) Necrotizing fasciitis
B) Cellulitis
C) Diabetic ulcer
D) Kaposi's sarcoma
Correct Answer: B) Cellulitis
Rationale: Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissue
characterized by wide, diffuse erythema, warmth, tenderness, and edema.
High-Yield Pearl: Memorize the classic triad of cellulitis: Erythema + Warmth + Edema.
Absence of an open sore rules out a primary ulcer.
2. Which of the following clinical presentations is most highly suspicious for necrotizing
fasciitis, requiring immediate surgical consultation?
,A) Diffuse erythema with well-defined borders
B) Localized open sore with a necrotic base
C) Severe pain out of proportion to physical findings, rapid progression, and systemic toxicity
D) Purple-red nodules that are non-tender to palpation
Correct Answer: C) Severe pain out of proportion to physical findings, rapid progression, and
systemic toxicity
Rationale: Necrotizing fasciitis is a life-threatening emergency. "Pain out of proportion" is the
hallmark clinical clue distinguishing it from simple cellulitis.
High-Yield Pearl: On the exam, if you see "pain out of proportion," think necrotizing fasciitis.
Do not hesitate; escalate care immediately.
3. A patient with a history of HIV presents with asymptomatic, violaceous, round nodules on
the lower extremities. There is no warmth or tenderness. What is the most likely diagnosis?
A) Cellulitis
B) Kaposi's sarcoma
C) Necrotizing fasciitis
D) Diabetic ulcer
Correct Answer: B) Kaposi's sarcoma
Rationale: Kaposi's sarcoma is a vascular tumor associated with HHV-8 in
immunocompromised patients (like HIV/AIDS). It presents as purple-red nodules or plaques
and lacks the acute warmth/tenderness of an infection.
High-Yield Pearl: "Violaceous" + "HIV" + "Non-tender" = Kaposi's sarcoma.
4. A 60-year-old diabetic patient presents with a localized, deep open sore on the plantar
surface of the foot surrounded by a callus. Unlike cellulitis, this lesion is best described as:
A) A wide, diffuse area of erythema
B) A localized open sore without diffuse erythema
C) A rapidly spreading zone of ecchymosis
, D) A vascular tumor
Correct Answer: B) A localized open sore without diffuse erythema
Rationale: Diabetic ulcers are localized wounds, usually on pressure points (plantar surface),
caused by neuropathy and microvascular disease. They are distinct from the diffuse erythema
of cellulitis.
High-Yield Pearl: Differentiate by distribution: Cellulitis is diffuse; Diabetic ulcer is localized.
5. When initiating empiric treatment for uncomplicated cellulitis in a healthy adult, the FNP
should target which primary pathogens?
A) Staphylococcus and Streptococcus species
B) Pseudomonas aeruginosa and E. coli
C) Fungal species
D) Human Herpesvirus 8 (HHV-8)
Correct Answer: A) Staphylococcus and Streptococcus species
Rationale: Staph and Strep are the primary causative organisms of cellulitis. Empiric coverage
(e.g., cephalexin, dicloxacillin) must cover these.
High-Yield Pearl: If the patient has risk factors for MRSA (history of MRSA, IV drug use,
abscess), you must add MRSA coverage (e.g., doxycycline, TMP-SMX, or linezolid).
6. A patient returns to the clinic 48 hours after starting antibiotics for cellulitis. The FNP notes
the erythema has expanded by 2 cm, and the patient now has a fever of 101.5°F. What is the
next best action?
A) Reassure the patient that antibiotics take 72 hours to work
B) Discontinue the current antibiotic and prescribe a topical antifungal
C) Assess for MRSA risk factors, consider broadening antibiotic coverage, and evaluate for
deeper infection
D) Refer to oncology for suspected Kaposi's sarcoma
Correct Answer: C) Assess for MRSA risk factors, consider broadening antibiotic coverage, and
evaluate for deeper infection
