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NSG 500 Exam 4 – Wilkes Advanced Health
Assessment (2026) Actual Questions & Study Guide
Guaranteed Pass | Graded A+ | Advanced Health
Assessment – Wilkes University
NSG 500 EXAM 4 – PRACTICE QUESTIONS & VERIFIED ANSWERS
SECTION 1: INTEGUMENTARY SYSTEM ASSESSMENT
1 A 68-year-old client presents with a skin lesion that is asymmetrical, has irregular borders,
and contains multiple colors. The nurse practitioner should suspect which of the following?
A. Seborrheic keratosis
B. Actinic keratosis
C. Malignant melanoma
D. Basal cell carcinoma
Correct Answer: C
Explanation: The ABCDE criteria for melanoma include Asymmetry, irregular Borders,
multiple Colors, Diameter >6 mm, and Evolution. This client's lesion exhibits Asymmetry, Border
irregularity, and multiple Colors (A, B, C), which are classic warning signs for malignant
melanoma. Seborrheic keratosis (A) typically appears as a waxy, stuck-on lesion. Actinic
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keratosis (B) presents as a rough, scaly patch on sun-exposed skin. Basal cell carcinoma (D)
often appears as a pearly, waxy bump with telangiectasia.
2 The nurse practitioner is assessing a client's skin turgor. Which of the following is the MOST
appropriate site for this assessment in an older adult?
A. The dorsal surface of the hand
B. The forearm or sternum
C. The abdomen
D. The forehead
Correct Answer: B
Explanation: Skin turgor is assessed by pinching the skin on the forearm or sternum and
observing how quickly it returns to normal. In older adults, the dorsal surface of the hand (A) is
less reliable due to age-related loss of elasticity. The abdomen (C) and forehead (D) are not
standard sites for turgor assessment.
3 A client presents with a circular, erythematous rash with a central clearing on the forearm.
The client reports recent exposure to a wooded area. This finding is MOST consistent with:
A. Contact dermatitis
B. Erythema migrans (Lyme disease)
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C. Tinea corporis
D. Urticaria
Correct Answer: B
Explanation: Erythema migrans is the characteristic rash of Lyme disease, presenting as a
circular, erythematous rash with central clearing ("bull's-eye" appearance). It typically appears
3-30 days after a tick bite. Contact dermatitis (A) is typically localized to the area of exposure.
Tinea corporis (C) is a fungal infection that often presents as a scaly, annular rash. Urticaria (D)
presents as raised, pruritic wheals.
4 The nurse practitioner is assessing a client's nails. Which of the following findings is associated
with iron deficiency anemia?
A. Clubbing
B. Koilonychia (spoon nails)
C. Beau's lines
D. Terry's nails
Correct Answer: B
Explanation: Koilonychia, or spoon nails, is characterized by concave, spoon-shaped nails
and is associated with iron deficiency anemia. Clubbing (A) is associated with chronic hypoxia
and cardiopulmonary disease. Beau's lines (C) are transverse depressions in the nail associated
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with severe illness. Terry's nails (D) are white nails with a pink band at the tip, associated with
cirrhosis and chronic renal failure.
5 A client reports a skin lesion that has been present for several years and has not changed. The
lesion is brown, waxy, and appears "stuck on" the skin. This is MOST consistent with:
A. Seborrheic keratosis
B. Actinic keratosis
C. Malignant melanoma
D. Squamous cell carcinoma
Correct Answer: A
Explanation: Seborrheic keratosis is a benign, non-cancerous skin growth that appears as a
brown, waxy, "stuck-on" lesion. It is common in older adults and does not typically change or
become malignant. Actinic keratosis (B) is a rough, scaly patch that is premalignant. Malignant
melanoma (C) is characterized by change and ABCDE criteria. Squamous cell carcinoma (D)
typically presents as a scaly, crusted lesion that may ulcerate.
6 The nurse practitioner is assessing a client's skin for pressure ulcers. Which stage is
characterized by full-thickness skin loss with exposed bone, tendon, or muscle?
A. Stage 1
B. Stage 2
NSG 500 Exam 4 – Wilkes Advanced Health
Assessment (2026) Actual Questions & Study Guide
Guaranteed Pass | Graded A+ | Advanced Health
Assessment – Wilkes University
NSG 500 EXAM 4 – PRACTICE QUESTIONS & VERIFIED ANSWERS
SECTION 1: INTEGUMENTARY SYSTEM ASSESSMENT
1 A 68-year-old client presents with a skin lesion that is asymmetrical, has irregular borders,
and contains multiple colors. The nurse practitioner should suspect which of the following?
A. Seborrheic keratosis
B. Actinic keratosis
C. Malignant melanoma
D. Basal cell carcinoma
Correct Answer: C
Explanation: The ABCDE criteria for melanoma include Asymmetry, irregular Borders,
multiple Colors, Diameter >6 mm, and Evolution. This client's lesion exhibits Asymmetry, Border
irregularity, and multiple Colors (A, B, C), which are classic warning signs for malignant
melanoma. Seborrheic keratosis (A) typically appears as a waxy, stuck-on lesion. Actinic
,2
keratosis (B) presents as a rough, scaly patch on sun-exposed skin. Basal cell carcinoma (D)
often appears as a pearly, waxy bump with telangiectasia.
2 The nurse practitioner is assessing a client's skin turgor. Which of the following is the MOST
appropriate site for this assessment in an older adult?
A. The dorsal surface of the hand
B. The forearm or sternum
C. The abdomen
D. The forehead
Correct Answer: B
Explanation: Skin turgor is assessed by pinching the skin on the forearm or sternum and
observing how quickly it returns to normal. In older adults, the dorsal surface of the hand (A) is
less reliable due to age-related loss of elasticity. The abdomen (C) and forehead (D) are not
standard sites for turgor assessment.
3 A client presents with a circular, erythematous rash with a central clearing on the forearm.
The client reports recent exposure to a wooded area. This finding is MOST consistent with:
A. Contact dermatitis
B. Erythema migrans (Lyme disease)
,3
C. Tinea corporis
D. Urticaria
Correct Answer: B
Explanation: Erythema migrans is the characteristic rash of Lyme disease, presenting as a
circular, erythematous rash with central clearing ("bull's-eye" appearance). It typically appears
3-30 days after a tick bite. Contact dermatitis (A) is typically localized to the area of exposure.
Tinea corporis (C) is a fungal infection that often presents as a scaly, annular rash. Urticaria (D)
presents as raised, pruritic wheals.
4 The nurse practitioner is assessing a client's nails. Which of the following findings is associated
with iron deficiency anemia?
A. Clubbing
B. Koilonychia (spoon nails)
C. Beau's lines
D. Terry's nails
Correct Answer: B
Explanation: Koilonychia, or spoon nails, is characterized by concave, spoon-shaped nails
and is associated with iron deficiency anemia. Clubbing (A) is associated with chronic hypoxia
and cardiopulmonary disease. Beau's lines (C) are transverse depressions in the nail associated
, 4
with severe illness. Terry's nails (D) are white nails with a pink band at the tip, associated with
cirrhosis and chronic renal failure.
5 A client reports a skin lesion that has been present for several years and has not changed. The
lesion is brown, waxy, and appears "stuck on" the skin. This is MOST consistent with:
A. Seborrheic keratosis
B. Actinic keratosis
C. Malignant melanoma
D. Squamous cell carcinoma
Correct Answer: A
Explanation: Seborrheic keratosis is a benign, non-cancerous skin growth that appears as a
brown, waxy, "stuck-on" lesion. It is common in older adults and does not typically change or
become malignant. Actinic keratosis (B) is a rough, scaly patch that is premalignant. Malignant
melanoma (C) is characterized by change and ABCDE criteria. Squamous cell carcinoma (D)
typically presents as a scaly, crusted lesion that may ulcerate.
6 The nurse practitioner is assessing a client's skin for pressure ulcers. Which stage is
characterized by full-thickness skin loss with exposed bone, tendon, or muscle?
A. Stage 1
B. Stage 2
