WI L K E S · A DVA N C E D H E A LT H A S S E S S M E N T
NSG 500
Exam 2
A complete 100-question practice examination covering
integumentary, HEENT, thoracic and lung, cardiovascular,
peripheral vascular, abdominal, and musculoskeletal
assessment. Each question is followed by the correct
answer and a detailed rationale for focused review and
remediation.
100 Questions · Answers with Rationales
2026 update Single Full Examination
P R A C T I C E E X A M I N AT I O N · 2 0 2 6
,NSG 500 - Advanced Health Assessment | Exam 2
NSG 500 - Advanced Health Assessment
Examination 2 | 100 Questions | Answers with Rationales
1. Which description best defines a macule?
A. An elevated, circumscribed, fluid-filled lesion less than 1 cm in diameter
B. A flat, discolored area of skin that is always greater than 1 cm in diameter
C. A raised, solid palpable lesion larger than 1 cm in diameter
D. A flat, circumscribed, discolored area of skin measuring 1 cm or less in
diameter
Correct Answer: D
Rationale: A macule is a flat (nonpalpable), circumscribed color change up to 1 cm in diameter; a larger flat
lesion is called a patch. Option B describes a nodule, and option C describes a vesicle. Recognizing primary lesion
morphology is the foundation of dermatologic diagnosis because treatment and urgency differ substantially
between flat and raised lesions.
2. A 26-year-old man has well-demarcated, silvery-scaled plaques on the
extensor surfaces of both elbows and knees. When the scales are gently
removed, small pinpoint bleeding appears. What is this finding called, and with
which condition is it associated?
A. Auspitz sign, associated with psoriasis
B. Koebner phenomenon, associated with lichen planus
C. Darier sign, associated with mastocytosis
D. Nikolsky sign, associated with pemphigus vulgaris
Correct Answer: A
Rationale: Pinpoint bleeding after removal of silvery scales is the Auspitz sign, a classic feature of psoriasis,
especially on extensor surfaces. The Nikolsky sign (epidermis shearing with light tangential pressure) suggests
pemphigus vulgaris or toxic epidermal necrolysis, and the Koebner phenomenon refers to lesions appearing at
sites of trauma, which is the distractor most likely to be confused here.
3. A 68-year-old farmer has a 6-mm papule on his nose that is pearly with a
rolled border and fine telangiectatic vessels on its surface. This lesion is most
consistent with:
A. Basal cell carcinoma
B. Actinic keratosis
C. Melanoma
D. Squamous cell carcinoma
Wilkes University | 2026 Edition 1
,NSG 500 - Advanced Health Assessment | Exam 2
Correct Answer: A
Rationale: A pearly papule with rolled borders and telangiectasia on sun-exposed skin is the classic presentation
of nodular basal cell carcinoma, the most common skin cancer. Actinic keratosis is a rough, gritty scaling patch
that feels like sandpaper, while squamous cell carcinoma is typically an indurated, crusted or ulcerated nodule;
neither shows the pearly rolled border described.
Wilkes University | 2026 Edition 2
, NSG 500 - Advanced Health Assessment | Exam 2
4. When teaching a patient about melanoma self-screening, which set of criteria
should the nurse practitioner instruct the patient to monitor?
A. Area, Border, Color, Discomfort, Elasticity
B. Asymmetry, Blistering, Crusting, Discharge, Exudate
C. Asymmetry, Border irregularity, Color variation, Diameter greater than 6
mm, Evolution of the lesion
D. Alignment, Bleeding, Color, Depth, Elevation
Correct Answer: C
Rationale: The ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm,
Evolution/change) identifies lesions at risk for melanoma; evolution of a changing lesion is the most sensitive
single criterion. The distractor options mix unrelated terms, and instructing patients on the correct mnemonic
directly improves early detection and reduces melanoma mortality.
5. A bedridden patient develops an area of intact, non-blanchable deep red skin
over the sacrum. According to staging guidelines, this pressure injury is classified
as:
A. Stage 3
B. Unstageable
C. Stage 2
D. Stage 1
Correct Answer: D
Rationale: Non-blanchable erythema of intact skin defines a Stage 1 pressure injury; the epidermis has not yet
been breached. Stage 2 involves partial-thickness skin loss with exposed dermis, Stage 3 extends into
subcutaneous tissue, and a wound is unstageable when the base is obscured by slough or eschar, which is the
distractor often chosen when students mistake depth assessment for color change.
6. An annular lesion with a scaly, slightly raised border and central clearing is
found on the forearm of a school-aged child. This pattern is most
characteristic of:
A. Erythema migrans
B. Nummular eczema
C. Tinea corporis
D. Granuloma annulare
Wilkes University | 2026 Edition 3
NSG 500
Exam 2
A complete 100-question practice examination covering
integumentary, HEENT, thoracic and lung, cardiovascular,
peripheral vascular, abdominal, and musculoskeletal
assessment. Each question is followed by the correct
answer and a detailed rationale for focused review and
remediation.
100 Questions · Answers with Rationales
2026 update Single Full Examination
P R A C T I C E E X A M I N AT I O N · 2 0 2 6
,NSG 500 - Advanced Health Assessment | Exam 2
NSG 500 - Advanced Health Assessment
Examination 2 | 100 Questions | Answers with Rationales
1. Which description best defines a macule?
A. An elevated, circumscribed, fluid-filled lesion less than 1 cm in diameter
B. A flat, discolored area of skin that is always greater than 1 cm in diameter
C. A raised, solid palpable lesion larger than 1 cm in diameter
D. A flat, circumscribed, discolored area of skin measuring 1 cm or less in
diameter
Correct Answer: D
Rationale: A macule is a flat (nonpalpable), circumscribed color change up to 1 cm in diameter; a larger flat
lesion is called a patch. Option B describes a nodule, and option C describes a vesicle. Recognizing primary lesion
morphology is the foundation of dermatologic diagnosis because treatment and urgency differ substantially
between flat and raised lesions.
2. A 26-year-old man has well-demarcated, silvery-scaled plaques on the
extensor surfaces of both elbows and knees. When the scales are gently
removed, small pinpoint bleeding appears. What is this finding called, and with
which condition is it associated?
A. Auspitz sign, associated with psoriasis
B. Koebner phenomenon, associated with lichen planus
C. Darier sign, associated with mastocytosis
D. Nikolsky sign, associated with pemphigus vulgaris
Correct Answer: A
Rationale: Pinpoint bleeding after removal of silvery scales is the Auspitz sign, a classic feature of psoriasis,
especially on extensor surfaces. The Nikolsky sign (epidermis shearing with light tangential pressure) suggests
pemphigus vulgaris or toxic epidermal necrolysis, and the Koebner phenomenon refers to lesions appearing at
sites of trauma, which is the distractor most likely to be confused here.
3. A 68-year-old farmer has a 6-mm papule on his nose that is pearly with a
rolled border and fine telangiectatic vessels on its surface. This lesion is most
consistent with:
A. Basal cell carcinoma
B. Actinic keratosis
C. Melanoma
D. Squamous cell carcinoma
Wilkes University | 2026 Edition 1
,NSG 500 - Advanced Health Assessment | Exam 2
Correct Answer: A
Rationale: A pearly papule with rolled borders and telangiectasia on sun-exposed skin is the classic presentation
of nodular basal cell carcinoma, the most common skin cancer. Actinic keratosis is a rough, gritty scaling patch
that feels like sandpaper, while squamous cell carcinoma is typically an indurated, crusted or ulcerated nodule;
neither shows the pearly rolled border described.
Wilkes University | 2026 Edition 2
, NSG 500 - Advanced Health Assessment | Exam 2
4. When teaching a patient about melanoma self-screening, which set of criteria
should the nurse practitioner instruct the patient to monitor?
A. Area, Border, Color, Discomfort, Elasticity
B. Asymmetry, Blistering, Crusting, Discharge, Exudate
C. Asymmetry, Border irregularity, Color variation, Diameter greater than 6
mm, Evolution of the lesion
D. Alignment, Bleeding, Color, Depth, Elevation
Correct Answer: C
Rationale: The ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm,
Evolution/change) identifies lesions at risk for melanoma; evolution of a changing lesion is the most sensitive
single criterion. The distractor options mix unrelated terms, and instructing patients on the correct mnemonic
directly improves early detection and reduces melanoma mortality.
5. A bedridden patient develops an area of intact, non-blanchable deep red skin
over the sacrum. According to staging guidelines, this pressure injury is classified
as:
A. Stage 3
B. Unstageable
C. Stage 2
D. Stage 1
Correct Answer: D
Rationale: Non-blanchable erythema of intact skin defines a Stage 1 pressure injury; the epidermis has not yet
been breached. Stage 2 involves partial-thickness skin loss with exposed dermis, Stage 3 extends into
subcutaneous tissue, and a wound is unstageable when the base is obscured by slough or eschar, which is the
distractor often chosen when students mistake depth assessment for color change.
6. An annular lesion with a scaly, slightly raised border and central clearing is
found on the forearm of a school-aged child. This pattern is most
characteristic of:
A. Erythema migrans
B. Nummular eczema
C. Tinea corporis
D. Granuloma annulare
Wilkes University | 2026 Edition 3
