NU 518 Exam 3 Study Questions and Answers
Question 1.
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular
skin check-up. She has just returned from her annual dig site in Greece. She has fair skin
and reddish-blonde hair. She has a family history of melanoma. She has many freckles
scattered across her skin. From this description, which of the following is not a risk factor
for melanoma in this patient? A) Age B) Hair color C) Actinic lentigines D) Heavy sun
exposure
Correct Answer: A
Question 2.
You are speaking to an 8th grade class about health prevention and are preparing to
discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the
ABCDEs? A) A = actinic; B = basal cell; C = color changes, especially blue; D = diameter
>6 mm; E =evolution B) A = asymmetry; B = irregular borders; C = color changes,
especially blue; D = diameter >6 mm; E = evolution C) A = actinic; B = irregular borders;
C = keratoses; D = dystrophic nails; E = evolution D) A = asymmetry; B = regular borders;
C = color changes, especially orange; D = diameter >6 mm; E = evolution
Correct Answer: B
Question 3.
You are beginning the examination of the skin on a 25-year-old teacher. You have
previously elicited that she came to the office for evaluation of fatigue, weight gain, and
hair loss. You strongly suspect that she has hypothyroidism. What is the expected
moisture and texture of the skin of a patient with hypothyroidism? A) Moist and smooth B)
Moist and rough C) Dry and smooth D) Dry and rough
Correct Answer: D
Question 4.
A 28-year-old patient comes to the office for evaluation of a rash. At first there was only
one large patch, but then more lesions erupted suddenly on the back and torso; the
lesions itch. On physical examination, you note that the pattern of eruption is like a
Christmas tree and that there are a variety of erythematous papules and macules on the
cleavage lines of the back. Based on this description, what is the most likely diagnosis? A)
Pityriasis rosea B) Tinea versicolor C) Psoriasis D) Atopic eczema
Correct Answer: A
Question 5.
A 19-year-old construction worker presents for evaluation of a rash. He notes that it
started on his back with a multitude of spots and is also on his arms, chest, and neck. It
itches a lot. He does sweat more than before because being outdoors is part of his job. On
physical examination, you note dark tan patches with a reddish cast that has sharp
,borders and fine scales, scattered more prominently around the upper back, chest, neck,
and upper arms as well as under the arms. Based on this description, what is your most
likely diagnosis? A) Pityriasis rosea B) Tinea versicolor C) Psoriasis D) Atopic eczema
Correct Answer: B
Question 6.
A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the
right temporal area of the forehead, you see a flattened papule the same color as his skin,
covered by a dry scale that is round and feels hard. He has several more of these
scattered on the forehead, arms, and legs. Based on this description, what is your most
likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma D)
Squamous cell carcinoma
Correct Answer: A
Question 7.
A 58-year-old gardener comes to your office for evaluation of a new lesion on her upper
chest. The lesion appears to be "stuck on" and is oval, brown, and slightly elevated with a
flat surface. It has a rough, wartlike texture on palpation. Based on this description, what is
your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell
carcinoma D) Squamous cell carcinoma
Correct Answer: B
Question 8.
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the
hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on
the ventilator for 3 weeks. You are completing your initial assessment and are evaluating
her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter,
with damage to the subcutaneous tissue. The underlying muscle is not affected. You
diagnose this as a pressure ulcer. What is the stage of this ulcer? A) Stage 1 B) Stage 2 C)
Stage 3 D) Stage 4
Correct Answer: C
Question 9.
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or
twisting her hair, and her mother has not noted this behavior at all. She does not put her
hair in braids. On physical examination, you note a clearly demarcated, round patch of hair
loss without visible scaling or inflammation. There are no hair shafts visible. Based on this
description, what is your most likely diagnosis? A) Alopecia areata B) Trichotillomania C)
Tinea capitis D) Traction alopecia
Correct Answer: A
Question 10.
A mother brings her 11 month old to you because her mother-in-law and others have told
her that her baby is jaundiced. She is eating and growing well and performing the
,developmental milestones she should for her age. On examination you indeed notice a
yellow tone to her skin from head to toe. Her sclerae are white. To which area should your
next questions be related? A) Diet B) Family history of liver diseases C) Family history of
blood diseases D) Ethnicity of the child
Correct Answer: A
Question 11.
A new mother is concerned that her child occasionally "turns blue." On further questioning,
she mentions that this is at her hands and feet. She does not remember the child's lips
turning blue. She is otherwise eating and growing well. What would you do now? A)
Reassure her that this is normal B) Obtain an echocardiogram to check for structural heart
disease and consult cardiology C) Admit the child to the hospital for further observation D)
Question the validity of her story
Correct Answer: A
Question 12.
You are examining an unconscious patient from another region and notice Beau's lines, a
transverse groove across all of her nails, about 1 cm from the proximal nail fold. What
would you do next? A) Conclude this is caused by a cultural practice. B) Conclude this
finding is most likely secondary to trauma. C) Look for information from family and records
regarding any problems which occurred 3 months ago. D) Ask about dietary intake.
Correct Answer: C
Question 13.
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of
exposure to ill people or other agents in the environment. He has a slight fever in the
office. The rash consists of small, bright red marks. When they are pressed, the red color
remains. What should you do? A) Prescribe a steroid cream to decrease inflammation. B)
Consider admitting the patient to the hospital. C) Reassure the parents and the patient
that this should resolve within a week. D) Tell him not to scratch them, and follow up in 3
days.
Correct Answer: B
Question 14.
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you press on
the rash, it doesn't blanch. What would you tell her regarding her rash? A) It is likely to be
related to her lupus. B) It is likely to be related to an exposure to a chemical. C) It is likely
to be related to an allergic reaction. D) It should not cause any problems.
Correct Answer: A
Question 15.
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his
scapula. It has been there for about a year and is getting larger. He says his wife has been
, able to squeeze out a cheesy-textured substance on occasion. He worries this may be
cancer. When gently pinched from the side, a prominent dimple forms in the middle of the
mass. What is most likely? A) An enlarged lymph node B) A sebaceous cyst C) An actinic
keratosis D) A malignant lesion
Correct Answer: B
Question 16.
A young man comes to you with an extremely pruritic rash over his knees and elbows
which has come and gone for several years. It seems to be worse in the winter and
improves with some sun exposure. On examination, you notice scabbing and crusting with
some silvery scale, and you are observant enough to notice small "pits" in his nails. What
would account for these findings? A) Eczema B) Pityriasis rosea C) Psoriasis D) Tinea
infection
Correct Answer: C
Question 17.
Mrs. Anderson presents with an itchy rash which is raised and appears and disappears in
various locations. Each lesion lasts for many minutes. What most likely accounts for this
rash? A) Insect bites B) Urticaria, or hives C) Psoriasis D) Purpura
Correct Answer: B
Question 18.
Ms. Whiting is a 68-year-old who comes in for her usual follow-up visit. You notice a few
flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her
forearms but nowhere else. She doesn't mention them. They are tender when you examine
them. What should you do? A) Conclude that these are lesions she has had for a long time.
B) Wait for her to mention them before asking further questions. C) Ask how she acquired
them. D) Conduct the visit as usual for the patient.
Correct Answer: C
Question 19.
A middle-aged man comes in because he has noticed multiple small, blood-red, raised
lesions over his anterior chest and abdomen for the past several months. They are not
painful and he has not noted any bleeding or bruising. He is concerned this may be
consistent with a dangerous condition. What should you do? A) Reassure him that there is
nothing to worry about. B) Do laboratory work to check for platelet problems. C) Obtain an
extensive history regarding blood problems and bleeding disorders. D) Do a skin biopsy in
the office.
Correct Answer: A
Question 20.
The nurse educator is preparing an education module for the nursing staff on the
epidermal layer of skin. Which of these statements would be included in the module? The
epidermis is: a Highly vascular. B Thick and tough. C Thin and nonstratified D Replaced
Question 1.
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular
skin check-up. She has just returned from her annual dig site in Greece. She has fair skin
and reddish-blonde hair. She has a family history of melanoma. She has many freckles
scattered across her skin. From this description, which of the following is not a risk factor
for melanoma in this patient? A) Age B) Hair color C) Actinic lentigines D) Heavy sun
exposure
Correct Answer: A
Question 2.
You are speaking to an 8th grade class about health prevention and are preparing to
discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the
ABCDEs? A) A = actinic; B = basal cell; C = color changes, especially blue; D = diameter
>6 mm; E =evolution B) A = asymmetry; B = irregular borders; C = color changes,
especially blue; D = diameter >6 mm; E = evolution C) A = actinic; B = irregular borders;
C = keratoses; D = dystrophic nails; E = evolution D) A = asymmetry; B = regular borders;
C = color changes, especially orange; D = diameter >6 mm; E = evolution
Correct Answer: B
Question 3.
You are beginning the examination of the skin on a 25-year-old teacher. You have
previously elicited that she came to the office for evaluation of fatigue, weight gain, and
hair loss. You strongly suspect that she has hypothyroidism. What is the expected
moisture and texture of the skin of a patient with hypothyroidism? A) Moist and smooth B)
Moist and rough C) Dry and smooth D) Dry and rough
Correct Answer: D
Question 4.
A 28-year-old patient comes to the office for evaluation of a rash. At first there was only
one large patch, but then more lesions erupted suddenly on the back and torso; the
lesions itch. On physical examination, you note that the pattern of eruption is like a
Christmas tree and that there are a variety of erythematous papules and macules on the
cleavage lines of the back. Based on this description, what is the most likely diagnosis? A)
Pityriasis rosea B) Tinea versicolor C) Psoriasis D) Atopic eczema
Correct Answer: A
Question 5.
A 19-year-old construction worker presents for evaluation of a rash. He notes that it
started on his back with a multitude of spots and is also on his arms, chest, and neck. It
itches a lot. He does sweat more than before because being outdoors is part of his job. On
physical examination, you note dark tan patches with a reddish cast that has sharp
,borders and fine scales, scattered more prominently around the upper back, chest, neck,
and upper arms as well as under the arms. Based on this description, what is your most
likely diagnosis? A) Pityriasis rosea B) Tinea versicolor C) Psoriasis D) Atopic eczema
Correct Answer: B
Question 6.
A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the
right temporal area of the forehead, you see a flattened papule the same color as his skin,
covered by a dry scale that is round and feels hard. He has several more of these
scattered on the forehead, arms, and legs. Based on this description, what is your most
likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma D)
Squamous cell carcinoma
Correct Answer: A
Question 7.
A 58-year-old gardener comes to your office for evaluation of a new lesion on her upper
chest. The lesion appears to be "stuck on" and is oval, brown, and slightly elevated with a
flat surface. It has a rough, wartlike texture on palpation. Based on this description, what is
your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell
carcinoma D) Squamous cell carcinoma
Correct Answer: B
Question 8.
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the
hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on
the ventilator for 3 weeks. You are completing your initial assessment and are evaluating
her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter,
with damage to the subcutaneous tissue. The underlying muscle is not affected. You
diagnose this as a pressure ulcer. What is the stage of this ulcer? A) Stage 1 B) Stage 2 C)
Stage 3 D) Stage 4
Correct Answer: C
Question 9.
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or
twisting her hair, and her mother has not noted this behavior at all. She does not put her
hair in braids. On physical examination, you note a clearly demarcated, round patch of hair
loss without visible scaling or inflammation. There are no hair shafts visible. Based on this
description, what is your most likely diagnosis? A) Alopecia areata B) Trichotillomania C)
Tinea capitis D) Traction alopecia
Correct Answer: A
Question 10.
A mother brings her 11 month old to you because her mother-in-law and others have told
her that her baby is jaundiced. She is eating and growing well and performing the
,developmental milestones she should for her age. On examination you indeed notice a
yellow tone to her skin from head to toe. Her sclerae are white. To which area should your
next questions be related? A) Diet B) Family history of liver diseases C) Family history of
blood diseases D) Ethnicity of the child
Correct Answer: A
Question 11.
A new mother is concerned that her child occasionally "turns blue." On further questioning,
she mentions that this is at her hands and feet. She does not remember the child's lips
turning blue. She is otherwise eating and growing well. What would you do now? A)
Reassure her that this is normal B) Obtain an echocardiogram to check for structural heart
disease and consult cardiology C) Admit the child to the hospital for further observation D)
Question the validity of her story
Correct Answer: A
Question 12.
You are examining an unconscious patient from another region and notice Beau's lines, a
transverse groove across all of her nails, about 1 cm from the proximal nail fold. What
would you do next? A) Conclude this is caused by a cultural practice. B) Conclude this
finding is most likely secondary to trauma. C) Look for information from family and records
regarding any problems which occurred 3 months ago. D) Ask about dietary intake.
Correct Answer: C
Question 13.
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of
exposure to ill people or other agents in the environment. He has a slight fever in the
office. The rash consists of small, bright red marks. When they are pressed, the red color
remains. What should you do? A) Prescribe a steroid cream to decrease inflammation. B)
Consider admitting the patient to the hospital. C) Reassure the parents and the patient
that this should resolve within a week. D) Tell him not to scratch them, and follow up in 3
days.
Correct Answer: B
Question 14.
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you press on
the rash, it doesn't blanch. What would you tell her regarding her rash? A) It is likely to be
related to her lupus. B) It is likely to be related to an exposure to a chemical. C) It is likely
to be related to an allergic reaction. D) It should not cause any problems.
Correct Answer: A
Question 15.
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his
scapula. It has been there for about a year and is getting larger. He says his wife has been
, able to squeeze out a cheesy-textured substance on occasion. He worries this may be
cancer. When gently pinched from the side, a prominent dimple forms in the middle of the
mass. What is most likely? A) An enlarged lymph node B) A sebaceous cyst C) An actinic
keratosis D) A malignant lesion
Correct Answer: B
Question 16.
A young man comes to you with an extremely pruritic rash over his knees and elbows
which has come and gone for several years. It seems to be worse in the winter and
improves with some sun exposure. On examination, you notice scabbing and crusting with
some silvery scale, and you are observant enough to notice small "pits" in his nails. What
would account for these findings? A) Eczema B) Pityriasis rosea C) Psoriasis D) Tinea
infection
Correct Answer: C
Question 17.
Mrs. Anderson presents with an itchy rash which is raised and appears and disappears in
various locations. Each lesion lasts for many minutes. What most likely accounts for this
rash? A) Insect bites B) Urticaria, or hives C) Psoriasis D) Purpura
Correct Answer: B
Question 18.
Ms. Whiting is a 68-year-old who comes in for her usual follow-up visit. You notice a few
flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her
forearms but nowhere else. She doesn't mention them. They are tender when you examine
them. What should you do? A) Conclude that these are lesions she has had for a long time.
B) Wait for her to mention them before asking further questions. C) Ask how she acquired
them. D) Conduct the visit as usual for the patient.
Correct Answer: C
Question 19.
A middle-aged man comes in because he has noticed multiple small, blood-red, raised
lesions over his anterior chest and abdomen for the past several months. They are not
painful and he has not noted any bleeding or bruising. He is concerned this may be
consistent with a dangerous condition. What should you do? A) Reassure him that there is
nothing to worry about. B) Do laboratory work to check for platelet problems. C) Obtain an
extensive history regarding blood problems and bleeding disorders. D) Do a skin biopsy in
the office.
Correct Answer: A
Question 20.
The nurse educator is preparing an education module for the nursing staff on the
epidermal layer of skin. Which of these statements would be included in the module? The
epidermis is: a Highly vascular. B Thick and tough. C Thin and nonstratified D Replaced
