Final Exam: NR 577 (NR577) Primary Care Management of Adolescents and
Adults Final Exam Review| Guide with Answers Chamberlain University
This study resource is built for Family Nurse Practitioner students preparing for
the NR 577 Final Exam. It mirrors the style, difficulty, and topic coverage of the
Chamberlain University curriculum, covering the management of acute and
chronic conditions across adolescents and adults. The unique MCQs include
verified updated answers and detailed rationales
1. A patient presents with thickened, yellow-brown, crumbling nails on both
feet. The surrounding skin is clear. What is the most likely diagnosis?
A) Tinea pedis
B) Onychomycosis
C) Psoriasis
D) Lichen planus
Explanation: Onychomycosis is a fungal infection of the nail bed that typically
presents with thickened, discolored, and brittle nails. Unlike tinea pedis, the
infection is limited to the nails and does not typically involve the surrounding
interdigital skin.
2. A 24-year-old patient presents with an intensely itchy, oozy, and crusted
rash on the flexural surfaces of the elbows and knees. The patient reports
the itching started before the rash appeared. What is the most likely
diagnosis?
A) Psoriasis
B) Eczema
C) Lichen planus
D) Contact dermatitis
,Explanation: Eczema (atopic dermatitis) classically presents as an itchy, oozy,
crusted lesion. A hallmark feature is that the itch often precedes the visible rash
(the "itch that rashes").
3. A 45-year-old patient presents with thick, non-scaly, purplish, polygonal
lesions limited to the wrists, limbs, and oral mucosa. What is the most likely
diagnosis?
A) Psoriasis
B) Eczema
C) Lichen planus
D) Tinea corporis
Explanation: Lichen planus presents as thick, non-scaly, violaceous (purple)
lesions. It commonly affects the flexural surfaces of the wrists, limbs, and oral
mucosa (presenting as Wickham striae).
4. Which of the following is NOT considered a risk or complication of
obesity?
A) Osteopenia
B) Type 2 Diabetes Mellitus
C) Obstructive Sleep Apnea
D) Polycystic Ovarian Syndrome (PCOS)
Explanation: Obesity is strongly associated with increased bone density and
osteoarthritis due to mechanical load, but it is generally protective against
osteopenia/osteoporosis. However, it increases the risk of HTN, dyslipidemia,
,DM2, coronary heart disease, stroke, gallbladder disease, OA, sleep apnea, cancer,
PCOS, mental health issues, eating disorders, and generalized pain.
5. A 60-year-old presents with a pearly, translucent papule with
telangiectasias on the nose. What is the most likely diagnosis?
A) Melanoma
B) Squamous cell carcinoma
C) Basal cell carcinoma
D) Actinic keratosis
Explanation: Basal cell carcinoma (BCC) is the most common skin cancer and
classically presents as a pearly, translucent papule with overlying telangiectasias,
most often on sun-exposed areas like the nose.
6. A patient has a mole with asymmetric borders, varied colors, and a
diameter greater than 6mm. What is the priority action?
A) Cryotherapy
B) Topical corticosteroids
C) Urgent dermatology referral for biopsy
D) Reassurance and observation
Explanation: The ABCDEs (Asymmetry, Border irregularity, Color variation,
Diameter >6mm, Evolving) are highly suspicious for melanoma. An urgent referral
for biopsy is required.
, 7. What is the first-line treatment for mild-to-moderate acne vulgaris?
A) Oral isotretinoin
B) Topical retinoids (e.g., tretinoin)
C) Oral antibiotics
D) Oral spironolactone
Explanation: Topical retinoids are the cornerstone of acne therapy. They
normalize follicular keratinization and are first-line for mild-to-moderate
comedonal and inflammatory acne.
8. A 32-year-old female presents with a malar rash, flushing, and
telangiectasias. She notes that her face gets worse with sun exposure and
hot drinks. What is the most likely diagnosis?
A) Acne vulgaris
B) Systemic lupus erythematosus
C) Rosacea
D) Seborrheic dermatitis
Explanation: Rosacea is a chronic inflammatory skin condition characterized by
facial flushing, erythema, telangiectasias, and papules/pustules. It is classically
triggered by sun exposure, heat, spicy foods, and alcohol.
9. A patient presents with an erythematous, warm, swollen leg with poorly
defined borders. What is the most appropriate initial treatment?
A) Topical mupirocin
B) Oral cephalexin
Adults Final Exam Review| Guide with Answers Chamberlain University
This study resource is built for Family Nurse Practitioner students preparing for
the NR 577 Final Exam. It mirrors the style, difficulty, and topic coverage of the
Chamberlain University curriculum, covering the management of acute and
chronic conditions across adolescents and adults. The unique MCQs include
verified updated answers and detailed rationales
1. A patient presents with thickened, yellow-brown, crumbling nails on both
feet. The surrounding skin is clear. What is the most likely diagnosis?
A) Tinea pedis
B) Onychomycosis
C) Psoriasis
D) Lichen planus
Explanation: Onychomycosis is a fungal infection of the nail bed that typically
presents with thickened, discolored, and brittle nails. Unlike tinea pedis, the
infection is limited to the nails and does not typically involve the surrounding
interdigital skin.
2. A 24-year-old patient presents with an intensely itchy, oozy, and crusted
rash on the flexural surfaces of the elbows and knees. The patient reports
the itching started before the rash appeared. What is the most likely
diagnosis?
A) Psoriasis
B) Eczema
C) Lichen planus
D) Contact dermatitis
,Explanation: Eczema (atopic dermatitis) classically presents as an itchy, oozy,
crusted lesion. A hallmark feature is that the itch often precedes the visible rash
(the "itch that rashes").
3. A 45-year-old patient presents with thick, non-scaly, purplish, polygonal
lesions limited to the wrists, limbs, and oral mucosa. What is the most likely
diagnosis?
A) Psoriasis
B) Eczema
C) Lichen planus
D) Tinea corporis
Explanation: Lichen planus presents as thick, non-scaly, violaceous (purple)
lesions. It commonly affects the flexural surfaces of the wrists, limbs, and oral
mucosa (presenting as Wickham striae).
4. Which of the following is NOT considered a risk or complication of
obesity?
A) Osteopenia
B) Type 2 Diabetes Mellitus
C) Obstructive Sleep Apnea
D) Polycystic Ovarian Syndrome (PCOS)
Explanation: Obesity is strongly associated with increased bone density and
osteoarthritis due to mechanical load, but it is generally protective against
osteopenia/osteoporosis. However, it increases the risk of HTN, dyslipidemia,
,DM2, coronary heart disease, stroke, gallbladder disease, OA, sleep apnea, cancer,
PCOS, mental health issues, eating disorders, and generalized pain.
5. A 60-year-old presents with a pearly, translucent papule with
telangiectasias on the nose. What is the most likely diagnosis?
A) Melanoma
B) Squamous cell carcinoma
C) Basal cell carcinoma
D) Actinic keratosis
Explanation: Basal cell carcinoma (BCC) is the most common skin cancer and
classically presents as a pearly, translucent papule with overlying telangiectasias,
most often on sun-exposed areas like the nose.
6. A patient has a mole with asymmetric borders, varied colors, and a
diameter greater than 6mm. What is the priority action?
A) Cryotherapy
B) Topical corticosteroids
C) Urgent dermatology referral for biopsy
D) Reassurance and observation
Explanation: The ABCDEs (Asymmetry, Border irregularity, Color variation,
Diameter >6mm, Evolving) are highly suspicious for melanoma. An urgent referral
for biopsy is required.
, 7. What is the first-line treatment for mild-to-moderate acne vulgaris?
A) Oral isotretinoin
B) Topical retinoids (e.g., tretinoin)
C) Oral antibiotics
D) Oral spironolactone
Explanation: Topical retinoids are the cornerstone of acne therapy. They
normalize follicular keratinization and are first-line for mild-to-moderate
comedonal and inflammatory acne.
8. A 32-year-old female presents with a malar rash, flushing, and
telangiectasias. She notes that her face gets worse with sun exposure and
hot drinks. What is the most likely diagnosis?
A) Acne vulgaris
B) Systemic lupus erythematosus
C) Rosacea
D) Seborrheic dermatitis
Explanation: Rosacea is a chronic inflammatory skin condition characterized by
facial flushing, erythema, telangiectasias, and papules/pustules. It is classically
triggered by sun exposure, heat, spicy foods, and alcohol.
9. A patient presents with an erythematous, warm, swollen leg with poorly
defined borders. What is the most appropriate initial treatment?
A) Topical mupirocin
B) Oral cephalexin
