Exam 2: NSG554/ NSG 554 (New 2024/ 2025 Update) - Nurse Practitioners in Primary Care I Exam | Questions and Verified Answers| 100% Correct| A Grade

Exam 2: NSG554/ NSG 554 (New 2024/ 2025 Update) - Nurse Practitioners in Primary Care I Exam | Questions and Verified Answers| 100% Correct| A Grade QUESTION Which type of office surgical procedure warrants sterile technique? a. Curettage b. Punch biopsy c. Scissor excision d. Shave biopsy Answer: B Punch biopsy requires sterile technique. The other procedures require cleaning with alcohol and clean technique with universal precautions. QUESTION When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug? a. Apply a thick layer of medication over the affected area. b. A solution spray preparation will be more effective on hairy areas. c. Put cool compresses over the affected area after application. d. Use a lotion or cream instead of an ointment preparation. Answer: B Hairy areas are difficult to penetrate, so in these areas, a solution, foam, spray, or gel may work better. Applying a thicker layer does not increase skin penetration or effectiveness of a medication. Warm or inflamed skin absorbs medications more readily; cool compresses will decrease absorption. Lotions and creams are not as readily absorbed as ointments, which have occlusive properties. QUESTION A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication? a. Cream b. Gel c. Ointment d. Powder Answer: B Gels are an excellent vehicle for use on hairy areas of the body. Creams and ointments are not recommended for hairy areas. Powders should be avoided in open wounds. QUESTION An adult patient has been diagnosed with atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp line. Which is correct when prescribing a corticosteroid medication to treat this condition? a. Initiate treatment with 0.1% triamcinolone acetonide. b. Monitor the patient closely for systemic adverse effects during use. c. Place an occlusive dressing over the medication after application. d. Prescribe 0.05% fluocinonide to apply liberally. Answer: A Treatment with 0.1% triamcinolone acetonide is appropriate in this case, because it is a class 4 corticosteroid and may be used on the face and is suggested for use for these conditions. Systemic side effects are rare when topical corticosteroids are used appropriately. Occlusive dressings increase the risk of adverse effects and are not recommended. 0.05% fluocinonide is a class III corticosteroid and should not be used on the face. QUESTION During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient's nose. What will the provider do? a. Consult with a dermatologist about possible melanoma. b. Reassure the patient that this is a benign lesion. c. Refer the patient for possible electrodessication and curettage. d. Tell the patient this is likely a squamous cell carcinoma. Answer: C This lesion is characteristic of basal cell carcinoma, which is treated with electrodessication and curettage. Melanoma lesions are usually asymmetric lesions with irregular borders, variable coloration, 6 mm diameter, which are elevated; these should be referred immediately. All suspicious lesions should be biopsied; until the results are known, the provider should not reassure the patient that the lesion is benign. Squamous cell carcinoma is roughened, scaling, and bleeds easily. QUESTION What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? a. Excisional biopsy b. Punch biopsy c. Shave biopsy d. Wide excision Answer: A A suspected malignant melanoma lesion should be biopsied with excisional biopsy; if diagnosed, a wide excision should follow. Punch and shave biopsy