High-Yield NCLEX-RN Style Questions with
Detailed Rationales (Updated 2025 Edition)
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1. What is the primary characteristic of a superficial partial‑thickness burn?
A. Affects epidermis only
B. Affects both epidermis and superficial dermis with blister formation
C. Full thickness involving subcutaneous tissue
D. Destroys muscle and bone
The answer is B
Explanation: Superficial partial‑thickness burns involve the epidermis and upper layers
of the dermis, cause redness and blistering, and blanch with pressure. They are painful,
often heal in 7–21 days with minimal scarring. Full‑thickness burns (choice C and D) are
deeper, while epidermal burns (A) do not blister.
2. Which intervention is appropriate for impaired skin integrity related to open burn
wounds?
A. Apply cold compress directly to wound
B. Cover with dry gauze only
C. Use sterile, moist dressings and change regularly
D. Expose wound to air to dry
The answer is C
Explanation: Maintaining a moist, sterile wound environment promotes
epithelialization, reduces pain, and prevents infection. Dry dressings can adhere to tissue,
air exposure can delay healing, and cold compresses can interfere with circulation.
3. A school‑aged child exhibits an erythematous, circular scalp patch with vesicles and
alopecia. The nurse suspects:
A. Tinea capitis
B. Psoriasis
C. Eczema
D. Impetigo
The answer is A
Explanation: Tinea capitis, a fungal infection, often presents with itchy, scaly patches
on the scalp, broken hair, and vesicles. Management includes oral antifungals. Psoriasis
shows silvery plaques, eczema is pruritic without alopecia, and impetigo has
honey‑crusted lesions.
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4. Which statement about psoriasis is correct?
A. It is a superficial fungal infection
B. Plaques have silvery scale and bleed when scraped
C. It involves only oil glands
D. It is a viral rash
The answer is B
Explanation: Psoriasis presents as well‑defined, red plaques with silvery, flaky scales
that often bleed (Auspitz sign) when removed. It is an autoimmune-mediated chronic
condition—not fungal, oil gland–related, or viral. Management includes topical steroids
and phototherapy.
5. A patient with cellulitis complains of pain, redness, and swelling of the lower leg.
The nurse’s priority is to:
A. Elevate the affected limb
B. Begin IV fluids
C. Apply warm compresses
D. Obtain wound cultures
The answer is A
Explanation: Elevation helps reduce edema and pain. Warm compresses can provide
comfort but do not address swelling. Cultures may be unnecessary unless there is an open
wound, and IV fluids are only indicated if systemic signs are present.
6. Which description fits third‑degree (full‑thickness) burns?
A. Red and painful
B. Blisters present
C. White, leathery, and painless
D. Only epidermis affected
The answer is C
Explanation: Full‑thickness burns destroy both epidermis and dermis, often presenting
with leathery texture and insensitivity due to nerve damage. They require surgical
intervention (e.g., grafting) and carry high infection risk.
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7. What is the most likely causative organism in impetigo?
A. Staphylococcus aureus
B. Candida albicans
C. Herpes simplex virus
D. Pseudomonas aeruginosa
The answer is A
Explanation: Impetigo is typically caused by Staph aureus (sometimes with
Streptococcus pyogenes), producing honey‑crusted lesions. Treatment includes topical or
systemic antibiotics. Fungal, viral, and opportunistic pathogens are rare causes.
8. Which characteristic is typical of basal cell carcinoma?
A. Rapid metastasis
B. Painless, pearly nodules with telangiectasia
C. Dark irregularly bordered lesion
D. Painful ulcerating lesion
The answer is B
Explanation: Basal cell carcinoma usually appears as a pearly papule with rolled edges
and visible blood vessels. It grows slowly and rarely metastasizes, but can ulcerate
locally. Melanoma (C) is irregular and pigmented.
9. A nurse assesses an elderly patient’s skin and notes senile purpura. This finding
indicates:
A. Excessive sun exposure
B. Vitamin C deficiency
C. Fragile blood vessels due to aging
D. Early melanoma
The answer is C
Explanation: With aging, collagen thinning causes blood vessels to rupture easily,
resulting in purpuric lesions after minor trauma. Although sun exposure accelerates
aging, this condition is a sign of natural changes.
10.Which condition is characterized by target lesions following herpes zoster?
A. Erythema multiforme
B. Psoriasis