MARYVILLE NURS 623
EXAM 1 (2025)
QUESTIONS AND
(ELABORATED) WITH
COMPLETE SOLUTIONS
Basics with skin conditions - CORRECT ANSWER -•Alopecia
•Rash
•Pruritus
•Uticaria
•Pigmentation change
Skin lesion—New vs. Change
HPI questions for skin problems - CORRECT ANSWER -Duration of symptoms
Precipitating factors
•Medications
•Food
•Occupation
•Outdoors
•Hobbies/Sport participation
•Exposure to insects
•Jewelry/metals/chemicals
•Family history
,Is it:
Local or systemic
Pruritus- all day or worse at night
Uticaria - duration
Pigmented changes
Pigmentation/Changes of the skin Diff diagnosis - CORRECT ANSWER -Nevi- brown, beige
or pink(< 5mm)
Melanoma
Related to pregnancy- melasma (mask of pregnancy)
Addison disease
Side effect of medication- steroid therapy
skin lesions - CORRECT ANSWER -Macule - flat, nonpalpable (freckle, petechia)
Papule - PALPABLE, solid elevation of skin (elevated nevus)
Nodule - elevated solid mass, deeper and firmer than papule (wart)
Tumor - solid mass deep in subcutaneous tissue (epithelioma)
Wheal - irregularly shaped, elevated area (hive, mosquito bite
Vesicle - elevation of skin with serous (clear) fluid
Pustule - similar to vesicle but filled with pus (acne)
Ulcer - deep loss of skin (venous statis ulcer)
,Atophy - thinning of skin
Bullae-Clear fluid-filled blisters > 10 mm in diameter. These may be caused by burns, bites,
irritant or allergic contact dermatitis, and drug reactions.
primary versus secondary skin lesions - CORRECT ANSWER -Primary skin lesions are those
which develop as a direct result of the disease process.
Secondary lesions are those which evolve from primary lesions or develop as a consequence
of the patient's activities.
Parasitic Skin Infections - CORRECT ANSWER -scabies and lice
Scabies - CORRECT ANSWER -Highly contagious infestation that occurs mainly in children,
young adults, health care workers, and institutionalized persons of all ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas of body most
attractive to mites. Itching, excoriation, , crusting, and scaling may be present making it hard
to see scabies.
Diagnostics:Ink burrow test
Scabies treatment - CORRECT ANSWER -Permethrin 5% cream (Remember you have 5
fingers)- leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
, The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
Lice treatment - CORRECT ANSWER -Permethrin 1% leave on for 10 mins then rinse. May
repeat in 7 days if needed.
Fungal skin infections - CORRECT ANSWER -· Candidiasis- bright, beefy red rash treat with
topical antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective, educate
patient.
· Fungal infections survive on keratin, so considered superficial.
· Pathogens: Epidermophyton, trichophyton, microsporum.
· Those at risk are DM and immunocompromised.
· Diagnostics: KOH
Tinea corporis
(Ringworm of body) - CORRECT ANSWER -Hx of erythematous round and elevated pruritic
lesion that grows in size & starts to clear in the center
Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1%
Tinea capitus (ringworm of head) - CORRECT ANSWER -Children common. Painless bald
spot, may have kerion that looks like honeycomb, inflammation. Boggy mass containing
broken hairs and oozing purulent material from follicular orifices
EXAM 1 (2025)
QUESTIONS AND
(ELABORATED) WITH
COMPLETE SOLUTIONS
Basics with skin conditions - CORRECT ANSWER -•Alopecia
•Rash
•Pruritus
•Uticaria
•Pigmentation change
Skin lesion—New vs. Change
HPI questions for skin problems - CORRECT ANSWER -Duration of symptoms
Precipitating factors
•Medications
•Food
•Occupation
•Outdoors
•Hobbies/Sport participation
•Exposure to insects
•Jewelry/metals/chemicals
•Family history
,Is it:
Local or systemic
Pruritus- all day or worse at night
Uticaria - duration
Pigmented changes
Pigmentation/Changes of the skin Diff diagnosis - CORRECT ANSWER -Nevi- brown, beige
or pink(< 5mm)
Melanoma
Related to pregnancy- melasma (mask of pregnancy)
Addison disease
Side effect of medication- steroid therapy
skin lesions - CORRECT ANSWER -Macule - flat, nonpalpable (freckle, petechia)
Papule - PALPABLE, solid elevation of skin (elevated nevus)
Nodule - elevated solid mass, deeper and firmer than papule (wart)
Tumor - solid mass deep in subcutaneous tissue (epithelioma)
Wheal - irregularly shaped, elevated area (hive, mosquito bite
Vesicle - elevation of skin with serous (clear) fluid
Pustule - similar to vesicle but filled with pus (acne)
Ulcer - deep loss of skin (venous statis ulcer)
,Atophy - thinning of skin
Bullae-Clear fluid-filled blisters > 10 mm in diameter. These may be caused by burns, bites,
irritant or allergic contact dermatitis, and drug reactions.
primary versus secondary skin lesions - CORRECT ANSWER -Primary skin lesions are those
which develop as a direct result of the disease process.
Secondary lesions are those which evolve from primary lesions or develop as a consequence
of the patient's activities.
Parasitic Skin Infections - CORRECT ANSWER -scabies and lice
Scabies - CORRECT ANSWER -Highly contagious infestation that occurs mainly in children,
young adults, health care workers, and institutionalized persons of all ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas of body most
attractive to mites. Itching, excoriation, , crusting, and scaling may be present making it hard
to see scabies.
Diagnostics:Ink burrow test
Scabies treatment - CORRECT ANSWER -Permethrin 5% cream (Remember you have 5
fingers)- leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
, The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
Lice treatment - CORRECT ANSWER -Permethrin 1% leave on for 10 mins then rinse. May
repeat in 7 days if needed.
Fungal skin infections - CORRECT ANSWER -· Candidiasis- bright, beefy red rash treat with
topical antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective, educate
patient.
· Fungal infections survive on keratin, so considered superficial.
· Pathogens: Epidermophyton, trichophyton, microsporum.
· Those at risk are DM and immunocompromised.
· Diagnostics: KOH
Tinea corporis
(Ringworm of body) - CORRECT ANSWER -Hx of erythematous round and elevated pruritic
lesion that grows in size & starts to clear in the center
Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1%
Tinea capitus (ringworm of head) - CORRECT ANSWER -Children common. Painless bald
spot, may have kerion that looks like honeycomb, inflammation. Boggy mass containing
broken hairs and oozing purulent material from follicular orifices
