NSG554 ACTUAL EXAM 2| WITH COMPLETE QUESTIONS AND ANSWERS |
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1. A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate
results, the provider will perform what intervention?
a. Blanch the lesions while examining them with a magnifying glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the lesions. - (ANSWER)ANS: D
The Tzanck test requires removing the tops from vesicular lesions in order to obtain fresh fluid from the base of the
lesions. Blanching of blue to red lesions under a microscope helps to evaluate whether blood is in the capillaries of the
lesions. Scraping lesions onto a slide is done to evaluate the presence of hyphae and spores common with candidiasis or
fungal infections. Gram staining is performed to distinguish gram-positive from gram-negative organisms in suspected
bacterial infections.
2. When examining a patient's skin, a practitioner uses dermoscopy for what purpose? (Select all that apply.)
a. Accentuating changes in color of pathologic lesions by fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions - (ANSWER)ANS: B, C, E
,Dermoscopy is used to visualize the epidermis and superficial dermis and can reveal changes in pigmentation throughout
lesions, whether borders are regular or irregular, and the various fissures, follicles, and pores present in lesions. The
Wood's light, or black light, is used to fluoresce lesions to accentuate changes in color. A direct light source is useful for
differentiating fluid masses from cystic masses.
3. A patient has actinic keratosis and the provider elects to use cryosurgery to remove the lesions. How will the provider
administer this procedure?
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
c. Applying until the freeze spreads laterally 1 mm from the lesion edges
d. Applying until the freeze spreads laterally 4 mm from the lesion edges - (ANSWER)ANS: A
For actinic keratosis, one to two freeze-thaw cycles are usually enough. Two or more freeze-thaw cycles are generally
required for thicker, seborrheic keratosis lesions. The freeze should spread laterally 3 to 4 mm from the edge of the
lesions.
4. A provider is preparing to administer electrocautery to a patient who has several seborrheic keratoses. The patient tells
the provider that he has a pacemaker. Which action is correct?
a. Administer the electrocautery per the usual protocol.
b. Apply electrocautery in short burst at low voltage.
c. Refer the patient to a dermatologist for removal.
d. Suggest another method for removal of the lesions. - (ANSWER)ANS: B
,Patients with pacemakers or implantable cardioverter-defibrillators may receive electrocautery if appropriate precautions,
such as lower voltage and shorter bursts are taken. It is not necessary to suggest another method or to refer to a
dermatologist.
5. Which type of office surgical procedure warrants sterile technique?
a. Curettage
b. Punch biopsy
c. Scissor excision
d. Shave biopsy - (ANSWER)ANS: B
Punch biopsy requires sterile technique. The other procedures require cleaning with alcohol and clean technique with
universal precautions.
6. 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)ANS: 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.
7. 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)ANS: 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.
8. 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)ANS: 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
2025/206 LATEST UPDATED | 100 % RATED AND VERIFIED SOLUTIONS | GET
AN A+
1. A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate
results, the provider will perform what intervention?
a. Blanch the lesions while examining them with a magnifying glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the lesions. - (ANSWER)ANS: D
The Tzanck test requires removing the tops from vesicular lesions in order to obtain fresh fluid from the base of the
lesions. Blanching of blue to red lesions under a microscope helps to evaluate whether blood is in the capillaries of the
lesions. Scraping lesions onto a slide is done to evaluate the presence of hyphae and spores common with candidiasis or
fungal infections. Gram staining is performed to distinguish gram-positive from gram-negative organisms in suspected
bacterial infections.
2. When examining a patient's skin, a practitioner uses dermoscopy for what purpose? (Select all that apply.)
a. Accentuating changes in color of pathologic lesions by fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions - (ANSWER)ANS: B, C, E
,Dermoscopy is used to visualize the epidermis and superficial dermis and can reveal changes in pigmentation throughout
lesions, whether borders are regular or irregular, and the various fissures, follicles, and pores present in lesions. The
Wood's light, or black light, is used to fluoresce lesions to accentuate changes in color. A direct light source is useful for
differentiating fluid masses from cystic masses.
3. A patient has actinic keratosis and the provider elects to use cryosurgery to remove the lesions. How will the provider
administer this procedure?
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
c. Applying until the freeze spreads laterally 1 mm from the lesion edges
d. Applying until the freeze spreads laterally 4 mm from the lesion edges - (ANSWER)ANS: A
For actinic keratosis, one to two freeze-thaw cycles are usually enough. Two or more freeze-thaw cycles are generally
required for thicker, seborrheic keratosis lesions. The freeze should spread laterally 3 to 4 mm from the edge of the
lesions.
4. A provider is preparing to administer electrocautery to a patient who has several seborrheic keratoses. The patient tells
the provider that he has a pacemaker. Which action is correct?
a. Administer the electrocautery per the usual protocol.
b. Apply electrocautery in short burst at low voltage.
c. Refer the patient to a dermatologist for removal.
d. Suggest another method for removal of the lesions. - (ANSWER)ANS: B
,Patients with pacemakers or implantable cardioverter-defibrillators may receive electrocautery if appropriate precautions,
such as lower voltage and shorter bursts are taken. It is not necessary to suggest another method or to refer to a
dermatologist.
5. Which type of office surgical procedure warrants sterile technique?
a. Curettage
b. Punch biopsy
c. Scissor excision
d. Shave biopsy - (ANSWER)ANS: B
Punch biopsy requires sterile technique. The other procedures require cleaning with alcohol and clean technique with
universal precautions.
6. 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)ANS: 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.
7. 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)ANS: 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.
8. 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)ANS: 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
