CMN 577 FINAL EXAM QUESTIONS WITH COMPLETE SOLUTIONS

CMN 577 FINAL EXAM QUESTIONS WITH
COMPLETE SOLUTIONS

An |8-year |boy |presents |to |the |clinic |with |8 |light-brown, |oval |macule |lesions |on |his |skin. |One |of
|those |lesion |measures |1.6 |cm. |What |is |the |child |at |risk |for?




a. Normal |finding

b. Neurofibromatosis

c. Melanoma

d. Tinea |versicolor |- |ANSWER Neurofibromatosis

Isotretinoin |(Accutane) |is |commonly |used |for |the |treatment |of |severe |cystic |acne |that |has |not
|responded |to |standard |treatment. |Which |of |the |following |considerations |is |not |true |for


|prescribing |Isotretinoin?




a) Isotretinoin |can |be |prescribed |by |any |healthcare |provider.

b) Isotretinoin |is |a |category |X |drug |and |requires |2 |forms |of |contraception, |one |of |which |can |be
|abstinence.




c) Before |use |of |Isotretinoin, |the |patient |must |sign |an |informed |consent |and |become |enrolled |in
|a |monitoring |program |called |iPledge.




d) If |a |patient's |acne |relapses |on |Isotretinoin, |then |they |may |complete |a |second |round |of |the
|therapy. |- |ANSWER a) |Isotretinoin |can |be |prescribed |by |any |healthcare |provider.

A |1-month-old |female |presents |to |your |clinic |with |her |mother |for |a |well |child |check. |The |mother
|reports |a |bright |red, |rubbery |appearing |bump |that |is |located |on |her |daughter's |neck. |She |says |that


|it |started |out |as |a |flat |red |area, |but |now |it |has |grown |and |is |sticking |out. |This |most |likely


|represents |which |type |of |birthmark:




a) Mongolian |spot

b) Port-wine |stain

c) Hemangioma

d) Melanocytic |nevi |- |ANSWER c) |Hemangioma

You |are |seeing |a |6-year-old |male |who |was |brought |in |by |his |mother. |The |mother |reports |they
|recently |took |a |family |vacation |last |week |and |stayed |in |a |few |different |hotels. |He |developed


|significant |itching |and |a |rash |the |day |of |returning |home. |He |is |noted |to |continuously |scratch

,during |the |visit. |The |father |and |older |sister |also |have |a |similar |rash |that |developed |at |the |same
|time. |On |exam, |you |note |linear |burrows |around |his |wrists, |ankles, |in |the |webbing |of |his |fingers,


|and |axillary |folds |with |excoriations |present. |There |is |no |facial |involvement. |He |has |never |had


|anything |like |this |before. |The |most |likely |diagnosis |would |be:




A. Atopic |Dermatitis

B. Impetigo

C. Molluscum |Contagiosum

D. Scabies |- |ANSWER D. |Scabies

A |16-year-old |female |presents |to |clinic |accompanied |by |her |mother. |She |has |a |rash |that
|appears |as |erythematous |plaques |with |thick, |white, |silvery |overlying |scales |on |her |elbows,


|knees, |and |umbilicus. |She |reports |this |has |been |going |on |for |about |2 |years |and |tends |to |come |and


|go. |The |mother |reports |her |father |has |psoriasis. |The |patient |is |not |on |any |medications |and |she


|is |not |currently |treating |her |rash |with |anything. |She |has |tried |various |moisturizers |in |the |past


|but |has |never |had |a |prescription |to |treat |this. |She |weighs |130 |pounds |and |has |no |allergies. |You


|diagnose |her |with |psoriasis |with |body |surface |area |involvement |less |than |10%. |Which |is |the


|best |option |as |first |line |therapy?




A. Ketoconazole |(Nizoral) |2% |cream

B. Clobetasol |(Temovate) |0.05% |ointment

C. Over |the |counter |hydrocortisone |(Cortizone-10) |1% |cream

D. Oral |prednisone |40 |mg |x |3 |days, |30 |mg |x |3 |days, |20 |mg |x |3 |days, |10 |mg |x |3 |days |- |ANSWER
B. |Clobetasol |(Temovate) |0.05% |ointment

A |3-year-old-boy |presents |to |clinic |with |his |mother |with |honey-colored |crusted |sores |around |his
|mouth |and |nose. |The |mother |states |her |son |started |attending |daycare |a |couple |of |weeks |ago


|and |noticed |the |sores |starting |to |develop |earlier |this |week. |Which |highly |contagious |childhood


|illness |do |you |suspect?




A. Impetigo

B. Varicella

C. Herpes |Simplex

D. Molluscum |contagiosum |- |ANSWER A. |Impetigo

Blepharitis |that |occurs |in |children |has |a |strong |correlation |with |which |disease?

,a. Rosacea

b. Eczema

c. Psoriasis

d. Pityriasis |rosea |- |ANSWER a. |Rosacea

A |child |with |Sturge-Weber |Syndrome |(SWS) |will |most |likely |have |what |finding |on |the |physical
|exam?




A) Port |wine |nevus |on |the |face

B) Mongolian |spot

C) Allergic |shiners

D) Retractions |- |ANSWER A) |Port |wine |nevus |on |the |face

1. What |skin |disorder |is |seen |with |short |hyphae |and |yeast |on |microscopic |examination |of
|scales?




A. Tinea |Versicolor

B. Pityriasis |Rosea

C. Psoriasis

D. Atopic |Dermatitis |- |ANSWER A. |Tinea |Versicolor

A |mother |brings |her |two-month-old |to |your |clinic |to |establish |care |after |a |recent |move. |She |asks
|you |about |a |raised |red |"mole-like" |spot |on |the |infant's |forehead |that |has |grown |in |size |over |the


|last |few |weeks. |You |determine |it |is |most |likely |a |hemangioma. |The |mother |then |asks |what |the


|treatment |is. |What |would |be |an |appropriate |response?




A. Watchful |approach |is |appropriate |as |these |lesions |typically |fade |as |the |child |ages

B. Oral |steroids |can |be |taken |to |shrink |the |size |of |the |lesion

C. Topical |antibiotics |to |treat |the |infection |causing |the |redness

D. Surgical |intervention |to |remove |the |lesion |- |ANSWER A. |Watchful |approach |is |appropriate
|as |these |lesions |typically |fade |as |the |child |ages




1. At |the |6-month |checkup |a |mother |is |inquiring |about |a |bulge |in |her |son's |right |groin. |She
|states |it |comes |and |goes |and |seems |to |disappear |when |he |is |fussing. |The |bulge |is |non |tender
|when |palpated |and |has |a |'silk |glove' |feel. |The |findings |are |most |consistent |with |which |type |of

, hernia?

a. hiatal

b. umbilical

c. inguinal

d. paraesophageal |- |ANSWER c. |inguinal

A |62-year-old |female |with |osteoarthritis |of |her |left |knee |is |prescribed |meloxicam |(Mobic)
7.5mg |PO |daily |for |pain; |when |reviewing |the |patient's |history |and |developing |the |patient's
|treatment |plan, |the |nurse |practitioner |knows |to |assess |for:




A. |History |of |GERD |and |advice |the |patient |to |eat |bland |foods |to |prevent |GI |complications

B. |History |of |peptic |ulcer |disease |and |prescribe |a |PPI |along |with |an |NSAID

C. |The |patient's |pain |level |and |start |her |on |the |highest |dose |of |NSAID |to |knock |out |the |patient's
|pain




D. |History |of |peptic |ulcer |disease |and |advice |the |patient |to |take |meloxicam |on |an |empty
|stomach |- |ANSWER | B. |History |of |peptic |ulcer |disease |and |prescribe |a |PPI |along |with |an


|NSAID




You |are |evaluating |a |4-year-old |child |for |possible |Duchenne |muscular |dystrophy |(DMD). |All |of |the
|following |are |characteristic |of |DMD |except:




A. |Delayed |motor |milestones

B. |Excessive |lumbar |lordosis

C. |Increased |gastrointestinal |motility

D. |Walking |on |toes |- |ANSWER C. |Increased |gastrointestinal |motility

Your |next |patient |is |a |60-year-old |female. |At |the |patient's |yearly |wellness |exam, |she |mentions
|that |her |hands |and |fingers |have |started |having |pain. |This |pain |is |usually |in |the |mornings |and


|improve |with |increased |movement |as |the |day |goes |on. |She |can |hardly |open |her |bottle |of |water


|when |the |pain |is |more |severe, |and |the |joints |in |her |fingers |appear |swollen. |She |also |says |as |the


|months |go |by, |she |feels |her |pain |is |steadily |getting |worse. |What |type |of |arthritis |does |the


|advanced |practice |nurse |suspect?




A. |Rheumatoid |Arthritis

B. |Old |Age