Comprehensive Nurse Practitioner Exam Review: Clinical Questions and Explanations
primary lesion - (ANSWER)lesion that develops on previously unaltered skin
lesion - (ANSWER)a region in an organ or tissue that has suffered damage thru injury or disease
secondary lesion - (ANSWER)lesion that either changes impression over time or occurs when a primary
lesion is scratched it may be infected
macule - (ANSWER)circumscribed flat area; different color and texture from surrounding tissue, <1cm
ex.) ephelides (freckles), petechia, flat nevi (moles)
patch - (ANSWER)a large macule; >1cm
ex.) mongolian spot, Cafe, au lair spot
papule - (ANSWER)Small solid elevated lesion; <1cm
ex.) bug bite, elevated nevus (mole) or verruca (wart)
plaque - (ANSWER)elevation of skin; >1cm; example psoriasis lesion
pustule - (ANSWER)a visible accumulation of purulent fluid under skin; <1cm; examples acne and
impetigo
vesicle - (ANSWER)a circumscribed elevation of skin contains "SEROUS FLUID: <1cm; examples, herpes
simples, varicella, shingles
nodule - (ANSWER)solid mass of skin, is elevated or palpated >1cm; often extends deeper into dermis:
examples xanthoma and fibroma
bulla - (ANSWER)blister, circumscribed elevation containing fluid >1cm , extends only into epidermis,
examples burns, superficial blister, contact dermatitis
,Comprehensive Nurse Practitioner Exam Review: Clinical Questions and Explanations
wheal - (ANSWER)elevated white or pink compressible papule or plaque, a red, axon-mediated flare
often surround it, commonly associated with allergic reaction, examples PPD test and mosquito bites
cyst - (ANSWER)any closed cavity or sac; contains fluid or semisolid material, normal or abnormal
epithelium. example sebaceous cyst
Abscess - (ANSWER)a localized collection of purulent fluid in a cavity formed by disintegration or
necrosis of tissues >1cm
tumor - (ANSWER)"MASS: > few cm in diameter; firm or soft; benign or malignant
configuration: annular - (ANSWER)circular, begins in center and spreads to periphery
configuration: confluent - (ANSWER)lesions run together
configuration: grouped - (ANSWER)lesion cluster
configuration: gyrate - (ANSWER)twisted, coiled, spiral and snake like
configuration: linear - (ANSWER)scratch, streak, line stripe
configuration: polycyclic - (ANSWER)annular lesions merge
configuration: solitary or discrete - (ANSWER)individual and distinct lesions that remain separate
configuration: target (iris) - (ANSWER)resembles iris of eye; lesion with concentric rings of color
configuration: zosteriform - (ANSWER)linear arrangement along nerve route
, Comprehensive Nurse Practitioner Exam Review: Clinical Questions and Explanations
comedones - (ANSWER)open are called black heads (openings capped with a blackened skin debris); and
closed are called white head (obstructed)
acne - (ANSWER)can be comedones, pustules, papules (pimples and zits), cysts, nodules and scaring
nonpharmacological management of acne - (ANSWER)wash several times daily with soap and water;
avoid topical oil based; use oil free cleansers and moisterizers
pharmacological management of acne - (ANSWER)comedolytic agents: benzoyl peroxice, salicylic acid,
topical antibiotics (clindamycin, erythromycin, tetracycline and metronidazole for rosacea). May
consider oral antibiotics and oral contraceptives
folliculitis - (ANSWER)inflammation of hair follicle; common cause staphylococci
furuncle - (ANSWER)"boil" localized infection in hair follicle, caused by staph
carbuncle - (ANSWER)>furuncle; may be necrotizing, staph
cellulitis - (ANSWER)most common causes: out patients strep ; inpatient: gram negative (ecoli, klebsiels,
psuedomonsa, enterbacter, staph aureus and strep
MRSA - (ANSWER)trimethoprm-sulfamethoxazole (bactrim); doxy, clindamycin
group a strep - (ANSWER)bactrim + beta lactam (PCN, amoxicillin , keflex) or doxy/inocycline +beta
lactam or clindamycin
erysipelas - (ANSWER)usually caused by strep, rapid progression of an erythematous, warm indurated
area (looks like sunburn,)
primary lesion - (ANSWER)lesion that develops on previously unaltered skin
lesion - (ANSWER)a region in an organ or tissue that has suffered damage thru injury or disease
secondary lesion - (ANSWER)lesion that either changes impression over time or occurs when a primary
lesion is scratched it may be infected
macule - (ANSWER)circumscribed flat area; different color and texture from surrounding tissue, <1cm
ex.) ephelides (freckles), petechia, flat nevi (moles)
patch - (ANSWER)a large macule; >1cm
ex.) mongolian spot, Cafe, au lair spot
papule - (ANSWER)Small solid elevated lesion; <1cm
ex.) bug bite, elevated nevus (mole) or verruca (wart)
plaque - (ANSWER)elevation of skin; >1cm; example psoriasis lesion
pustule - (ANSWER)a visible accumulation of purulent fluid under skin; <1cm; examples acne and
impetigo
vesicle - (ANSWER)a circumscribed elevation of skin contains "SEROUS FLUID: <1cm; examples, herpes
simples, varicella, shingles
nodule - (ANSWER)solid mass of skin, is elevated or palpated >1cm; often extends deeper into dermis:
examples xanthoma and fibroma
bulla - (ANSWER)blister, circumscribed elevation containing fluid >1cm , extends only into epidermis,
examples burns, superficial blister, contact dermatitis
,Comprehensive Nurse Practitioner Exam Review: Clinical Questions and Explanations
wheal - (ANSWER)elevated white or pink compressible papule or plaque, a red, axon-mediated flare
often surround it, commonly associated with allergic reaction, examples PPD test and mosquito bites
cyst - (ANSWER)any closed cavity or sac; contains fluid or semisolid material, normal or abnormal
epithelium. example sebaceous cyst
Abscess - (ANSWER)a localized collection of purulent fluid in a cavity formed by disintegration or
necrosis of tissues >1cm
tumor - (ANSWER)"MASS: > few cm in diameter; firm or soft; benign or malignant
configuration: annular - (ANSWER)circular, begins in center and spreads to periphery
configuration: confluent - (ANSWER)lesions run together
configuration: grouped - (ANSWER)lesion cluster
configuration: gyrate - (ANSWER)twisted, coiled, spiral and snake like
configuration: linear - (ANSWER)scratch, streak, line stripe
configuration: polycyclic - (ANSWER)annular lesions merge
configuration: solitary or discrete - (ANSWER)individual and distinct lesions that remain separate
configuration: target (iris) - (ANSWER)resembles iris of eye; lesion with concentric rings of color
configuration: zosteriform - (ANSWER)linear arrangement along nerve route
, Comprehensive Nurse Practitioner Exam Review: Clinical Questions and Explanations
comedones - (ANSWER)open are called black heads (openings capped with a blackened skin debris); and
closed are called white head (obstructed)
acne - (ANSWER)can be comedones, pustules, papules (pimples and zits), cysts, nodules and scaring
nonpharmacological management of acne - (ANSWER)wash several times daily with soap and water;
avoid topical oil based; use oil free cleansers and moisterizers
pharmacological management of acne - (ANSWER)comedolytic agents: benzoyl peroxice, salicylic acid,
topical antibiotics (clindamycin, erythromycin, tetracycline and metronidazole for rosacea). May
consider oral antibiotics and oral contraceptives
folliculitis - (ANSWER)inflammation of hair follicle; common cause staphylococci
furuncle - (ANSWER)"boil" localized infection in hair follicle, caused by staph
carbuncle - (ANSWER)>furuncle; may be necrotizing, staph
cellulitis - (ANSWER)most common causes: out patients strep ; inpatient: gram negative (ecoli, klebsiels,
psuedomonsa, enterbacter, staph aureus and strep
MRSA - (ANSWER)trimethoprm-sulfamethoxazole (bactrim); doxy, clindamycin
group a strep - (ANSWER)bactrim + beta lactam (PCN, amoxicillin , keflex) or doxy/inocycline +beta
lactam or clindamycin
erysipelas - (ANSWER)usually caused by strep, rapid progression of an erythematous, warm indurated
area (looks like sunburn,)
