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Nr 511 / Nr511 Mid-Term

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NR 511 / NR511 MID-TERM LATEST EXAM 2024 2 VERSIONS WITH OVER 350 ACTUAL QUESTIONS WITH DETAILED VERIFIED ANSWERS AND RATIONALES/ BRAND NEW!! | A+ GRADE ASSURED | 100% GUARANTEED PASS!! BRAND NEW UPDATES A 16-year-old male presents to your office. He was sent by an orthopedist. He has recently had surgical fixation of a humerus fracture. The patient has been going to physical therapy and has been developing a rash on his arm after therapy that disappears shortly after returning home. He does not have the rash prior to therapy. The patient denies fevers and chills, and his incision is well healed, with no signs of infection. Of note, the patient has been experiencing more hand edema than the average patient and has had edema wraps used at the end of therapy to help with his swelling. The wraps are made of a synthetic plastic material. The rash the patient gets is erythematous and blotchy, not raised; it is on the operative upper extremity. What is the most likely diagnosis? 1.Contact dermatitis. 2.Atopic dermatitis. 3.Seborrheic dermatitis. 4.Psoriasis. - ANSWER- Contact dermatitis. rationale: The patient's history and rash are consistent with a latex or plastic sensitivity due to the edema wraps used in therapy. Elizabeth, age 83, presents with a 2-day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules at that site. What do you suspect? 1.Varicella. 2.Herpes zoster. 3.Syphilis. 4.Rubella - ANSWER- herpes zoster rationale: The rash of herpes zoster is distinctive, in that it appears on only one side of the body. Herpes zoster begins in a dermatomal distribution, most commonly in the thoracic, cervical, and lumbosacral areas, although it also occurs on the face. The classic presentation is when there is pain for 1-2 days preceding the eruption. A biopsy of a small, yellow-orange papulonodule on the eyelid will probably show: 1.Fragmented, calcified elastic tissue. 2.Mature sebaceous glands. 3.Lipid-laden cells. 4.Endothelial swelling and an infiltrate rich in plasma cells - ANSWER- lipid-laden cells rationale: A biopsy of a small, yellow-orange papulonodule on the eyelid will probably show lipid-laden cells. This is a description of a noneruptive xanthoma of the eyelid (xanthelasma). Sandy asks what she can do for Dolores, her 90-year-old mother, who takes a bath every day and who has extremely dry skin. You respond: 1."After bathing every day, use a generous amount of moisturizer." 2."Use a special moisturizing soap every day." 3."Your mother does not need a bath every day." 4."Increase your mother's intake of fluids." - ANSWER- "Your mother does not need a bath every day." rationale: Dolores does not need a bath every day because that will exacerbate the dryness of her skin Helen, age 39, comes to your clinic for generalized joint pain, especially in the knees and hands. She tells you that the pain is moderate, spreading, and symmetrical. She reports having had a sore throat and low-grade fever for a few days and then developing a rash, described as warm erythema of the cheeks, which lasted about 4 days before disappearing. You ask her if the rash on the cheeks included the nasolabial folds or circumoral skin, and she tells you that it did not cover these areas. Two days later, she developed a nonspecific macular eruption that preceded the joint pain. Her rash faded within 2 weeks, but she tells you that it comes and goes if she bathes in hot water or spends time in the sunlight. Your patient's symptoms are most consistent with a diagnosis of: 1.Rubella. 2.Erythema infectiosum. 3.Rheumatoid arthritis. 4.Scarlet fever - ANSWER- Erythema infectiosum. rationale: Erythema infectiosum (fifth disease) is distinguished by its erythematous, warm rash, which gives the appearance of "slapped cheeks," and it does not involve the nasolabial folds or the circumoral region. Women are more likely to have joint pain as a symptom of erythema infectiosum.

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NR 511 / NR511 MID-
a a a a




TERM LATEST EXAM 2024 2 VERSIONS WITH OVER 350
a a a a a a a a




a ACTUAL QUESTIONS WITH DETAILED VERIFIED ANS
a a a a a




WERS AND RATIONALES/ BRAND NEW!! | A+ GRADE A
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Aa16-year-

oldamaleapresentsatoayouraoffice.aHeawasasentabyaanaorthopedist.aHeahasarecentlyahadasurg

icalafixationaofaaahumerusafracture.aTheapatientahasabeenagoingatoaphysicalatherapyaandaha

sabeenadevelopingaaarashaonahisaarmaafteratherapyathatadisappearsashortlyaafterareturningah

ome.aHeadoesanotahaveathearashaprioratoatherapy.aTheapatientadeniesafeversaandachills,aand

hisaincisionaisawellahealed,awithanoasignsaofainfection.aOfanote,atheapatientahasabeenaexperi
a




encingamoreahandaedemaathanatheaaverageapatientaandahasahadaedemaawrapsausedaatath

eaendaofatherapyatoahelpawithahisaswelling.aTheawrapsaareamadeaofaaasyntheticaplasticamate

rial.aThearashatheapatientagetsaisaerythematousaandablotchy,anotaraised;aitaisaonatheaoperativ

eaupperaextremity.aWhataisatheamostalikelyadiagnosis?

1.Contactadermatitis.

2.Atopicadermatitis.

3.Seborrheicadermatitis.

4.Psoriasis.a-aANSWER-aContactadermatitis.

,rationale:aTheapatient'sahistoryaandarashaareaconsistentawithaaalatexaoraplasticasensitivityadu

eatoatheaedemaawrapsausedainatherapy.



Elizabeth,aagea83,apresentsawithaaa2-

dayahistoryaofapainaandaburningainathealeftaforehead.aThisamorningasheanoticedaaarashawitha

erythematousapapulesaatathatasite.aWhatadoayouasuspect?

1.Varicella.

2.Herpesazoster.

3.Syphilis.

4.Rubellaa-aANSWER-aherpesazoster



rationale:aThearashaofaherpesazosteraisadistinctive,ainathataitaappearsaonaonlyaoneasideaofathe

body.aHerpesazosterabeginsainaaadermatomaladistribution,amostacommonlyainatheathoracic,a
a




cervical,aandalumbosacralaareas,aalthoughaitaalsoaoccursaonatheaface.aTheaclassicapresenta

tionaisawhenathereaisapainafora1-2adaysaprecedingatheaeruption.



Aabiopsyaofaaasmall,ayellow-orangeapapulonoduleaonatheaeyelidawillaprobablyashow:

1.Fragmented,acalcifiedaelasticatissue.

2.Matureasebaceousaglands.

3.Lipid-ladenacells.

4.Endothelialaswellingaandaanainfiltratearichainaplasmaacellsa-aANSWER-alipid-ladenacells

,rationale:aAabiopsyaofaaasmall,ayellow-

orangeapapulonoduleaonatheaeyelidawillaprobablyashowalipid-

ladenacells.aThisaisaaadescriptionaofaaanoneruptiveaxanthomaaofatheaeyelida(xanthelasma).



SandyaasksawhatasheacanadoaforaDolores,ahera90-year-

oldamother,awhoatakesaaabathaeveryadayaandawhoahasaextremelyadryaskin.aYouarespond:

1."Afterabathingaeveryaday,auseaaagenerousaamountaofamoisturizer."

2."Useaaaspecialamoisturizingasoapaeveryaday."

3."Youramotheradoesanotaneedaaabathaeveryaday."

4."Increaseayouramother'saintakeaofafluids."a-aANSWER-

"Youramotheradoesanotaneedaaabathaeveryaday."
a




rationale:aDoloresadoesanotaneedaaabathaeveryadayabecauseathatawillaexacerbateatheadryne

ssaofaheraskin



Helen,aagea39,acomesatoayouraclinicaforageneralizedajointapain,aespeciallyainatheakneesaanda

hands.aSheatellsayouathatatheapainaisamoderate,aspreading,aandasymmetrical.aSheareportsah

avingahadaaasoreathroataandalow-

gradeafeveraforaaafewadaysaandathenadevelopingaaarash,adescribedaasawarmaerythemaaofath

eacheeks,awhichalastedaabouta4adaysabeforeadisappearing.aYouaaskaheraifathearashaonatheac

heeksaincludedatheanasolabialafoldsaoracircumoralaskin,aandasheatellsayouathataitadidanotacov

eratheseaareas.aTwoadaysalater,asheadevelopedaaanonspecificamacularaeruptionathataprece

dedatheajointapain.aHerarashafadedawithina2aweeks,abutasheatellsayouathataitacomesaandagoes

, ifasheabathesainahotawateraoraspendsatimeainatheasunlight.aYourapatient'sasymptomsaareamo
a




staconsistentawithaaadiagnosisaof:

1.Rubella.

2.Erythemaainfectiosum.

3.Rheumatoidaarthritis.

4.Scarletafevera-aANSWER-aErythemaainfectiosum.



rationale:aErythemaainfectiosuma(fifthadisease)aisadistinguishedabyaitsaerythematous,awarm

rash,awhichagivesatheaappearanceaofa"slappedacheeks,"aandaitadoesanotainvolveatheanasola
a




bialafoldsaoratheacircumoralaregion.aWomenaareamorealikelyatoahaveajointapainaasaaasympto

maofaerythemaainfectiosum.



Whichapresentationaisamostaconcerningaforaskinacancer?

1.Darkapigmentationaofa1asolitaryanailathatahasadevelopedaquicklyaandawithoutatrauma.

2.Aa1-

mmablue,around,anonpalpableadiscolorationaofatheaskinathatahasabeenapresentasinceabirthaw

ithoutachange.

3.Aa5-mmablackamoleawitharound,aregularaboarders.

4.Aa2-mmabrownamoleathataisaraiseda1ammabutaroundaandaregulara-aANSWER-

Darkapigmentationaofa1asolitaryanailathatahasadevelopedaquicklyaandawithoutatrauma
a




.



rationale:aThisaisaconcerningaforaacralamelanoma.

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