NURS 623 LATEST 2026 EXAMINATION TEST QUESTIONS
AND ANSWERS RATED A+
✔✔Bacterial infections of the skin - ✔✔· Impetigo
· highly contagious
Cellulitis
· Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin,
· PCN allergy use Erythromycin.
· non purulent assume staph aureus
Purulent cellulitis
· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
✔✔Impetigo - ✔✔Honey crusted plaques, usually on face
Bullous: begin as small vesicles that rupture easily with serous fluid turning into crust
Nonbullous, vesticulopustular: thick, adherent lesions, dirty yellow-colored crust with
erythematous margins
Treatment:
Clean lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin). With
no treatment, it is self-limiting 2-3 wks
✔✔follilculitis - ✔✔Staphylococcus. Multiple small papules on erythematous base, can
be large yellow white tender pustules in adults. Common in places hair is present,
widespread is characteristic, bumpy rash, no itching.
Treatment:
Only if becomes infected. Large lesions cleansed with weak soap solution, followed by
soaking with saline or aluminum subacetate BID. TAO can be used BID for 5 days. Oral
ABT 1st gen cephalo. if resistant
✔✔Localized cellulitis - ✔✔The typical lesion of cellulitis is wide, diffuse area of
erythematous skin that is warm and tender to palpation. Infection is occasionally
accompanied by severe edema. Systemic symptoms such as fever, chills, and malaise
may also be present.
CAUSES- Diabetic patient or other immunocompromised patients. Any break in the
skin. Skin breaks from surgical incisions, skin tears, wounds, trauma, insect bites or
stings, and animal or human bites. PREEXISTING conditions- stasis ulcers,
dermatitides, viral skin infections, superficial bacterial infections, and bolus disease all
have the risk for secondary infections.
,Subjective- tender, warm, erythematous areas of skin usually on face, neck, and
extremities. Usually report an insect bite or some form of skin break. If recurrent
cellulitis may deny any trauma or injury.
Objective- Lower leg most common site of infection .If lower extremity cellulites should
look for SS of tinea pedis (Athletes foot) infection can be point of entry for bacteria. In
children and occasionally adults the checks and periorbital area are more common sites
of involvement. Red and warm appearance to the skin will be noted. Red boarders are
flat and diffused.
✔✔Localized cellulitis treatment - ✔✔Diagnostic testing- most cases are diagnosed by
history and PE . Usually no discharge or obvious wound therefore unable to obtain a
culture. If open wound or purulent discharge present a culture and gram stain should be
obtained. For patients with fever a CBC should be done . If periorbital cellulitis EOM
should be done and test of cranial nerves.
Management- Take into consideration severity of infection, site of infection, underlying
disease, and virulence of the pathogen.
For those who have cellulitis not related to human or animal bites takes
DICLOXACILLIN or CEPHALEXIN for 10-14 days. Patients with penicillin allergy get
Erythromycin.
Infected human and animal bites are treated with Augmentin for at least 2 weeks.
LE's cellulitis requires bedrest and elevation of the leg.
Need to consider comorbid conditions and consider referral of treatment.
Hemophilus influenza can e treated with Ceftin
If gram neg microorganism treat with fluoroquinolones such as levofloxacin can be
used.
Diabetic are typically treated with Augmentin
✔✔purulent cellulitis treatment - ✔✔· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
✔✔Viral Skin Infections - ✔✔chicken pox, shingles, measles, warts, herpes
✔✔Herpes Zoster (shingles) - ✔✔Unexplained pain along dermatome. Unilateral
vesicular rash along dermatome lasting 3-5 days, up to 30.
Treatment
, Famcyclovir, Acyclovir, Valacyclovir.
Prednisone taper.
Vaccine.
✔✔herpes simplex - ✔✔Oral or genital, can be asymptomatic. Tenderness, pain, mild
paresthesia's, or burning before onset. Prodrome can include headache, fever, muscle
ache, lymphadenopathy, local pain. Grouped vesicles on erythematous base.
No cure.
Oral: lip ointment Blistex. OTC Abreva. Denavir for extensive lesions.
Genital: Valacyclovir and famciclovir better choices
✔✔acne vulgaris - ✔✔Located on face, chest, back, and upper outer arms.
· Mild = total lesions <30, noninflammatory. Comedones with small papules.
· Moderate = total lesions 30-125, inflammation. Papules & pustules with yellow/green
tops.
· Severe = lesions > 125, nodulocystic acne.
Treatments:
Tretinoin, topical vs. systemic antibiotics, Isotretinoin
✔✔Rosacea - ✔✔Chronic, central face, persistent erythema telangiectasia,
erythematous papules.
Treatment :
Avoid triggers, topical flagyl (may take 6-8 wks), PO tetracycline, minocycline, or
doxycycline
✔✔Atopic Dermatitis (eczema) - ✔✔o A chronic inflammatory skin disorder with a
complex pathogenesis involving genetic susceptibility, immunologic and epidermal
barrier dysfunction, and environmental factors.
o Pruritus is the primary symptom; skin lesions range from mild erythema to severe
lichenification.
o Presents as red patches with white scales on top
o Chronic and recurring.
✔✔Atopic dermatitis treatment - ✔✔o Moisturizers
o Avoidance of allergic and irritant triggers- avoid frequent bathing with hot water
•Burrow's solution, silver nitrate solutions (to dry out lesions)
•Topical steroids for inflammation
•Petrolatum/emollients to maintain hydration
✔✔Contact Dermatitis - ✔✔o a rash that occurs at the site of exposure to a substance
capable of producing an allergic or irritant skin response.
AND ANSWERS RATED A+
✔✔Bacterial infections of the skin - ✔✔· Impetigo
· highly contagious
Cellulitis
· Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin,
· PCN allergy use Erythromycin.
· non purulent assume staph aureus
Purulent cellulitis
· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
✔✔Impetigo - ✔✔Honey crusted plaques, usually on face
Bullous: begin as small vesicles that rupture easily with serous fluid turning into crust
Nonbullous, vesticulopustular: thick, adherent lesions, dirty yellow-colored crust with
erythematous margins
Treatment:
Clean lesions. Bactroban TID x 7 days. Antibiotic (Keflex, Augmentin, Cloxacillin). With
no treatment, it is self-limiting 2-3 wks
✔✔follilculitis - ✔✔Staphylococcus. Multiple small papules on erythematous base, can
be large yellow white tender pustules in adults. Common in places hair is present,
widespread is characteristic, bumpy rash, no itching.
Treatment:
Only if becomes infected. Large lesions cleansed with weak soap solution, followed by
soaking with saline or aluminum subacetate BID. TAO can be used BID for 5 days. Oral
ABT 1st gen cephalo. if resistant
✔✔Localized cellulitis - ✔✔The typical lesion of cellulitis is wide, diffuse area of
erythematous skin that is warm and tender to palpation. Infection is occasionally
accompanied by severe edema. Systemic symptoms such as fever, chills, and malaise
may also be present.
CAUSES- Diabetic patient or other immunocompromised patients. Any break in the
skin. Skin breaks from surgical incisions, skin tears, wounds, trauma, insect bites or
stings, and animal or human bites. PREEXISTING conditions- stasis ulcers,
dermatitides, viral skin infections, superficial bacterial infections, and bolus disease all
have the risk for secondary infections.
,Subjective- tender, warm, erythematous areas of skin usually on face, neck, and
extremities. Usually report an insect bite or some form of skin break. If recurrent
cellulitis may deny any trauma or injury.
Objective- Lower leg most common site of infection .If lower extremity cellulites should
look for SS of tinea pedis (Athletes foot) infection can be point of entry for bacteria. In
children and occasionally adults the checks and periorbital area are more common sites
of involvement. Red and warm appearance to the skin will be noted. Red boarders are
flat and diffused.
✔✔Localized cellulitis treatment - ✔✔Diagnostic testing- most cases are diagnosed by
history and PE . Usually no discharge or obvious wound therefore unable to obtain a
culture. If open wound or purulent discharge present a culture and gram stain should be
obtained. For patients with fever a CBC should be done . If periorbital cellulitis EOM
should be done and test of cranial nerves.
Management- Take into consideration severity of infection, site of infection, underlying
disease, and virulence of the pathogen.
For those who have cellulitis not related to human or animal bites takes
DICLOXACILLIN or CEPHALEXIN for 10-14 days. Patients with penicillin allergy get
Erythromycin.
Infected human and animal bites are treated with Augmentin for at least 2 weeks.
LE's cellulitis requires bedrest and elevation of the leg.
Need to consider comorbid conditions and consider referral of treatment.
Hemophilus influenza can e treated with Ceftin
If gram neg microorganism treat with fluoroquinolones such as levofloxacin can be
used.
Diabetic are typically treated with Augmentin
✔✔purulent cellulitis treatment - ✔✔· I&D first line
· NO 1st gen cephalosporine
· Consider MRSA- Bactrim, Cleocin, Doxycycline
✔✔Viral Skin Infections - ✔✔chicken pox, shingles, measles, warts, herpes
✔✔Herpes Zoster (shingles) - ✔✔Unexplained pain along dermatome. Unilateral
vesicular rash along dermatome lasting 3-5 days, up to 30.
Treatment
, Famcyclovir, Acyclovir, Valacyclovir.
Prednisone taper.
Vaccine.
✔✔herpes simplex - ✔✔Oral or genital, can be asymptomatic. Tenderness, pain, mild
paresthesia's, or burning before onset. Prodrome can include headache, fever, muscle
ache, lymphadenopathy, local pain. Grouped vesicles on erythematous base.
No cure.
Oral: lip ointment Blistex. OTC Abreva. Denavir for extensive lesions.
Genital: Valacyclovir and famciclovir better choices
✔✔acne vulgaris - ✔✔Located on face, chest, back, and upper outer arms.
· Mild = total lesions <30, noninflammatory. Comedones with small papules.
· Moderate = total lesions 30-125, inflammation. Papules & pustules with yellow/green
tops.
· Severe = lesions > 125, nodulocystic acne.
Treatments:
Tretinoin, topical vs. systemic antibiotics, Isotretinoin
✔✔Rosacea - ✔✔Chronic, central face, persistent erythema telangiectasia,
erythematous papules.
Treatment :
Avoid triggers, topical flagyl (may take 6-8 wks), PO tetracycline, minocycline, or
doxycycline
✔✔Atopic Dermatitis (eczema) - ✔✔o A chronic inflammatory skin disorder with a
complex pathogenesis involving genetic susceptibility, immunologic and epidermal
barrier dysfunction, and environmental factors.
o Pruritus is the primary symptom; skin lesions range from mild erythema to severe
lichenification.
o Presents as red patches with white scales on top
o Chronic and recurring.
✔✔Atopic dermatitis treatment - ✔✔o Moisturizers
o Avoidance of allergic and irritant triggers- avoid frequent bathing with hot water
•Burrow's solution, silver nitrate solutions (to dry out lesions)
•Topical steroids for inflammation
•Petrolatum/emollients to maintain hydration
✔✔Contact Dermatitis - ✔✔o a rash that occurs at the site of exposure to a substance
capable of producing an allergic or irritant skin response.
