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“ NR509 BATES TEST BANK - MIDTERM ”LATEST
EXAM SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION)
WELL REVISED GUARANTEE PASS
NR509 Bates Test Bank - Midterm
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no
history of
exposure to ill people or other agents in the environment. He has a slight fever
in the office. The rash consists of small, bright red marks. When they are
pressed, the red color remains.
What should you do?
A) Prescribe a steroid cream to decrease inflammation.
B) Consider admitting the patient to the hospital.
C) Reassure the parents and the patient that this should resolve within a week.
D) Tell him not to scratch them, and follow up in 3 days.
B) Consider admitting the patient to the hospital.
Although this may not be an impressive rash, the fact that they do not "blanch" with
pressure is very concerning. This generally means that there is pinpoint bleeding
under the
skin, and while this can be benign, it can be associated with life-threatening illnesses
like
meningococcemia and low platelet counts (thrombocytopenia) associated with
, Page 2 of 126
serious blood
disorders like leukemia.
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic
lupus erythematosus). She has noticed a raised, dark red rash on her legs.
When you press on the rash, it doesn't blanch. What would you tell her
regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
A) It is likely to be related to her lupus.
A "palpable purpura" is usually associated with a vasculitis. This is an inflammatory
condition of the blood vessels often associated with systemic rheumatic disease. It
can cut off circulation to any portion of the body and can mimic many other diseases
in this
manner. While allergic and chemical exposures may be a possible cause of the rash,
this patient's SLE should make you consider vasculitis.
Jacob, a 33-year-old construction worker, complains of a "lump on his back"
over his scapula. It has been there for about a year and is getting larger. He
says his wife has been able to squeeze out a cheesy-textured substance on
occasion. He worries this may be cancer. When gently pinched from the side, a
prominent dimple forms in the middle of the mass. What is
most likely?
A) An enlarged lymph node
B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion
B) A sebaceous cyst
This is a classic description of an epidermal inclusion cyst resulting from a blocked
sebaceous gland. The fact that any lesion is enlarging is worrisome, but the other
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descriptors
are so distinctive that cancer is highly unlikely. This would be an unusual location for
a lymph
node, and these do not usually drain to the skin.
A young man comes to you with an extremely pruritic rash over his knees and
elbows which has come and gone for several years. It seems to be worse in
the winter and improves with some sun exposure. On examination, you notice
scabbing and crusting with some silvery scale, and you are observant enough
to notice small "pits" in his nails. What would account for these findings?
A) Eczema
B) Pityriasis rosea
C) Psoriasis
D) Tinea infection
C) Psoriasis
This is a classic presentation of plaque psoriasis. Eczema is usually over the flexor
surfaces and does not scale, whereas psoriasis affects the extensor surfaces.
Pityriasis usually is
limited to the trunk and proximal extremities. Tinea has a much finer scale
associated with it,
almost like powder, and is found in dark and moist areas.
Mrs. Anderson presents with an itchy rash which is raised and appears and
disappears in
various locations. Each lesion lasts for many minutes. What most likely
accounts for this
rash?
A) Insect bites
B) Urticaria, or hives
C) Psoriasis
D) Purpura
B) Urticaria, or hives
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This is a typical case of urticaria. The most unusual aspect of this condition is that
the lesions "move" from place to place. This would be distinctly unusual for the other
causes
listed.
Ms. Whiting is a 68 year old who comes in for her usual follow-up visit. You
notice a few flat red and purple lesions, about 6 cm in diameter, on the ulnar
aspect of her forearms but nowhere else. She doesn't mention them. They are
tender when you examine them. What should you do?
A) Conclude that these are lesions she has had for a long time.
B) Wait for her to mention them before asking further questions.
C) Ask how she acquired them.
D) Conduct the visit as usual for the patient.
C) Ask how she acquired them.
These are consistent with ecchymoses, or bruises. It is important to ask about
antiplatelet medications such as aspirin, trauma history, and history of blood
disorders in the patient and her family. Because of the different ages of the bruises
and the isolation of them to
the ulnar forearms, these may be a result of abuse or other violence. It is your duty
to investigate the cause of these lesions.
A middle-aged man comes in because he has noticed multiple small, blood-
red, raised
lesions over his anterior chest and abdomen for the past several months. They
are not painful
and he has not noted any bleeding or bruising. He is concerned this may be
consistent with a dangerous condition. What should you do?
A) Reassure him that there is nothing to worry about.
B) Do laboratory work to check for platelet problems.
C) Obtain an extensive history regarding blood problems and bleeding
disorders.
D) Do a skin biopsy in the office.
“ NR509 BATES TEST BANK - MIDTERM ”LATEST
EXAM SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION)
WELL REVISED GUARANTEE PASS
NR509 Bates Test Bank - Midterm
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no
history of
exposure to ill people or other agents in the environment. He has a slight fever
in the office. The rash consists of small, bright red marks. When they are
pressed, the red color remains.
What should you do?
A) Prescribe a steroid cream to decrease inflammation.
B) Consider admitting the patient to the hospital.
C) Reassure the parents and the patient that this should resolve within a week.
D) Tell him not to scratch them, and follow up in 3 days.
B) Consider admitting the patient to the hospital.
Although this may not be an impressive rash, the fact that they do not "blanch" with
pressure is very concerning. This generally means that there is pinpoint bleeding
under the
skin, and while this can be benign, it can be associated with life-threatening illnesses
like
meningococcemia and low platelet counts (thrombocytopenia) associated with
, Page 2 of 126
serious blood
disorders like leukemia.
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic
lupus erythematosus). She has noticed a raised, dark red rash on her legs.
When you press on the rash, it doesn't blanch. What would you tell her
regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
A) It is likely to be related to her lupus.
A "palpable purpura" is usually associated with a vasculitis. This is an inflammatory
condition of the blood vessels often associated with systemic rheumatic disease. It
can cut off circulation to any portion of the body and can mimic many other diseases
in this
manner. While allergic and chemical exposures may be a possible cause of the rash,
this patient's SLE should make you consider vasculitis.
Jacob, a 33-year-old construction worker, complains of a "lump on his back"
over his scapula. It has been there for about a year and is getting larger. He
says his wife has been able to squeeze out a cheesy-textured substance on
occasion. He worries this may be cancer. When gently pinched from the side, a
prominent dimple forms in the middle of the mass. What is
most likely?
A) An enlarged lymph node
B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion
B) A sebaceous cyst
This is a classic description of an epidermal inclusion cyst resulting from a blocked
sebaceous gland. The fact that any lesion is enlarging is worrisome, but the other
, Page 3 of 126
descriptors
are so distinctive that cancer is highly unlikely. This would be an unusual location for
a lymph
node, and these do not usually drain to the skin.
A young man comes to you with an extremely pruritic rash over his knees and
elbows which has come and gone for several years. It seems to be worse in
the winter and improves with some sun exposure. On examination, you notice
scabbing and crusting with some silvery scale, and you are observant enough
to notice small "pits" in his nails. What would account for these findings?
A) Eczema
B) Pityriasis rosea
C) Psoriasis
D) Tinea infection
C) Psoriasis
This is a classic presentation of plaque psoriasis. Eczema is usually over the flexor
surfaces and does not scale, whereas psoriasis affects the extensor surfaces.
Pityriasis usually is
limited to the trunk and proximal extremities. Tinea has a much finer scale
associated with it,
almost like powder, and is found in dark and moist areas.
Mrs. Anderson presents with an itchy rash which is raised and appears and
disappears in
various locations. Each lesion lasts for many minutes. What most likely
accounts for this
rash?
A) Insect bites
B) Urticaria, or hives
C) Psoriasis
D) Purpura
B) Urticaria, or hives
, Page 4 of 126
This is a typical case of urticaria. The most unusual aspect of this condition is that
the lesions "move" from place to place. This would be distinctly unusual for the other
causes
listed.
Ms. Whiting is a 68 year old who comes in for her usual follow-up visit. You
notice a few flat red and purple lesions, about 6 cm in diameter, on the ulnar
aspect of her forearms but nowhere else. She doesn't mention them. They are
tender when you examine them. What should you do?
A) Conclude that these are lesions she has had for a long time.
B) Wait for her to mention them before asking further questions.
C) Ask how she acquired them.
D) Conduct the visit as usual for the patient.
C) Ask how she acquired them.
These are consistent with ecchymoses, or bruises. It is important to ask about
antiplatelet medications such as aspirin, trauma history, and history of blood
disorders in the patient and her family. Because of the different ages of the bruises
and the isolation of them to
the ulnar forearms, these may be a result of abuse or other violence. It is your duty
to investigate the cause of these lesions.
A middle-aged man comes in because he has noticed multiple small, blood-
red, raised
lesions over his anterior chest and abdomen for the past several months. They
are not painful
and he has not noted any bleeding or bruising. He is concerned this may be
consistent with a dangerous condition. What should you do?
A) Reassure him that there is nothing to worry about.
B) Do laboratory work to check for platelet problems.
C) Obtain an extensive history regarding blood problems and bleeding
disorders.
D) Do a skin biopsy in the office.
