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Exam 1: NUR 6111 (Latest 2025/2026) Advance Practice
Nursing Exam Questions with Verified Answers | 100%
Correct – William Paterson University.
180 Most Tested & Difficult Questions with Rotated Answers
QUESTION 1
A 6-month-old infant is brought to the clinic with dry, scaly, pruritic patches on the cheeks and extensor
surfaces. The mother has a history of asthma. Which of the following is the most likely diagnosis?
A) Seborrheic dermatitis
B) Atopic dermatitis ✅
C) Contact dermatitis
D) Psoriasis
Rationale: Atopic dermatitis (eczema) commonly presents in infants on the face and extensor surfaces.
It is associated with atopic conditions such as asthma, allergic rhinitis, and urticaria.
QUESTION 2
A 78-year-old man presents with multiple tan-brown, wart-like plaques on his back that appear “stuck
on.” The lesions are not pruritic. What is the most likely diagnosis?
A) Actinic keratosis
B) Seborrheic keratosis ✅
C) Malignant melanoma
D) Basal cell carcinoma
Rationale: Seborrheic keratoses are benign, “stuck-on” appearing plaques that are very common in
older adults. They are not premalignant.
QUESTION 3
A 65-year-old white male has a rough, scaly, erythematous patch on his bald scalp that has been
bleeding intermittently. A shave biopsy confirms actinic keratosis with focal full-thickness atypia. The
most appropriate next step is:
A) Observation with annual skin exam
B) Cryotherapy ✅
,2
C) Topical 5-fluorouracil
D) Mohs micrographic surgery
Rationale: Actinic keratosis with atypia should be treated. Cryotherapy is a standard, effective
treatment for individual lesions. Topical 5-FU is for field therapy.
QUESTION 4
A patient develops urticaria, wheezing, and hypotension within minutes after eating peanuts. This is an
example of which type of hypersensitivity reaction?
A) Type II
B) Type I ✅
C) Type III
D) Type IV
Rationale: Type I hypersensitivity is IgE-mediated and rapid (minutes). It includes anaphylaxis, urticaria,
and angioedema.
QUESTION 5
A newborn at 28 weeks gestation develops grunting respirations, nasal flaring, and retractions 2 hours
after birth. The most likely cause is:
A) Transient tachypnea of the newborn
B) Respiratory distress syndrome (RDS) ✅
C) Meconium aspiration syndrome
D) Congenital pneumonia
Rationale: RDS is caused by surfactant deficiency in premature infants, typically <34 weeks. It presents
shortly after birth with signs of respiratory distress.
QUESTION 6
A premature infant develops abdominal distension, bloody stools, and feeding intolerance on day 10 of
life. The most likely diagnosis is:
A) Malrotation with volvulus
B) Necrotizing enterocolitis (NEC) ✅
C) Hirschsprung disease
D) Gastroenteritis
Rationale: NEC is a serious intestinal inflammatory condition affecting preterm infants, often presenting
with abdominal distension, bloody stools, and pneumatosis intestinalis on X-ray.
QUESTION 7
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A 4-month-old infant is found unresponsive in the crib on a soft mattress. The infant had been healthy.
The most common age range for SIDS is:
A) Birth to 2 weeks
B) 1–4 months ✅
C) 6–12 months
D) 12–18 months
Rationale: SIDS peaks between 1 and 4 months of age. Risk factors include prone sleeping, soft bedding,
and maternal smoking.
QUESTION 8
Which immunoglobulin is primarily responsible for mucosal immunity and is found in tears, saliva, and
breast milk?
A) IgG
B) IgA ✅
C) IgM
D) IgE
Rationale: Secretory IgA is the main antibody in mucosal secretions, providing protection at body
surfaces.
QUESTION 9
A patient with a known history of selective IgA deficiency is scheduled for a blood transfusion. Which
complication is of greatest concern?
A) Febrile non-hemolytic transfusion reaction
B) Anaphylactic reaction due to anti-IgA antibodies ✅
C) Acute hemolytic reaction
D) Transfusion-associated circulatory overload
Rationale: Patients with selective IgA deficiency may develop anti-IgA antibodies, leading to severe
anaphylaxis upon transfusion of IgA-containing products.
QUESTION 10
During the resting membrane potential, which statement is correct?
A) Na⁺ is predominantly extracellular, K⁺ is predominantly intracellular ✅
B) K⁺ is predominantly extracellular, Na⁺ is predominantly intracellular
C) Both Na⁺ and K⁺ are equally distributed
D) Ca²⁺ is the primary ion determining resting potential
Rationale: The resting membrane potential is maintained by the Na⁺/K⁺ ATPase pump, keeping Na⁺
outside and K⁺ inside.
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QUESTION 11
Depolarization of a nerve cell occurs when:
A) Voltage-gated Na⁺ channels open and Na⁺ enters the cell ✅
B) Voltage-gated K⁺ channels open and K⁺ exits the cell
C) Cl⁻ channels open and Cl⁻ enters the cell
D) Na⁺/K⁺ ATPase pumps Na⁺ out of the cell
Rationale: Depolarization is caused by rapid influx of Na⁺ through voltage-gated sodium channels.
QUESTION 12
A 70-year-old man has a non-healing, pearly nodule on his nose with telangiectasias. Biopsy shows basal
cell carcinoma. Which treatment offers the highest cure rate for this lesion?
A) Topical 5-fluorouracil
B) Mohs micrographic surgery ✅
C) Curettage and electrodesiccation
D) Cryotherapy
Rationale: Mohs surgery is indicated for basal cell carcinoma in high-risk areas (face) and provides the
highest cure rate with tissue preservation.
QUESTION 13
A 65-year-old woman reports a change in a pre-existing mole on her back. It has become irregular in
shape, darker, and larger. Which three features are most suspicious for melanoma?
A) Symmetry, uniform color, small size
B) Asymmetry, border irregularity, color variation ✅
C) Smooth borders, single color, regular shape
D) Papular, non-pigmented, pruritic
Rationale: The ABCDEs of melanoma: Asymmetry, Border irregularity, Color variation, Diameter >6 mm,
Evolution (change over time).
QUESTION 14
A 25-year-old man presents with a red, warm, tender area on his lower leg after a scrape while hiking.
He has no fever or systemic symptoms. The most appropriate initial antibiotic is:
A) Doxycycline
B) Cephalexin (Keflex) 500 mg q12h for 5 days ✅
C) Clindamycin
D) Trimethoprim-sulfamethoxazole
Exam 1: NUR 6111 (Latest 2025/2026) Advance Practice
Nursing Exam Questions with Verified Answers | 100%
Correct – William Paterson University.
180 Most Tested & Difficult Questions with Rotated Answers
QUESTION 1
A 6-month-old infant is brought to the clinic with dry, scaly, pruritic patches on the cheeks and extensor
surfaces. The mother has a history of asthma. Which of the following is the most likely diagnosis?
A) Seborrheic dermatitis
B) Atopic dermatitis ✅
C) Contact dermatitis
D) Psoriasis
Rationale: Atopic dermatitis (eczema) commonly presents in infants on the face and extensor surfaces.
It is associated with atopic conditions such as asthma, allergic rhinitis, and urticaria.
QUESTION 2
A 78-year-old man presents with multiple tan-brown, wart-like plaques on his back that appear “stuck
on.” The lesions are not pruritic. What is the most likely diagnosis?
A) Actinic keratosis
B) Seborrheic keratosis ✅
C) Malignant melanoma
D) Basal cell carcinoma
Rationale: Seborrheic keratoses are benign, “stuck-on” appearing plaques that are very common in
older adults. They are not premalignant.
QUESTION 3
A 65-year-old white male has a rough, scaly, erythematous patch on his bald scalp that has been
bleeding intermittently. A shave biopsy confirms actinic keratosis with focal full-thickness atypia. The
most appropriate next step is:
A) Observation with annual skin exam
B) Cryotherapy ✅
,2
C) Topical 5-fluorouracil
D) Mohs micrographic surgery
Rationale: Actinic keratosis with atypia should be treated. Cryotherapy is a standard, effective
treatment for individual lesions. Topical 5-FU is for field therapy.
QUESTION 4
A patient develops urticaria, wheezing, and hypotension within minutes after eating peanuts. This is an
example of which type of hypersensitivity reaction?
A) Type II
B) Type I ✅
C) Type III
D) Type IV
Rationale: Type I hypersensitivity is IgE-mediated and rapid (minutes). It includes anaphylaxis, urticaria,
and angioedema.
QUESTION 5
A newborn at 28 weeks gestation develops grunting respirations, nasal flaring, and retractions 2 hours
after birth. The most likely cause is:
A) Transient tachypnea of the newborn
B) Respiratory distress syndrome (RDS) ✅
C) Meconium aspiration syndrome
D) Congenital pneumonia
Rationale: RDS is caused by surfactant deficiency in premature infants, typically <34 weeks. It presents
shortly after birth with signs of respiratory distress.
QUESTION 6
A premature infant develops abdominal distension, bloody stools, and feeding intolerance on day 10 of
life. The most likely diagnosis is:
A) Malrotation with volvulus
B) Necrotizing enterocolitis (NEC) ✅
C) Hirschsprung disease
D) Gastroenteritis
Rationale: NEC is a serious intestinal inflammatory condition affecting preterm infants, often presenting
with abdominal distension, bloody stools, and pneumatosis intestinalis on X-ray.
QUESTION 7
,3
A 4-month-old infant is found unresponsive in the crib on a soft mattress. The infant had been healthy.
The most common age range for SIDS is:
A) Birth to 2 weeks
B) 1–4 months ✅
C) 6–12 months
D) 12–18 months
Rationale: SIDS peaks between 1 and 4 months of age. Risk factors include prone sleeping, soft bedding,
and maternal smoking.
QUESTION 8
Which immunoglobulin is primarily responsible for mucosal immunity and is found in tears, saliva, and
breast milk?
A) IgG
B) IgA ✅
C) IgM
D) IgE
Rationale: Secretory IgA is the main antibody in mucosal secretions, providing protection at body
surfaces.
QUESTION 9
A patient with a known history of selective IgA deficiency is scheduled for a blood transfusion. Which
complication is of greatest concern?
A) Febrile non-hemolytic transfusion reaction
B) Anaphylactic reaction due to anti-IgA antibodies ✅
C) Acute hemolytic reaction
D) Transfusion-associated circulatory overload
Rationale: Patients with selective IgA deficiency may develop anti-IgA antibodies, leading to severe
anaphylaxis upon transfusion of IgA-containing products.
QUESTION 10
During the resting membrane potential, which statement is correct?
A) Na⁺ is predominantly extracellular, K⁺ is predominantly intracellular ✅
B) K⁺ is predominantly extracellular, Na⁺ is predominantly intracellular
C) Both Na⁺ and K⁺ are equally distributed
D) Ca²⁺ is the primary ion determining resting potential
Rationale: The resting membrane potential is maintained by the Na⁺/K⁺ ATPase pump, keeping Na⁺
outside and K⁺ inside.
, 4
QUESTION 11
Depolarization of a nerve cell occurs when:
A) Voltage-gated Na⁺ channels open and Na⁺ enters the cell ✅
B) Voltage-gated K⁺ channels open and K⁺ exits the cell
C) Cl⁻ channels open and Cl⁻ enters the cell
D) Na⁺/K⁺ ATPase pumps Na⁺ out of the cell
Rationale: Depolarization is caused by rapid influx of Na⁺ through voltage-gated sodium channels.
QUESTION 12
A 70-year-old man has a non-healing, pearly nodule on his nose with telangiectasias. Biopsy shows basal
cell carcinoma. Which treatment offers the highest cure rate for this lesion?
A) Topical 5-fluorouracil
B) Mohs micrographic surgery ✅
C) Curettage and electrodesiccation
D) Cryotherapy
Rationale: Mohs surgery is indicated for basal cell carcinoma in high-risk areas (face) and provides the
highest cure rate with tissue preservation.
QUESTION 13
A 65-year-old woman reports a change in a pre-existing mole on her back. It has become irregular in
shape, darker, and larger. Which three features are most suspicious for melanoma?
A) Symmetry, uniform color, small size
B) Asymmetry, border irregularity, color variation ✅
C) Smooth borders, single color, regular shape
D) Papular, non-pigmented, pruritic
Rationale: The ABCDEs of melanoma: Asymmetry, Border irregularity, Color variation, Diameter >6 mm,
Evolution (change over time).
QUESTION 14
A 25-year-old man presents with a red, warm, tender area on his lower leg after a scrape while hiking.
He has no fever or systemic symptoms. The most appropriate initial antibiotic is:
A) Doxycycline
B) Cephalexin (Keflex) 500 mg q12h for 5 days ✅
C) Clindamycin
D) Trimethoprim-sulfamethoxazole
