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APEA 3P Exam Study Guide | Nurse Practitioner Exam
Prep | Digital Download PDF
1. A 72yearold fairskinned patient presents with a smooth, shiny, pearly white bump on the right cheek
that has been slowly growing over the past year. What is the most likely diagnosis?
A) Actinic keratosis
B) Squamous cell carcinoma
C) Seborrheic keratosis
D) Basal cell carcinoma
Correct Answer: D) Basal cell carcinoma
Basal cell carcinoma is the most common type of skin cancer in the USA and typically appears as a
smooth, shiny bump with a pearly white or pink color, commonly found on sunexposed areas such as the
cheeks, nose, face, neck, arms, and back. Actinic keratosis presents as dry, scaly lesions; squamous cell
carcinoma appears as chronic red scaly rough textured lesions; and seborrheic keratosis looks like
wartlike growths that appear pasted on.
2. A patient presents with numerous dry, round, pink to red lesions with rough and scaly texture on
sunexposed areas. These lesions are slowgrowing and do not heal. What is this condition and what is its
significance?
A) Seborrheic keratosis; benign growth
B) Actinic keratosis; precursor to squamous cell carcinoma
C) Basal cell carcinoma; most common skin cancer
D) Melanoma; requires immediate biopsy
Correct Answer: B) Actinic keratosis; precursor to squamous cell carcinoma
,2
Actinic keratosis is characterized by numerous dry, round, pink to red lesions with rough and scaly texture
that are slowgrowing and do not heal, typically found in sunexposed areas. It serves as a precursor lesion
to squamous cell carcinoma. Seborrheic keratosis is benign and asymptomatic, while basal cell carcinoma
appears as a shiny bump, and melanoma has distinct ABCDE features.
3. What is the gold standard diagnostic test for both basal cell carcinoma and actinic keratosis?
A) Visual inspection with dermatoscope
B) Wood's lamp examination
C) Biopsy
D) Skin scraping with potassium hydroxide preparation
Correct Answer: C) Biopsy
Biopsy is the gold standard for diagnosing both basal cell carcinoma and actinic keratosis. When biopsy is
not an option, referral to dermatology is recommended. Visual inspection and dermatoscopy provide
clinical suspicion but cannot confirm diagnosis definitively, and Wood's lamp and KOH preparations are
used for other skin conditions like fungal infections.
4. A patient is being treated for multiple actinic keratosis lesions with 5fluorouracil (Efudex). What
important patient education should the nurse practitioner provide?
A) Apply thick layer and cover with bandage
B) Wear sunscreen during treatment
C) Expect immediate healing within 24 hours
D) Avoid all topical products during treatment
Correct Answer: B) Wear sunscreen during treatment
,3
5fluorouracil (Efudex) treatment causes the skin to ooze, crust, scab, and become red, making the skin
highly sensitive to sun exposure. Patients must wear sunscreen to prevent further damage. The medication
should be applied as prescribed, not covered with bandages, and healing takes time with expected skin
reactions, not immediate resolution.
5. A patient presents with a chronic red, scaly, roughtextured lesion with irregular borders and crusting on
the rim of the ear. Which skin cancer is most likely?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Melanoma
D) Seborrheic keratosis
Correct Answer: B) Squamous cell carcinoma
Squamous cell carcinoma presents as a chronic red, scaly, roughtextured lesion with irregular borders and
may have crusting or bleeding. It commonly occurs on the rims of ears, lips, nose, face, and top of hands.
Basal cell carcinoma appears as a smooth shiny bump, melanoma has ABCDE features, and seborrheic
keratosis is a benign wartlike growth.
6. What is the precursor lesion to squamous cell carcinoma?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Melanoma in situ
Correct Answer: C) Actinic keratosis
, 4
Actinic keratosis is the precursor lesion to squamous cell carcinoma, presenting as numerous dry, round,
pink to red lesions with rough and scaly texture that do not heal and grow slowly in sunexposed areas.
Seborrheic keratosis is benign, basal cell carcinoma and melanoma are established cancers with their own
distinct characteristics.
7. A 45yearold patient with a history of blistering sunburns as a child presents for skin examination.
Which of the following is a risk factor for skin cancer?
A) Dark skin pigmentation
B) Limited sun exposure during childhood
C) History of blistering sunburns as a child
D) Family history of benign skin lesions
Correct Answer: C) History of blistering sunburns as a child
Risk factors for skin cancer include blistering sunburns as a child, history of sunburns, light skin, chronic
exposure to UV light from sunlight or tanning beds, presence of moles, and family history of skin cancer.
Dark skin pigmentation provides some protection, limited sun exposure reduces risk, and family history
of benign lesions does not confer increased risk for malignancy.
8. A patient notices a mole on their back that is asymmetrical with irregular borders and variegated colors
of black, blue, dark brown, and light brown. The lesion is larger than 6mm and has recently changed in
size. What is the most likely diagnosis?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Melanoma
Correct Answer: D) Melanoma
APEA 3P Exam Study Guide | Nurse Practitioner Exam
Prep | Digital Download PDF
1. A 72yearold fairskinned patient presents with a smooth, shiny, pearly white bump on the right cheek
that has been slowly growing over the past year. What is the most likely diagnosis?
A) Actinic keratosis
B) Squamous cell carcinoma
C) Seborrheic keratosis
D) Basal cell carcinoma
Correct Answer: D) Basal cell carcinoma
Basal cell carcinoma is the most common type of skin cancer in the USA and typically appears as a
smooth, shiny bump with a pearly white or pink color, commonly found on sunexposed areas such as the
cheeks, nose, face, neck, arms, and back. Actinic keratosis presents as dry, scaly lesions; squamous cell
carcinoma appears as chronic red scaly rough textured lesions; and seborrheic keratosis looks like
wartlike growths that appear pasted on.
2. A patient presents with numerous dry, round, pink to red lesions with rough and scaly texture on
sunexposed areas. These lesions are slowgrowing and do not heal. What is this condition and what is its
significance?
A) Seborrheic keratosis; benign growth
B) Actinic keratosis; precursor to squamous cell carcinoma
C) Basal cell carcinoma; most common skin cancer
D) Melanoma; requires immediate biopsy
Correct Answer: B) Actinic keratosis; precursor to squamous cell carcinoma
,2
Actinic keratosis is characterized by numerous dry, round, pink to red lesions with rough and scaly texture
that are slowgrowing and do not heal, typically found in sunexposed areas. It serves as a precursor lesion
to squamous cell carcinoma. Seborrheic keratosis is benign and asymptomatic, while basal cell carcinoma
appears as a shiny bump, and melanoma has distinct ABCDE features.
3. What is the gold standard diagnostic test for both basal cell carcinoma and actinic keratosis?
A) Visual inspection with dermatoscope
B) Wood's lamp examination
C) Biopsy
D) Skin scraping with potassium hydroxide preparation
Correct Answer: C) Biopsy
Biopsy is the gold standard for diagnosing both basal cell carcinoma and actinic keratosis. When biopsy is
not an option, referral to dermatology is recommended. Visual inspection and dermatoscopy provide
clinical suspicion but cannot confirm diagnosis definitively, and Wood's lamp and KOH preparations are
used for other skin conditions like fungal infections.
4. A patient is being treated for multiple actinic keratosis lesions with 5fluorouracil (Efudex). What
important patient education should the nurse practitioner provide?
A) Apply thick layer and cover with bandage
B) Wear sunscreen during treatment
C) Expect immediate healing within 24 hours
D) Avoid all topical products during treatment
Correct Answer: B) Wear sunscreen during treatment
,3
5fluorouracil (Efudex) treatment causes the skin to ooze, crust, scab, and become red, making the skin
highly sensitive to sun exposure. Patients must wear sunscreen to prevent further damage. The medication
should be applied as prescribed, not covered with bandages, and healing takes time with expected skin
reactions, not immediate resolution.
5. A patient presents with a chronic red, scaly, roughtextured lesion with irregular borders and crusting on
the rim of the ear. Which skin cancer is most likely?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Melanoma
D) Seborrheic keratosis
Correct Answer: B) Squamous cell carcinoma
Squamous cell carcinoma presents as a chronic red, scaly, roughtextured lesion with irregular borders and
may have crusting or bleeding. It commonly occurs on the rims of ears, lips, nose, face, and top of hands.
Basal cell carcinoma appears as a smooth shiny bump, melanoma has ABCDE features, and seborrheic
keratosis is a benign wartlike growth.
6. What is the precursor lesion to squamous cell carcinoma?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Melanoma in situ
Correct Answer: C) Actinic keratosis
, 4
Actinic keratosis is the precursor lesion to squamous cell carcinoma, presenting as numerous dry, round,
pink to red lesions with rough and scaly texture that do not heal and grow slowly in sunexposed areas.
Seborrheic keratosis is benign, basal cell carcinoma and melanoma are established cancers with their own
distinct characteristics.
7. A 45yearold patient with a history of blistering sunburns as a child presents for skin examination.
Which of the following is a risk factor for skin cancer?
A) Dark skin pigmentation
B) Limited sun exposure during childhood
C) History of blistering sunburns as a child
D) Family history of benign skin lesions
Correct Answer: C) History of blistering sunburns as a child
Risk factors for skin cancer include blistering sunburns as a child, history of sunburns, light skin, chronic
exposure to UV light from sunlight or tanning beds, presence of moles, and family history of skin cancer.
Dark skin pigmentation provides some protection, limited sun exposure reduces risk, and family history
of benign lesions does not confer increased risk for malignancy.
8. A patient notices a mole on their back that is asymmetrical with irregular borders and variegated colors
of black, blue, dark brown, and light brown. The lesion is larger than 6mm and has recently changed in
size. What is the most likely diagnosis?
A) Seborrheic keratosis
B) Basal cell carcinoma
C) Actinic keratosis
D) Melanoma
Correct Answer: D) Melanoma
