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83 Cards in this Set
- Front
- Back
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Multiple lesions blending together |
Confluent or coalescent |
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Flat discoloration less than 1 cm in diameter |
Macule |
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Circumscribed area of skin edema |
Wheal |
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Narrow linear crack into epidermis, exposing dermis |
Fissure |
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Vesicle-like lesion with purulent content |
Pustule |
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Flat discoloration greater than 1 cm in diameter |
Patch |
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Raised lesion, larger than 1 cm, may be same or different color from the surrounding skin |
Plaque |
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Netlike cluster |
Reticular |
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Loss of epidermis and dermis |
Ulcer |
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Loss of skin markings and full skin thickness |
Atrophy |
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Skin thickening usually found over pruritic or friction areas |
Lichenification |
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In a ring formation |
Annular |
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How many grams of a topical cream or ointment are needed for a single application to the hands?
A. 1 B. 2 C. 3 D. 4 |
B. 2
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How many grams of a topical cream or ointment are needed for a single application to an arm?
A. 1 B. 2 C. 3 D. 4 |
C. 3
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How many grams of a topical cream or ointment are needed for a single application to the entire body?
A. 10 to 30 B. 30 to 60 C. 60 to 90 D. 90 to 120 |
B. 30 to 60
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You write a prescription for a topical agent and anticipate the greatest rate of absorption when it is applied to the:
A. palms of the hands B. soles of the feet C. face D. abdomen |
C. face
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You prescribe a topical medication and want it to have maximum absorption, so you choose the following vehicle:
A. gel B. lotion C. cream D. ointment |
D. ointment
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One of the mechanisms of action of a topical corticosteroid preparation is as:
A. an antimitotic B. an exfoliant C. a vasoconstrictor D. a humectant |
C. a vasoconstrictor
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To enhance the potency of a topical corticosteroid, the prescriber recommends that the patient apply the preparation:
A. to dry skin by gentle rubbing B. and cover with an occlusive dressing C. before bathing D. with an emollient |
B. and cover with an occlusive dressing
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Which of the following is the least potent topicalcorticosteroid?
A. betamethasone dipropionate 0.1% (Diprosone) B. clobetasol propionate 0.05% (Cormax) C. hydrocortisone 2.5% D. fluocinonide 0.05% (Lidex) |
C. hydrocortisone 2.5%
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Antihistamines exhibit therapeutic effect by:
A. inactivating circulating histamine B. preventing the production of histamine C. blocking activity at histamine receptor sites D. acting as a procholinergic agent |
C. blocking activity at histamine receptor sites
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A possible adverse effect with the use of a first-generation antihistamine such as diphenhydraminein an 80-year-old man is:
A. urinary retention B. hypertension C. tachycardia D. urticaria |
A. urinary retention
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Which of the following medications is likely to cause the most sedation?
A. chlorpheniramine B. ceirizine C. fexofenadine D. loratadine |
A. chlorpheniramine
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Clinical features of bullous impetigo include:
A. intense itch B. vesicular lesions C. dermatomal pattern D. systemic symptoms such as fever and chills |
B. vesicular lesions
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The likely causative organisms of nonbullous impetigo in a 6-year-old child include:
A. H. influenzae and S. pneumoniae B. group A streptococcus and S. aureus C. M. catarrhalis and select viruses D. P. aeruginosa and select fungi |
B. group A streptococcus and S. aureus
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The spectrum of antimicrobial activity of mupirocin (Bactroban) includes:
A. primarily gram-negative organisms B. select gram-positive organisms C. Pseudomonas species and anaerobic organisms D. only organisms that do not produce beta-lactamase |
B. select gram-positive organisms
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An impetigo lesion that becomes deeply ulcerated is known as:
A. cellulitis B. erythema C. ecthyma D. empyema |
C. ecthyma
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First-line treatment of impetigo with less than 5 lesions of 1-2 centimeters in diameter on the legs in a 9-year-old girl is:
A. topical mupirocin B. topical neomycin C. oral cefixime D. oral doxycycline |
A. topical mupirocin
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An oral antimicrobial option for the treatment of methicillin-sensitive S. aureus includes all of the following except:
A. amoxicillin B. dicloxacillin C. cephalexin D. cefadroxil |
A. amoxicillin
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Which of the following is an oral antimicrobial option for the treatment of a community-acquired methicillin-resistant S. aureus cutaneous infection?
A. amoxicillin B. dicloxacillin C. cephalexin D. trimethoprim-sulfamethoxazole |
D. trimethoprim-sulfamethoxazole
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You see a kindergartner with impetigo and advise that she can return ________ hours after initiating effective antimicrobial therapy.
A. 24 B. 48 C. 72 D. 96 |
A. 24
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The use of which of the following medications contributes to the development of acne vulgarism?
A. lithium B. propranolol C. sertraline D. clonidine |
A. lithium
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First-line therapy for acne vulgaris with closedcomedones includes:
A. oral antibiotics B. isotretinoin C. benzoyl peroxide D. hydrocortisone cream |
C. benzoyl peroxide
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When prescribing tretinoin (Retin-A), the NP advises the patient to:
A. use it with benzoyl peroxide to minimize irritating effects B. use a sunscreen because the drug is photosensitizing C. add a sulfa-based cream to enhance anti acne effects D. expect a significant improvement in acne lesions after approximately 1 week of use. |
B. use a sunscreen because the drug is photosensitizing
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In the treatment of acne vulgarism, which lesions respond best to topical antibiotic therapy?
A. open comedones B. cysts C. inflammatory lesions D. superficial lesions |
C. inflammatory lesions
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You have initiated therapy for an 18-year-old man with acne vulgarism and have prescribed doxycycline. He returns in 3 weeks, complaining that his skin is “no better.” Your next action is to:
A. counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved B. discontinue the doxycycline and initiate minocyclinetherapy C. advise him that antibiotics are likely not an effective treatment for him and should not be continued D. add a second antimicrobial agent such trimethoprim-sulfamethoxazole. |
A. counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved
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Who is the best candidate for isotretinoin (Accutane) therapy?
A. a 17-year-old patient with pustular lesions and poor response to benzoyl peroxide B. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect C. a 14-year-old patient with open and closed comedomes and a family history of “ice pick” scars D. an 18-year-old patient with inflammatory lesionsand improvement with tretinoin (Retin-A) |
B. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect
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In a 22-year-old woman using isotretinoin (Accutane) therapy, the NP ensures follow-up to monitor for all of the following tests except:
A. hepatic enzymes B. triglyceride measurements C. pregnancy test D. platelet count |
D. platelet count
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Leonard is an 18-year-old man who has been taking isotretinoin (Accutane) for the treatment of acne for the past 2 months. Which of the following is the most important question for the clinician to ask at his follow-up office visit?
A. Are you having any problems remembering to take your medication? B. Have you noticed any dry skin around your mouth since you started using Accutane? C. Do you notice any improvement in your skin? D. Have you noticed any recent changes in your mood? |
D. Have you noticed any recent changes in your mood?
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A 14-year-old male presents with acne consisting of 25 comedones and 20 inflammatory lesions with no nodules. This patient can be classified as having:
A. mild acne B. moderate acne C. severe acne D. very severe acne |
B. moderate acne
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In a 13-year-old female patient with mild acne and who experiences an inadequate response to benzoyl peroxide treatment, an appropriate treatment option would be to:
A. add a topical retinoid B. add an oral antibiotic C. consider isotretinoin D. consider hormonal therapy |
A. add a topical retinoid
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A common infective agent in domestic pet catbites is:
A. viridans streptococcus species B. Pasteurella multocida C. Bacteroides species D. Haemophilus influenzae |
B. Pasteurella multocida
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A 28-year-old woman presents to your practice with chief complaint of a cat bite sustained on her right ankle. Her pet cat had bitten her after she inadvertentlystepped on its paw while she was in her home. Her cats 3 years old, is up-to-date on immunizations, and does not go outside. Physical examination reveals pinpoint superficial puncture wounds on the right ankle consistent with the presenting history. She washed the wound with soap and water immediately and asks if she needs additional therapy. Treatment for this patient’s cat bite wound should include standard wound care with the addition of:
A. oral erythromycin B. topical bacitracin C. oral amoxicillin-clavulanate D. parenteral rifampin. |
C. oral amoxicillin-clavulanate
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A 24-year-old man arrives at the walk-in center. He reports that he was bitten in the thigh by a raccoon while walking in the woods. The examination reveals awound that is 1 cm deep on his right thigh. The woundis oozing bright red blood. Your next best action is to:
A. administer high-dose parenteral penicillin B. initiate antibacterial prophylaxis with amoxicillin C. give rabies immune globulin and rabies vaccine D. suture the wound after proper cleansing. |
C. give rabies immune globulin and rabies vaccine
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A significant rabies risk is associated with a bite from all of the following except:
A. humans B. foxes C. bats D. skunks |
A. humans
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You see a 33-year-old male with a minor dog bite on his hand. The examination reveals a superficial wound on the left palm. The dog is up-to-date on immunizations. In deciding whether to initiate antimicrobial therapy, you consider that ______ of dog bites become bacterially infected.
A. 5% B. 20% C. 50% D. 75% |
A. 5%
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You see a 52-year-old woman who was bitten by a rat while opening a Dumpster. The examination reveals a wound approximately 1 cm deep that is oozing bright red blood. Treatment of this patient should include standard wound care with the addition of:
A. rabies immune globulin. B. rabies vaccine C. oral ciprofloxacin D. oral amoxicillin-clavulanate |
D. oral amoxicillin-clavulanate
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You see a 28-year-old man who was involved in a fight approximately 1 hour ago with another person. The patient states, “He bit me in the arm.” Examination ofthe left forearm reveals an open wound consistent withthis history. Your next best action is to:
A. obtain a culture and sensitivity of the wound site B. refer for rabies prophylaxis C. irrigate the wound and débris as needed D. close the wound with adhesive strips |
C. irrigate the wound and débris as needed
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A patient presents with a painful, blistering thermal burn involving the first, second, and third digits of his right hand. The most appropriate plan of care is to:
A. apply an anesthetic cream to the area and open the blisters B. apply silver sulfadiazine cream (Silvadene) to the area followed by a bulky dressing C. refer the patient to burn specialty care D. wrap the burn loosely with a non adherent dressingand prescribe an analgesic agent |
C. refer the patient to burn specialty care
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Gram-negative bacteria that commonly cause burn wound infections include all of the following except:
A. P. aeruginosa B. E. coli C. K. pneumoniae D. H. influenzae. |
D. H. influenzae.
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Which of the following is recommended for preventing a burn wound infection?
A. topical corticosteroid B. topical silver sulfadiazine C. oral erythromycin D. oral moxifloxacin |
B. topical silver sulfadiazine
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]You examine a patient with a red, tender thermal burn that has excellent capillary refill involving the entire surface of the anterior right thigh. The estimated involved body surface area (BSA) is approximately:
A. 5% B. 9% C. 13% D. 18% |
B. 9%
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A burn that is about twice as large as an adult’s palmar surface of the hand including the fingers encompasses a BSA of approximately ____%.
A.1 B.2 C.3 D.4 |
A.1
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Affected skin blanches with ease |
First-degree burn |
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Surface is raw and moist |
Second-degree burn |
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Affected area is white and leathery |
Third-degree burn |
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A mother brings to the clinic her 3-year-old daughter,who presents with dry red patches on her face aroundthe eyes. The mother has observed her daughter constantly rubbing the area, which has caused swelling around the eyes. Physical examination is consistentwith atopic dermatitis. The NP considers that this is a diagnosis that
A. requires a skin culture to confirm contributingbacterial organisms B. should be supported by a biopsy of the affected area C. necessitates obtaining peripheral blood eosinophil leve D. is usually made by clinical assessment alone |
D. is usually made by clinical assessment alone
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Type I hypersensitivity reactions, such as atopicdermatitis, involve the action of which antibodiesbinding to receptor sites on mast cells?
A. IgG B. IgM C. IgE D. IgA |
C. IgE
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During type I hypersensitivity reactions, histamine released from degraded mast cells causes all of the following except:
A. vasodilation B. mucous gland stimulation C. enhanced sebum production D. tissue swelling |
C. enhanced sebum production
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The most important aspect of skin care for individuals with atopic dermatitis is:
A. frequent bathing with antibacterial soap B. consistent use of medium-potency to high-potencytopical steroids C. application of lubricants D. treatment of dermatophytes |
C. application of lubricants
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One of the most common trigger agents for contact dermatitis is:
A. exposure to nickel B. use of fabric softener C. bathing with liquid body wash D. eating spicy foods |
A. exposure to nickel
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A common site for atopic dermatitis in an adult is on the:
A. dorsum of the hand B. face C. neck D. flexor surfaces |
D. flexor surfaces
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A common site for atopic dermatitis in an infant is:
A. the diaper area B. the face C. the neck D. the posterior trunk |
B. the face
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In counseling a patient with atopic dermatitis, you suggest all of the following can be used to alleviate symptoms of a flare except:
A. the use of oral antihistamines B. applying a heating pad on the affected region for30 minutes C. the use of topical corticosteroids D. applying cool, wet dressings made from a clean cloth and water to the affected area |
B. applying a heating pad on the affected region for 30 minutes
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The mechanism of action of pimecrolimus (Elidel) in the treatment of atopic dermatitis is as a/an:
A. immunomodulator B. antimitotic C. mast cell activator D. exfoliant |
A. immunomodulator
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When counseling a patient about the use of tacrolimus (Protopic) or pimecrolimus (Elidel), you mention that:
A. this is the preferred atopic dermatitis treatment in infants B. there is a possibility of increased cancer risk with its use C. the product is used interchangeably with topical corticosteroids D. the product is a potent antihistamine. |
B. there is a possibility of increased cancer risk with its use
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You see a 34-year-old man with atopic dermatitis localized primarily on the arms who complains of severe itching. The condition becomes worse at night and interferes with his sleep. You recommend:
A. taking a bedtime dose of antihistamine B. taking a bedtime dose of acetaminophen C. taking a hot shower prior to bedtime D. applying a warm compress to the affected areas30 minutes prior to bedtime |
A. taking a bedtime dose of antihistamine
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A 38-year-old woman with advanced human immunodeficiency virus (HIV) disease presents with a chief complaint of a painful, itchy rash over her trunk. Examination reveals linear vesicular lesions that do not cross the midline and are distributed over the posterior thorax. This presentation is most consistent with:
A. herpes zoster B. dermatitis herpetiformis C. molluscum contagiosum D. impetigo |
A. herpes zoster
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A Tzanck smear that is positive for giant multinucleated cells was taken from a lesion caused by:
A. herpesvirus B. S. aureus C. streptococci D. allergic reaction. |
A. herpesvirus
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What is the most effective protection against shingles?
A. previous episode of chickenpox as a child B. prior episode of shingles C. receipt of varicella-zoster immunization D. avoiding children and daycare centers |
C. receipt of varicella-zoster immunization
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Shingles most commonly involve the dermatomes of the:
A. legs and pubic area B. face C. upper arms and shoulders D. thorax |
D. thorax
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When caring for an adult with an outbreak of shingles, you advise that:
A. there is no known treatment for this condition B. during outbreaks, the chickenpox (varicella) virus is shed C. although they are acutely painful, the lesions heal well without scarring or lingering discomfort D. this condition commonly strikes young and old alike. |
B. during outbreaks, the chickenpox (varicella) virus is shed
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Analgesia options for a patient with shingles can include all of the following except:
A. topical lidocaine gel 5% with oral acetaminophen B. Burow’s solution with a high-potency oral NSAID C. Burow’s solution with an oral opioid D. fentanyl transdermal patch and a topical medium-potency corticosteroid on the affected area |
D. fentanyl transdermal patch and a topical medium- potency corticosteroid on the affected area
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Risk factors for the development of postherpetic neuralgia include:
A. age younger than 50 years at the time of the outbreak B. severe prodromal symptoms C. lumbar location of lesions D. low volume of lesions |
B. severe prodromal symptoms
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Treatment options in postherpetic neuralgia include all of the following except:
A. injectable methylprednisolone B. oral pregabalin C. oral nortriptyline D. topical lidocaine |
A. injectable methylprednisolone
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The zoster vaccine (Zostavax) is a(n):
A. inactivated/killed virus vaccine B. conjugate vaccine containing a virus-like particle (VLP) C. live, attenuated vaccine D. inactivated toxin vaccine |
C. live, attenuated vaccine
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Characteristics of onychomycosis include all of the following except:
A. it is readily diagnosed by clinical examination B. nail hypertrophy C. brittle nails D. fingernails respond more readily to therapy thantoenails |
A. it is readily diagnosed by clinical examination
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Oral anti fungal treatment options for onychomycosis include all of the following except:
A. itraconazole B. fluconazole C. metronidazole D. terbinafine |
C. metronidazole
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When prescribing itraconazole (Sporanox), the NP considers that:
A. the drug is a cytochrome P-450 3A4 inhibitor B. one pulse cycle is recommended for fingernailtreatment, and two cycles are needed for toenailtherapy C. continuous therapy is preferred in the presence ofhepatic disease D. taking the drug on an empty stomach enhances theefficacy of the product. |
A. the drug is a cytochrome P-450 3A4 inhibitor
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When prescribing pulse dosing with itraconazole for the treatment of fingernail fungus, the clinician realizes that:
A. a transient increase in hepatic enzymes is commonly seen with its use B. drug-induced leukopenia is a common problem C. the patient needs to be warned about excessive bleeding because of the drug’s antiplatelet effect D. its use is contraindicated in the presence of iron- deficiency anemia. |
A. a transient increase in hepatic enzymes is commonly seen with its use
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When prescribing fluconazole, the NP considers that it is a cytochrome P-450:
A. 3A4 inhibitor B. 2CP inhibitor C. 2D6 inducer D. 1A2 inducer |
B. 2CP inhibitor
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In diagnosing onychomycosis, the NP considers that:
A. nails often have a single midline groove B. pitting is often seen C. microscopic examination reveals hyphae D. Beau lines are present |
C. microscopic examination reveals hyphae
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In counseling a patient on the use of topical products to treat nail fungal infections, the NP considers that:
A. nail lacquers, such as ciclopirox olamine 8% solution (Penlac), offer similar effectiveness to oral antifungals B. some herbal products, such as tea tree oil, can be an effective alternative to oral agents C. topical products have limited penetration through the nail matrix to reach the site of infection D. cream-based products are more effective than gel- based products in treating nail fungal infections. |
C. topical products have limited penetration through the nail matrix to reach the site of infection
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