Download AANP FNP Review - MSK & Derm Latest Exam 2025-2026 With Correct Verified Answers and more Exams Nursing in PDF only on Docsity!
AANP FNP Review - MSK & Derm Latest Exam
2025 - 2026 With Correct Verified Answers
Anterior shoulder pain; joint stiffness, measurable loss of ROM external rotation & abduction. More common with diabetes. AKA frozen shoulder. Diagnosis most likely? A)Supraspinatus tendonitis B)Ankylosing spondylitis C)Osteoarthritis D)Adhesive capsulitis - correct answer>>D)Adhesive capsulitis 2 types: non-bullous, erythematous macule evolves into pustule that ruptures, leaving honey crusted exudate; vs bullous, clear & yellow fluid ruptures within 1-3 days, leaving a rim of red with moist base (scalded appearance) deep ulcerated (ecthyma). Both are contagious (no school 48-72 after tx started) & pruritic, worse in warm weather. Common caused by staph aureus or strep pyogenes. Diagnosis most likely? A)Cellulitis B)Erysipelas C)Impetigo D)Atopic dermatitis - correct answer>>C)Impetigo Gradual onset: early-morning joint stiffness with inactivity, short duration (<15 min); pain awakens at night; pain with overuse, swelling, & tender to palpation; DIP common; may be unilateral; and absence of systemic symptoms. AKA osteoarthritis. Heberden's nodes (nodules on DIP, distal). Bouchard's nodes (nodules on PIP, proximal). Diagnosis most likely? A)Degenerative joint disease B)Rheumatoid arthritis C)Systemic lupus erythematosus D)Reactive arthritis - correct answer>>A)Degenerative Joint Disease Lesions like "bulls-eye", erupt suddenly with hives, blisters, petechiae, purpura, hemorrhagic lesions, & skin sloughing. AKA Stevens-Johnson syndrome. May have prodrome, fever with flu-like symptoms 1-3 days before rash appears (palmar rash). Typically caused by reaction to meds (NSAIDs, Sulfa, antiepileptic), infection (herpes or Mycoplasma PNA), &/or malignancies. Diagnosis most likely? A)Kawasaki disease B)Rubeola C)Rubella D)Erythema Multiforme - correct answer>>D)Erythema Multiforme Maculopapular butterfly shaped rash on middle of face (malar rash); most evident after exposure to sun; non pruritic thick scaly red rashes on sun exposed areas (discoid rash); systemic s/s such as fatigue, oral ulcers, gastritis, chronic inflammatory disease affects skin, joints, kidneys, lungs, nervous system, & serous membranes. Characterized by remissions and relapses; more common in women in 20's, 30's; increased risk of miscarriage. Mild form is cutaneous lupus erythematous. Diagnosis most likely? A)Systemic lupus erythematosus B)Reactive arthritis C)Rubeola D)Roseola - correct answer>>A)Systemic lupus erythematosus Affects skin & pulmonary. Cutaneous begins as papule enlarges in 24-48hr, develops eschar & necrosis. Flu like s/s such as cough, chest pain with cough, hemoptysis,
dyspnea, hypoxia, & progress to shock. Pulmonary after inhaling aerosol, working with animals or bioterrorism (hx of exposure of handling animals). CDC: prophylaxis (cipro for 60d), exposure (doxycycline, cipro, or levofloxacin for 7-10d or 60d for bioterrorism). Diagnosis most likely? A)Brown recluse spider bite B)Erysipelas C) D)Anthrax - correct answer>>D)Anthrax Acute nonpurulent arthritis. 1 MSK and 1 other of the following findings: asymmetrical oligoarthrtitis, predominately lower extremity, sausage shaped finger (dactylitis); toe or heel pain; cervicitis, prostatitis, acute diarrhea within one month (equal affect genders), conjunctivitis or uveitis (affect male more), genital ulceration, urethritis; & joint pain knee/ankle/feet. AKA Reiter Syndrome. Commonly occurs days to weeks after diarrhea caused by Shigella, Salmonella or Campylobacter or Chlamydia. Diagnosis most likely? A)Ankylosing spondylitis B)Reactive arthritis C)Sarcoidosis D)Systemic lupus erythematosus - correct answer>>B)Reactive arthritis Erythematous papules & plaques "fine-silvery scales" found over elbows, scalp, knees, gluteal folds; with pitting of fingernails. Cause, inherited, excessive mitotic growth of epithelial cells. Auspitz sign (pinpoint areas of bleeding remain in the skin when a plaque is removed). Chronic (Koebner phenomenon, scar formation in places not near typical psoriasis). Diagnosis most likely A)Atopic dermatitis B)Folliculitis C)Psoriasis D)Cellulitis - correct answer>>C)Psoriasis Pain on palpation of "snuffbox" area, pain on axial loading of thumb; pain worse when gripping or squeezing. Scaphoid fx, usually after fall with outstretched hand, XR initially may be normal so repeat in 2weeks to detect fx. Concerns avascular necrosis and nonunion. If suspected splint wrist (thumb spica splint) & refer to hand surgeon. Diagnosis most likely? A)Colles fracture B)Navicular fracture C)Ankylosing spondylitis D)Carpal tunnel syndrome - correct answer>>B)Navicular fracture Painful blistering on side of finger or cuticle, caused by HSV 1 or 2. Transmission, direct contact, cover skin lesion until healed. Diagnosis most likely? A)Impetigo B)Cellulitis C)Partial thickness burn D)Herpetic whitlow - correct answer>>D)Herpetic whitlow Either gradual onset with symptoms that last for years; or more rapid onset with progression & resolution of disease. Common s/s are fever, fatigue, anorexia and arthralgias, rash, lesions, color change, nodule formation under skin, blurred vision, eye pain, severe redness, & sensitivity to light. Inflammatory condition resulting in production of noncaseating granulomas predominately lungs, lymph nodes, eyes, skin. More common adults 20-40y, & in women & African Am. Diagnosis most likely?
Gradual onset, systemic s/s such as fatigue, low-grade fever, body aches, & myalgia, along with peripheral polyarthritis >3 joints (small joints-fingers, hands, wrist, ankles, feet, & shoulders). Morning stiffness that lasts longer than 1hr (longer than OA) with painful, warm, & swollen joints ("sausage joints"), swan neck deformities. Classic - Bouchard's nodes (PIP). Commonly symmetrical joint involvement & present for 6 weeks; peak age 20-40y. Concerns are uveitis (eye pain with conjunctival injection, NO purulent drainage), scleritis, pericarditis, & malignancies. Diagnosis most likely? A)Rheumatoid arthritis B)Osteoarthritis C)Sarcoidosis D)Reactive arthritis - correct answer>>A)Rheumatoid arthritis Acute onset painful, large, red nodules & papules, under one or both axilla, that become abscessed, characterized by recurrences & scars. Cause bacterial infection of axillary sebaceous gland, commonly staph aureus. Diagnosis most likely? A)Folliculitis B)Erysipelas C)Cellulitis D)Hidradenitis suppurative - correct answer>>D)Hidradenitis suppurative Sudden onset one-sided hip pain. For mild non-displaced, may be able to bear weight; OR for displaced, inability to walk or bear weight on affected hip. Severe hip pain with external rotation of the hip/leg; can have leg shortening. More common elderly, & higher mortality risk. Diagnosis most likely? A)Quadriceps injury B)Pelvic fracture C)Lumbar radiculopathy D)Hip fracture - correct answer>>D)Hip fracture Fever, chills, nausea & vomiting, & skin lesion. Red, white, & blue sign (central blistering with surrounding gray to purple discoloration at bite blanched skin, & surrounded by large areas of redness), geographic (midwestern & southeastern US). Diagnosis most likely? A)Lyme disease B)Brown recluse spider bite C)Erythema multiforme D)Cellulitis - correct answer>>B)Brown recluse spider bite Active patient complains of "ball-like" mass behind knee, or may be asymptomatic. If cyst ruptures, will cause inflammatory reaction like cellulitis of area (redness, swelling, tenderness). AKA ruptured baker's cyst. Symptomatic RICE & NSAIDs. Large bursae can be drained. Diagnosis most likely? A)Bursitis B)Septic arthritis C)Sarcoidosis D)Cellulitis - correct answer>>A)Bursitis Pain in hip, abdomen, &/or back, often unable to bear weight, & other s/s depending on degree of injury & structures (nerves, blood vessels, organs). May have hx high impact trauma. On exam, ecchymosis & swelling in lower abdomen, hip, groin, scrotum. Bladder/fecal incontinence, vaginal/rectal bleeding, hematuria, numbness. Risk for internal hemorrhage (life threatening). Diagnosis most likely? A)Lumbar radiculopathy B)Hip fracture C)Pelvic fracture D)Spinal stenosis - correct answer>>C)Pelvic fracture
Oval plaque with central salmon-colored area & dark red peripheral zone on anterior trunk; with fine scales following skin lines (maculopapular rashes oval shaped); "Herald patch" or "Christmas Tree" patch; & Koplik spots. Cause unknown (possibly viral), symptomatic tx. Diagnosis most likely? A)Rubeola B)Pityriasis rosea C)Psoriasis D)Secondary syphilis - correct answer>>B)Pityriasis rosea Painful, hot, red & swollen metatarsophalangeal (MTP) joint, commonly great toe (podagra), limping r/t severe pain. Uric acid crystals in joint. Hx previous attack. More common middle aged man 30+, obese. Associated - tophi on ears/joints. Tests: uric acid level 2wk after attack and gold standard joint aspiration. Triggers are alcohol, meats, seafood; or meds including aspirin, diuretics, cyclosporine, & niacin. Risk joint destruction. Which medication could be prescribed for maintenance treatment (select all)? A)Colchicine B)Indomethacin C)Allopurinol D)Probenecid - correct answer>>C & D - C)Allopurinol & D)Probenecid Hypopigmented round macules on chest/shoulders/back; appear after skin is tanned from sun; asymptomatic. Caused by yeast (Pityrosporum orbiculare or Pityrosporum ovale). Teach pt that hypopigmented spots will not spontaneously disappear after treatment starts & may take several months for pigment to fill in. Which will treat this condition? A)Topical steroids B)Mupirocin C)Emollients D)Topical selenieum sulfide - correct answer>>D)Topical selenieum sulfide Which are tests to detect knee instability (select all)? A)Hook test B)Lachman's C)McMurray's D)Murphy's E)Drawer sign F)Spurling's - correct answer>>B & E - B)Lachman's & E)Drawer sign Slow growing, waxy, pearly, domed nodule, usually distinct borders with or without telangiectasia; white, light pink, brown or flesh colored. Papule, nodule with or without central erosion. Think "PUT ON" (Pearly papule, Ulcerating, Telangiectasia, On the face, scalp, Pinnae, Nodules). Risk factors are light-colored skin, Australian decent, & sun- exposed area. Low metastatic risk but high tissue destruction risk if untreated. Diagnosis most likely? A)Actinic keratosis B)Rosacea C)Basal cell carcinoma D)Roseola - correct answer>>C)Basal cell carcinoma Ankle sprain: Grade 1 - mild (slight stretching and damage to ligament, stable joint) able to bear weight and ambulate. Grade 2 - moderate (partial tearing of ligament) ecchymoses, moderate swelling, pain to palpation, weight bearing painful. Mild/mod joint instability. Consider x-ray/referral. Grade 3 severe (complete rupture of ligaments & joint instability) inability to bear weight after injury, inability to ambulate at least 4
Pruritic rash on hands, flexural folds, & neck, with well-demarcated round-to-oval erythematous coin-shaped plaques, exacerbated by stress & environment; starts as itchy, small vesicles that rupture, leaving red & weeping lesions that become lichenified. Associated with risk of infection & formation of fissures. Common triad (3As) of allergies, atopy (eczema), & asthma. Promote skin moisture (skin lubricants, hydrating baths). Topical steroids for skin & oral antihistamine for pruritis. Diagnosis most likely? A)Atopic dermatitis B)Contact dermatitis C)Scabies D)Psoriasis - correct answer>>A)Atopic dermatitis Plantar foot pain (unilateral or bilateral) worsened by walking or weight bearing, & worse in morning or with prolonged walking. Risk factors obesity, diabetes, aerobic exercise, flat feet, prolonged standing. XR to r/o fx or bone spurs. Treatments including NSAIDs, diclofenac gel, orthotics, stretching, refer to podiatry. Diagnosis most likely? A)Gout B)Morton's neuroma C)Ankle fracture D)Plantar fasciitis - correct answer>>D)Plantar fasciitis Severe pruritic rash, worse at night, located between webs of toes & fingers, axillae, waistline, groin, breasts, butt, & penis. Rash appears in linear burrows. Can last up to 4 weeks. Treat household: topical (Permethrin, apply entire body, leave on 8-12h, then wash off) and fomites (hot water wash or bagged in hot temp for several days). Diagnosis most likely? A)Dermatitis B)Scabies C)Tinea corporis D)Shingles - correct answer>>B)Scabies Locking of knee, popping or giving out, c/o knee pain with difficulty walking & bending knee. May be unable to fully extend affected knee - decreased ROM; may limp, may c/o joint line pain. Usually hx overuse or recent trauma that twisted the knee. Positive McMurray's test ("click" with rotation of ankle knee manipulation). XR for r/t differentials but won't show tear (MRI). Treatments are RICE, crutches, immobilizer, after 48h straight leg raises help strengthen quads. Diagnosis most likely? A)Meniscus tear B)MCL tear C)ACL tear D)Degenerative joint disease - correct answer>>A)Meniscus tear FLU-LIKE symptoms, then rash appears 7-14 days exposure, and spontaneously resolves. Red rash, expanded with central clearing "bulls- eye" appearance, feels hot to touch, & rough texture. Common areas belt line, axilla, popliteal, & groin. Geographic (northeast US); transmission tick bite. AKA Lyme disease. Risk for systemic infx with organ shutdown, Guillain-Barre, or migratory arthritis. Treatment doxycycline 14-28d (alternate amoxicillin or ceftin - avoid doxycycline children d/t staining teeth). Stages: 1 (single painless annular lesion), 2 (AV heart block, Bell's palsy), 3 (joint pain 1yr after
lesion). Diagnosis most likely? A)Erythema multiforme B)Rocky mountain spotted fever C)Rheumatoid arthritis D)Erythema Migrans - correct answer>>D)Erythema Migrans Gradual onset of pain on outside of the elbow radiating to forearms. Overuse injury. Pain worsens with twisting & grasping movements (opening jars, shaking hands); may have decreased hand grip strength; pain with wrist extension. AKA tennis elbow. Diagnosis most likely? A)Medial epicondylitis B)Lateral epicondylitis C)Cervical radiculopathy D)Osteoarthritis - correct answer>>B)Lateral epicondylitis Sudden onset of hot, indurated, erythema with clear demarcation (sharply demarcated with raised edges), usually on lower legs or cheeks. Skin break allows pathogen S. pyogenes. For non-purulent, prescribe keflex or dicloxacillin; PCN 1st line. Hospital for infants or immunocompromised. Diagnosis most likely? A)Dermatitis B)Folliculitis C)Hidradenitis suppurative D)Erysipelas - correct answer>>D)Erysipelas Recurrent shin pain in one or both legs that becomes more severe over time. Pain along inner border of tibia and occurs during and after exercise. Overuse injury (microtears & inflammation of muscles, bones & tendons). Mild swelling and focal area of tenderness painful on palpation may suggest fx. AKA shin splints. More common in runners, flat feet, female athlete triad (amenorrhea, eating disorder, & osteoporosis). XR to r/o differential but won't show stress fx, would need bone scan or MRI. Tx include RICE (stop activity for several weeks), stretch before exercise, start lower intensity, & wear cushioned soles. Diagnosis most likely? A)Osteomyelitis B)Ankle sprain C)Medial Tibial Stress D)Tibia ligament tear - correct answer>>C)Medial Tibial Stress Skin lesion that may be pruritic. Think ABCDE: A (asymmetric shaped) B (border irregular) C (color brown, black, red, white, blue) D (diameter >6mm) E (evolving, elevated, & most are new). Recognize acral lentiginous melanoma (among African American & Asians; and located on nail beds, palmar, & plantar surfaces). Risk factors are family hx of melanoma, sun-exposure, tanning beds, lots of nevus, & light skin or eye color. Diagnosis most likely? A)Melanoma B)Actinic keratosis C)Folliculitis D)Erysipelas - correct answer>>A)Melanoma Shoulder pain with elevation or abduction (reaching into back pocket); click when arm raised above head. Anterior are tender with palpation. May have impingement syndrome - pain with ROM such as lateral shoulder when hand at or above level of shoulder (reaching into pantry to get a can, or reaching up in the closet). Positive painful arc test (glenonumeral painful arc 45-60 degree; subacromial painful arc 60-120 degree; & acromioclavicular painful arc 170-180 degree). Diagnosis most likely? A)Adhesive
before rash & until all lesions are crusted over D)2-5 days from when sick symptoms started - correct answer>>C)1-2 days before rash & until all lesions are crusted over Abduction (varus) movement going away from body. Adduction (valgum) movement going toward the body. Recurvatum, hyperextension, or backward curvature. Genu - knees. Which of the following are benign variants (select all)? A)Talipes equinovarus B)Genu recurvatum C)Genu valgum D)Genu varus - correct answer>>B, C, & D - B)Genu recurvatum C)Genu valgum & D)Genu varus Location based infection: tinea capitus (head, most common), tinea barbrae (beard), tinea manuum (hands), tinea corporis (body), and tinea cruris (genitalia "jock itch"). Cause yeast. Gold standard treatment, griseofulvin (baseline LFT and repeat 2 weeks after initiating meds). Diagnosis most likely? A)Dermatophytosis B)Dermatitis C)Psoriasis D)Pityriasis rosea - correct answer>>A)Dermatophytosis Sudden onset of posterior thigh pain while performing activities such as running at a fast pace or sprinting. Usually report hearing a popping noise followed by sudden pain. On physical exam, there may be swelling, bruising, & tenderness on the posterior thigh. A muscular mass may be palpated. Refer to ortho. Which muscle injury is described? A)Quadriceps B)Hamstring C)Piriformis D)Gluteus - correct answer>>B)Hamstring Sudden onset of sore throat, cough, fever, headache, stiff neck, photophobia, & changes in LOC. Abrupt onset of petechial to hemorrhagic rashes (purple to dark red, painful skin lesions). Cause Neisseria Meningitides, Gram - diplococci, spread via respiratory. Risk factors, college students in dorms. Refer to ED, risk of death within 48h. Prophylaxis tx for close contacts in prior 7d before symptom onset (Rifampin). Diagnosis most likely? A)Thrombocytopenia B)Lyme disease C)Meningococcemia D)Rocky mountain spotted fever - correct answer>>C)Meningococcemia A patient has pectus excavatum and diagnosed with a heart valve condition. Sports participation allowed in the absence of symptoms, activity intolerance. Which heart valve condition? A)Mitral valve prolapse B)Aortic regurgitation C)Mitral stenosis D)Aortic stenosis - correct answer>>A)Mitral valve prolapse Infection of dermis and subcutaneous fat with heat, redness, & discomfort in the region, poorly demarcated. Gram positive staph or Strep. Diagnosis most likely? A)Erysipelas B)Cellulitis C)Dermatophytoses D)Impetigo - correct answer>>B)Cellulitis Gradual onset of pain in medial area of elbow; high risk baseball, bowlers, golfers; may have decreased hand grip strength. AKA Golpher's elbow. Diagnosis most likely?
A)Medial epicondylitis B)Lateral epicondylitis C)De Quervain's tenosynovitis D)Cervical radiculopathy - correct answer>>A)Medial epicondylitis Maculopapular rash in a lace like pattern; slapped cheek; rash appears a few days after symptoms (fever, HA, cough, sore throat, sore joints). Erythema infectiosum, as the rash goes away it may appear lacy, parvovirus B19. Rash may be itchy, especially on soles of feet. Diagnosis most likely? A)Pityriasis rosea B)Hand foot & mouth disease C)Roseola D)Fifth disease - correct answer>>D)Fifth disease Acute or chronic knee swelling or pain. On knee exam, there is increased laxity with valgus pressure. There is no laxity with varus pressure. The pt may may recall hearing or feeling a "pop" prior to onset of swelling or pain; or may be asymptomatic. What area is most likely injured? A)Anterior cruciate ligament B)Medial collateral ligament C)Meniscus D)posterior cruciate ligament - correct answer>>B)Medial collateral ligament Pregnancy mask, brown to tan colored stains, in the malar area (upper cheeks & nose) & forehead. Diagnosis most likely? A)Melasma B)Vitiligo C)Systemic lupus erythematosus D)Xanthelasma - correct answer>>A)Melasma Benign small papules, bright cherry red in color, always blanch with pressure. Diagnosis most likely? A)Urticaria B)Telangiectasia C)Cherry angioma D)Rosacea - correct answer>>C)Cherry angioma On exam the NP performs the following, extending the neck, rotating the head, & applying downward pressure on the head. The NP documents a positive Spurling test. The NP knows this finding indicates? A)Meningococcemia B)Spinal stenosis C)Cervical radiculopathy D)Fibromyalgia - correct answer>>C)Cervical radiculopathy Painless, pedunculated outgrowths of skin that are the same color (skin tags). Diagnosis most likely? A)Acrochordon B)Seborrheic keratosis C)Actinic keratosis D)Nevus - correct answer>>A)Acrochordon Lateral deltoid pain with weakness and loss of strength in external rotation or abduction; usually pain disturbs sleep; often overuse (wear & tear) injury. Diagnosis most likely? A)Adhesive capsulitis B)Ankylosing spondylitis C)Supraspinatus tendonitis D)Rotator cuff tear - correct answer>>D)Rotator cuff tear Soft, wart-like growth on trunk ranging from light brown-black;
the muscle. May have swelling, bruising, & palpable tenderness. Can be partial or complete. Diagnosis most likely? A)Rotator cuff tear B)Adhesive capsulitis C)Cervical radiculopathy D)Bicep tendon rupture - correct answer>>D)Bicep tendon rupture
