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A woman is leaving on a trip to Hawaii and has come in for a checkup. During the examination the nurse learns that she has diabetes and takes oral hypoglycemic agents. The patient needs to be concerned about which possible effect of her medications? a Increased possibility of bruising b Skin sensitivity as a result of exposure to salt water c Lack of availability of glucose-monitoring supplies d Importance of sunscreen and avoiding direct sunlight ---------CORRECT ANSWER- ----------------D A 13-year-old girl is interested in obtaining information about the cause of her acne. The nurse should share with her that acne: a Is contagious. b Has no known cause. c Is caused by increased sebum production. d Has been found to be related to poor hygiene. ---------CORRECT ANSWER---------- -------C
A 75-year-old woman who has a history of diabetes and peripheral vascular disease has been trying to remove a corn on the bottom of her foot with a pair of scissors. The nurse will encourage her to stop trying to remove the corn with scissors because: a The woman could be at increased risk for infection and lesions because of her chronic disease. b With her diabetes, she has increased circulation to her foot, and it could cause severe bleeding. c She is 75 years old and is unable to see; consequently, she places herself at greater risk for self-injury with the scissors. d With her peripheral vascular disease, her range of motion is limited and she may not be able to reach the corn safely. ---------CORRECT ANSWER-----------------A The nurse keeps in mind that a thorough skin assessment is extremely important because the skin holds information about a persons: a Support systems. b Circulatory status. c Socioeconomic status. d Psychological wellness. ---------CORRECT ANSWER-----------------B A patient comes in for a physical examination and complains of freezing to death while waiting for her examination. The nurse notes that her skin is pale and cool and attributes this finding to: a Venous pooling. b Peripheral vasodilation.
a Color variation b Border regularity c Symmetry of lesions d Diameter of less than 6 mm ---------CORRECT ANSWER-----------------A A patient comes to the clinic and states that he has noticed that his skin is redder than normal. The nurse understands that this condition is due to hyperemia and knows that it can be caused by: a Decreased amounts of bilirubin in the blood b Excess blood in the underlying blood vessels c Decreased perfusion to the surrounding tissues d Excess blood in the dilated superficial capillaries ---------CORRECT ANSWER-------- ---------D During a skin assessment, the nurse notices that a Mexican-American patient has skin that is yellowish-brown; however, the skin on the hard and soft palate is pink and the patients scleras are not yellow. From this finding, the nurse could probably rule out: a Pallor b Jaundice c Cyanosis d Iron deficiency ---------CORRECT ANSWER-----------------B
A black patient is in the intensive care unit because of impending shock after an accident. The nurse expects to find what characteristics in this patients skin? a Ruddy blue. b Generalized pallor. c Ashen, gray, or dull. d Patchy areas of pallor. ---------CORRECT ANSWER-----------------C An older adult woman is brought to the emergency department after being found lying on the kitchen floor for 2 days; she is extremely dehydrated. What would the nurse expect to see during the examination? a Smooth mucous membranes and lips b Dry mucous membranes and cracked lips c Pale mucous membranes d White patches on the mucous membranes ---------CORRECT ANSWER---------------
- -B A 42-year-old woman complains that she has noticed several small, slightly raised, bright red dots on her chest. On examination, the nurse expects that the spots are probably: a Anasarca. b Scleroderma. c Senile angiomas. d Latent myeloma. ---------CORRECT ANSWER-----------------C
d Acrochordons. ---------CORRECT ANSWER-----------------C A man has come in to the clinic for a skin assessment because he is worried he might have skin cancer. During the skin assessment the nurse notices several areas of pigmentation that look greasy, dark, and stuck on his skin. Which is the best prediction? a Senile lentigines, which do not become cancerous b Actinic keratoses, which are precursors to basal cell carcinoma c Acrochordons, which are precursors to squamous cell carcinoma d Seborrheic keratoses, which do not become cancerous ---------CORRECT ANSWER-----------------D The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should: a Ask the patient to urinate into a sterile cup. B Ask the patient to obtain a specimen of semen. C Insert a cotton-tipped applicator into the urethra. D Compress the glans between the examiners thumb and forefinger, and collect any discharge. ---------CORRECT ANSWER-----------------D When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:
a From urethritis. B Sebaceous cysts. C Subcutaneous plaques. D From an inflammation of the epididymis. ---------CORRECT ANSWER----------------- B When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would: a Assess the patient for the presence of a hernia. B Suspect the presence of serous fluid in the scrotum. C Consider this finding normal, and proceed with the examination. D Refer the patient for evaluation of a mass in the scrotum. ---------CORRECT ANSWER-----------------B When the nurse is performing a genital examination on a male patient, which action is correct? A Auscultating for the presence of a bruit over the scrotum B Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament c Palpating the inguinal canal only if a bulge is present in the inguinal region during inspection d Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side ---------CORRECT ANSWER-----------------D
C Retracting the foreskin should be avoided until the infant is 3 months old. D Any dirt or smegma that has collected under the foreskin should be noted. ------ ---CORRECT ANSWER-----------------C A 2-year-old boy has been diagnosed with physiologic cryptorchidism. Considering this diagnosis, during assessment the nurse will most likely observe: a Testes that are hard and painful to palpation. B Atrophic scrotum and a bilateral absence of the testis. C Absence of the testis in the scrotum, but the testis can be milked down. D Testes that migrate into the abdomen when the child squats or sits cross- legged. ---------CORRECT ANSWER-----------------C A 22-year-old architecture major comes to your office, complaining of severe burning with urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She reports one new partner within the last month. She does not smoke but does drink occasionally. Her parents are both in good health. On examination you see a young woman appearing slightly ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual ex ---------CORRECT ANSWER-----------------A
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis ---------CORRECT ANSWER-----------------D A 30-year-old paralegal analyst comes to your clinic, complaining of a bad- smelling vaginal discharge with some mild itching, present for about 3 weeks. She tried douching but it did not help. She has had no pain with urination or with sexual intercourse. She has noticed the smell increased after intercourse and during her period last week. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of one spontaneous vaginal delivery. She is married and has one child. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure and her father died from a heart disease. On examination she appears healthy and has unremarkable vital signs. On examination of the perineum there are no lesions noted. On palpation of the inguinal nodes there is no lymphadenopathy. On speculum examination a thin gray-white discharge is seen in the vault. The pH of the ---------CORRECT ANSWER-----------------C
A 28-year-old married clothing sales clerk comes to your clinic for her annual examination. She requests a refill on her birth control pills. Her only complaint is painless bleeding after intercourse. She denies any other symptoms. Her past medical history consists of two spontaneous vaginal deliveries. Her past six Pap smears have all been normal. She is married and has two children. Her mother is in good health and her father has high blood pressure. On examination you see a young woman appearing healthy and relaxed. Her vital signs are unremarkable and her head, eyes, ears, throat, neck, cardiac, lung, and abdominal examinations are normal. Visualization of the perineum shows no lesions or masses. Speculum examination shows a red mass at the os. On taking a Pap smear the mass bleeds easily. Bimanual examination shows no cervical motion tenderness and both ovaries are palpated and nontender. What is the most likely ---------CORRECT ANSWER-----------------C An 18-year-old college freshman comes to your clinic, complaining of severe left- sided lower abdominal pain and a foul yellow discharge. The pain began last night while she was having intercourse with her boyfriend. Afterward the pain became more severe and the discharge started. By this morning she had a fever of 101 degrees and walking was making the pain worse. Only lying very still makes the pain better. She has tried ibuprofen and acetaminophen without any improvement. She denies any nausea, vomiting, diarrhea, or constipation. Her past medical history is unremarkable. She has had two past sexual partners. She uses the birth control patch instead of condoms. She smokes a half pack of cigarettes a day and drinks four to five beers per weekend night. She denies any illegal drug use. Her parents are both healthy. On examination you find a young woman who appears ill. Her temperature is 102 degrees and her pulse is ---------CORRECT ANSWER-----------------C
A 34-year-old married daycare worker comes to your office, complaining of severe pelvic pain for the last 6 hours. She states that the pain was at first cramp- like but is now sharp. Nothing makes the pain better or worse. She has had no vaginal bleeding or discharge. She has had no pain with urination. She has had some nausea for the last few days but denies vomiting, constipation, or diarrhea. She states she feels so bad that when she stands up she has fainted. Her past medical history consists of two prior cesarean sections and an appendectomy. She is married and has two children. She denies any tobacco, alcohol, or drug use. Her parents are both healthy. On examination you find a pale young woman who is obviously in a great deal of pain. She is lying on her right side with her eyes closed. Her blood pressure is 90/60 and her pulse is 110. She is afebrile. She has bowel sounds and her abdomen is soft. The speculum ---------CORRECT ANSWER-----------------B A 23-year-old waitress comes to your clinic complaining of severe pelvic pain radiating to her right side. The pain began yesterday and is getting much worse. She has had no burning with urination and denies any recent sexual activity. She has no nausea, vomiting, constipation, diarrhea, fever, or vaginal discharge. Her last period was 3 to 4 weeks ago. Her past medical history consists of severe acne, depression, and mild obesity. She has had no surgeries. She broke up with her boyfriend 6 months ago and denies dating anyone else. She smokes one pack of cigarettes a day, drinks three to four beers two to three times a week, and denies any illegal drug use. Her mother is diabetic and her father has coronary artery disease. On examination you see a mildly obese female in moderate distress. Her blood pressure is 130/80 and her pulse is 90. She is afebrile. On auscultation she has active bowel sounds. She has no rebound ---------CORRECT ANSWER-------------- ---A A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar area. She states that 2 days earlier she could feel a small tender spot
Mrs. Jaeger is a 67-year-old who went through menopause at age 55. She has now had some vaginal bleeding. Which of the following should be considered? A) Endometrial cancer B) Hormone replacement therapy C) Uterine or cervical polyps D) All of the above ---------CORRECT ANSWER-----------------D Abby is a newly married woman who is unable to have intercourse because of vaginismus. Which of the following is true? A) This is most likely due to lack of lubrication. B) This is most likely due to atrophic vaginitis. C) This is most likely due to pressure on an ovary. D) Psychosocial reasons may cause this condition. ---------CORRECT ANSWER-------- ---------D Which of the following is true of human papilloma virus (HPV) infection? A) Pap smear is a relatively ineffective screening method. B) It commonly resolves spontaneously in 1-2 years. C) It is the second most common STI in the United States. D) HPV infections cause a small but important number of cervical cancers. --------- CORRECT ANSWER-----------------B
Which of the following is true of the HPV vaccine? A) Ideally it should be administered within 3 years of first intercourse. B) It covers against almost every HPV type. C) It can be used as adjuvant therapy in cervical cancer. D) It can protect against anogenital lesions. ---------CORRECT ANSWER----------------- D A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient? A) Age B) Hair color C) Actinic lentigines D) Heavy sun exposure ---------CORRECT ANSWER-----------------A You are speaking to an 8th grade class about health prevention and are preparing to discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs? A) A = actinic; B = basal cell; C = color changes, especially blue; D = diameter > mm; E =evolution B) A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution
A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? A) Pityriasis rosea B) Tinea versicolor C) Psoriasis D) Atopic eczema ---------CORRECT ANSWER-----------------B A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma D) Squamous cell carcinoma ---------CORRECT ANSWER-----------------A A 58-year-old gardener comes to your office for evaluation of a new lesion on her upper chest. The lesion appears to be "stuck on" and is oval, brown, and slightly
elevated with a flat surface. It has a rough, wartlike texture on palpation. Based on this description, what is your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma D) Squamous cell carcinoma ---------CORRECT ANSWER-----------------B A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full- thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer? A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4 ---------CORRECT ANSWER-----------------C An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis? A) Alopecia areata
