Integumentary Flashcards by Alyssa Willis

A flat, nonpalpable, irregular shaped area that is a change in the color of the skin that is more than 1cm in diameter is a:

A. Wheal
B. Macule
C. Plaque
D. Patch

Patch

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This chronic immune mediated inflammatory skin disorder is characterized by a relapsing/remitting pattern, and thickening of the dermis and epidermis leading to increased epidermal shedding:

A. Seborrheic dermatitis
B. Pityriasis rosea
C. Lichen planus
D. Psoriasis

Psoriasis

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All of the following skin disorders are life threatening with the exception of:

A. Pemphigus vulgaris
B. Stevens-johnson syndrome
C. Erysipelas
D. Hydradenitis suppurative

Hydradenitis suppurative

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The provider notices an area of erythema with hair loss on the scalp of a five-year old child. Which is the likely diagnosis of this condition?

A. Tinea capitis
B. Impetigo
C. Tinea corporis
D. Tinea pedis

Tinea capitis

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The provider is conducting a routine physical assessment on an otherwise healthy 24-year-old woman who has expressed concern about a skin lesion on her back. Upon physical exam, the provider determines that the lesion is a nevus (mole). Which of the following assessment findings would indicate a need for further evaluation?

A. Color variation within nervus
B. A nevus diameter of at least 4 mm
C. Consistent, very dark brown coloration within the nevus
D. A skin-colored nevus that is flat and perfectly round

Color variation within nervus

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A patient tells their provider “I have a history of dermatitis, and I think it’s back because I can’t stop itching.” Leading up to the physical exam, the provider may decide to exclude which form of dermatitis from their differential diagnosis?

A. Contact- Irritant Dermatitis
B. Contact- Allergic Dermatitis
C. Atopic Dermatitis
D. Seborrheic Dermatitis

Contact- Irritant Dermatitis

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Risk factors for developing oropharyngeal candidiasis infections include the following except?

A. Use of mouthwash
B. Chemotherapy
C. Diabetes mellitus
D. Inhaled steroids

Use of mouthwash

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Which of the following examples is not suspicious for malignancy?

A. 1cm round lesion on the skin, slightly raised, uniform brown in color that shows symmetry
B. 3cm red, pink and ivory scaly lesion with asymmetric borders that are rolled
C. 1.5 cm linear brown to pink lesion that has areas of raised and flat spots. Pt states the spot used to be small and round
D. 1cm purple dome shaped papule on the back of the neck of a patient

1cm round lesion on the skin, slightly raised, uniform brown in color that shows symmetry

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A 2 year old child presents to the clinic with a chief complaint of a rash under the nose. On assessment the rash consists of dry yellow crust with some oozing vesicles filled with yellow fluid. The clinician diagnoses the child with impetigo. What is the infectious agent?

A. C. albicans
B. S. aureus
C. Trichophyton
D. Molluscipoxvirus

S. aureus

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A 32-year-old patient presents to urgent care with a suspected insect bite. Once you assess the lesion, you describe it as an elevated, irregularly shaped area of cutaneous edema that is solid and 1mm in diameter. Based on the description what type of skin lesion do you suspect this to be?

A. Bulla
B. Wheal
C. Patch
D. Cyst

Wheal

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A patient presents to his primary care physician with a skin lesion he is concerned about. You assess the lesion and describe it as a brownish patch, and you diagnose it as actinic keratosis. What condition could actinic keratosis evolve into?

A. Scleroderma
B. Cutaneous melanoma
C. Squamous cell carcinoma
D. Nevi

Squamous cell carcinoma

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What advice can you provide to a parent of an infant with irritant contact dermatitis on their diaper area?

A. the use of disinfectant wipes
B. Antiviral medication
C. Antibiotics
D. Topical protection of zinc oxide

Topical protection of zinc oxide

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Which layer of the skin is the papillary capillaries located as the primary source of blood supply?

A. The dermis
B. The epidermis
C. The subcutaneous layer
D. The basement membrane

The dermis

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A 28-year-old female patient presents to the clinic with painful blisters around her mouth that have appeared over the last two days. She reports a tingling sensation prior to the blisters’ appearance. The patient has a history of cold sores and mentions that she experienced a stressful week at work. Based on her symptoms and history, what is the most likely diagnosis for this patient?

A. Shingles
B. Herpes simplex virus type 1 (HSV-1) infection
C. Contact dermatitis
D. Bacterial impetigo

Herpes simplex virus type 1 (HSV-1) infection

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A 7-year-old girl named Emily presents to the pediatric clinic with a fever, malaise, and a rash that has developed over the past 48 hours. The rash started as tiny red spots on her torso and has now spread to her face and limbs. The spots have progressed to fluid-filled blisters, some of which have crusted over. Emily’s mother mentions that Emily was previously healthy and had not received the varicella vaccine. Based on the information provided, which of the following steps should be the priority in managing Emily’s condition?

A. Administering the varicella vaccine to prevent further complications.
B. Prescribing antiviral medication to shorten the duration of the illness.
C. Symptomatic treatment, including antihistamines and calamine lotion, should be advised for itch relief.
D. Hospitalizing Emily for observation due to the risk of secondary bacterial infection.

Symptomatic treatment, including antihistamines and calamine lotion, should be advised for itch relief.

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34-week pregnant patient presents for an initial prenatal visit. The patient reports “bumps’ in her vaginal area after shaving. The patient denies any medical history or any other concerns. A physical exam is notable for a one-inch diameter lesion with multiple small vesicles (within) on the left side of the labia majora. The NP will:

A. Treat the patient with Flagyl due to bacterial vaginosis
B. Treat the patient with penicillin G due to a positive group B streptococcal infection
C. No need for treatment; lesions will resolve on their own
D. Immediately treat with acyclovir.

Immediately treat with acyclovir.

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A 5-year-old presents to the clinic, accompanied by his father, with itching on the child’s arms and legs. The father states that the areas were sprayed with sunscreen yesterday. The exam is notable for erythema and edema with bilateral pruritic vesicular arm and leg lesions. The NP suspects:

A. Herpes and will be treated with acyclovir
B. Allergic contact dermatitis and will be treated with steroids
C. Benign exam and no treatment are required
D. Seborrheic Dermatitis will be treated with an antifungal

Allergic contact dermatitis and will be treated with steroids

An 85-year-old female patient presents to the clinic for an annual visit. The exam is notable for short, thin gray hair with no hair loss along the frontal hairline. The NP knows that this:

A. Is a usual finding and may be treated with minoxidil or light therapy
B. Needs to be treated with an antifungal
C. Needs to be treated with antibiotics
D. Need to be treated with an antiviral

Is a usual finding and may be treated with minoxidil or light therapy

Which stage pressure injury is being described in the following: Full thickness skin loss involving damage of subcutaneous tissue

A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

Stage 3

Roger is a nurse practitioner student who is learning about the candida albican, and who is at risk for developing the fungal infection. Roger states the following are all risk factors for oropharyngeal develop, except:

A. Use of inhaled steroid therapy
B. Medical history of diabetes
C. Medical history of HIV/AIDS
D. Use of nystatin

Use of nystatin

Which childhood viral infection is associated with koplik spots?

A. Rubeola
B. Varicella
C. Roseola infantum
D. Hand, food and mouth disease

Rubeola

A 10 years old boy who started indoor soccer complains of multiple bumps on the lower right arm. He denies pain, pruritus, or discomfort from the lesions. During the skin exam, the nurse practitioner notices multiple dome-shaped papules 1 to 5 mm in diameter with slightly umbilicated. Which diagnosis is most likely?

A. Molluscum contagiosum
B. Verruca Vulgaris
C. Hand, foot, and mouth disease (HFMD)
D. Basal cell carcinoma

Molluscum contagiosum

A mother presents with her 4-year-old daughter who has multiple lesions around her lips. According to the mother, the lesions started as one but have now spread, with vesicles that have become redder and developed pustules that have broken open, forming a honey-colored crust. Which of the following is the appropriate treatment for these lesions?

A. Topical mupirocin
B. Oral antibiotic
C. Topical retapamulin
D. Acyclovir

Oral antibiotic

A patient presents with a suspicious mole on her nose. Using the ABCDE rule to evaluate the lesion, which of the following characteristics should raise concern for diagnosing cutaneous melanoma?

A. Edema
B. Erythema
C. Symmetry
D. Elevation

Elevation

Which of these is a non-modifiable risk factor for a person to develop cutaneous melanoma? A. Young & male B. Freckles C. Sunbed usage after age 30 D. Living along the equator

Freckles

While educating parents on the prevention of diaper dermatitis, which statement would require further teachings? A. I will make sure to change his diaper frequently, to avoid any moisture buildup B. If he starts to appear red, we can apply our zinc oxide cream to help with irritation C. We will make sure to use scented diaper wipes that are specifically made for infants D. Since he was diagnosed with allergic dermatitis, we can use the antifungal cream that his pediatrician prescribed

We will make sure to use scented diaper wipes that are specifically made for infants

While assessing a child with complaints of itchiness and skin lesions, you notice a linear array of marks that are in a pattern of 3 on their back. What would you suspect to be the cause of this mark? A. Fleas B. Ticks C. Varicella D. Lice

Fleas

Which of the following does not produce a raised or palpable skin lesion? A. Plaque psoriasis B. Atopic dermatitis C. Telangiectasia D. Pemphigus

Telangiectasia

A 55 year old male present complaining of general fatigue, headache, and muscle aches across his upper chest and shoulders. He lives in the wood and harvests his own wood for heat. On examination you notice one spot of redness on his back in the shape of bulls-eye. As the provider you suspect Lyme disease and know all of the following are true except: A. Treatment is delayed until confirmative blood work for positive Lyme B. Diagnosis of Lyme disease is based on clinical presentation and history C. Doxycycline is not used in children under 8 or pregnant/breastfeeding women D. Reinfection can occur, as well as possibility of chronic Lyme disease

Treatment is delayed until confirmative blood work for positive Lyme

Which infantile hemangioma can cause glaucoma, seizures, stroke, and intellectual disability? A. Nevus simplex B. Blue rubber bleb nevus syndrome C. Sturge-Weber Syndrome D. Nevus flammeus

Sturge-Weber Syndrome

Which of the following is the most frequently reported vector-borne disease? A. Lyme disease B. Tinea pedis C. Candidiasis D. Folliculitis

Lyme disease

A nurse practitioner is working in dermatology. She is caring for a patient who has chronic seborrheic dermatitis in their chart. Which of the following areas would the nurse not see inflammation and flare-ups? A. Scalp B. Palms C. Axillae D. Chest

Palms

A nurse practitioner is caring for a 22 year old female patient with polycystic ovarian syndrome (PCOS). The patient reports she has been noticing abnormal hair growth on her face and body. The nurse practitioner knows she is experiencing which of the following? A. Androgenic alopecia B. Paronychia C. Hirsutism D. Female-pattern alopecia

Hirsutism

A 45-year-old female presents to her local urgent care for immediate skin evaluation. The patient reported that she was gardening at home two days ago and is now presenting with scaly, erythematous, and pruritic skin on her forearms and hands. Upon examination, the provider noticed vesicles in multiple areas on her hands and forearms, and the lesions appeared linearly. The provider is considering a diagnosis of dermatitis due to her work in the garden. Which of the following types of dermatitis would this patient be most likely experiencing? A. Contact dermatitis B. Seborrheic dermatitis C. Statis dermatitis D. Atopic dermatitis

Contact dermatitis

A 35-year-old male patient presents to his local emergency department due to a sudden presentation of symptoms, including fever, painful ulcerations in his mouth, and a systemic, widespread rash. The patient reported that he has a recent history of a sinus infection diagnosed by his primary care provider and was prescribed an oral antibiotic for its treatment several days ago. Upon examination, the emergency department provider noticed lesions on his trunk, widespread epidermal detachment, and mucosal involvement, with less than 10% of the body surface of the patient involved. What is the most likely diagnosis for this patient’s presentation? A. Erythema Multiforme B. Stevens-Johnson syndrome C. Pemphigus D. Toxic Epidermal Necrolysis

Stevens-Johnson syndrome

A 6-year-old female child presents to a pediatric clinic with her parents, reporting a red, scaly rash covering her right upper arm. The patient's notable history includes the recent adoption of a puppy into their family. Upon examination, the rash has oval scaling patches that spread peripherally, and no rash was noted in the ovals’ centers. There is no noted fever nor systemic symptoms, with the patient only reporting mild itching due to the rash. Which of the following is the most likely diagnosis for this pediatric patient? A. Thrush B. Ritter disease C. Tinea corporis D. Impetigo

Tinea corporis

A nurse practitioner is educating a patient about skin structure and its response to constant pressure or friction. Which statement about the epidermis and its cell types is correct? A. Keratinocytes found in the epidermis can thicken in response to continuous friction, forming corns or calluses B. The epidermis contains rete pegs that primarily support the subcutaneous layer. C. Keratinocytes in the epidermis are responsible for producing collagen, a key component of skin elasticity. D. The epidermis is primarily responsible for synthesizing vitamin D in response to ultraviolet light exposure.

Keratinocytes found in the epidermis can thicken in response to continuous friction, forming corns or calluses

A 55-year-old patient presents with a pearly, slightly raised lesion on the face that has not healed over several months. The nurse practitioner suspects basal cell carcinoma (BCC). What is the most important information for the nurse practitioner to convey regarding the primary cause of BCC? A. Prolonged exposure to air pollution. B. Frequent use of cosmetics containing parabens. C. A high-fat diet combined with obesity. D. Chronic exposure to ultraviolet (UV) radiation.

Chronic exposure to ultraviolet (UV) radiation.

A 65-year-old patient presents to the clinic for a routine skin exam. The nurse practitioner notices several moles of varying sizes, some of which the patient states have been present since childhood. What is the most important information for the nurse practitioner to convey to the patient regarding moles? A. Moles that have been present since childhood are always benign and require no further monitoring. B. Small Moles (less than 1 cm) never transition to malignant melanoma. C. Any mole that changes in size, shape, color, or texture should be evaluated by a healthcare provider. D. Moles that occur in groups are more likely to transition to malignant melanoma.

Any mole that changes in size, shape, color, or texture should be evaluated by a healthcare provider.

A pediatric client presents with symptoms of allergic contact dermatitis after exposure to a metal bracelet. What is the most important intervention for the nurse practitioner to implement to address the child’s condition? A. Prescribe an oral antihistamine to alleviate the allergic reaction. B. Recommend complete avoidance of the allergen to prevent future reactions. C. Administer an intramuscular corticosteroid to immediately reduce inflammation. D. Suggest the use of moisturizing creams to prevent skin dryness.

Recommend complete avoidance of the allergen to prevent future reactions.

A 7-month-old infant presents with irritant contact dermatitis (ICD) in the diaper area. What is the most appropriate recommendation to manage the infant's irritant contact dermatitis? A. Apply a topical corticosteroid cream and use regular diaper wipes for cleaning. B. Use fragrance-free products, frequent diaper changes, and a barrier cream containing petrolatum or zinc oxide. C. Avoid exposing the perineal area to air to prevent further irritation. D. Limit cleaning to antibacterial soap and ensure the area is scrubbed gently with a washcloth.

Use fragrance-free products, frequent diaper changes, and a barrier cream containing petrolatum or zinc oxide.

A 3-year-old child in daycare presents with red sores around the mouth and nose. The parent reports that the sores have ruptured and formed a yellow crust. The parent states other children at daycare also have similar symptoms. What is the most important information for the nurse practitioner to convey to the parent about managing impetigo? A. "Ensure the child avoids direct contact with other children and uses a prescribed antibiotic ointment to prevent the spread of infection." B. "Keep the child at home until the sores dry and scab over, as antibiotics are not effective for this condition." C. "Encourage frequent washing of the sores with hot water and soap to remove the crusts completely." D. "Apply over-the-counter hydrocortisone cream to the sores to reduce inflammation."

"Ensure the child avoids direct contact with other children and uses a prescribed antibiotic ointment to prevent the spread of infection."