NURS 6531 FINAL EXAM (PART 1&2)
COMPLETE QUESTIONS WITH CORRECT
DETAILED ANSWERS AND RATIONALES
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PART ONE
When counseling a patient with rosacea about management of this condition, the
provider may recommend (Select all that apply.)
a. applying a topical steroid.
b. avoiding makeup.
c. avoiding oil-based products.
d. eliminating spicy foods.
e. exposing the skin to sun.
f. using topical antibiotics. - ANSWER ✔ ANS: C, D, F
RATIONALE: Patients with rosacea should avoid oil-based products and eliminate
spicy foods, alcohol, and hot fluids. Topical antibiotics may be used if pustules are
present. Topical steroids are not recommended. Patients do not need to avoid
makeup and should avoid the sun.
Which medications may be used as part of the treatment for a patient with
hidradenitis suppurativa? (Select all that apply.)
a. Chemotherapy
b. Erythromycin
c. Infliximab
d. Isotretinoin
e. Prednisone - ANSWER ✔ ANS: B, C, D, E
,RATIONALE: Hidradenitis suppurativa is not malignant and chemotherapy is not
used. Erythromycin,
infliximab, isotretinoin, and prednisone are all used.
A patient is seen in the clinic for patches of hair loss. The provider notes several
well-demarcated patches on the scalp and eyebrows without areas of inflammation
and several hairs within the patch with thinner shafts near the scalp. Based on these
findings, which type
of alopecia is most likely?
a. Alopecia areata
b. Anagen effluvium
c. Cicatricial alopecia
d. Telogen effluvium - ANSWER ✔ ANS: A
RATIONALE: These findings are characteristic of alopecia areata. Anagen
effluvium and telogen effluvium both result in diffuse hair loss and not discrete
patches. Cicatricial alopecia involves inflammation.
A patient diagnosed with alopecia is noted to have scaling on the affected areas of
the scalp. Which confirmatory test(s) will the provider order?
a. Examination of scalp scrapings with potassium hydroxide (KOH)
b. Grasping and pulling on a few dozen hairs
c. Serum iron studies and a complete blood count
d. Venereal Disease Research Laboratory (VDRL) test - ANSWER ✔ ANS: A
RATIONALE: Scaling on the scalp is suggestive of tinea capitis. To confirm this,
the provider will perform scalp scraping or test hair samples with KOH preparation
to look for hyphae. Grasping and pulling on hairs is used to identify anagen or
telogen hairs by appearance. Serum iron and aCBC are used if anemia is suspected
as a cause. VDRL is performed if syphilis is suspected.
A female patient is diagnosed with androgenetic alopecia. Which medication will
the primary health care provider prescribe?
a. Anthralin
b. Cyclosporine
c. Finasteride
d. Minoxidil - ANSWER ✔ ANS: D
RATIONALE: Either minoxidil or finasteride are used for androgenetic alopecia,
but finasteride is Pregnancy
Category X, so minoxidil is the only medication approved by the FDA for use in
women. Anthralin and cyclosporine are used to treat alopecia areata.
, A young adult has been bitten by a dog resulting in several puncture wounds near
the thumb of one hand but can move all fingers and the bleeding has stopped. What
understanding
regarding dog bites should direct the care of this patient?
a. Infection is a likely outcome for a dog bite.
b. Dog bites generally result in serious injury.
c. Neurovascular and destructive soft tissue injuries can occur from such a bite.
d. Oral antibiotics are needed to address the increased risk for the development of
osteomyelitis. - ANSWER ✔ ANS: C
RATIONALE: Dog bites account for most of the domestic animal bites that
require medical care, yet dog bites have had the lowest incidence of wound
infection (2% to 13%). Even though most dog bites are relatively minor, severe
injuries can occur. These can include crush injuries, destructive soft tissue injuries,
neurovascular injuries, orthopedic injuries, and death. Osteomyelitis is a risk for
human bites.
A patient has sustained a human bite on the hand during a fist fight. Which is
especially concerning with this type of bite injury?
a. Possible exposure to rabies virus
b. Potential septic arthritis or osteomyelitis
c. Sepsis from Capnocytophaga canimorsus infection
d. Transmission of human immunodeficiency virus - ANSWER ✔ ANS: B
RATIONALE:Clenched-fist injury, or "fight bite," has a high complication rate
from the high penetrating
force with the potential for osteomyelitis, tendinitis, and septic arthritis. Humans
do not transmit rabies unless infected, which is highly unlikely. Humans do not
transmit C. canimorsus. HIV transmission is potential, but the risk is extremely
low.
Which type of bite is generally closed by delayed primary closure? (Select all that
apply.) p. 262
a. Bites to the face
b. Bites to the hand
c. Deep puncture wounds
d. Dog bites on an arm
e. Wounds 6 hours old or older - ANSWER ✔ ANS: B, C, E
RATIONALE: Cat and human bites, deep puncture wounds, clinically infected
wounds, wounds more than 6 to 12 hours old, and bites to the hand should be left
, open and closed by delayed primary closure. A bite to the face is closed by primary
closure. Dog bites do not require delayed or secondary closure.
A patient comes to the clinic after being splashed with boiling water while
cooking. The patient has partial thickness burns on both forearms, the neck, and
the chin. What will the provider do?
a. Clean and dress the burn wounds.
b. Order a CBC, glucose, and electrolytes.
c. Perform a chest radiograph.
d. Refer the patient to the emergency department (ED). - ANSWER ✔ ANS: D
RATIONALE:Patients with burns on the face, potential circumferential burns, and
any patient at risk of
airway compromise should be referred to the ED for evaluation and treatment. The
provider should do this urgently and not clean and dress the wounds or order
diagnostic tests.
A patient sustains chemical burns on both arms after a spill at work. What is the
initial action by the health care providers in the emergency department (ED)? p.
269
a. Begin aggressive irrigation of the site.
b. Contact the poison control center.
c. Remove the offending chemical and garments.
d. Request the Material Safety Data information. - ANSWER ✔ ANS: C
RATIONALE:The initial response to a chemical burn is to remove the patient's
clothing and the offending chemical. Aggressive irrigation is usually recommended
next, but providers should first determine the source to make sure that it is safe to
use water. Contacting Poison Control and getting MSDS information are useful
measures after the clothing and chemical is removed.
A patient is taking a sulfonamide antibiotic and develops a rash that begins
peeling. Which type of rash is suspected?
a. Erythema multiforme
b. Stevens-Johnson
c. Urticaria
d. Wheal and flare - ANSWER ✔ ANS: B
RATIONALE: The Stevens-Johnson syndrome rash typically peels in sheets.
Erythema multiforme, urticaria, and wheal and flare rashes do not peel.
