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While evaluating your patient who presented with a panic attack, the patient states their reason for the panic attack was they found out they are going to die from skin cancer because their sister is a CNA and found melanoma on their skin. You perform a skin survey to find a 9mm seborrheic keratosis as the source of the concern. Which of the following is the most appropriate response to the patient?

a. Fortunately, this is a benign lesion and poses no risk of malignancy.

b. Unfortunately, this is a cancerous lesion and poses a medium to high risk of malignancy.

c. Removal of the lesion will require us to perform a local wide excision to guarantee negative borders.

d. Your 5-year survival will be determined by early, aggressive treatment to avoid metastasis.

a. Fortunately, this is a benign lesion and poses no risk of malignancy.

Rationale: Seborrheic keratoses are non-cancerous lesions, although if an untrained observer were to evaluate a large, brown, irregular seborrheic keratosis, it is quite conceivable they would misdiagnose it as a melanoma.

The patient with a sebaceous cyst on the arm that is now draining is noted to have unilateral cellulitic streaking ascending proximally from the abscess site. Which of the following represents the most appropriate treatment in this scenario?

a. Incision and drainage without antibiotic coverage

b. Incision and drainage plus metronidazole PO

c. Incision and drainage plus IV vancomycin or other anti MRSA coverage

d. Oral antibiotics without incision and drainage

c. Incision and drainage plus IV vancomycin or other anti MRSA coverage

Rationale: The presence of cellulitis requires the abscess to be treated with incision and drainage plus the cellulitis be treated with IV antibiotics.

Which diagnostic test is commonly used to identify fungal infections of the skin?

a. Wood's lamp examination

b. Skin biopsy

c. Patch test

d. Tzanck smear

a. Wood's lamp examination

Rationale: A Wood's lamp emits long-wave ultraviolet light (UV-A) that causes certain substances on the skin to fluoresce. Fungi that cause superficial skin infections (dermatophytes) can sometimes fluoresce under this light.

A 30-year-old woman presents with a history of recurrent herpes simplex virus (HSV) infections on her lips. She wants to know how to manage future outbreaks. What is the most appropriate initial management for recurrent HSV?

a. Immunotherapy

b. Daily oral antiviral prophylaxis

c. Oral antivirals at the onset of symptoms

d. Topical antibiotics during outbreaks

c. Oral antivirals at the onset of symptoms

Rationale: Antiviral medications such as acyclovir, valacyclovir, and famciclovir are commonly prescribed to reduce the severity and duration of HSV outbreaks. Managing HSV involves a comprehensive approach that includes antiviral therapy for acute episodes, preventive strategies for recurrent outbreaks, and supportive care to alleviate symptoms.

A 21-year-old athlete presents with painful, erythematous, non-pustular firm cysts on both forearms, which are not the result of an injury. The patient is afebrile. Medication includes cephalexin (Keflex), 500 mg q.i.d. Two days later, the patient returns with fluctuant, pustular, larger lesions that are more painful. The nurse practitioner should perform wound:

a. debridement and continue the patient on cephalexin (Keflex).

b. culture and sensitivity and switch the patient to ciprofloxacin (Cipro).

c. culture and sensitivity and switch the patient to trimethoprim-sulfamethoxazole (Bactrim).

d. debridement and switch the patient to amoxicillin (Amoxil).

c. culture and sensitivity and switch the patient to trimethoprim-sulfamethoxazole (Bactrim).

Rationale: Trimethoprim-sulfamethoxazole is effective against a broader spectrum of bacteria, including Staphylococcus aureus, which is commonly implicated in skin infections like abscesses and cellulitis.

Which of the following does not represent populations at risk for skin cancer?

a. Dark skin with minimal freckles

b. Male sex

c. Caucasian

d. Light skin that freckles easily

a. Dark skin with minimal freckles

Rationale: Light skin, easily freckling, males, and Caucasians are all at-risk populations for skin cancer.

Your 58-year-old male patient identifies a bothersome 2cm lesion on his forehead during your admission exam which is right where his baseball caps hit and cause discomfort. You identify it as a seborrheic keratosis. Which of the following represents the most effective strategy for removal?

a. Elliptical excision

b. Local wide excision

c. Punch biopsy

d. Shave biopsy

d. Shave biopsy

Rationale: Since seborrheic keratoses are topical, shave biopsy is very ideal in their removal. Punch of a 2cm lesion would be atypical and unnecessary. A local wide excision is more typical of melanoma management. Elliptical excision is unnecessary since the lesion is superficial.

You are admitting an otherwise healthy 67-year-old female patient with a leading diagnosis of hypotension. She has a history of palmar dyshidrotic eczema who has been taking mometasone ointment for over a month. She reports stopping this medication a few days prior to admission. With this information, what is the likely diagnosis of her admission?

a. Dehydration

b. Acute heart failure

c. Suppression of the HPA axis causing an Addisonian crisis

d. Suppression of the adrenal glands causing Cushing syndrome

c. Suppression of the HPA axis causing an Addisonian crisis

Rationale: Dehydration and heart failure are both possible causes but unlikely to cause this without any precipitating history. HPA axis suppression is possible from chronic use of mid to high potency steroids and her stopping of the mometasone wound indicate this may be the case with an Addisonian crisis.

The treatment of Shigeliosis is:

a. Flagyl

b. Erythromycin

c. Cipro

d. Doryx

c. Cipro

Rationale: Cipro is often prescribed to shorten the duration of illness, reduce the severity of symptoms, and limit the spread of infection to others.

A pediatric male is present with his mother, who states that he is extremely restless at night and constantly scratches his anal area. Which diagnostic procedure would confirm a diagnosis of pinworm infestation?

a. Examination of bed linens

b. Blood tests for anemia and eosinophilia

c. The patch test

d. Examination of transparent tape sample from perianal skin

d. Examination of transparent tape sample from perianal skin

Rationale: Scotch Tape Test (Cellophane Tape Test): This is a common diagnostic method where a piece of transparent adhesive tape (such as Scotch tape) is pressed against the perianal skin in the morning before bathing or using the toilet.

The tape is then carefully placed on a glass slide or slide labeled with the patient's name and date of collection and submitted to a laboratory for examination under a microscope.

The presence of pinworm eggs or occasionally adult worms clinging to the tape can confirm the diagnosis.

Your patient presents with a red, well-differentiated, raised circular lesion on their nose which has a bloody-appearing central appearance. Which type of lesion does this likely represent?

a. Basal cell carcinoma

b. Actinic keratosis

c. Cherry hemangioma

d. Squamous cell carcinoma

a. Basal cell carcinoma

Rationale: Tell-tale characteristics of basal cell carcinoma is central reddening or bloody/ulcerated appearance with a raise lesion that does not appear to have squamous cells over it.

What is the etiology of verruca?

a. Group B Strep infection in the skin

b. Human Papilloma Virus infection in the skin

c. Chronic UV-B exposure to the skin

d. Chronic UV-A exposure to the skin

b. Human Papilloma Virus infection in the skin

Rationale: HPV infection is the cause of verruca. Chronic UV-B exposure is a cause of actinic keratosis, solar lentigo, and squamous cell carcinoma.

What is the most likely diagnosis for an elderly patient with GI cancer who presents with skin pallor, conjunctival pallor, palpitations, and weakness?

a. Iron deficiency anemia

b. Peptic ulcer disease

c. Gastroesophageal reflux disease

d. Autoimmune hemolytic anemia

a. Iron deficiency anemia

Rationale: Iron deficiency anemia due to GI cancer may present with symptoms such as fatigue, weakness, pale skin, shortness of breath, and dizziness. These symptoms occur because of reduced oxygen-carrying capacity in the blood due to low hemoglobin levels.

Your patient is being treated with disease modifying anti-rheumatic drugs for a plaque-like skin condition located on the extensor surfaces of joints. Which condition is this likely describing?

a. Eczema

b. Plaque psoriasis

c. Contact dermatitis

d. Osteoarthritis

b. Plaque psoriasis

Plaque psoriasis is trademarked by these findings. Eczema tends to be on the flexor surfaces and is not treated with DMARDs. Contact dermatitis is due to exposure to an irritant and is typically self-limiting without the use of DMARDs.

Which of the following medications is prescribed for the treatment of pinworm?

a. Corticosteroids

b. Lindane (Kwell)

c. Albendazole(Albenza)

d. Metronidazole (Flagyl)

c. Albendazole(Albenza)

Rationale: Albendazole (Albenza) can treat pinworm infections (Enterobius vermicularis). It belongs to the same class of medications as mebendazole and works similarly by interfering with the parasite's ability to absorb sugars, leading to its eventual elimination from the body.

Which of the following is a true statement about squamous cell carcinoma?

a. Metastatic disease in squamous carcinoma is less common than basal cell carcinoma

b. Basal cell carcinoma is more prone to metastasis than squamous cell carcinoma

c. Squamous cell carcinoma is more common than basal cell carcinoma

d. Squamous cell carcinoma is more likely to have metastasis than basal cell carcinoma

d. Squamous cell carcinoma is more likely to have metastasis than basal cell carcinoma

Rationale: Squamous cell carcinoma is more common to have metastasis than basal cell carcinoma. Basal cell carcinoma is more common than squamous cell carcinoma.

What is the most common form of skin cancer?

a. Keratoacanthoma

b. Basal cell carcinoma

c. Malignant melanoma

d. Squamous cell carcinoma

b. Basal cell carcinoma

Rationale: Basal cell carcinoma is the most common type of skin cancer and with squamous cell carcinoma as the second most type.

A 27-year-old male patient, who works as a janitor, presents with a 6-month history of an intermittent rash on his hands. History reveals itching and occasional burning. Examination reveals irregularly-distributed scaly maculopapular erythematous patches extending from the dorsum of the hand several inches up the forearms, and dry palms with no nail involvement. The most likely diagnosis is:

a. eczema.

b. psoriasis.

c. contact dermatitis.

d. scabies infestation.

c. contact dermatitis.

Rationale: Contact dermatitis is a type of skin inflammation that occurs when the skin comes into direct contact with an irritating substance (irritant contact dermatitis) or an allergen (allergic contact dermatitis). It is a common skin condition characterized by red, itchy, and sometimes painful rash that develops at the site of contact with the triggering substance.

Erysipelas typically presents on the face with:

a. A papular erythematous malar rash

b. Painful progressive erythema and edema

c. Scattered ruborous macules across the cheeks

d. Vesicles on an erythematous base following a dermatome

b. Painful progressive erythema and edema

Rationale: Erysipelas is a bacterial skin infection that typically presents with distinctive symptoms and tends to affect the face more commonly than other parts of the body.

Symptoms: The infection usually starts suddenly and can cause symptoms such as:

Red, swollen, and shiny skin

Well-defined borders between affected and unaffected skin

Pain and tenderness

Fever and chills

Blisters or sores filled with fluid (bullae) in severe cases

The 61-year-old female patient with lichen sclerosis has been prescribed clobetasol propionate 0.05% ointment. Which of the following statements made by the patient demonstrates good understand of her new prescription?

a. I will not use this anywhere other than where it is prescribed since it has a high risk of damaging my skin

b. I can add additional medications at the same site if they are put on top of the steroid

c. If I don't see results from this, I can switch to a higher potency steroid than an ointment.

d. I like this drug since I can take this for months and stop it abruptly without any side effects

a. I will not use this anywhere other than where it is prescribed since it has a high risk of damaging my skin

Rationale: This is a super high potency steroid and must be only used where directed. Stopping any superpotency steroid may manifest symptoms of HPA axis suppression. Steroids should be used without any medications on them as it may potentiate the effects of the steroid. If this does not work, there is no more potent vehicle than an ointment and this is the most aggressive steroid routinely available for this disease process.

A 43-year-old male patient weighing 100kg was burned over 20 percent of their body with partial thickness burns after escaping a house fire. Using the Parkland formula, what is the most appropriate amount of IV fluid resuscitation to provide the patient in the first 8 hours?

a. 4 Liters

b. 2 Liters

c. 3 Liters

d. 8 Liters

a. 4 Liters

Rationale: The Parkland formula for resuscitation in burns is 4ml x kg x burn % with 50% delivered to patient over first 8 hrs. For this patient 4x100x20=8000ml, of which half is to be given in the first 8 hrs.

Your patient presents with darkened, velvety creases of the groin, neck, and axilla with skin tags present. What does this possibly indicate?

a. Chronic azotemia

b. Evidence of insulin resistance

c. Chronic hypertension

d. Actinic keratosis

b. Evidence of insulin resistance

Rationale: Acanthosis nigricans is described as the presence of darkened, velvety creases of the groin, neck, and axilla with skin tags present. This is suggestive of increased insulin resistance and metabolic syndrome.

Using the rule of palms, a patient with burn surface equivalent to 20 of the patient's palms would be how many percent body surface area?

a. 40 percent

b. 20 percent

c. 10 percent

d. 15 percent

b. 20 percent

Rationale: Each palm is equivalent to 1% of the patient's body surface area

A Caucasian male patient with fair skin and green eyes is at a particularly high risk for which of the following serious skin conditions?

a. Skin cancer

b. Wrinkles

c. Sunburn

d. Keratoacanthoma

a. Skin cancer

Rationale: Although wrinkles, sunburn, and keratoacanthoma are skin conditions, none of them are serious nor predisposed from this patient's profile. Skin cancer risk is very high for this patient.

An adult photography developer presents with two small vesicles on his right middle finger, proximal to the nail bed. He says he wears gloves when he works with photography chemicals. He admits to chewing his fingers, and notes that this is his fourth episode. Previous cultures have been negative. The MOST likely diagnosis is:

a. Impetigo

b. Herpetic whitlow

c. Atopic dermatitis

d. Habit tic

b. Herpetic whitlow

Rationale: The primary symptom of herpetic whitlow is the presence of painful, small, fluid-filled blisters or ulcers on the fingers or thumbs. These lesions can be localized to one finger or involve multiple digits

An 87-year-old patient presents with round, pruritic plaques and small vesicles on the lower legs. The most likely diagnosis is:

a. cutaneous T-cell lymphoma.

b. allergic contact dermatitis.

c. plaque psoriasis.

d. nummular eczema.

d. nummular eczema.

Rationale: The hallmark feature of nummular eczema is the presence of round or oval-shaped patches of inflamed skin. These patches are well-defined and can range in size from a few centimeters to several inches in diameter.

All the following are thought to cause acne except

a. genetics

b. bacterial contamination of the skin

c. ingestion of soda and chocolate

d. increase in androgens

c. ingestion of soda and chocolate

Rationale: It's important to note that acne is influenced by multiple factors, including genetics, hormonal changes, skincare routines, and lifestyle habits. While diet can play a role for some individuals, it's not the primary cause of acne.

Herpes zoster can be difficult to diagnose in the prodromal stage, but can later be identified by the presence of characteristic:

a. "herald spots" at the site of infection

b. Bilateral dermatomal lesions

c. Unilateral vesicular lesions

d. Herpetic whitlows of the fingers

c. Unilateral vesicular lesions

Rationale: The characteristic feature of herpes zoster is a unilateral, painful rash that typically appears in a dermatomal distribution, following the path of a single sensory nerve or dermatome.

Your patient with a diagnosis of metabolic syndrome was just admitted to the ICU for pneumonia. Which of the following assessment findings suggests insulin resistance?

a. Presence of A-V nicking on funduscopic exam

b. Striae noted on bilateral flanks

c. Presence of darkened, velvety creases of the groin, neck, and axilla with skin tags present

d. Absence of acanthosis nigricans

c. Presence of darkened, velvety creases of the groin, neck, and axilla with skin tags present

Rationale: Striae are "stretch marks" and are a non-specific finding other than for possibly Cushing syndrome or normal for rapid growth through adolescence and pregnancy. AV nicking indicates hypertension. Acanthosis nigricans is defined as the presence of darkened, velvety creases of groin, neck, and axilla with skin tags present.

Treatment of acute poison ivy includes:

a. SoluMedrol

b. Synalar

c. Prednisone 40mg for 10 days

d. Sporonax

c. Prednisone 40mg for 10 days

Rationale: Prednisone is sometimes prescribed for severe cases of poison ivy dermatitis, especially when the rash covers a large area of the body, is particularly severe, or involves sensitive areas like the face, genitals, or eyes.

An adult female presents with right leg pain and rash. The patient exhibits significant swelling of the right lower extremity from the ankle to the end of the upper thigh, erythema, induration, and weeping lesions in the anterior lower leg. The patient "picked at" the affected area, and its condition progressed to the current state over a period of 1 week. Over the past 2 days, the swelling and pain have increased greatly. BP=86/50, P=104, R=24/min, and T=101.2 degrees F (38.4 degrees C); BMI=45.9. The nurse practitioner should:

a. Prescribe cephalexin (Keflex), 500mg every 6 hours

b. Refer to an infectious disease specialist

c. Refer for immediate evaluation in the emergency dept

d. Prescribe trimethoprim-sulfamethoxazole 160mg/800mg (Bactrim DS), every 12 hours

c. Refer for immediate evaluation in the emergency dept

Rationale: Immediate and comprehensive management is crucial to prevent complications and promote healing in cases of severe cellulitis or skin infections presenting in primary care settings.

During an appointment history and physical, you examine your patient and find a new multicolored mole measuring 9mm with irregular borders. What is the most likely diagnosis?

a. Squamous Cell Carcinoma

b. Melanoma

c. Cutaneous Horn

d. Simple Nevus

b. Melanoma

Rationale: These are all classic findings for melanoma: irregular borders, diameter over 6mm, multicolor, and new or rapidly evolved.

A 60-year-old man presents with a thickened, scaly, erythematous plaque on his scalp that has not responded to over-the-counter treatments. What is the most appropriate initial treatment?

a. Topical calcineurin inhibitors

b. Oral antifungals

c. Oral corticosteroids

d. Topical corticosteroids

d. Topical corticosteroids

Rationale: Topical corticosteroids reduce inflammation by inhibiting the inflammatory response at the cellular level. They suppress immune reactions that contribute to skin inflammation and irritation. Overall, topical corticosteroids are effective for managing scalp conditions characterized by inflammation, thickened plaques, and scaling.

A 45-year-old man presents with a 2-day history of a red, swollen, and painful lower leg. Examination reveals erythema and warmth suggestive of cellulitis. He has no known allergies. What is the most appropriate initial antibiotic treatment?

a. Cephalexin

b. Trimethoprim-sulfamethoxazole

c. Clindamycin

d. Doxycycline

a. Cephalexin

Rationale: Cephalexin is an antibiotic commonly used in the treatment of skin and soft tissue infections, including cellulitis. Cephalexin belongs to the class of first-generation cephalosporin antibiotics. It works by interfering with the bacteria's cell wall formation, leading to cell death.

Your patient is being educated about the management of the new diagnosis of melanoma. Which of the following techniques is the most likely approach to be used in removal of the melanoma?

a. Punch biopsy

b. Shave biopsy

c. Local wide excision

d. Cryotherapy

c. Local wide excision

Rationale: Due to the expansive nature and skin depth of melanoma, a local wide excision is used to aid in full removal. By the time it appears on the skin, it is usually already deeper also. The remaining options are all too superficial.

A 35-year-old woman presents with a new, darkly pigmented lesion on her back that she noticed a few months ago. The lesion is asymmetrical, has irregular borders, and varies in color. What is the most appropriate next step in management?

a. Perform an excisional biopsy

b. Perform a punch biopsy

c. Perform a shave biopsy

d. Reassure the patient and advise regular monitoring

a. Perform an excisional biopsy

Rationale: When a healthcare provider needs to definitively diagnose or rule out a suspected condition, such as a skin lesion or tumor, an excisional biopsy allows for the entire lesion or a significant portion of it to be removed and examined under a microscope by a pathologist.

Which of the following is the most valuable in differentiating between actinic keratosis (AK) and squamous cell carcinoma (SCC)?

a. A surgical pathology specimen

b. telangiectasia

c. Response to fluorouracil

d. Response to cryotherapy

a. A surgical pathology specimen

Rationale: The only way to differentiate between AK and SCC is a pathologic specimen to review with microscopy. Telangiectasia is commonly found on both lesions, and their response to cryo or chemotherapy does not accurately describe their etiology.

An adult daycare worker presents with severe itching on the arms and around the arms and wrists. The patient's skin is mildly excoriated from scratching. Microscopic examination of a skin reveals scabies. The treatment of choice for the patient would be?

a. cetirizine

b. triamcinolone

c. ketocanozale

d. permethrin

d. permethrin

Rationale: Permethrin is commonly prescribed for the treatment of scabies, a contagious skin infestation caused by the Sarcoptes scabiei mite. Permethrin is a synthetic pyrethroid insecticide that works by paralyzing and killing the mites and their eggs upon contact. It disrupts the nervous system of the mites, leading to their death.

What is the etiology of squamous cell carcinoma?

a. Chronic UV-A exposure to the skin

b. Group B Strep infection in the skin

c. Human Papilloma Virus infection in the skin

d. Chronic UV-B exposure to the skin

d. Chronic UV-B exposure to the skin

Rationale: HPV infection is the cause of verruca. Chronic UV-B exposure is a cause of actinic keratosis, solar lentigo, and squamous cell carcinoma. Group B strep is not associated with any particular skin lesion.

Your patient has been noticing cracking and peeling on their hands and having some vesicular rash component. Which of the following is not likely the diagnosis?

a. Dyshidrotic eczema

b. Palmoplantar eczema

c. Pompholyx

d. Psoriasis

d. Psoriasis

Rationale: Pompholyx and dishidrotic eczema are all synonyms for palmoplantar eczema which this describes precisely. Psoriasis tends to be on the extensor surfaces, not the flexor surfaces such as the palm.

Which of the following treatments is best for children under 9 years of age who are diagnosed with early Lyme disease?

a. Chloramphenicol 50mg/kg/d in 2 divided doses

b. Sulfasoxazole 120mg/kg/d in 2 divided doses

c. Amoxicillin (Amoxil) 50mg/kg/d in 3 divided doses

d. Tetracycline (Achromycin) 30mg/kg/d in 4 divided doses

c. Amoxicillin (Amoxil) 50mg/kg/d in 3 divided doses

Rationale: Treatment of Lyme disease in children under 9 years old generally follows similar principles to treatment in older children and adults, but considerations may include dosage adjustments and monitoring for potential side effects. Amoxicillin is often the first-line treatment for early localized or early disseminated Lyme disease.

What is the following is not an effective strategy of treatment for verruca?

a. Cryotherapy

b. Punch biopsy

c. Curettage

d. Shave biopsy

d. Shave biopsy

Rationale: As verruca are deeply rooted in the dermis, shave biopsy is ineffective in reaching the root. The remaining options are all considered reasonable techniques.

Which procedure is considered the most effective technique to guarantee negative margins for dermatologic lesions such as basal cell carcinoma and melanoma?

a. Punch biopsy

b. Mohs procedure

c. Elliptical excision

d. Shave biopsy

b. Mohs procedure

Rationale: Mohs procedure involves many small samples taken progressively until the margins are deemed negative. The remainder are techniques, but do not guarantee negative margins.

What is the definitive treatment for uncomplicated skin abscess on the arm?

a. Doxycycline IV q 3 days

b. Prescription of gram-negative antibiotic coverage

c. Incision and drainage

d. NSAID pain relief and warm compresses

c. Incision and drainage

Rationale: The definitive treatment for an uncomplicated skin abscess is to open and drain the contents. The body will then re-approximate by secondary intention once the contents has been evacuated. Gram negative coverage is not recommended for an area typically associated with gram-positive flora.

Which dermatologic procedure is the safest way to address lesions on patients who have bleeding disorders or are anticoagulated?

a. Cryotherapy

b. Elliptical excision

c. Punch biopsy

d. Shave biopsy

a. Cryotherapy

Rationale: Cryotherapy is a beneficial technique for patients with bleeding disorders or are on anti-platelet or anticoagulation as it does not require incision to the tissue.

An adult female with a diagnosis of eczema was given a prescription of hydrocortisone valerate 0.2% (Westcort) ointment last week for increased itching. The patient returns today reporting no improvement and more itching. The nurse practitioner's examination finds many vesicles and papules on hands, chest, and buttocks. The nurse practitioner also finds a linear burrow between the fingers and prescribes:

a. permethrin 5% (Elimite) cream.

b. a higher potency topical steroid.

c. ketoconazole (Nizoral) topical.

d. imiquimod 5% (Aldara) cream.

a. permethrin 5% (Elimite) cream.

Rationale: Permethrin is highly effective against Sarcoptes scabiei, the mite that causes scabies. Scabies is a contagious skin condition characterized by intense itching and a rash, often affecting areas such as the wrists, elbows, armpits, and genitalia.

A frail elderly male with a history of sun exposure and rough, scaly, brownish lesions on the face, ears, and hands presents with a firm erythematous, ulcerated nodule on the dorsal surface of the hand. The most likely diagnosis is:

a. Melanoma

b. Sebaceous hyperplasia

c. Seborrheic keratosis

d. Squamous cell carcinoma

d. Squamous cell carcinoma

Rationale: Squamous cell carcinoma (SCC) is a type of skin cancer that can also occur in other areas of the body, including the lining of the respiratory and digestive tracts. The symptoms of SCC can vary depending on the location of the cancer. SCC typically appears as a firm, red nodule or a flat sore with a scaly crust. It may also present as a rough, scaly patch that may bleed or crust over.

What is the etiology of actinic keratosis?

a. Chronic UV-A exposure to the skin

b. Human Papilloma Virus infection in the skin

c. Chronic UV-B exposure to the skin

d. Group B Strep infection in the skin

C. Chronic UV-B exposure to the skin

Rationale: HPV infection is the cause of verruca. Chronic UV exposure is a cause of actinic keratosis, solar lentigo, and squamous cell carcinoma.

An 18-year-old presents with acne. He notes that he washes his face with a mild skin cleanser 3 to 4 times daily, however the acne persists and has worsened. The nurse practitioner explains that:

a. the patient needs to change cleansers.

b. the face should not be scrubbed more than every other day.

c. the patient should also avoid chocolate.

d. frequent facial scrubs can worsen acne.

d. frequent facial scrubs can worsen acne.

Rationale: Frequent facial scrubs can exacerbate acne rather than alleviate it, especially if the skin is already sensitive or prone to acne. Excessive scrubbing can strip the skin of its natural oils, prompting the sebaceous glands to produce more oil (sebum) to compensate. This excess oil can clog pores and contribute to acne formation.