NR569 Week 4: Midterm Exam (march-2026)

A 36-year-old female presents to the emergency department with a rash that is prominent over the trunk and proximal extremities. The patient states that the rash started several days after completing a 7-day course of trimethoprim/sulfamethoxazole (Bactrim) for a mild skin infection. The patient reports that the rash is getting worse and has started to form blisters. This morning he noticed several painful blisters inside his mouth on the lower lip. Upon examination, large vesicle target-like lesions are noted. The lesions are greater than 0.5 cm in diameter. Based on this assessment, the nurse practitioner should suspect which of the following?

Answers: A – D

A. Drug exanthem.
B. Stevens-Johnson Syndrome (SJS) and toxic epidermal necrosis (TEN). ✅
C. Exfoliative dermatitis.
D. Allergic vasculitis.

The clinician has diagnosed a patient with poison ivy (contact dermatitis). Which information should be included in patient teaching?

Answers: A – D

A. “You can return to school when the blisters have crusted.”
B. “The rash is not contagious.” ✅
C. “Avoid contact with pregnant females due to a small risk of serious birth defects in the fetus.”
D. “If you touch the blistered area you should wash your hands immediately, so you don’t spread it to another part of your body.”

You are caring for a 59-year-old male who was admitted to the hospital for pneumonia. The patient reports a history of heavy daily alcohol use. On day 3 of hospital admission he develops nausea, vomiting, and severe left upper quadrant pain. His amylase and lipase are significantly elevated. What is your priority differential diagnosis for this patient?

Answers: A – D

A. Acute cholecystitis.
B. Acute pancreatitis. ✅
C. Appendicitis.
D. Myocardial infarction.

Your patient reports complaints of pitting edema to bilateral lower extremities and orthopnea that have become progressively worse over the last 3-4 weeks. The patient has a 20-year history of poorly controlled hypertension and diabetes. What are important differentials to include in your differential diagnoses?

Answers: A – D

A. COPD & pneumonia.
B. Hypertensive crisis & cardiogenic shock.
C. Pulmonary edema & congestive heart failure. ✅
D. Pulmonary embolism & liver failure.

During the physical exam of a patient, the nurse practitioner notes pitting on the fingernails. This finding is correlated with which of the following conditions?

Answers: A – D

A. Pityriasis rosea.
B. Seborrheic dermatitis.
C. Herpetic whitlow.
D. Psoriasis. ✅

A 21-year-old male presents to the emergency department with increasing dyspnea and pleuritic chest pain of sudden onset after getting hit in the left side of the chest during a bar fight. Examination reveals moderate respiratory distress with absence of breath sounds and hyperresonance to percussion on the left, with tracheal deviation to the right. Which of the following is the most appropriate next step?

Answers: A – D

A. Perform a needle decompression. ✅
B. Order a chest computerized tomography.
C. Order a d-dimer assay.
D. Order a ventilation-perfusion (V/Q) scan………………………………….add to cart and proceed to check out to purchase the entire exam at $75 only