A 26-year-old married woman presents to the nurse practitioner and reports: "I think I have an STD from my husband cheating on me." Upon physical examination, the NP finds a single, painless, indurated labial lesion. This finding is most consistent with which of the following?
Primary syphilis
Herpes simplex virus (HSV)
Human papillomavirus (HPV)
Latent syphilis
The Correct Answer is A
Choice A reason: Primary syphilis typically presents with a single, painless, indurated ulcer known as a chancre at the site of inoculation. This lesion is highly characteristic and usually appears within 2–3 weeks of exposure. It is often unnoticed by patients due to its painless nature and resolves spontaneously, although the infection persists systemically.
Choice B reason: Herpes simplex virus usually causes painful vesicular lesions that may ulcerate. These lesions are often multiple and associated with burning or tingling sensations. The presentation of a painless, indurated lesion does not match HSV.
Choice C reason: Human papillomavirus (HPV) typically causes genital warts—soft, flesh-colored, cauliflower-like lesions. These are not indurated or ulcerative and are usually painless but do not resemble the described chancre.
Choice D reason: Latent syphilis refers to a stage of syphilis where the infection is present but asymptomatic. There are no visible lesions during this phase, making it inconsistent with the current physical findings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: REM sleep behavior disorder involves acting out dreams due to loss of normal muscle atonia during REM sleep. It typically presents with violent movements or vocalizations during sleep, not with uncomfortable leg sensations or the urge to move the legs.
Choice B reason: Restless legs syndrome is characterized by an urge to move the legs, often accompanied by uncomfortable sensations such as burning or tingling, especially in the evening or at rest. Symptoms are relieved by movement and can interfere with sleep and social functioning, matching the patient’s description.
Choice C reason: Circadian rhythm sleep-wake disorders involve misalignment between the internal circadian clock and the external environment, leading to sleep disturbances. These disorders do not typically present with sensory symptoms in the legs.
Choice D reason: Hypersomnolence disorder is marked by excessive daytime sleepiness despite adequate sleep duration. It does not involve sensory discomfort or the urge to move the legs, making it an unlikely diagnosis in this case.
Correct Answer is D
Explanation
Choice A reason: PANSS is not a self-report tool. It is a clinician-administered scale that requires structured interviews and observation. Patients do not complete it independently.
Choice B reason: While PANSS does assess both positive and negative symptoms, this answer is incomplete. PANSS also includes a third domain—general psychopathology—which encompasses symptoms like anxiety, depression, and cognitive impairment.
Choice C reason: PANSS is comprehensive and takes time to administer. It includes 30 items rated on a 7-point scale and requires clinical expertise, making it more complex than brief screening tools.
Choice D reason: PANSS is distinct in its tripartite structure, measuring positive symptoms (e.g., hallucinations, delusions), negative symptoms (e.g., blunted affect, social withdrawal), and general psychopathology (e.g., anxiety, poor impulse control). This multidimensional approach provides a thorough evaluation of schizophrenia.
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