A 61-year-old man presents with thickened toenails. Keratin and debris have accumulated distally and underneath, and the nail has separated from the nail bed. Which of the following is most consistent with this clinical scenario?
Pseudomonas
Onychomycosis
Herpetic whitlow
Parasitic infection
The Correct Answer is B
Choice A reason: Pseudomonas infections can cause green discoloration of nails, but do not typically cause thickening with distal subungual keratin accumulation as described.
Choice B reason: Onychomycosis is a fungal nail infection characterized by thickening, debris accumulation under the nail, and onycholysis (nail separation from the bed), matching the patient’s clinical presentation.
Choice C reason: Herpetic whitlow is a viral infection of the finger or toe causing painful vesicles, not thickened nails with subungual debris.
Choice D reason: Parasitic infections rarely affect nails in this manner and do not produce the chronic thickening and keratin buildup observed in onychomycosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is correct; most low back pain is nonspecific and does not require imaging unless there are red flags.
Choice B reason: Imaging may be indicated if pain persists despite conservative management or if there are neurologic deficits, making this statement accurate.
Choice C reason: Combining cognitive behavioral therapy with physical therapy is evidence-based and effective in improving outcomes for chronic low back pain.
Choice D reason: This is incorrect. Opioids are not first-line treatment due to risks of dependence, overdose, and limited efficacy. First-line management emphasizes non-pharmacologic strategies and non-opioid medications.
Correct Answer is C
Explanation
Choice A reason: This question targets somatic concerns, not generalized anxiety symptoms.
Choice B reason: This question assesses depersonalization or derealization, which are dissociative experiences.
Choice C reason: This is correct. Persistent worry about multiple life domains over several months is characteristic of generalized anxiety disorder and is central to evaluating anxiety symptoms.
Choice D reason: This question screens for manic or hypomanic episodes, which are not specific to anxiety disorders.
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