Medical Case Studies: Diagnosis and Treatment of Various Conditions, Exams of Nursing

Download Medical Case Studies: Diagnosis and Treatment of Various Conditions and more Exams Nursing in PDF only on Docsity! Fnp 654 Final Exam Questions And Answers 2024 Graded A Success Assured A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have symptoms that include asymmetric weakness in the arms and difficulty walking. The neurologist recognizes these symptoms as characteristic of involvement of which portion of the nervous system? Lower motor neurons The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks about long-term care. What will the provider include when teaching the family about this disease? Preventing malnutrition is a key element in care. Which symptoms may occur with Bell's palsy? Select all that apply. Alteration in taste, Drooling, Tinnitus A 35-year-old patient reports suddenly experiencing an asymmetric smile along with drooping and tearing in one eye. The patient has a history of a recent viral illness, but is otherwise healthy. During the exam, the provider notes that there is unilateral full face paralysis on the right side. What is the initial intervention for this patient? Prescribe oral prednisolone What is recommended to prevent ophthalmic complications in patients with Bell's palsy? Lubricating eye drops A patient reports a recurrent sensation of spinning associated with nausea and vomiting. Which test will the provider order to confirm a diagnosis for this patient? The Hallpike-Dix positioning maneuver An elderly patient reports sensations of being off balance when walking, but does not experience dizziness. The provider will refer this patient to which specialist for further evaluation? Neurologist Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is developing muscle weakness and paresthesias? Lumbar puncture Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome? Select all that apply. Bladder scans Cardiac telemetry Fever Vital capacity measures Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesias, along with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS does this patient have? Miller Fisher syndrome (MFS) A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a majority of patients with cluster headaches? Oxygen A patient reports recurrent headaches occurring 1 or 2 times per month that generally occur with weather changes or when sleep patterns are disrupted and describes them as severe, with throbbing on one side of the head and sometimes accompanied by nausea. What is the recommended treatment for this type of headache? Rizatriptan Which medications may be useful in treating tension-type headache? Select all that apply. Antiemetics Muscle relaxants NSAIDs A provider suspects that a patient has bacterial meningitis. When should antibiotics be given? Prior to obtaining a CT scan or lumbar puncture A patient is brought to the emergency department with fever, lethargy, and headache without meningeal signs. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient's trunk. What do these findings indicate? A poor prognosis that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment? Benzodiazepines A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance? Opioids A 17-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn and expresses suspicions that his teachers hate him and want him to fail. What will the provider tell this parent? The adolescent should be evaluated by a psychiatrist. A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next? Ask about the patient's speech and thinking patterns Which are considered "negative" symptoms of schizophrenia? Select all that apply. Impaired self care Poor school performance Withdrawing from peers When prescribing medications to an 80-year-old patient, the provider will consult the Beers list to help identify potentially problematic drugs. An 80-year-old woman who lives alone is noted to have a recent weight loss of 5 pounds. She appears somewhat confused, according to her daughter, who is concerned that she is developing dementia. The provider learns that the woman still drives, volunteers at the local hospital, and attends a book club with several friends once a month. What is the initial step in evaluating this patient? Obtain a CBC, serum electrolytes, BUN, and glucose The practitioner is establishing a plan for routine health maintenance for a new female client who is 80 years old. The client has never smoked and has been in good health. What will the practitioner include in routine care for this patient? Pneumovax vaccine if not previously given Yearly influenza vaccine A previously healthy 30-year-old patient is brought to the emergency department with signs of stroke. Diagnostic testing determines an ongoing ischemic cause. The patient's spouse reports that symptoms began approximately 2 hours prior to transport. What is the recommended treatment? Tissue plasminogen activator (tPA) administration An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient's blood pressure is 220/190 mm Hg. What is the likely treatment for this patient? Neurosurgical consultation A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely? Ischemic stroke A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with a subsequent worsening of symptoms. Based on this response, what is the likely cause of this patient's symptoms? Lewy body dementia A patient with Alzheimer's disease (AD) is taking donepezil to treat cognitive symptoms. The patient's son reports noting increased social withdrawal and sleep impairment. What is the initial step to manage these symptoms? Encourage activity and exercise An elderly patient has symptoms of depression and the patient's daughter asks about possible Alzheimer's disease since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient? Prescribe a trial of an antidepressant medication Which are common hyperkinetic movement disorders? Dystonia Essential tremor Tourette's syndrome A patient reports trembling of both hands causing difficulty performing tasks with the hands. The provider notes symmetric, rhythmic movements which are present at rest and no other neurological findings. A history reveals that the trembling decreases when the patient has a glass of wine with dinner. What is the initial action? Prescribing a beta blocker medication A patient with Parkinson's disease (PD) has been taking carbidopa-levodopa (Sinemet) with good results, but develops increased dyskinesia. Which drug will be added to this patient's regimen to help control this symptom? Amantadine A primary care provider suspects Parkinson's disease (PD) in a patient. Which tests may be performed to diagnose this disorder? Presence of 2 cardinal signs which improve with levodopa What are common symptoms seen in patients with Parkinson's disease? Bradykinesia Festination Rigidity A patient who is near death is exhibiting signs of agitation, anxiety, and intractable pain. When discussing palliative sedation with this patient's family, what will be discussed? The fact that this is an intervention of last resort The need for informed consent from the patient and family The possibility that this measure may hasten death When should palliative care be initiated by a primary care provider? As part of routine health maintenance When using the "Five Wishes" approach to documenting patient preferences for end-of-life care, the provider will document which types of preferences? How much information to give various family members The level of sedation versus alertness the patient desires The people designated to make care decisions for the patient Serum ACTH Serum electrolytes TB skin testing A young adult woman is unable to conceive after trying to get pregnant for over 6 months. The woman reports having had irregular periods since the onset of menarche. The provider notes that the woman is overweight, has acanthosis nigricans, and an excess hair distribution. What does the provider suspect as the most likely primary cause of these symptoms? Polycystic ovarian syndrome A woman who has hirsutism with acne, and oligomenorrhea will most likely be treated with which medication to control these symptoms? Norgestimate An obese adolescent female patient reports irregular periods and excessive acne. The provider notes an increased amount of hair on her upper back, shoulders, and upper abdomen. What will the provider do, based on these findings? Refer to an endocrinologist for evaluation A patient is in the emergency department with confusion and fatigue and a corrected serum calcium concentration is 10.8 mg/dL. What is the initial treatment for this patient prior to admission to the inpatient unit? Rapid administration of intravenous normal saline A patient carpal spasm when a blood pressure cuff is inflated. Which diagnostic testing will the provider consider to evaluate the cause of this finding? Magnesium and vitamin D A patient has low serum calcium associated with low serum albumin. What is the recommended treatment for this patient? Correction of other serum electrolytes A patient with normal renal function has a potassium level of 6.0 mEq/L. Which underlying cause is possible in this patient? Adrenocortical deficiency A hospitalized patient with renal failure is accidently given parenteral potassium and has a potassium level of 7.0 mEq/L. An ECG reveals a normal QRS interval. What is the initial recommended treatment for this patient? Insulin and glucose infusion A patient has a serum potassium level of 3 mEq/L and a normal blood pressure. Which test should be performed initially to assist with the differential diagnosis? Serum bicarbonate A patient has euvolemic hyponatremia secondary to chronic syndrome of inappropriate antidiuretic hormone (SIADH) and is hospitalized for fluid replacement. When preparing to discharge the patient home, what will be included in teaching? Limiting fluids to 500 mL/day for several days An elderly patient who is taking a thiazide diuretic has been ill with nausea and vomiting and is brought to the emergency department for evaluation. An assessment reveals oliguria, hypotension, and tachycardia and serum sodium is 118 mEq/L. What is the treatment? Emergency volume repletion with 3% NaCl. A high school athlete is brought to the emergency department after collapsing during outdoor practice on a hot day. The patient is weak, irritable, and confused. Serum sodium is 152 mEq/L and has dry mucous membranes and tachycardia. What is the initial approach to rehydration in this patient? Intravenous fluid resuscitation with an isotonic solution A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient? Annual monitoring of calcium, creatinine, and bone density Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary hyperparathyroidism? Inappropriate secretion of PTH along with hypercalcemia Which findings are symptoms of hyperparathyroidism? Cognitive impairment Left ventricular hypertrophy Renal calculi A female calls the provider to report having unprotected sexual intercourse approximately 4 days prior. Which regimen will the provider recommend? Ulipristal Acetate taken one time A woman has a history of migraines with aura and request oral contraceptives to prevent pregnancy. Which type of contraceptive will the provider recommend? Progestin-only contraception A woman who is taking oral contraceptive pills (OCPs) to prevent pregnancy calls the provider to report forgetting to take the pills for 4 days. She has not had sexual intercourse during that time. What will the provider recommend? Resume the pills and use a backup method the remainder of the cycle A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy test is negative. What will the provider do, based on this symptom? Evaluate for various causes of amenorrhea A woman who has stopped having menstrual periods has vasomotor symptoms, but does not want to use hormone replacement therapy. What measures will the provider recommend? Select all that apply. Avoiding caffeine Engaging in regular exercise Keeping the house cool Shortly after the onset of menopause, a woman begins to show signs of osteopenia. The provider orders oral Bazedoxifene combined with conjugated estrogen (BZA/CE). What will the provider tell her about the purpose of this treatment? It will reduce the incidence of fractures. A 16-year-old female has primary amenorrhea. A pregnancy test is negative. Further testing reveals a normal TSH and an elevated prolactin level. Which test will the provider order next? Magnetic resonance imaging An adolescent female has amenorrhea. The provider notes short stature, neck webbing, and a pigeon chest deformity. Based on these symptoms, what is the underlying disorder causing this patient's amenorrhea? Turner's syndrome A 15-year-old female who participates in high school track and gymnastics is experiencing amenorrhea after having eight normal periods. A pregnancy test is negative. What may be Age under 25 years Cigarette smoking Vaginal douching A sexually active female has symptoms of PID with fever. Cultures are pending. For outpatient treatment, what will the provider order? Rocephin, doxycycline, and metronidazole A female patient reports cramping, dysuria, low back pain, and nausea. A dipstick urinalysis is normal and a pregnancy test is negative. What will the provider do next? Obtain vaginal secretions for testing A female patient reports vulvar pruritus and dyspareunia. The provider notes white papules on the vulva with thinning of the epithelium. What condition does the provider suspect? Lichen sclerosis A sexually active young female reports vaginal discharge and moderate vulvovaginal irritation. The examination reveals a white, non-inflammatory discharge adhering to the vaginal walls, clue cells on microscopic examination and a positive KOH whiff test. What will the provider do next? Prescribe metronidazole 500 mg for 7 days A postmenopausal woman is diagnosed with lichen planus. After several weeks of treatment with a potent corticosteroid ointment, the woman reports improvement in itching, but states that she has extreme vaginal dryness. What will the provider recommend? Using a topical estrogen cream along with the steroid What is the benefit of using a liquid-based medium when performing a Pap test? It allows HPV, gonorrhea, and chlamydia testing with the same specimen. A young female has a Pap test which reveals atypical squamous cells of undetermined significance. What will the next step be in managing this patient? Repeat cytology in 12 months What is true about HPV infection in women? Most HPV lesions will resolve spontaneously without causing cancer. Which is the most important factor limiting access to health care for sexual and gender minorities? Laws prohibiting full marriage equality What is the medical diagnostic term used to identify transgender patients? Gender dysphoria A female patient with vaginal atrophy is prescribed a local estrogen therapy product with conjugated equine estrogen cream. What will the provider recommend as adjunctive therapy for this patient? Adding progesterone to the regimen What is a possible cause of decreased arousal, libido, and orgasm in a postmenopausal woman? Diminished testosterone The provider orders the oral phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction in a 65-year-old male patient. What will be included when teaching this patient about taking this medication? The medication is best taken on an empty stomach. This medication may be taken once daily. A 50-year-old man reports having erectile dysfunction. What is an important response by the provider when developing a plan of care for this patient? Evaluating the patient for cardiovascular disease Which is true about hypoactive sexual desire in older men? Men with hypoactive sexual desire may have normal excitement and orgasm. A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick during a well patient exam. What type of urinary tract infection does this represent? Complicated An asymptomatic pregnant woman has a positive leukocyte esterase and positive nitrites on a urine dipstick screening. What will the provider do next? Obtain a urine culture An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend? Empiric ceftriaxone and azithromycin A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick during a well patient exam. What type of urinary tract infection does this represent? Complicated An asymptomatic pregnant woman has a positive leukocyte esterase and positive nitrites on a urine dipstick screening. What will the provider do next? Obtain a urine culture An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend? Empiric ceftriaxone and azithromycin A couple who has been trying to conceive for over 9 months asks the provider about artificial reproductive therapy. When discussing risks and benefits associated with these methods, what will the provider include? Select all that apply. Higher rates of pregnancy-induced hypertension Increased premature births More frequent multiple gestations A provider is caring for a couple who are trying to conceive. To most accurately evaluate ovulation and luteal surge in the woman, what test will the provider recommend or perform? Urinary luteal hormone home kit In order to help prevent unplanned pregnancies, which group of providers may make the most impact by providing contraceptive counseling to women? Primary care providers An adolescent female calls a primary care clinic to report that she has missed two periods and is having morning nausea and vomiting. What will the provider suggest? Coming to the clinic for pregnancy testing A provider sees a woman who has just learned she is pregnant with an unplanned pregnancy. What is an initial step in helping this woman make decisions about his pregnancy? Actively listen to the woman's concerns and questions Administration of sodium bicarbonate and allopurinol Daily renal function and chemistry values Meticulous assessment of hydration status A patient reports a neck mass that has been present off and on for 5 or 6 weeks which varies in size. The provider palpates a lymph node measuring 1.25 cm. Which test will provide proper histologic diagnosis for this patient? Lymph node biopsy Which types of lymphomas typically have an aggressive presentation? Select all that apply. Adult T cell leukemia-lymphoma Burkitt lymphoma Diffuse large B cell lymphoma A 30-year-old male patient is diagnosed with Hodgkin lymphoma. Initial lab work reveals a WBC of 20 × 109/L, hemoglobin of 10.1 gm/dL, a serum albumin of 45 gm/dL, and lymphopenia of 0.5 × 109/L. Staging studies identify stage III disease. What is this patient's prognostic score? 4 A 70-year-old patient reports frequent infections, shortness of breath, fatigue, and palpitations. An exam reveals pallor and petechiae. The provider orders a peripheral blood smear and bone marrow biopsy. Which findings are consistent with a diagnosis of myelodysplasia? Select all that apply. Anisocytosis and poikilocytosis of erythrocytes on peripheral smear Defects in cellular maturation in all cell lines in bone marrow aspirate Hypercellular bone marrow with peripheral cytopenia Larger than normal megakaryocytes in bone marrow A patient with myelodysplastic syndrome (MDS) has severe neutropenia and anemia is given erythropoietin (EPO) with improvement in hemoglobin. Which intervention has been shown to prevent infection in patients with MDS who have severe neutropenia? Prophylactic treatment with floroquinolones A male patient has a history of recurrent epistaxis. Prior to a scheduled surgery, the provider asks about a family history of bleeding disorders. The patient reports no female relatives who had excessive bleeding episodes, but states that a maternal uncle and his maternal grandfather both had post-surgical complications related to bleeding. Based on this history, which diagnosis is possible? Hemophilia A patient is noted to have prolonged bleeding after an intravenous needle is removed. A subsequent laboratory test reveals a prolonged activated partial thromboplastin (aPTT) time with a normal prothrombin time (PT). Based on this result, the provider may suspect alteration in function of which factor? Factor VIII 3. A patient has type 1 Von Willebrand disease (vWD). What treatment is generally effective to prevent and treat bleeding episodes in this patient? Desmopressin A patient with systemic lupus erythematosus (SLE) has frequent symptoms and has been taking prednisone for each episode. The provider plans to start hydroxychloroquine and the patient asks why this medication is necessary. What will the provider tell this patient about this medication? It is effective in reducing disease flares and for tapering steroids A patient with systemic lupus erythematosus (SLE) develops end-stage renal disease. Because of the underlying SLE, what treatment is recommended for this patient? Kidney transplantation Which laboratory tests may help distinguish systemic lupus erythematosus (SLE) from other systemic rheumatologic disorders? Serum complement levels Which is a distinctive finding in patients who have Churg-Strauss syndrome (CSS)? Increased eosinophils A patient has a palpable purpural rash. This finding is most consistent with small-vessel vasculitis. A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is presumed to have a vasculitic disease. What is the likely treatment for this child? Aspirin and intravenous immunoglobulin A 60-year-old patient reports new onset of bilateral shoulder pain with morning stiffness lasting approximately one hour. Which will be included in initial diagnostic testing for this patient? Select all that apply. ESR and CRP Liver function tests Protein electrophoresis A patient who is taking prednisolone 20 mg daily to treat polymyalgia rheumatica, reports blurred vision. What will the provider do? Increase the prednisolone dose to 60 mg daily A patient is diagnosed with polymyalgia rheumatica with giant cell arteritis. Which dose of prednisolone will be given initially? 60 mg daily Which are symptoms of rheumatoid arthritis that distinguish it from osteoarthritis? Select all that apply. Extra-articular inflammatory signs Morning stiffness of at least one hour Symmetric tender, swollen joints A patient is diagnosed with rheumatoid arthritis after a review of systems, confirmatory lab tests, and synovial fluid analysis. What will the provide order initially to treat this patient? Disease-modifying anti-rheumatic drugs A patient has swelling and tenderness in the small joints of both hands and reports several weeks of malaise and fatigue. A RF test is negative. What will the primary care provider do next? Order radiographic tests, a CBC, and acute-phase reactant levels A pregnant woman tests positive for HIV infection. What will the provider recommend? Treatment with highly active antiretroviral therapy A homeless patient who has HIV infection has been on antiretroviral therapy (ART) for 18 months and has had normal CD4 counts and viral loads for past year. What will the provider recommend? Continue monitoring viral load and CD4 counts every 3 to 4 months Which patients with documented HIV infection may be classified has having acquired immunodeficiency syndrome (AIDS)? Select all that apply. A patient is diagnosed with ankylosing spondylitis and begins taking a COX-2 inhibitor with minimal pain and inflammation relief. What will the provider order initially to manage this patient's symptoms? Changing to a COX-1 inhibitor medication A patient reports a history of recurrent lower back pain for 6 months. The patient describes the pain as a deep ache and stiffness that is worse upon awakening and improves after walking. Which findings will the examiner elicit to help make a clinical diagnosis of ankylosing spondylitis? Select all that apply. Assessment of the degree of lumbar lordosis Evaluation of lateral thoracic spine flexion Measurement of chest expansion A provider performs a nail fold capillaroscopy on a patient who reports marked color changes of both hands with cold exposure and notes tortuous and dilated capillary loops. This finding is consistent with secondary Raynaud's phenomena. A patient who has secondary Raynaud's phenomena with severe digital ischemia. Which treatment is indicated for this patient? Intravenous prostaglandin E1 When examining a patient's skin, a practitioner uses dermoscopy in order to Select all that apply. assess changes in pigmentation throughout various lesions. determine whether lesion borders are regular or irregular. visualize skin fissures, hair follicles, and pores in lesions. A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate results, the provider will remove the top of the vesicles and obtain fluid from the lesions. An infant has atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp line. Which is correct when prescribing a corticosteroid medication to treat this condition? Initiate treatment with 0.1% triamcinolone acetonide (Kenalog lotion) When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug? Place an occlusive dressing over the medication A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication? Gel Which type of bite is generally closed by delayed primary closure? Select all that apply. Bites to the hand Deep puncture wounds Wounds 8 hours old A patient has been bitten by a dog and has sustained several puncture wounds near the thumb of one hand. The patient is able to move all fingers and the bleeding has stopped. What is the correct treatment for this patient? Obtain a physician consultation for evaluation and treatment A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury? Potential septic arthritis or osteomyelitis A patient comes to the clinic after being splashed by boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do? Refer the patient to the emergency department A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers in the emergency department? Remove the offending chemical and garments A patient with well-localized vitiligo is referred to a dermatologist for treatment. What will the initial treatment be? Twice-daily application of a mid-potency steroid cream A parent reports the appearance of areas of depigmented skin on a child which has spread rapidly. The provider notes asymmetrically patterned tri-colored, macules in a dermatomal distribution. What type of vitiligo does the provider suspect? Segmented vitiligo A patient who is diagnosed with vitiligo asks the provider what can be done to minimize the contrast between depigmented and normal skin. What will the provider recommend? Applying a cosmetic cover-up or tanning cream A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? Prescribe oral clindamycin A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? Amoxicillin-clavulanate A child has vesiculopustular lesions around the nose and mouth with areas of honey-colored crusts. The provider notes a few similar lesions on the child's hands and legs. Which treatment is appropriate for this child? Amoxicillin-clavulanate A child has irritant contact dermatitis with lesions on the extremities and face. Which treatment is recommended for this patient? Oral corticosteroids A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient? The vesicles may continue to develop for up to 2 weeks. A patient who has recurrent, frequent genital herpes outbreaks asks about therapy to minimize the episodes. What will the provider recommend as first-line treatment? Acyclovir Erythromycin Infliximab Isotretinoin Prednisone A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information? It is often progressive with relapses and permanent scarring. A patient is newly diagnosed with hyperhidrosis with excessive sweating on the palms and soles. What will the provider recommend to treat this condition? Aluminum chloride hexahydrate A patient has excessive sweating of the palms, soles, and axillae. The provider understands that this presentation is often due to which cause? Anxiety A patient reports generalized excessive sweating and states that night sweats are present. Which diagnostic test is a priority for this patient to determine the underlying cause? Purified protein derivative test A patient with intertrigo shows no improvement and persistent redness after treatment with drying agents and antifungal medications. The patient reports an onset of odor associated with a low-grade fever. What will the provider do next to manage this condition? Culture the lesions to determine the cause When recommending ongoing treatment for a patient who has recurrent intertrigo, what will the provider suggest? Select all that apply. Aluminum sulfate solution Burow's solution compresses An overweight patient has intertrigo, with recurrent fungal infections. In addition to medication therapy, what will the provider recommend to treat the condition? Select all that apply. Expose areas to light and air Use a hand-held dryer to dry the area Wear natural-fiber clothing A patient with recurrent herpetic whitlow is counseled about management of symptoms and prevention of complications. What will be included in this teaching? Select all that apply. Contact the provider if symptoms persist longer than 3 weeks Cool compresses may help with comfort and decrease erythema Keep hands away from the mouth and eyes to prevent inoculation A patient is diagnosed with herpetic whitlow and in a follow-up evaluation, is noted to have paronychial inflammation of the tendon sheath in one finger. What is a priority treatment for this patient? Refer the patient to the emergency department A female patient who works with caustic chemicals has developed acute paronychia. What will he provider include when teaching this patient about her condition? Select all that apply. Analgesics may be necessary for comfort Use protective gloves while working Wear waterproof gloves when washing dishes A patient has pruritis related to use of fabric softeners in clothing and reports all-over itching. A physical examination reveals no areas of inflammation. Besides stopping the use of this product, what is an initial intervention to stop the pruritis? Cooling the skin A patient undergoing renal dialysis has extensive pruritis. Which medication will the provider order? Gabapentin (Neurontin) A patient complains of persistent pruritis of the extremities. A history is negative for medical and psychiatric causes and the patient has not had significant exposures. The physical examination of the affected skin is negative, except for marks made by scratching. What will the provider order to evaluate the cause of this itching? Select all that apply. Blood urea nitrogen and serum creatinine Complete blood count with differential Thyroid panel and blood glucose A child has plaques on the extensor surfaces of both elbows and on the face with minimal scaling and pruritis. What is the likely cause of these lesions? Psoriasis A patient with psoriasis develops lesions on the intertriginous areas of the skin. Which treatment is recommended? Topical, low-potency steroids A patient with severe, recalcitrant psoriasis has tried topical medications, intralesional steroid injections, and phototherapy with ultraviolet B light without consistent improvement in symptoms. What is the next step in treating this patient? Methotrexate A patient has a purpural rash with flat, non-palpable lesions. Which laboratory tests will be most helpful in the initial diagnosis? Complete blood count with platelets A pediatric patient has immune thrombocytopenic purpura and has a platelet count of 60,000/mm3. What is the recommended treatment based on this laboratory value? Close observation A patient presents with a purpural rash. The provider notes localized swelling and palpable lesion. What underlying condition may be the cause of this rash? A vasculitis disorder An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition? Select all that apply. Begin first-line treatment with a topical antifungal medication Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo The provider is prescribing 5% permethrin cream for an adolescent patient who has scabies. What will the provider include in education for this patient? Stuffed animals and pillows should be placed in plastic bags for 1 week. A patient has a pruritic eczematous dermatitis which has been present for one week and reports similar symptoms in other family members. What will the practitioner look for to help determine a diagnosis of scabies? Intra-epidermal burrows on the interdigital spaces of the hands A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug? Yaz, Ortho Tri-Cyclen, and Estrostep are approved for acne treatment. An elderly adult patient with bullous pemphigoid is prescribed oral prednisone and hydroxyzine to manage symptoms. Which medication side effect is of immediate concern for this patient? Sedation A patient is newly diagnosed with bullous pemphigoid and has moderate to severe itching. The provider orders a topical corticosteroid will discuss which potential complication with this patient? Secondary infection When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid lesions, the practitioner will perform direct immunofluorescence microscopy. A patient is in the clinic with 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? Alopecia areata A patient with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order? Examination of scalp scrapings with potassium hydroxide A female patient is diagnosed with androgenetic alopecia. Which medication will the provider order? Minoxidil What is included in the mitigation phase of emergency management? Identification of risks A primary care office develops a plan for what to do in case of a fire in the building. As part of the plan, two people are to take charge in case of this emergency. Which phase of emergency planning does this represent? Response A patient with asthma has been given three bronchodilator treatments but continues to have wheezing and shortness of breath. The nurse caring for the patient notes an oxygen saturation of 90% on room air. What action is indicated? Notify the patient's physician immediately Which clinical findings are worrisome in a patient experiencing acute bronchospasm, requiring immediate treatment? Select all that apply. A silent chest after previously wheezing Decreasing blood pressure Presence of an urticarial rash Which symptom in a patient with asthma indicates severe bronchospasm? Pausing to breathe while attempting to talk A child with no previous history of asthma is brought to the emergency department with wheezing, stridor, and shortness of breath. When the child is started on oxygen and given a nebulized bronchodilator treatment, the treatment team notes a wheal and flare rash on the child's trunk. What medication will be given immediately? Intramuscular epinephrine A man self-administers epinephrine using an Epi-Pen after experiencing a bee sting and developing angioedema and wheezing. What should the man do next? Obtain transport to an emergency department immediately A patient is seen in the emergency department after experiencing a spider bite. The spider is in a jar and is less than one inch in size, yellow-brown, and has a violin-shaped marking on its back. Depending on the patient's symptoms, which treatments and diagnostic evaluations may be ordered? Select all that apply. CBC, BUN, electrolytes, and creatinine Coagulation studies Tetanus prophylaxis A child experiences a snake bite while camping and is seen in the emergency department. The child's parents are not able to identify the type of snake. An inspection of the site reveals two puncture wounds on the child's arm with no swelling or erythema at the site. The child has normal vital signs. Which treatment is indicated? Cleaning the wound, giving tetanus prophylaxis, and observing for 12 hours A patient reports heart palpitations but no other symptoms and has no prior history of cardiovascular disease. The clinic provider performs an electrocardiogram and notes atrial fibrillation and a heart rate of 120 beats per minute. Which is the initial course of action in treating this patient? Refer the patient to a cardiologist A patient who takes a beta blocker medication is in the emergency department with syncope, shortness of breath, and hypotension. A cardiac monitor reveals a heart rate of 35 beats per minute. Which medication may be used to stabilize this patient? Epinephrine Which cardiac arrhythmia in an unstable patient requires unsynchronized shocks, or defibrillation? Polymorphic ventricular tachycardia Current American Heart Association (AHA) recommendations include: Select all that apply. A rate of 100 compressions per minute at a minimum Untrained rescuers giving compressions without breaths Using a ratio of 2 rescue breaths to 30 compressions The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which arrhythmia? Ventricular fibrillation A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)? Assessment of gasping breaths or not breathing What is true when considering activated charcoal for gastrointestinal decontamination to treat a toxic substance ingestion? It must be administered within 60 minutes of ingestion. A lawn maintenance worker is brought to the emergency department after an accident in which a large amount of pesticide was sprayed all over his clothing. He is able to relate the details of the accident to the emergency department personnel. What is the priority treatment on admission? contact the fraternity to determine whether others are affected. What is the first priority in emergency management of a biological terrorism attack? Containing the exposures A patient who was sexually assaulted one month prior tells her provider that she is concerned about contracting HIV. When is it appropriate to perform testing? In two weeks and then 3 to 6 months after the assault During a health maintenance examination, 17-year-old female reports having been raped repeatedly at a college party during the previous semester and tells the practitioner that she did not seek help at the time. Which action is a priority for the primary care provider? Reporting the alleged assault to law enforcement When beginning a health maintenance exam, the health care provider learns that an adult patient has been sexually assaulted the previous day. What is the initial responsibility of the provider? Refer the patient to the emergency department for a forensic examination Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope? Select all that apply. 12-lead electrocardiogram Complete blood count Serum glucose testing A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of consciousness. Which is the most likely type of syncope in this patient? Reflex syncope An elderly patient reports experiencing syncope each morning when getting out of bed. Which assessment will the health care provider perform first to evaluate this patient's symptoms? Orthostatic blood pressures A child is brought to the emergency department after getting lost while camping on a cold, rainy day. The child is lethargic on admission. The cardiorespiratory monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10 breaths per minute, and a normal blood pressure. The assessment reveals erythema and edema of the child's hands and feet. What treatments are indicated? Select all that apply. Apply warmed blankets Elevate the child's extremities Remove all clothing A patient is brought to a clinic after fainting while working outdoors on a hot day. The patient has slurred speech and headache and has a temperature of 104° F. What will the provider do? Transport the patient to the emergency department A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the provider suspect? Heat exhaustion