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A series of multiple-choice questions and answers related to pediatric and adolescent health, covering topics such as viral infections, sexually transmitted infections, asthma, sinusitis, and vaccine recommendations. It is designed to test knowledge and understanding of common health issues and clinical scenarios encountered in pediatric practice. The questions address diagnosis, treatment, and management strategies relevant to adolescent patients, making it a valuable resource for medical students, nursing students, and healthcare professionals preparing for exams or seeking to enhance their clinical skills in pediatrics. The content is presented in a question-and-answer format, providing immediate feedback and reinforcing key concepts in adolescent medicine.
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124.nWhichnofnthenfollowingnviralninfectionsnisnassociatednwithnoccasionalnabnormalnformsnofnlymp hocytesnduringnannacuteninfection? A)nCytomegalovirusn(CMV) B)nEpstein-Barrnvirusn(EBV) C)nHumannpapillomanvirusn(HPV) D)nCoxsackienvirusn-nCORRECTnANSWER-B)nEpstein-Barrnvirusn(EBV) AntestnfornannacuteninfectionnofnthenEpstein-Barrnvirusnwillnshownabnormalnformsnofnlymphocytes. 2.nAllnofnthenfollowingnareninfectionsnthatnaffectnmostlynthenlabianandnvaginanexcept: A)nBacterialvaginosis B)nCandidiasis C)nTrichomoniasis D)nChlamydiantrachomatisn-nCORRECTnANSWER-D)nChlamydiantrachomatis Infectionsnthatncommonlynaffectnthenlabianandnvaginanincludenbacterialnvaginosis,ncandidiasis,nandn trichomoniasis.nChlamydiantrachomatisncommonlynaffectsnthencervix,nendometrialnliningn,nfallopia nntubes,nandnpelvicncavity. 411.nWhichnofnthenfollowingnisnthenmostncommonncausenofnnongonococcalnurethritis? A)nEscherichiancoli B)nChlamydiantrachomatis C)nNeisseriangonorrhoeae D)nMycoplasman-nCORRECTnANSWER-B)nChlamydiantrachomatisn ThenmostncommonncausenofnnongonococcalnurethritisnisnChlamydiantrachomatis. An 10 - year- oldnboyncomplainsnofnansuddennonsetnofnscrotalnpainnwhennhenwokenupnthatnmorning.nHenisnalsonco
mplainingnofnseverennauseanandnvomiting.nDuringnthenphysicalnexamination,nthennursenpractitionern findsnantender,nwarm,nandnswollennleftnscrotum.nThencremastericnreflexnisnnegativenandnthenurinendi psticknisnnegativenfornleukocytes,nnitrites,nandnblood.nThenmostnlikelyndiagnosisnis: A)nAcutenepididymitis B)nAnseverensalmonellaninfection C)nTesticularntorsion D)nAcutenorchitisn-nCORRECTnANSWER-C)nTesticularntorsionn Testicularntorsionnsignsnandnsymptomsnincludensuddennonsetnofnunilateralnscrotalnpain,nnausea,nvo miting,nandnabdominalnpain.nAcutenepididymitisncausesnfever,nchills,nnausea,nandnunilateralnpainna ndnisnmostncom- nmonlynseenninnsexuallynactivenmen.nUnilateralnscrotalnpainndoesnnotnoccurnwithnSalmonellaninfecti on.nAcutenorchitisnisnoftennbasednonnhavingnanrecentnmumpsninfec- ntionnornparotitisnwithntesticularnedema. An 10 - year- oldnmalenwhonwasnrecentlynacceptednintonhisnschool'snsoccernteamnhasnanhistorynofnexercise- inducednasthma.nThenchildnwantsntonknownwhennhenshouldntakenhisnalbuterolninhaler.nThennursenpra ctitionernwouldnadvisenthenpatient: A)nPremedicatenhimselfn 20 nminutesnpriorntonstartingnexercise B)nWaitnuntilnhenstartsntonexercisenbeforenusingntheninhaler C)nPremedicaten 60 nminutesnbeforenstartingnexercise D)nWaitnuntilnhenfinishesnhisnexercisenbeforenusingnhisninhalern-nCORRECTnANSWER- A)nPremedicatenhimselfn 20 nminutesnpriorntonstartingnexercisen Exercise- inducednasthmanisnbestncontrollednbynusingnthenProventilninhalern(bronchodilator)napproximatelyn 2 0 nminutesnpriorntonexercise,ntonpreventnvasospasmnofnthenbronchiolesnandnshortnessnofnbreathnwith nexercise.nThesenbronchodilatorsnusuallynlastnapproximatelyn 4 nhours.nTheynalsonworknquicklyntonope nnupnthenbronchiolesnifnannacutenattack/shortnessnofnbreathnoccurs An 12 - year-oldngirlnisncomplainingnofnan 2 - weeknhistorynofnfacialnpressurenthatnworsensnwhennshenbendsnover.nShencomplainsnofntoothnpainninn
catch-upn(ifndidnnotnreceivenatnagen 11 - 12 nyears),nHPVnornGardasilncatch- upn(ifndidnnotnreceivenatnagen 11 - 12 nyears),nandnthenMCV4nornmeningococcalnconjugatenvaccinen(Menactra).nOnlynonendosenofnTdapni snrecommendedn(lifetime).nThereafter,nthenTdnformnofnthenvaccinenisnindicatedneveryn 10 nyears. An 13 - year- oldnboynwantsntonbentreatednfornhisnacne.nHenhasnanlargennumbernofnclosednandnopenncomedonesno nnhisnface.nThenpatientnhasnbeenntreatingnhimselfnwithnOTCnbenzoylnperoxidenandnsalicylicnacidntopi calnproducts.nWhichnofnthenfollowingnwouldnbenrecommendednnext? A)nRetinoicnacidn(Accutane) B)nTetracycline C)nRetinnAn0.25%ngel D)nWashnfacencarefullynwithnmedicatednsoapnatnbedtimen-nCORRECTnANSWER- C)nRetinnAn0.25%ngeln Topicalnagentsnarenthenfirst- linentreatmentnfornacnenvulgaris.nRetinnAn0.25%ngelnwouldnbenthennextnstep.nOralnpreparationsnwoul dnthennbenofferednfornthennextnstepn(tetracycline),nandnAccutanenwouldnbenthenfinalnstepnofntherapy. An 13 - year- oldnmalenisnbroughtninnbynhisnmothernfornanphysicalnexam.nDuringnthengenitalnexam,nthennursenpracti tionernnoticesnthatnthenpatientnisnatnTannernStagenII.nWhichnofnthenfollowingnisnthenbestndescriptionno fnthisnTannernstage? A)nThenpenisnisngrowingnmoreninnlengthnthanninnwidthnandnthentesticlesnbecomenlargernwithndarkernsc rotalnskinnandnthenpubicnhairnisnstartingntoncurl B)nThenpenisnisngrowingnmoreninnwidthnthanninnlengthnwithndarkernscrotalnskinnandnmorennumerousnp ubicnhairsnthatnarendarker,ncurly,nandncoarser C)nThentesticlesnbecomenlargernandnthenskinnofnthenscrotumnstartsntonbecomendarkernwithnstraight,nf ine,ncountablenhairsnonnthengenitalsnandnthenaxilla D)nThentesticles,npenilenwidthnandnlengthnarenallndevelopingnquicklyn-nCORRECTnANSWER- C)nThentesticlesnbecomenlargernandnthenskinnofnthenscrotumnstartsntonbecomendarkernwithnstraight,nf ine,ncountablenhairsnonnthengenitalsnandnthenaxillan
TannernStagenIInisnwhennthentesticlesnstartntongrow.nThenscrotalnskinnbecomesnthickernandnstartsntong etndarkern(hyperpigmentation).nThenpubicnhairnisnofnanfinentexturenandnstraightnandntherenarenfewnco untablenhairsnonnthengenitalsnandnthenaxilla. An 13 - year- oldnpatientnhasnanthroatnculturenthatnisnpositivenfornstrepnthroat.nShenreportsnthatnhernyoungernbroth ernwasnrecentlyndiagnosednwithnstrepnthroatnandntreated.nThenpatientnhasnanseverenallergyntonpenicil linnandnreportsnthatnerythromycinnmakesnhernverynnauseated.nWhichnofnthenfollowingnantibioticsnisnt henbestnchoice? A)nAzithromycinn(Zithromax) B)nCephalexinn(Keflex) C)nCefuroximenaxetiln(Ceftin) D)nLevofloxacinn(Levaquin)n-nCORRECTnANSWER-A)nAzithromycinn(Zithromax)n Ifnthenpatientnhasnanseverenpenicillinnallergy,ntherenisnan10%nchancenofncross- reactivityntoncephalosporinsn(especiallynfirstngeneration).nBecausenthenpatientnisnanchild,nthenlevoflo xacinnisncontraindicated.nNauseanisnancom- nmonnadversenreactionntonerythromycinn(itnisnnotnannallergicnreaction).nThenbestnoptionnisntonusenazit hromycinnbecausenofnitsnminimalnGInadverseneffects.nAzithromycinnhasnfewerndrugninteractionsnco mparednwithnothernmacrolides. An 14 - year- oldnfemalenwhonisnsexuallynactivenisnbroughtninnbynhernmothernfornannimmunizationnupdate.nAccordi ngntonthenmother,nherndaughternhadn 1 ndosenofnhepatitisnBnvaccine.nWhichnofnthenfollowingnvaccinesn wouldnyounadministernatnthisnvisit? A)nTdnandnhepatitisnB B)nDTaPn(diphtheria,ntetanus,nacellularnpertussis)nandnhepatitisnB C)nHepatitisnBnonly D)nMMRn(measles,nmumps,nrubella)nandnTdn-nCORRECTnANSWER-A)nTdnandnhepatitisnBn ThenCDCnrecommendsnTdnandnhepatitisnBnforn 14 - year- oldnfemales.nItnisnrecommendednfornherntoncontinuenthenhepatitisnseries,nwhichnincludesnantotalnofn 3 ninjections. An 14 - year- oldnfemalenwithnamenorrheanisntestednfornpregnancynandnhasnanpositivenresult.nThenpatientntellsnthen
thatnherndaughternisnstartingnTannernStagenII.nWhatnarenthenphysicalnexamnfindingsnduringnthisnstage ? A)nBreastnbudsnandnsomenstraightnpubicnhair B)nFullyndevelopednbreastsnandncurlynpubicnhair C)nBreastntissuenwithnthenareolanonnanseparatenmoundnwithncurlynpubicnhairn D)nNonbreastntissuenandnnonpubicnhairn-nCORRECTnANSWER- A)nBreastnbudsnandnsomenstraightnpubicnhairn TannernStagenIIninnfemalesnincludesnbreastnbudsnandnfewnstraight,nfinenpubicnhairs. An 15 - month- oldnchildnwhonisneatingnandnbehavingnnormallynisnfoundntonhavenanhighnfever.nAfternanfewndays,nthenfe vernresolvesnandntheninfantnbreaksnoutninnanmaculopapularnrash.nThisnisnandescriptionnofnwhichnofnth enfollowingnconditions? A)nErythemaninfectiosum B)nRoseolaninfantum C)nFifthndisease D)nScarletnfevern-nCORRECTnANSWER-B)nRoseolaninfantumn Thensigns/symptomsnofnroseolaninfantumnincludenhighnfevernfornanfewndaysnwithnanmaculopapularnr ashnoccuringnafternthenfevernbreaks.nFifthndiseasenisnanlacy- appearingnrashnthatnusuallynbeginsnonnthenfacenandnmovesntonthenextremitiesnandntrunk.nItnisnknownn bynthen"slappedncheekn"nappearancenatnonset.nErythemaninfectiosumnisnthensamenasnFifthndisease.n Scarletnfevernisnanrednrashnthatnfeelsnlikensandpapernthatnusuallynbeginsnonnthennecknandntrunknandn spreadsntonthenextremities.nPatientsnwillnhavenothernsymptomsnsuchnasnfever,nsorenthroat,nandnbeef ynredntongue.nThisnisncausednbynthenGroupnAnStreptococcusnbacterium. An 15 - month- oldninfantnisninnyournofficenfornanwellnbabyncheck.nThenmotherndeniesnhistorynofnchickenpoxninfection .nWhichnofnthenfollowingnimmunizationsnisnindicatednatnthisnvisit? A)nDTaP,nHib,nIPV,nhepatitisnB B)nDTaP,nHib,nPCV,nIPV,nMMR C)nMMR,nhepatitisnB,nvaricella D)nDTaP,nIPV,nMMR,nvaricellan-nCORRECTnANSWER-D)nDTap,nIPV,nMMR,nvaricellan
Immunizationsnfornan 15 - month-oldnchildnincludenDTap,nIPV,nMMR,nandnvaricellanvaccine. An 15 - year- oldnbasketballnplayernwhonisn 6 nftntallnisnseennforncomplaintsnofnpainfulnlumpsnonnhisnknees.nUponnins pection,nthennursenpractitionernnotesnanbonelikengrowthnonnthenupperntibianmidlinenbelownthenkneec apnonnbothnknees.nThenpatientnhasnfullnrangenofnmotionnwithnnonjointntenderness,nredness,nornswelli ng.nWhichnofnthenfollowingnconditionsnisnbestndescribed? A)nOsteosarcomanofnthentibia B)nJuvenilenrheumatoidnarthritis C)nOsgood-nSchlatterndisease D)nPaget'sndiseasenofnthenbonen-nCORRECTnANSWER-C)nOsgood-Schlatterndiseasen Osgood- Schlatterndiseasenisncharacterizednbynhavingnpainnovernthentibialntuberositynwithnpalpationnofnanbony nmassnovernthenanteriorntuberclenofnonenornbothnknees.nExercisenworsensnthenpain An 15 - year- oldnfemalenwhonattendsnanpublicnschoolnisnreferredntonthennursenpractitionernbynonenofnhernteachers .nThenteennhasnbeennmissingnschoolnandnisnfallingnbehindninnhernschoolwork.nAfternclosingnthenexamn roomndoor,nthennursenpractitionernstartsntoninterviewnthenteen,naskingnaboutnhernmoods,nhernappetit e,nhernsleep,nwhethernshenanynplannofnhurtingnherselfnornothers,nandnothernquestions.nWhatnisnthenle velnofnhealthnpreventionnthatnthennursenpractitionernisnperforming? A)nPrimarynprevention B)nSecondarynprevention C)nTertiarynprevention D)nDropoutnpreventionnprogramn-nCORRECTnANSWER-B)nSecondarynpreventionn Thennursenpractitionernisnevaluatingnthenteenagernfor majorndepression.nBecausenthenteenagernalreadynhasnthendiseasen(depression),nitnisnanscreeningn"te st."nAllnscreeningntests/labsn(mammography,nPapnsmears,netc.)nare secondarynpreventionnactivities. An 15 - year- oldnWhitenmalenisnbroughtninnbynhisnfathernfornanphysicalnexam.nHenisnconcernednthatnhisnsonnisn"toon short"nfornhisnage.nThenfathernreportsnthatnwhennhenwasnthensamenage,nhenwasnmuchntaller.nHisnsonn
D)nCleannthenwoundnwithnsoapnandnwaternandnprescribenAugmentinn500mgnPOnBIDnxn 10 ndaysnfornth enpatientn-nCORRECTnANSWER- D)nCleannthenwoundnwithnsoapnandnwaternandnprescribenAugmentinn 500 nmgnPOnBIDnxn 10 ndaysnfornth enpatientn Catnwoundsnarenmorenlikelyntonbecomeninfectedncomparednwithndognbites;ninnaddition,nthisnpatient' snbitenisnlocatednonnannextremity.nThesenfactsnjustifynthenprescriptionnofnAugmentinn 500 nmgnPOnBIDn xn 10 daysnfornthenpatient. An 17 - year- oldnboynreportsnfeelingnsomethingnonnhisnleftnscrotum.nOnnpalpation,nsoftnandnmovablenbloodnvesse lsnthatnfeelnlikenan"bagnofnworms"narennotednunderneathnthenscrotalnskin.nItnisnnotnswollennornredden ed.nThenmostnlikelyndiagnosisnis: A)nChronicnorchitis B)nChronicnepididymitis C)nTesticularntorsion D)nVaricocelen-nCORRECTnANSWER-D)nVaricocelen Palpationnofnvaricosenveins,nknownnasn"bagnofnworms"ninnthenscrotum,nisnanclassicnsymptomnofnanva ricocele.nChronicnepididymitisnandnchronicnorchi- ntisnarencausednbynanbacterialninfectionnandncommonlynhavenburning,nfrequency,nandnpain.nTesticul arntorsionnisnannemergentnconditionninnwhichnthentesticlenbecomesntwisted,ninterruptingnthenbloodns upplyntonthentestis;ntonavoidndamage,nthenconditionnmustnbencorrectednwithinn 6 nhours. An 17 - year- oldnhighnschoolnstudentnisnconsideringnhernbirthncontrolnoptions.nShenwantsntonknownmorenaboutnSe asonale.nWhichnofnthenfollowingnstatementsnisnfalse? A)nTakingnSeasonalenresultsninnonlyn 4 nperiodsnpernyear B)nHernperiodnwillnoccurnwithinnthen 7 ndaysnwhennshenisnonntheninertnpills C)nItnisnanprogesterone-onlynmethodnofnbirthncontrolnandndoesnnotncontainnestrogen D)nTaken 1 ntabletndailynforn 84 nconsecutivendaysnfollowednbyn 7 ndaysnofninertnpillsn- nCORRECTnANSWER-C)nItnisnanprogesterone- onlynmethodnofnbirthncontrolnandndoesnnotncontainnestrogenn
Seasonalenisnannextended- cyclenformnofnbirthncontrol.nItncontainsnbothnlevonorgestrelnandnethinylnestradiol.nTherenaren 84 npinkn tabletsn(active)nandn 7 nwhitenpillsn(inert).nInngeneral,nmorenspottingn(breakthroughnbleeding)nisnexper ienced withnextended- cyclenpillsnduringnthenfirstnfewnmonthsnofnusen(comparednwithnthenmonthlynbirthncontrolnpills). An 19 - year- oldnfemalenhasnrecentlynbeenndiagnosednwithnacutenhepatitisnB.nShenisnsexuallynactivenandnisnmono gamous.nShenreportsnusingncondomsninconsistently.nWhatnwouldnyounrecommendnfornhernmalensex ualnpartnernwhonwasnalsontestednfornhepatitisnwithnthenfollowingnresults:nHBsAgn(−),nanti- HBsn(−),nanti-HCVn(−),nanti-HAVn(+)? A)nAnhepatitisnBnvaccination B)nHepatitisnBnimmunoglobulin C)nHepatitisnBnvaccinationnandnhepatitisnBnimmunoglobulin D)nNonvaccinationnisnneedednatnthisntimen-nCORRECTnANSWER- C)nHepatitisnBnvaccinationnandnhepatitisnBnimmunoglobulinn HepatitisnBnvaccinationnisngivennfornlong- termnprophylaxisntreatmentntonpreventnhepatitisnBninfection.nHepatitisnBnimmunoglobulinnisngivennfo rnpreventionnofnhepatitisnBninfectionnwhennthenpersonnhasnbeenndirectlynexposedntonthenhepatitisnBni nfection.nThenimmnoglobulinnisnnotnanvaccinenandndoesnnotnprotectnagainstnlong-termnprophylaxis. An 19 - year- oldnmalenathletencomplainsnofnacutenkneenpainnafternanfootballngame.nThennursenpractitionernelicitsn McMurray'snsign,nwhichnisnpositivenonnthenpatient'sninjurednknee.nThisnisnantestnfor: A)nMeniscalninjury B)nInflammationnofnthenkneenjoint C)nOsteophytesnofnthenkneenjoint D)nTenosynovitisn-nCORRECTnANSWER-A)nMeniscalninjuryn Withnannacutenkneeninjury,nthenkneenshouldnbenassessednusingnMcMurray'snsign.nAnpositivenMcMurr ay'snsignnindicatesnanmeniscalninjury.nInflammationnofnthenknee,nosteophytes,nandntenosynovitisnwo uldnnotnelicitnanpositivenMcMurray'snsign.
C)nChondromalacianofnthenpatella D)nDisseminatedngonorrhealninfectionn-nCORRECTnANSWER-D)nDisseminatedngonorrhealninfectionn SymptomsnofnPIDnwithnpainful,nswollennjointsnofnextremitiesnindicatendisseminatedngonorrhealninfe ction.nUntreatedndisseminatedngonorrheancannleadntonsepticnarthritis.nSymptomsnmaynbenmildnfrom nslightnjointnpainnandnnonfeverntonseverenjointnpainnwithnhighnfever.nPIDnsymptomsndonnotnoccurnwithn septicnarthritis,nReiter'snsyndrome,nornchondromalacianofnthenpatella. An 22 - yearnoldnisngoingnonnan 5 - dayncruisenfornhernhoneymoon.nShenreportsnanhistorynofnseverenmotionnsickness.nWhichnofnthenfollo wingnmedicinesncannbenprescribednfornmotionnsickness? A)nDimenhydrinaten(Dramamine) B)nMetochlopramiden(Reglan) C)nOndansetronn(Zofran)n_ D)nScopolaminenpatchn(TransdermnScop)n-nCORRECTnANSWER- D)nScopolaminenpatchn(TransdermnScop)n Scopolaminenpatchn(TransdermnScop)nisnanprescriptionnmedicinenthatnisnusednfornmotion/seansickn ess.nItnisnansmall,ncircularnpatchnthatnisnplacednbehindnthenearnandnisneffectivenforn 3 ndays.nAdvisenthe npatientntonapplynitn 4 nhoursnbeforenthentripntonbeneffective.nBecausenthenquestionnisnaskingnaboutnan" prescribed"nmed,nanswersnwithnOTCsnsuchnasnDramaminenarenincorrect.nZofrannisnindicatednfornca ncer-relatednnauseanandnvomitingn(chemo,nradiation,nsurgery). An 22 - year- oldnmalenisnbroughtntonannurgentncarencenternbynhisnanxiousnmother.nShenreportsnthatnhernsonnreturn ednfromnancampingntripn 2 ndaysnagonwithnanhighnfevernandnbadnheadache.nApparently,nthenpatientnha dncomplainedntonhernofnanpainfulnandnstiffnnecknalongnwithnnauseanshortlynafternhenarrived.nAccordin gntonthenmother,nhernsonnstartednbreakingnoutninnanrashnthendaynbefore,nsomenofnwhichnisnturningnand arknredntonpurplencolor.nDuringnthenphysicalnexam,nthennursenpractitionernevaluatesnthenpatientnforn Kernig'snsign,nwhichnisnpositive.nWhichnofnthenfollowingnconditionsnisnmostnlikely? A)nStevens-Johnsonnsyndrome B)nMeningococcemia C)nRockynMountainnspottednfever D)nErythemanmultiformen-nCORRECTnANSWER-B)nMeningococcemian
Kernig'snmaneuvernisnperformednbynflexingnbothnhipsnandnlegsnandnhavingnthenpatientnstraightennthen legsnagainstnresistance,ntestingnfornmen- ningitis.nAnpositiventestnindicatesnmeningitis.nOtherncharacteristicsnofnmeningitisnincludenhighnfever,n headache,nstiffnneck,nandnnausea/vomiting. An 22 - year- oldnmalenpresentsntonthenurgentncarenclinicnwithnburnsncausednbynanhotnoilnspillnwhilenfryingnfood.nH endeniesnfacialninvolvement,ndyspnea,nornweakness.nDuringnthenphysicalnexam,nthennursenpractition ernnoticesnbrightnrednskinnwithnnumerousnbullaenonnthenrightnarmnandnhandnandnbrightnrednskinnonnth enrightnthighnandnthenrightnlowernleg.nOnnanpainnscalenofn 1 - 10,nhenreportsnthenpainnasn8.nBasednonnthenRulenofnNines,nwhatnisnthenTBSAnofnthisnpatient'snburns? A)n36%n B)n27%n C)n18%n D)n9%n-nCORRECTnANSWER-B)n27%n ThisnpatientnhasnanTBSAnofn27%nandnshouldnbenreferredntonthenemergencyndepartmentnasnsoonnasnp ossible.nChecknthen"ABCs"nandnmonitornthenpatientnfornshock.nDonnotnpuncturenbullae. An 25 - year-oldnfemalenpresentsnwithnannonsetnofnseverenright- sidednpelvicnpainnfornthenpastn 48 nhours.nShenreportsnsmallnamountsnofnvaginalnbleeding.nThenpainnisn aggravatednbynjumpingnornanynmovementnthatnjarsnhernpelvis.nThenbestninitialninterventionnisnwhichno fnthenfollowing? A)nFollicle-stimulatingnhormonen(FSH) B)nSerumnquantitativenpregnancyntest C)nPelvicnultrasound D)nCBCnwithnwhitencellndifferentialsn-nCORRECTnANSWER-B)nSerumnquantitativenpregnancyntestn Severenright-sidednpainnwithnvaginalnbleedingninnan 25 - year- oldnpatientnrequiresnannevaluationnfornpregnancy,nbynperformingnanserumnquantitativenpregnancynte st.nEctopicnpregnancynand/ornmiscarriagenshouldnbenrulednout. An 25 - year- oldnmalenwhonwasninvolvedninnancarnaccidentnisnbroughtninntonthenlocalnemergencyndepartment.nHenr eportsnwearingnanseatnbeltnandnwasnthendrivernofnthenvehicle.nThenpatientnisncomplainingnofnpainnonn hisnrightnleg.nThenskinnisnintact,nbutnthenrightnfootnisnabductednslightly.nThenrightnkneenisntendernandns
A)nMetronidazolen(Flagyl) B)nCeftriaxonensodiumn(Rocephin) C)nDoxycyclinenhyclaten(Vibramycin) D)nClotrimazolen(Gyne-Lotrimin)n-nCORRECTnANSWER-A)nMetronidazolen(Flagyl)n Trichomoniasisnsymptomsnincludendysuria,nseverenvaginalnpruritis,nandnmalodorousnvaginalndischa rge.nWetnprepnwillnshowntrichomonadsnthatnarenpear- shapednandnhavenseveralnflagellan(whiplikentails)natnonenend.nCDCnrecommendationnforntreatmentni snmetronidazole. An 25 - year- oldnwoman'snlastnmenstrualnperiodnwasn 6 nweeksnago.nShenisncomplainingnofnnauseanwithnvomitingni nnthenmorningnandnfatigue.nHernbreastsnfeelnbloated.nThennursenpractitionernsuspectsnthatnshenisnpr egnant.nHernsymptomsnwouldnbenconsidered: A)nPositivensignsnofnpregnancy B)nProbablensignsnofnpregnancy C)nPresumptivensignsnofnpregnancy D)nPossiblensignsnofnpregnancyn-nCORRECTnANSWER-C)nPresumptivensignsnofnpregnancyn Presumptivensignsnofnpregnancynarensymptomsnexperiencednbynthenwoman,nsuchnasnamenorrhea,n breastntenderness,nnausea/nvomiting,nfatigue,nandnincreasednurinarynfrequency. An 28 - year- oldnmalennursenofnHispanicndescentnreportsnanhistorynofnancoldnthatnresolvedn 2 nweeksnagonexceptnfo rnandryncoughnandnpainnovernhisnrightncheeknthatnworsensnwhennhenbendsndown.nThenpatientndeniesnf ever.nHentellsnthenemployeenhealthnnursenpractitionernthatnhenisnverynallergicntonbothncephalexinn(Ke flex)nandnerythromycin.nThenvitalnsignsnshownthatnthenpatient'sntemperaturenisn99.2ndegreesnFahren heit,nanpulsenofn 72 nbeatsnpernminute,nandnanrespiratorynratenofn 12 nbreathsnpernminute.nWhichnofnthen followingnconditionsnisnmostnlikely? A)nAcutensinusitis B)nAcutenbronchitis C)nFevernsecondaryntonthenpreviousnviralnURIn(uppernrespiratoryninfection) D)nMunchausen'snsyndromen-nCORRECTnANSWER-A)nAcutensinusitisn Acutensinusitisnsymptomsnincludencough,nfacialnpain,nandnlow-gradenfever.
An 28 - year- oldnmalennursentellsnthenemployeenhealthnnursenpractitionernthatnhenwasntreatednfornanUTIntwicenthen previousnyear.nThenpatientndeniesnfever,nflanknpain,nornurethralndischargenduringnthenvisit.nWhichnofnt henfollowingnisnthenbestnfollow-upnfornthisnpatient? A)nRefernthenpatientntonanurologist B)nPrescribenthenpatientnofloxacinn(Floxin)nforn 2 nweeksninsteadnofn 1 nweek C)nAdvisenthenpatientnthatnhenneedsntonvoidneveryn 2 nhoursnwhennawake D)nRefernthenpatientntonthenlocalnED,nbecausenhenhasnanverynhighnrisknofnsepsisn- nCORRECTnANSWER-A)nRefernthenpatientntonanurologistn ItnisnrecommendednthatnfrequentnUTIsninnmalesnbenreferredntonanurologistnfornevaluationnandntreatm ent. An 28 - year- oldnmultiparanwhonisnatn 32 nweeksnofngestationnpresentsntonyournofficencomplainingnofnansuddennons etnofnsmallnamountsnofnbrightnrednvaginalnbleeding.nShenhasnhadnseveralnepisodesnandnappearsnanxi ous.nOnnexam,nhernuterusnisnsoftntonpalpation.nWhichnofnthenfollowingnisnmostnlikely? A)nPlacentanabruptio B)nPlacentanprevia C)nAcutencervicitis D)nMolarnpregnancyn(hydatidiformnmole)n-nCORRECTnANSWER-B)nPlacentanprevian Placentanprevianoccursnwhennabnormalnimplantationnofnthenplacentanoccurs.nAncommonnsymptomn ofnplacentanprevianisnpainless,nbrightnrednbleeding. An 28 - year- oldnstudentnisnseenninnthenschoolnhealthnclinicnwithncomplaintsnofnanhackingncoughnthatnisnproductiv enofnsmallnamountsnofnsputumnandnanrunnynnose.nHendoesnnotntakenanynmedications,ndeniesnanynall ergies,nandnhasnnonsignificantnmedicalnhistory.nPhysicalnexaminationnrevealsnanlow- gradentemperaturenofn99.9ndegreesnFahrenheit,nrespirationsnofn16/min,nanpulsenofn 90 nbeatsnpernmin ute,nandndiffusenfinencracklesninnthenbasenofnthenlungs.nAnchestnradiographn(x- ray)nshowsndiffuseninfiltratesnonnthenlowernlobenofnthenrightnlung.nThentotalnwhitenbloodncellncountnisn 10,500/uL.nWhatnisnthenmostnlikelyndiagnosis?
Atn 12 nweeksngestation,nthenfundusnofnthenuterusnshouldnbenlocatednapproximatelynatnthensymphysis npubis. An 30 - year-oldnfemalenwhonisnsexuallynactivencomplainsnofnanlargenamountnofnmilk- nlikenvaginalndischargenfornseveralnweeks.nAnmicroscopynslidenrevealsnanlargenamountnofnsquamousn epithelialncellsnthatnhavenblurrednmargins.nVerynfewnwhitenbloodncellsnarenseen.nThenvaginalnpHnisnat n6.0.nWhatnisnmostnlikely? A)nTrichomonasninfection B)nBacterialnvaginosis C)nCandidalninfection D)nAnnormalnfindingn-nCORRECTnANSWER-B)nBacterialnvaginosisn Bacterialnvaginosisnisnanbacterialninfectionnofnthenvagina.nSignsnandnsymptomsnincludencopiousnoff- whitentongrayndischargenwithnfoulnodornwithoutnvaginalnerythemanornirritation.nWetnprepnwillnshownpo sitivenforncluencells.nWhennperformingnanwetnprep,nthen"whiffntest"nwillnbenpositivenfornanstrongn"fishy "nodornwhennvaginalndischargenisnmixednwithnonendropnofnKOH. An 30 - year- oldnmalenpatientnrefusesntontakenhisnafternoonndosenofnpills.nThennursentellsnhimnofnthenpossiblencon sequencesnofnhisnaction,nbutnthenpatientnstillnrefusesntoncooperate.nWhichnofnthenfollowingnisnthenbe stncoursenfornthennursentonfollow? A)nDocumentninnthenpatient'snrecordnhisnbehaviorsnandnthenactionntakennbynthennurse B)nReassurenthenpatientnthatnhenwillnbenfinenafterntakingnthenmedicine C)nDocumentnonlynthenpatientnbehavior D)nDocumentnonlynthennurse'snactionn-nCORRECTnANSWER- A)nDocumentninnthenpatient'snrecordnhisnbehaviorsnandnthenactionntakennbynthennursen Ifnanpatientnisnnon- compliant,ndocumentationnofnthenpatientnbehaviornandnthenactionsntakennbynthennursenbothnmustnb endocumented. An 30 - year- oldnmalenwithnanhistorynofngoutnisnwalkingntonthenexaminationnroomnandnthennursenpractitionernnotic esnthatnhenisnlimping.nWhennthenpatientnsitsndown,nthennursenpractitionernnotesnthatnthenmetatarsop halangealnjointnofnthengreatntoenisnverynswollennandnisnbrightnred.nThenpatientnreportsnthatnhenwasnatt
endingnanpartynthennightnbeforenandndrank.nThenpatientnisnrequestingnanprescriptionntontreatnhisnpainf ulntoe.nThennursenpractitionernprescribesnthenpatientnindomethacinn(Indocin)n 50 nmgnTIDnPRNnandnco lchicine.nRegardingncolchicine,nwhichnofnthenfollowingninstructionsnisncorrect? A)nTaken 1 npillneverynhourntoneveryn 2 nhoursnuntilnreliefnisnobtainednornadversengastrointestinalneffectsn occur,nsuchnasnabdominalnpain,nnausea,norndiarrhea B)nTaken 1 npillneverynhournuntilnreliefnisnobtainednupnton 24 nhours C)nTaken 1 npillneveryn 4 nton 6 nhoursnuntilnthenpainnisnrelieved D)nTaken 2 nton 3 npillsnQIDnuntilnreliefnisnobtainednornadven-nCORRECTnANSWER- A)nTaken 1 npillneverynhourntoneveryn 2 nhoursnuntilnreliefnisnobtainednornadversengastrointestinalneffectsn occur,nsuchnasnabdominalnpain,nnausea,norndiarrhean Colchicinenactsnasnannanti- inflammatorynandnhelpsntonsuppressngoutynattacks.nItnisnusuallyntakennasn 1 ntabletn(0.6nmg)neveryn 1 nt on 2 nhoursnuntilnreliefnisnobtainedn(ornadversengastrointestinalneffectsnoccur,nsuchnasnabdominalnpai n,nnausea,norndiarrhea).nPrescribenthenpatientnonlyn 10 ntabletsnatnantimen(donnotnrefill)nduringnanflare- up.nThenmaximumndosenisn 6 nmg/day.nManynpatientsnwillndevelopnGInadverseneffectsnevennbeforenthe npainnisnrelieved.nColchicinencannalsonbentakenndailyninnsmallnamountsnfornprophylaxis. An 30 - year- oldnprimigravidanisndiagnosednwithnanpossiblenthreatenednabortion.nThenresultnofnthenurinenpregnan cyntestnisnpositive.nWhichnofnthenfollowingnstatementsnisntruenregardingnanthreatenednabortion? A)nVaginalnbleedingnandncrampingnarenpresent,nbutnthencervixnremainsnclosed B)nVaginalnbleedingnandncrampingnarenpresentnalongnwithnandilatedncervix C)nThenfetusnandnplacentanarenallnexpelled D)nThenproductsnofnconceptionnandnthenplacentanremainninsidenthenuterusnalong withnandilatedncervixn-nCORRECTnANSWER- A)nVaginalnbleedingnandncrampingnarenpresent,nbutnthencervixnremainsnclosedn Threatenednabortionnisndefinednasnvaginalnbleedingnandncrampingnwith- noutnthenpresencenofncervicalndilation. An 35 - year- oldnmalenhasnanhistorynofnannuppernrespiratorynviralninfectionn 4 nweeksnago.nHenreportsnthatnhenstarte dnfeelingnshortnofnbreathnandnnowncomplainsnofnsharpnpainninnthenmiddlenofnhisnchestnthatnseemsnton