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NSG 6440 Question Bank / NSG6440 Question Bank (Latest, 2021): South University (Already Graded A) $20.49   Add to cart

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NSG 6440 Question Bank / NSG6440 Question Bank (Latest, 2021): South University (Already Graded A)

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NSG 6440 Question Bank / NSG6440 Question Bank (Latest, 2021): South University (Already Graded A)

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  • March 22, 2021
  • 57
  • 2020/2021
  • Exam (elaborations)
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NSG 6440 Question Bank: Answers with Rationales

,NSG 6440 Question Bank: Answers with Rationales

1. A patient with diabetes has right anterior shin edema, erythema, warmth, and

tenderness to touch. This developed over the past 3 days. There is no visible pus. What

is the most likely diagnosis to consider?

Deep vein thrombosis (DVT)

Buerger’s disease

Cellulitis

Venous disease

Rationale:

This description is one of cellulitis. Cellulitis involves an infection of the

subcutaneous layers of the skin. It must be treated with an oral antibiotic. In a patient

with diabetes, it is particularly important to identify, and aggressively treat cellulitis

early, because elevated blood sugar levels will make eradication more difficult.

Buerger’s disease involves inflammation of the medium-sized arteries and does not

present on the anterior shin only. DVT seldom presents on the anterior shin, so this is

not likely. Venous disease does not present acutely, as in this situation.




2. An example of a first-generation cephalosporin used to treat a skin infection is:

cephalexin.

cefuroxime.

, cefdinir.

cefaclor.

Rationale:

Two common first-generation cephalosporins used to treat skin and skin structure

infections are cephalexin and cefadroxil. These are taken two to four times daily and

are generally well tolerated. These antibiotics provide coverage against

Staphylococcus and Streptococcus, common skin pathogens.




3. A patient reports that he found a tick on himself about 2 weeks ago. He presents today

with a red circle and a white center near where he remembers the tick bite. He did not

seek treatment at that time. Today he complains of myalgias and arthralgias. Which

laboratory test can be used to help diagnose Lyme disease?

CBC

Lyme titer

ELISA

Skin scraping

Explanation:

A detailed history should always precede testing for Lyme disease. The red circle with

the white center is likely erythema migrans (EM). EM is the characteristic skin lesion of

Lyme disease (and other illnesses) and usually occurs within 1 month following the tick

, bite. Many learned authorities, including the Infectious Diseases Society of America,

conclude that individuals should not be screened/tested for Lyme disease unless they

have a high probability of having Lyme disease. In this case, historical features coupled

with physical exam support the diagnosis, and thus screening. The most common initial

serologic test for screening is an ELISA. If it is positive, it should be confirmed with a

Western blot. Unfortunately, there are a large number of false positives and so a

confirmation should be performed.

4. A 16-year-old male has nodulocystic acne. What might have the greatest positive

impact in managing his acne?

Retin-A plus minocycline

Benzoyl peroxide plus erythromycin

Isotretinoin (Accutane)

Oral antibiotics

Rationale:

Nodulocystic acne is the most severe form of acne vulgaris. Nodules and cysts

characterize this disease. They can be palpated and usually seen on the skin, although

they actually are under the skin’s surface. They develop when the follicle wall

ruptures and leaks pus and cell contents into the dermis. The contaminated material

infects adjoining follicles and the nodule develops. Isotretinoin is the only known

effective treatment.

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