The patient reports no tenderness or drainage and states the rash started after
participating in a wrestling tournament.
Upon examination, the nurse practitioner finds plaques with crusting on the right
lower leg.
A culture is done and shows a Staphylococcus aureus infection.
Which bacterial skin infection does the nurse practitioner suspect?
a) impetigo
b) folliculitis
c) Herpes gladiatorum
d) Hidradenitis suppurativa
- Nonbullous impetigo, an S. aureus infection, occurs in a localized area that
initially begins as papules and progresses to vesicles, pustules, and then honey-
colored plaques.
In performing a neurological exam and assessing the patient's cranial nerves, the
nurse practitioner notes fasciculations across the tongue's surface.
Which nerve is affected?
a) CN VI (abducens)
b) CN XII (hypoglossal)
c) CN XI (accessory)
d) CN X (vagus)
- Cranial nerve XII is the hypoglossal nerve and allows motor movement of the
tongue muscles. This nerve is tested by asking the patient to stick out the tongue
and observing for atrophy, fasciculations, and tongue deviation to one side.
,A 34-week pregnant patient presents to the emergency room with sudden onset
of abdominal pain and vaginal bleeding.
Which condition is most likely?
a) placental abruption
b) ectopic pregnancy
c) Miscarriage
d) Placenta previa
- Placental abruption is the early separation of the placenta from the lining of the
uterus.
It is a rare but serious complication of the second half of pregnancy.
Placental abruption is an emergency situation that places the well-being of the
mother and fetus at risk.
Which is a common causative organism of pelvic inflammatory disease?
a) Neisseria gonorrhoeae
b) Trichomonas vaginalis
c) Treponema pallidum
d) Mycoplasma genitalium
- Gonorrhea and chlamydia are the most common organisms causing pelvic
inflammatory disease.
A middle-aged patient presents to the clinic for evaluation of new-onset
hypertension and occasional flank pain.
, There is a family history of a maternal grandmother deceased with "some kind of
kidney problem", and an in-office urinalysis is positive for 3 plus protein.
In addition to addressing hypertension, which is the next appropriate step in the
management of this patient?
a) refer for genetic testing
b) restrict all protein in diet
c) repeat urinalysis in 3 months
d) order a renal US
- This patient has a positive family history of renal disease, flank pain, and
proteinuria, all of which are indicators of polycystic kidney disease. The
hypertension should be treated and a renal ultrasound ordered. An ultrasound of
the kidneys is the preferred diagnostic test.
An older adult patient with hypertension, depression, and diabetes mellitus type 2
is experiencing periods of intermittent confusion. A cognitive assessment does not
demonstrate impairment.Current medications include aspirin, lisinopril (Zestril),
atorvastatin (Lipitor), metformin (Glucophage), sertraline (Zoloft),
diphenhydramine (Benadryl) as needed for sleep and acetaminophen (Tylenol) as
needed for pain.
Which is the best action?
a) discontinue sertraline (zoloft)
b) Increase sertraline
c) prescribe donepezil (aricept)
d) discontinue diphenhydramine (Benadryl)
- Diphenhydramine (Benadryl) is a first-generation antihistamine for allergic
reactions, cold symptoms, and insomnia. Because of its potent anticholinergic