UTICA UNIVERSITY NUR 621: HEALTH
PROMOTION & PRIMARY CARE I — FINAL EXAM
TEST BANK 100% CORRECT!
Table of Contents
1. EENT, Respiratory, and Upper/Lower Respiratory Disorders
2. Cardiovascular and Pulmonary Disorders
3. Musculoskeletal and Rheumatological Disorders
4. Dermatological and Integumentary Conditions
5. Health Promotion, Screening, and Immunizations
1. EENT, Respiratory, and Upper/Lower Respiratory
Disorders
Question 1
A 24-year-old college student presents with severe sore throat, odynophagia, and fever.
A rapid antigen detection test (RADT) for Group A Streptococcal (GAS) pharyngitis is
negative. What is the most appropriate next step in management for this patient?
● A. Immediately prescribe a 10-day course of Amoxicillin.
● B. Order a backup throat culture because RADT lacks sensitivity in adults.
● C. Reassure the patient and do not perform a backup throat culture, as the risk of
rheumatic fever in adults is exceptionally low.
Docsity
● D. Prescribe azithromycin and instruct the patient to isolate for 5 days.
Correct Answer: C
Rationale: In adult patients, the incidence of acute rheumatic fever following GAS
pharyngitis is extremely low. Consequently, a negative RADT does not require a backup
throat culture in symptomatic adults unless specific institutional guidelines dictate
otherwise. Conversely, children and adolescents should receive a backup throat culture
following a negative RADT if symptoms persist.
Docsity
,Question 2
An 8-year-old child is brought to the primary care clinic with a 3-day history of sore
throat, fever, and tender anterior cervical lymphadenopathy. An RADT for GAS
pharyngitis is negative. What is the clinical standard of care for this patient?
● A. Discharge home with supportive care only; no further testing is necessary.
● B. Perform a backup throat culture.
Docsity
● C. Initiate empiric broad-spectrum coverage with cefuroxime.
● D. Order an antistreptolysin O (ASO) titer immediately.
Correct Answer: B
Rationale: Children and adolescents have a higher prevalence of GAS pharyngitis and
a higher baseline risk of developing acute rheumatic fever if left untreated. Therefore, a
negative rapid antigen test in a child or adolescent with continued symptoms must be
followed up with a throat culture (the gold standard).
Docsity
Question 3
Which of the following clinical presentations in a patient with acute pharyngitis strongly
points toward a viral etiology rather than GAS, thereby contraindicating routine strep
testing or antibiotic prescription?
● A. Patchy tonsillar exudates and palatal petechiae
● B. Sudden onset of high fever and tender anterior cervical nodes
● C. Concurrent cough, rhinorrhea, and oral ulcers
Docsity
● D. Scarlatiniform rash and strawberry tongue
Correct Answer: C
Rationale: Features such as cough, rhinorrhea, hoarseness, and oral ulcers are
cardinal signs of a viral upper respiratory infection (e.g., adenovirus, enterovirus) rather
than streptococcal pharyngitis, making testing for GAS unnecessary.
Question 4
What is the preferred first-line pharmacological treatment for a patient confirmed to have
GAS pharyngitis who has no known drug allergies?
, ● A. Azithromycin for 3 days
● B. Doxycycline for 7 days
● C. Penicillin or Amoxicillin for a 10-day course
Docsity
● D. Ciprofloxacin for 5 days
Correct Answer: C
Rationale: A full 10-day course of Penicillin or Amoxicillin remains the gold standard,
highly effective, and narrow-spectrum first-line choice for treating GAS pharyngitis to
prevent acute rheumatic fever.
Docsity
Question 5
A patient diagnosed with GAS pharyngitis reports a mild, non-anaphylactic rash history
when taking penicillins (e.g., delayed maculopapular rash). Which of the following is an
acceptable alternative treatment?
● A. Levofloxacin
● B. First-generation cephalosporin (e.g., cephalexin or cefadroxil) for 10 days
Docsity
● C. Tetracycline
● D. Nitrofurantoin
Correct Answer: B
Rationale: For patients with penicillin allergy that is non-anaphylactic (i.e., no history of
immediate type-1 hypersensitivity, urticaria, or anaphylaxis), a 10-day course of a
first-generation cephalosporin (such as cephalexin or cefadroxil) is safe and effective.
Clindamycin or clarithromycin are other alternatives.
Docsity+ 1
Question 6
A 45-year-old patient presents with a history of recurrent throat infections. The provider
is evaluating guidelines regarding indications for a tonsillectomy. According to standard
clinical criteria, a tonsillectomy may be indicated if a patient has experienced how many
documented infections in a single year?
● A. 3 or more infections in one year
PROMOTION & PRIMARY CARE I — FINAL EXAM
TEST BANK 100% CORRECT!
Table of Contents
1. EENT, Respiratory, and Upper/Lower Respiratory Disorders
2. Cardiovascular and Pulmonary Disorders
3. Musculoskeletal and Rheumatological Disorders
4. Dermatological and Integumentary Conditions
5. Health Promotion, Screening, and Immunizations
1. EENT, Respiratory, and Upper/Lower Respiratory
Disorders
Question 1
A 24-year-old college student presents with severe sore throat, odynophagia, and fever.
A rapid antigen detection test (RADT) for Group A Streptococcal (GAS) pharyngitis is
negative. What is the most appropriate next step in management for this patient?
● A. Immediately prescribe a 10-day course of Amoxicillin.
● B. Order a backup throat culture because RADT lacks sensitivity in adults.
● C. Reassure the patient and do not perform a backup throat culture, as the risk of
rheumatic fever in adults is exceptionally low.
Docsity
● D. Prescribe azithromycin and instruct the patient to isolate for 5 days.
Correct Answer: C
Rationale: In adult patients, the incidence of acute rheumatic fever following GAS
pharyngitis is extremely low. Consequently, a negative RADT does not require a backup
throat culture in symptomatic adults unless specific institutional guidelines dictate
otherwise. Conversely, children and adolescents should receive a backup throat culture
following a negative RADT if symptoms persist.
Docsity
,Question 2
An 8-year-old child is brought to the primary care clinic with a 3-day history of sore
throat, fever, and tender anterior cervical lymphadenopathy. An RADT for GAS
pharyngitis is negative. What is the clinical standard of care for this patient?
● A. Discharge home with supportive care only; no further testing is necessary.
● B. Perform a backup throat culture.
Docsity
● C. Initiate empiric broad-spectrum coverage with cefuroxime.
● D. Order an antistreptolysin O (ASO) titer immediately.
Correct Answer: B
Rationale: Children and adolescents have a higher prevalence of GAS pharyngitis and
a higher baseline risk of developing acute rheumatic fever if left untreated. Therefore, a
negative rapid antigen test in a child or adolescent with continued symptoms must be
followed up with a throat culture (the gold standard).
Docsity
Question 3
Which of the following clinical presentations in a patient with acute pharyngitis strongly
points toward a viral etiology rather than GAS, thereby contraindicating routine strep
testing or antibiotic prescription?
● A. Patchy tonsillar exudates and palatal petechiae
● B. Sudden onset of high fever and tender anterior cervical nodes
● C. Concurrent cough, rhinorrhea, and oral ulcers
Docsity
● D. Scarlatiniform rash and strawberry tongue
Correct Answer: C
Rationale: Features such as cough, rhinorrhea, hoarseness, and oral ulcers are
cardinal signs of a viral upper respiratory infection (e.g., adenovirus, enterovirus) rather
than streptococcal pharyngitis, making testing for GAS unnecessary.
Question 4
What is the preferred first-line pharmacological treatment for a patient confirmed to have
GAS pharyngitis who has no known drug allergies?
, ● A. Azithromycin for 3 days
● B. Doxycycline for 7 days
● C. Penicillin or Amoxicillin for a 10-day course
Docsity
● D. Ciprofloxacin for 5 days
Correct Answer: C
Rationale: A full 10-day course of Penicillin or Amoxicillin remains the gold standard,
highly effective, and narrow-spectrum first-line choice for treating GAS pharyngitis to
prevent acute rheumatic fever.
Docsity
Question 5
A patient diagnosed with GAS pharyngitis reports a mild, non-anaphylactic rash history
when taking penicillins (e.g., delayed maculopapular rash). Which of the following is an
acceptable alternative treatment?
● A. Levofloxacin
● B. First-generation cephalosporin (e.g., cephalexin or cefadroxil) for 10 days
Docsity
● C. Tetracycline
● D. Nitrofurantoin
Correct Answer: B
Rationale: For patients with penicillin allergy that is non-anaphylactic (i.e., no history of
immediate type-1 hypersensitivity, urticaria, or anaphylaxis), a 10-day course of a
first-generation cephalosporin (such as cephalexin or cefadroxil) is safe and effective.
Clindamycin or clarithromycin are other alternatives.
Docsity+ 1
Question 6
A 45-year-old patient presents with a history of recurrent throat infections. The provider
is evaluating guidelines regarding indications for a tonsillectomy. According to standard
clinical criteria, a tonsillectomy may be indicated if a patient has experienced how many
documented infections in a single year?
● A. 3 or more infections in one year
