MN 553 EVALUATION EXAM ACTUAL QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Life style changes are the first step in the treatment of GERD. Food or drink that
may aggravate GERD include: - ✔✔Caffeine
✔✔metoclopramide improves GERD symptoms by - ✔✔increasing lower esophageal
tone
✔✔Antacids treat gastroesophageal reflux disease by:
1. Increasing lower esophageal tone
2. Increasing gastric pH
3. Inhibiting gastric acid secretion
4. Increasing serum calcium level - ✔✔2. Increasing gastric pH
✔✔when treating patients using the "step-down" approach, the patient with GERD is
started on ______________first - ✔✔proton pump inhibitors
✔✔If a patient with symptoms of GERD states that he has been self-treating at home
with OTC ranitidine daily, the appropriate treatment would be - ✔✔proton pump inhibitor
(omeprazole) for 12 weeks
✔✔If a patient with GERD who is taking a PPI daily is not improving, the plan of care
would by: - ✔✔PPI (omeprazole) twice a day for 4-8 weeks
✔✔The next step in treatment when a patient has been on proton pump inhibitors twice
daily for 12 weeks and not improving is:
1. Add a prokinetic (metoclopramide)
2. Referral for endoscopy
3. Switch to another proton pump inhibitor
4. Add a cytoprotective drug - ✔✔2. Referral for endoscopy
✔✔Infants with reflux are initially treated with:
1. Histamine2 receptor antagonist (ranitidine)
2. Proton pump inhibitor (omeprazole)
3. Anti-reflux maneuvers (elevate head of bed)
4. Prokinetic (metoclopramide) - ✔✔3. Anti-reflux maneuvers (elevate head of bed)
✔✔Long term use of protein pump inhibitors may lead to: - ✔✔hip fractures in at-risk
persons
✔✔An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test
is:
1. Histamine2 receptor antagonists for 4 to 8 weeks
, 2. Proton pump inhibitor bid for 12 weeks until healing is complete
3. Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
4. Proton pump inhibitor bid and levofloxacin for 14 days - ✔✔3. Proton pump inhibitor
bid plus clarithromycin plus amoxicillin for 14 days
✔✔Treatment failure in patients with peptic ulcer disease associated with H. pylori may
be because of:
1. Antimicrobial resistance
2. An ineffective antacid
3. Overuse of proton pump inhibitors
4. All of the above - ✔✔1. Antimicrobial resistance
✔✔If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the
second-line treatment is: - ✔✔Proton pump inhibitor bid plus metronidazole plus
tetracycline plus bismuth subsalicylate for 14 days
✔✔After H. pylori treatment is completed, the next step in peptic ulcer disease therapy
is:
1. Testing for H. pylori eradication with a serum ELISA test
2. Endoscopy by a specialist
3. A proton pump inhibitor for 8 to 12 weeks until healing is complete
4. All of the above - ✔✔3. A proton pump inhibitor for 8 to 12 weeks until healing is
complete
✔✔Erik presents with one golden-crusted lesion at the site of an insect bite consistent
with impetigo. His parents have limited finances and request the least expensive-
treatment. Which medication would be the best choice for treatment?
1. Mupirocin (Bactroban)
2. Bacitracin and polymixin B (generic double antibiotic ointment)
3. Retapamulin (Altabax)
4. Oral cephalexin (Keflex) - ✔✔2. Bacitracin and polymixin B (generic double antibiotic
ointment)
✔✔Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier.
Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating
nasal MRSA includes:
1. Take the oral medication exactly as prescribed.
2. Insert one-half of the dose in each nostril twice a day.
3. Alternate treating one nare in the morning and the other in the evening.
4. Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks
needed in some patients. - ✔✔2. Insert one-half of the dose in each nostril twice a day.
✔✔instructions for applying a topical antibiotic or antiviral ointment include: - ✔✔wash
hands before and after application of topical antimicrobials
SOLUTIONS GRADED A+
✔✔Life style changes are the first step in the treatment of GERD. Food or drink that
may aggravate GERD include: - ✔✔Caffeine
✔✔metoclopramide improves GERD symptoms by - ✔✔increasing lower esophageal
tone
✔✔Antacids treat gastroesophageal reflux disease by:
1. Increasing lower esophageal tone
2. Increasing gastric pH
3. Inhibiting gastric acid secretion
4. Increasing serum calcium level - ✔✔2. Increasing gastric pH
✔✔when treating patients using the "step-down" approach, the patient with GERD is
started on ______________first - ✔✔proton pump inhibitors
✔✔If a patient with symptoms of GERD states that he has been self-treating at home
with OTC ranitidine daily, the appropriate treatment would be - ✔✔proton pump inhibitor
(omeprazole) for 12 weeks
✔✔If a patient with GERD who is taking a PPI daily is not improving, the plan of care
would by: - ✔✔PPI (omeprazole) twice a day for 4-8 weeks
✔✔The next step in treatment when a patient has been on proton pump inhibitors twice
daily for 12 weeks and not improving is:
1. Add a prokinetic (metoclopramide)
2. Referral for endoscopy
3. Switch to another proton pump inhibitor
4. Add a cytoprotective drug - ✔✔2. Referral for endoscopy
✔✔Infants with reflux are initially treated with:
1. Histamine2 receptor antagonist (ranitidine)
2. Proton pump inhibitor (omeprazole)
3. Anti-reflux maneuvers (elevate head of bed)
4. Prokinetic (metoclopramide) - ✔✔3. Anti-reflux maneuvers (elevate head of bed)
✔✔Long term use of protein pump inhibitors may lead to: - ✔✔hip fractures in at-risk
persons
✔✔An acceptable first-line treatment for peptic ulcer disease with positive H. pylori test
is:
1. Histamine2 receptor antagonists for 4 to 8 weeks
, 2. Proton pump inhibitor bid for 12 weeks until healing is complete
3. Proton pump inhibitor bid plus clarithromycin plus amoxicillin for 14 days
4. Proton pump inhibitor bid and levofloxacin for 14 days - ✔✔3. Proton pump inhibitor
bid plus clarithromycin plus amoxicillin for 14 days
✔✔Treatment failure in patients with peptic ulcer disease associated with H. pylori may
be because of:
1. Antimicrobial resistance
2. An ineffective antacid
3. Overuse of proton pump inhibitors
4. All of the above - ✔✔1. Antimicrobial resistance
✔✔If a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the
second-line treatment is: - ✔✔Proton pump inhibitor bid plus metronidazole plus
tetracycline plus bismuth subsalicylate for 14 days
✔✔After H. pylori treatment is completed, the next step in peptic ulcer disease therapy
is:
1. Testing for H. pylori eradication with a serum ELISA test
2. Endoscopy by a specialist
3. A proton pump inhibitor for 8 to 12 weeks until healing is complete
4. All of the above - ✔✔3. A proton pump inhibitor for 8 to 12 weeks until healing is
complete
✔✔Erik presents with one golden-crusted lesion at the site of an insect bite consistent
with impetigo. His parents have limited finances and request the least expensive-
treatment. Which medication would be the best choice for treatment?
1. Mupirocin (Bactroban)
2. Bacitracin and polymixin B (generic double antibiotic ointment)
3. Retapamulin (Altabax)
4. Oral cephalexin (Keflex) - ✔✔2. Bacitracin and polymixin B (generic double antibiotic
ointment)
✔✔Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier.
Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating
nasal MRSA includes:
1. Take the oral medication exactly as prescribed.
2. Insert one-half of the dose in each nostril twice a day.
3. Alternate treating one nare in the morning and the other in the evening.
4. Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks
needed in some patients. - ✔✔2. Insert one-half of the dose in each nostril twice a day.
✔✔instructions for applying a topical antibiotic or antiviral ointment include: - ✔✔wash
hands before and after application of topical antimicrobials
