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An otherwise healthy adult patient presents to the clinic with a diagnosis
of community-acquired pneumonia and no recent antibiotic therapy.
Which is the best option for treatment?
Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line
therapy for adults without comorbidities.
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Community-acquired pneumonia (CAP) is pneumonia not acquired in a
hospital or long-term care facility. Patients with suspected CAP should
receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
be used to assist in decisions regarding the need for hospitalization in
patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial treatment
of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
option for treatment, but are no longer recommended routinely as first-line
treatment, given increased macrolide resistance. This is a change from the
2007 ATS/IDSA guidelines. Respiratory fluoroquinolones and
amoxicillin/clavulanate should be used in patients who fail first-line
medications, have significant comorbidities, have had recent antibiotic
therapy, are allergic to alternative agents, or have a documented infection
with highly drug-resistant pneumococci.
,You have a 35-year-old female patient who is complaining of wrist pain.
She is an administrative assistant who does a great deal of computer work
in her job. You will test her for carpal tunnel syndrome. When you tap at
the volar surface of the wrist you are performing which of the following
tests?
Tinel's sign
A gastrinoma located on the pancreas or the stomach which secretes gastrin,
stimulating high levels of acid production in the stomach is which of the
following?
Zollinger-Ellison syndrome
A 16-year-old male is in the office. He has a insect bite on his left forearm and
you suspect a brown recluse spider bite. What medical management would
you provide?
ice pack and elevation of the area
In addition to being overweight, the American Diabetes Association
recommends type 2 diabetes mellitus testing in adults who:
have an HDL level of < 35 mg/dL
Which of the following found on an ECG would confirm atrial fibrillation?
-absent P waves
-irregular ventricular rate
,As an FNP you understand that all of the following statements about chronic
heart failure are accurate EXCEPT:
-The preponderance is in females until the age of 75, then there is equal
occurrence in males and females.
-Patients who are underweight have a greater risk of CHF.
The FNP has a 45-year-old male patient with BPH who has poison ivy. The
FNP plans to prescribe Benadryl for this. What is a possible adverse effect
with the use of Benadryl for this patient?
urinary retention
You are testing a client suspected of having Parkinson's disease. You support
the client's elbow with his forearm extended in your hand and grasp his wrist,
flexing the forearm. You find rigid resistance to this motion. This is
considered which of the following?
cogwheeling
The complex network of nerve fibers that innervate the organs within the
abdomen like the gastrointestinal tract, pancreas, and gall bladder is the
enteric nervous system
Aplastic anemia would be classified as which of the following?
normocytic anemia
, Charles Darwin wrote On the Origin of Species about human evolution. He
also is known for which of the following?
developing the "baby journal" as a systematic method to document observed
behavioral development
Your patient has AIDS. He is in the hospital suffering from an infection. He
presented with severe watery diarrhea, abdominal cramps, nausea, malaise
and has an electrolyte imbalance. Which of the following opportunistic
infections do these symptoms best describe?
cryptosporidiosis
Cryptosporidiosis presents with severe watery diarrhea - sometimes as
many as 30- 40 stools per day. The patient also has abdominal cramps,
nausea, malaise and tests will show an electrolyte balance.
A patient with sensitive skin had a TB skin test but has no symptoms. He returns
with redness and swelling that appears positive. What is the next step?
Schedule a CXR
The nurse practitioner should not cross certain boundaries with patients.
Which of the following would not be considered crossing one of these
boundaries?
Not sharing personal information with the patient
The United States Preventive Services Task Force recommends screening
older patients for depression:
at each primary care visit