,FNP 593 Week 2 Quiz | Primary Health of Acute Clients/Families (2026)
Q&A | USU
1. Which of the following is the primary pharmacologic treatment for a child diagnosed with
scabies who is 2 months of age?
A) Permethrin 5% cream
B) Lindane 1% lotion
C) Crotamiton 10% cream
D) Ivermectin oral tablet
Correct Answer: A) Permethrin 5% cream
Rationale: Permethrin 5% cream is the first-line and safest treatment for scabies in children
aged 2 months and older. It is applied from the neck down and left on for 8–14 hours.
Lindane is not recommended in young children due to neurotoxicity risk, and ivermectin is
not approved for children under 15 kg.
2. A 4-year-old child presents with acute diarrhea. Which of the following should be included
in the differential diagnosis?
A) Gastroenteritis
B) Inflammatory bowel disease
C) Lactase deficiency
D) All of the above
Correct Answer: D) All of the above
Rationale: Acute diarrhea in a child can be caused by infectious gastroenteritis,
inflammatory bowel disease, lactase deficiency, and many other conditions. A broad
differential diagnosis is essential to avoid missing serious pathology. The other options are all
plausible etiologies.
,3. A patient is diagnosed with giardiasis after backpacking through the mountains. Which of
the following is the most appropriate treatment?
A) Metronidazole
B) Amoxicillin
C) Azithromycin
D) Ciprofloxacin
Correct Answer: A) Metronidazole
Rationale: Metronidazole is the first-line treatment for giardiasis, typically given for 5–7
days. Tinidazole and nitazoxanide are alternatives. Amoxicillin, azithromycin, and
ciprofloxacin are not effective against Giardia lamblia.
4. A 58-year-old male with a 20-pack-year smoking history presents with substernal chest
pressure while shoveling snow. The pain radiates to his jaw, lasts 10 minutes, and resolves
with rest. ECG is normal. What is the most appropriate next step?
A) Exercise stress test
B) Coronary angiography
C) High-sensitivity troponin
D) Echocardiogram
Correct Answer: C) High-sensitivity troponin
Rationale: Given suspected unstable angina or NSTEMI, high-sensitivity troponin is the
most appropriate next step to rule out myocardial injury. A normal ECG does not exclude
acute coronary syndrome. Stress testing is contraindicated acutely, angiography is invasive,
and echocardiography is less sensitive for ACS.
5. Which medication class is first-line for heart failure with reduced ejection fraction (HFrEF)
in a patient with diabetes and CKD stage 3?
A) Thiazolidinediones
B) SGLT2 inhibitors (dapagliflozin)
, C) Calcium channel blockers (amlodipine)
D) Digoxin
Correct Answer: B) SGLT2 inhibitors (dapagliflozin)
Rationale: SGLT2 inhibitors reduce HF hospitalization and cardiovascular death in HFrEF,
are safe in CKD stage 3, and provide diabetes benefits. Thiazolidinediones worsen heart
failure, CCBs lack mortality benefit, and digoxin is third-line.
6. A 72-year-old woman with hypertension reports dizziness when standing up quickly. BP
supine 135/85, standing 100/70, HR unchanged. Which is the best initial treatment?
A) Midodrine
B) Fludrocortisone
C) Discontinue or reduce antihypertensives
D) Increase salt intake
Correct Answer: C) Discontinue or reduce antihypertensives
Rationale: Drug-induced orthostatic hypotension is common. The first step is reducing or
stopping offending agents such as diuretics and alpha-blockers. Non-pharmacologic measures
(hydration, compression stockings) come next. Midodrine and fludrocortisone are second-
line.
7. Which ECG finding is most specific for acute pericarditis?
A) ST elevation in V1–V4 with reciprocal changes
B) PR depression and diffuse ST elevation
C) Deep Q waves in inferior leads
D) T wave inversion in aVR
Correct Answer: B) PR depression and diffuse ST elevation
Q&A | USU
1. Which of the following is the primary pharmacologic treatment for a child diagnosed with
scabies who is 2 months of age?
A) Permethrin 5% cream
B) Lindane 1% lotion
C) Crotamiton 10% cream
D) Ivermectin oral tablet
Correct Answer: A) Permethrin 5% cream
Rationale: Permethrin 5% cream is the first-line and safest treatment for scabies in children
aged 2 months and older. It is applied from the neck down and left on for 8–14 hours.
Lindane is not recommended in young children due to neurotoxicity risk, and ivermectin is
not approved for children under 15 kg.
2. A 4-year-old child presents with acute diarrhea. Which of the following should be included
in the differential diagnosis?
A) Gastroenteritis
B) Inflammatory bowel disease
C) Lactase deficiency
D) All of the above
Correct Answer: D) All of the above
Rationale: Acute diarrhea in a child can be caused by infectious gastroenteritis,
inflammatory bowel disease, lactase deficiency, and many other conditions. A broad
differential diagnosis is essential to avoid missing serious pathology. The other options are all
plausible etiologies.
,3. A patient is diagnosed with giardiasis after backpacking through the mountains. Which of
the following is the most appropriate treatment?
A) Metronidazole
B) Amoxicillin
C) Azithromycin
D) Ciprofloxacin
Correct Answer: A) Metronidazole
Rationale: Metronidazole is the first-line treatment for giardiasis, typically given for 5–7
days. Tinidazole and nitazoxanide are alternatives. Amoxicillin, azithromycin, and
ciprofloxacin are not effective against Giardia lamblia.
4. A 58-year-old male with a 20-pack-year smoking history presents with substernal chest
pressure while shoveling snow. The pain radiates to his jaw, lasts 10 minutes, and resolves
with rest. ECG is normal. What is the most appropriate next step?
A) Exercise stress test
B) Coronary angiography
C) High-sensitivity troponin
D) Echocardiogram
Correct Answer: C) High-sensitivity troponin
Rationale: Given suspected unstable angina or NSTEMI, high-sensitivity troponin is the
most appropriate next step to rule out myocardial injury. A normal ECG does not exclude
acute coronary syndrome. Stress testing is contraindicated acutely, angiography is invasive,
and echocardiography is less sensitive for ACS.
5. Which medication class is first-line for heart failure with reduced ejection fraction (HFrEF)
in a patient with diabetes and CKD stage 3?
A) Thiazolidinediones
B) SGLT2 inhibitors (dapagliflozin)
, C) Calcium channel blockers (amlodipine)
D) Digoxin
Correct Answer: B) SGLT2 inhibitors (dapagliflozin)
Rationale: SGLT2 inhibitors reduce HF hospitalization and cardiovascular death in HFrEF,
are safe in CKD stage 3, and provide diabetes benefits. Thiazolidinediones worsen heart
failure, CCBs lack mortality benefit, and digoxin is third-line.
6. A 72-year-old woman with hypertension reports dizziness when standing up quickly. BP
supine 135/85, standing 100/70, HR unchanged. Which is the best initial treatment?
A) Midodrine
B) Fludrocortisone
C) Discontinue or reduce antihypertensives
D) Increase salt intake
Correct Answer: C) Discontinue or reduce antihypertensives
Rationale: Drug-induced orthostatic hypotension is common. The first step is reducing or
stopping offending agents such as diuretics and alpha-blockers. Non-pharmacologic measures
(hydration, compression stockings) come next. Midodrine and fludrocortisone are second-
line.
7. Which ECG finding is most specific for acute pericarditis?
A) ST elevation in V1–V4 with reciprocal changes
B) PR depression and diffuse ST elevation
C) Deep Q waves in inferior leads
D) T wave inversion in aVR
Correct Answer: B) PR depression and diffuse ST elevation
