504 Exam 5: Leik Practice
Questions 2024-2025. Questions &
Correct Detailed Answers. Already
Graded A
A 10-year-old boy has type 1 diabetes. His late afternoon blood sugars
over the past 2 weeks have ranged between 210 mg/dL and 230 mg/dL.
He currently injects 10 units of regular insulin and 25 units of NPH in the
morning and 15 units of regular insulin and 10 units of NPH insulin in the
evening. Which of the following is the best treatment plan for this
patient?
A) Increase both types of the morning dose
B) Increase only the NPH insulin in the morning
C) Decrease the afternoon dose of NPH insulin
D) Decrease both NPH and regular insulin doses in the morning – ANS B)
Increase only the NPH insulin in the morning
Regular insulin is rapid/short-acting insulin. Depending on the type of
regular insulin, the onset is 10 to 15 minutes and peaks within an
average of 1.5 hours, with a duration of 3 to 5 hours. NPH insulin is an
intermediate-acting insulin. Depending on the type of NPH insulin, the
pg. 1
,onset is 1.5 to 3 hours. NPH peaks in 4 to 12 hours, and the duration is
from 18 to 24 hours. By increasing the morning NPH, the peak will occur
in the afternoon, bringing down the blood glucose. A 13-year-old
adolescent girl is brought to the health clinic by her mother for a sports
physical. The mother reports that the teen's last vaccines were given at
the age of 6 years. Which of the following vaccines is recommended by
the Centers for Disease Control and Prevention (CDC) for this patient?
A) Td and HPV vaccines
B) Tdap, MCV4, and the HPV vaccines
C) DTap and the flu vaccine
D) DT and MCV4 vaccines – ANS B) Tdap, MCV4, and the HPV vaccines
Vaccine questions usually are not this complicated, but there are several
lessons that can be learned with this question. The 2017 Centers for
Disease Control and Prevention (CDC) recommendations for individuals
13 to 18 years of age are the Tdap catch-up (if not received at age 11-12
years), human papillomavirus (HPV) catch-up (if not received at age 11-
12 years), and the MCV4 or meningococcal conjugate vaccine
(Menactra). Only one dose of Tdap is recommended (lifetime).
Thereafter, the Td form of the vaccine is indicated every 10 years. The
pg. 2
,DTaP (diphtheria-tetanus-acellular pertussis) and DT (diphtheria-tetanus)
forms of the tetanus vaccine are not given after the age of 7 years. A 13-
year-old boy wants to be treated for his acne. He has a large number of
closed and open comedones on his face. The patient has been treating
himself with over-the-counter benzoyl peroxide and topical salicylic acid
products. Which of the following would be recommended next?
A) Isotretinoin (Accutane)
B) Tetracycline
C) Retin-A 0.25% gel
D) Careful face washing with medicated soap at bedtime – ANS C) Retin-
A 0.25% gel
Topical agents are the first-line treatment for acne vulgaris. Retin-A 0.25%
gel would be the next step. Oral preparations (tetracycline) would then
be offered, and Accutane would be the final step. A 14-year-old girl who
is sexually active is brought to the health clinic by her mother for an
immunization update. According to the mother, her daughter has had
one dose of hepatitis B vaccine. Which of the following vaccines would
you administer at this visit?
A) Tdap, hepatitis B, and HPV vaccine
pg. 3
, B) DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B
C) Hepatitis B only
D) MMR (measles, mumps, rubella), Td, and HPV vaccine – ANS A) Tdap,
hepatitis B, and HPV vaccine
There are two types of HPV vaccine. Gardasil can be used for both girls
and boys, but Cervarix can only be used for females. HPV vaccine is
recommended for preteen boys and girls at age 11 or 12 years. Young
women can get HPV vaccine until age 27 years and men can get the HPV
vaccine until age 22 years. A 15-year-old boy has just moved into the
community and is staying in a foster home temporarily. There is no
record of his immunizations. His foster mother wants him to be checked
before he enters the local high school. Which of the following
immunizations does this patient need?
A) Meningococcal vaccine
B) Measles-mumps-rubella (MMR) vaccine
C) Tdap vaccine
D) All of the above – ANS D) All of the above
pg. 4
Questions 2024-2025. Questions &
Correct Detailed Answers. Already
Graded A
A 10-year-old boy has type 1 diabetes. His late afternoon blood sugars
over the past 2 weeks have ranged between 210 mg/dL and 230 mg/dL.
He currently injects 10 units of regular insulin and 25 units of NPH in the
morning and 15 units of regular insulin and 10 units of NPH insulin in the
evening. Which of the following is the best treatment plan for this
patient?
A) Increase both types of the morning dose
B) Increase only the NPH insulin in the morning
C) Decrease the afternoon dose of NPH insulin
D) Decrease both NPH and regular insulin doses in the morning – ANS B)
Increase only the NPH insulin in the morning
Regular insulin is rapid/short-acting insulin. Depending on the type of
regular insulin, the onset is 10 to 15 minutes and peaks within an
average of 1.5 hours, with a duration of 3 to 5 hours. NPH insulin is an
intermediate-acting insulin. Depending on the type of NPH insulin, the
pg. 1
,onset is 1.5 to 3 hours. NPH peaks in 4 to 12 hours, and the duration is
from 18 to 24 hours. By increasing the morning NPH, the peak will occur
in the afternoon, bringing down the blood glucose. A 13-year-old
adolescent girl is brought to the health clinic by her mother for a sports
physical. The mother reports that the teen's last vaccines were given at
the age of 6 years. Which of the following vaccines is recommended by
the Centers for Disease Control and Prevention (CDC) for this patient?
A) Td and HPV vaccines
B) Tdap, MCV4, and the HPV vaccines
C) DTap and the flu vaccine
D) DT and MCV4 vaccines – ANS B) Tdap, MCV4, and the HPV vaccines
Vaccine questions usually are not this complicated, but there are several
lessons that can be learned with this question. The 2017 Centers for
Disease Control and Prevention (CDC) recommendations for individuals
13 to 18 years of age are the Tdap catch-up (if not received at age 11-12
years), human papillomavirus (HPV) catch-up (if not received at age 11-
12 years), and the MCV4 or meningococcal conjugate vaccine
(Menactra). Only one dose of Tdap is recommended (lifetime).
Thereafter, the Td form of the vaccine is indicated every 10 years. The
pg. 2
,DTaP (diphtheria-tetanus-acellular pertussis) and DT (diphtheria-tetanus)
forms of the tetanus vaccine are not given after the age of 7 years. A 13-
year-old boy wants to be treated for his acne. He has a large number of
closed and open comedones on his face. The patient has been treating
himself with over-the-counter benzoyl peroxide and topical salicylic acid
products. Which of the following would be recommended next?
A) Isotretinoin (Accutane)
B) Tetracycline
C) Retin-A 0.25% gel
D) Careful face washing with medicated soap at bedtime – ANS C) Retin-
A 0.25% gel
Topical agents are the first-line treatment for acne vulgaris. Retin-A 0.25%
gel would be the next step. Oral preparations (tetracycline) would then
be offered, and Accutane would be the final step. A 14-year-old girl who
is sexually active is brought to the health clinic by her mother for an
immunization update. According to the mother, her daughter has had
one dose of hepatitis B vaccine. Which of the following vaccines would
you administer at this visit?
A) Tdap, hepatitis B, and HPV vaccine
pg. 3
, B) DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B
C) Hepatitis B only
D) MMR (measles, mumps, rubella), Td, and HPV vaccine – ANS A) Tdap,
hepatitis B, and HPV vaccine
There are two types of HPV vaccine. Gardasil can be used for both girls
and boys, but Cervarix can only be used for females. HPV vaccine is
recommended for preteen boys and girls at age 11 or 12 years. Young
women can get HPV vaccine until age 27 years and men can get the HPV
vaccine until age 22 years. A 15-year-old boy has just moved into the
community and is staying in a foster home temporarily. There is no
record of his immunizations. His foster mother wants him to be checked
before he enters the local high school. Which of the following
immunizations does this patient need?
A) Meningococcal vaccine
B) Measles-mumps-rubella (MMR) vaccine
C) Tdap vaccine
D) All of the above – ANS D) All of the above
pg. 4
