1. Escherichia coli.
2. Campylobacter jejuni.
3. Salmonella.
4. Shigella.
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, 1. Escherichia coli.
Your client Mr. Jones has Sjögren syndrome. Which treatment do you suggest?
1. artificial tears and chewing sugarless gum
2. frequent rinsing of the mouth with mouthwash
3. drinking at least 1 glass of milk per day
4. removing wax from the ears at regular intervals
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1. Artificial tears and chewing sugarless gum.
Sjögren syndrome is a multisystem autoimmune disease characterized by
dysfunction of the exocrine glands; it is specifically notable for dry eyes
and dry mouth. Treatment is aimed at increasing comfort and lubrication.
Artificial tears can be self-administered as needed; preservative-free
products are usually better tolerated. For dry mouth, increasing hydration
and chewing sugarless gum may be helpful. Oral pilocarpine (Salagen) 5
mg 4 times a day and cevimeline (Evoxac) 30 mg 3 times a day have been
shown to increase saliva production.
Treatment for achalasia may include:
1. balloon dilation of the lower esophageal sphincter
2. beta blockers
3. a fundoplication
4. an esophagogastrectomy
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, 1. balloon dilation of the lower esophageal sphincter
Achalasia is an absence of peristalsis of the esophagus and a high
gastroesophageal sphincter pressure. After initial noninvasive treatments,
clients may require a balloon dilation of the lower esophageal sphincter.
In which of the following circumstances is the reticulocyte count elevated?
1. aplastic anemia
2. iron deficiency anemia
3. poisoning
4. acute blood loss
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4. acute blood loss
The reticulocyte count indicates the percentage of newly maturing red
blood cells (RBCs) released into the circulating blood from the bone
marrow. As an RBC matures, it loses its endothelial reticulum. The
reticulocyte count is elevated in cases of blood loss as the body tries to
replace the loss; it might also be elevated during treatment of anemias (eg,
iron, folic acid, and vitamin B12) and bone marrow disorders, when
immature RBCs are displaced by other proliferating cells.
Sandra, age 63, says that her previous doctor never discussed why he took her off
hormone replacement therapy (HRT) 3 years ago. Her last menstrual period was at
age 49, and she started HRT that same year. You share with her some of the results of
the Women’s Health Initiative (WHI). Which statement regarding the study is true?
1. Estrogen plus progestin increased the risk of a cardiac event in apparently healthy
women after 10 years of use.
2. Women on HRT have a higher risk of colorectal cancer.
3. Postmenopausal hormones do not actually prevent fractures of the hip.
, 4. Estrogen alone is associated with a greater risk of breast cancer than a combination
of estrogen plus progestin.
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1. Estrogen plus progestin increased the risk of a cardiac event in
apparently healthy women after 10 years of use.
The WHI found that estrogen plus progestin increased the risk of a cardiac
event in apparently healthy women if used more than 10 years post
menopause.
In which of the following scenarios is antibiotic treatment necessary following an
injury to the skin?
1. Laceration requiring sutures from a knife cut while cutting an avocado.
2. Laceration requiring sutures on the foot of a diabetic.
3. Laceration requiring sutures on the hand of someone who has not had a tetanus
booster in the last 5 years.
4. “Road rash” abrasion from a bicycle accident.
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2. Laceration requiring sutures on the foot of a diabetic.
Hilda, age 73, presents with a complaint of low back pain. Red flags in her history of a
minor fall, osteopenia, and prolonged steroid use for systemic lupus erythematosus
suggest the possibility of which of the following serious underlying conditions as the
cause of her low back pain?
1. Cancer.
2. Cauda equina syndrome.
3. Neurologic compromise.