Primary Care: A Collaborative Practice/ Interprofessional Collaborative Practice 6TH EDITION ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION

Primary Care: A Collaborative Practice/ Interprofessional Collaborative Practice 6TH EDITION ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION 1. VUCA - ANSWER Volatility, Uncertainty, Complexity, Ambiguity in healthcare. 2. Interprofessional Collaboration - ANSWER Team-based approach for coordinated patient care. 3. Evidence-Based Practice (EBP) - ANSWER Using research findings to inform healthcare decisions. 4. Clinical Practice Guidelines - ANSWER Standardized recommendations for patient care. 5. Level 3 ACOs - ANSWER Advanced ACOs with comprehensive health care services. 6. Electronic Medical Records - ANSWER Digital records linking all health care components. 7. Health-related Outcomes - ANSWER Results reflecting patient health status and care quality. 8. Care Experiences - ANSWER Patients' perceptions of their health care interactions. 9. Quality of Life - ANSWER Overall well-being and life satisfaction of patients. 10.Financial Reporting Requirements - ANSWER Mandatory disclosures of financial performance metrics. 11.Bundled Payments - ANSWER Single payment for a group of related services. 12.Performance Measures - ANSWER Metrics assessing health improvements in patients. 13.Care Navigators - ANSWER Assist patients in accessing health care services. 14.Practice Analytics - ANSWER Data analysis to improve health care delivery. 15.Emergency Room Visits - ANSWER Hospital visits for urgent medical issues. 16.Hospital Stays - ANSWER Duration of patient hospitalization for treatment. 17.Readmission Rates - ANSWER Frequency of patients returning to the hospital. 18.Medicare Spending - ANSWER Costs incurred by Medicare for patient care. 19.Super ACO - ANSWER Alliance of smaller practices to enhance care. 20.UTI in males should be treated with - ANSWER fluoroquinolones for 10 to 14 days 21.Acute prostatitis should be treated with - ANSWER Bactrim DS (tmpsmx) for 2 weeks or fluoroquinolones 22.Spermatocele is - ANSWER a small non tender, freely movable mass above and behind testis 23.Epididymitis - ANSWER scrotum is red, enlarge and difficult to distinguish from testis, a positive prehn sign is observed 24.Prehn sign - ANSWER a relief when scrotum is elevated with epididymitis 25.An erythematous and enlarge testicles with absent of cremasteric sign in some instances with small area of cyanosis (blue dot sign) - ANSWER Testicular Torsion 26.Testicular edema is so pronounced, painful, usually involves systemic viral infection (Mumps) and includes unilateral or bilateral erythema, edema, and scrotal tenderness, which occurs 4 to 7 days after initial fever - ANSWER Orchiti 27.Cost Savings - ANSWER Reduction in expenses associated with health care. 28.Retail Health Movement - ANSWER Trend of walk-in clinics in retail settings. 29.Urgent Care Clinics - ANSWER Facilities providing immediate care for non-life-threatening issues. 30.Concierge Practices - ANSWER Direct fee practices offering enhanced patient access. 31.A patient diagnosed with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend? a. Calcineurin inhibitors b. Lubricants and emollients c. Oral diphenhydramine d. Prophylactic topical steroids ANS: B - ANSWER Emollients and lubricants are used long-term to reduce flare-ups. Calcineurin inhibitors can be helpful for managing chronic moderate to severe eczema. Oral diphenhydramine helps with symptoms of itching but is not used to prevent symptoms. Corticosteroids should be used sparingly to treat symptoms and stopped once the inflammation has subsided. 32.A patient who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the provider recommend to help prevent these infections? a. Bleach baths twice weekly b. Frequent bathing with soap and water c. Low-dose oral antibiotics d. Topical antibiotic ointments ANS: A - ANSWER Bleach baths and intranasal mupirocin have been shown to reduce bacterial superinfections of the skin. Frequent bathing with soap and water may increase flare-ups and increase the risk for superinfections. Oral and topical antibiotic prophylaxes are not recommended. 33.A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? a. Amoxicillin-clavulanate b. Clindamycin c. Doxycycline d. Sulfamethoxazole-trimethoprim ANS: A - ANSWER This patient has symptoms consistent with erysipelas, which is commonly caused by staphylococcal or streptococcal bacteria. These may be treated empirically with penicillinase-resistant penicillin if not allergic. Clindamycin, doxycycline, and sulfamethoxazole-trimethoprim are used for methicillin-resistant staphylococcus aureus infections. 34.A patient has vesiculopustular lesions around the nose and mouth with areas of honey-colored crusts. The provider notes a few similar lesions on the patient's hands and legs. Which treatment is appropriate for this patient? a. Mupirocin, 2% ointment b. Culture and sensitivity of the lesions c. Sulfamethoxazole-trimethoprim d. Surgical referral ANS: A - ANSWER This patient has symptoms of impetigo which has spread to the hands and legs. Mupirocin, 2% ointment, should be applied three times a day for 10 days. It is not necessary to obtain a culture since this can be treated empirically in most cases. MRSA is unlikely, so sulfamethoxazole-trimethoprim is not indicated. Surgical referrals are generally not indicated. 35.A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? a. Apply moist heat until symptoms resolve. b. Begin treatment with amoxicillin-clavulanate. c. Prescribe trimethoprim-sulfamethoxazole. d. Wait for culture results before ordering an antibiotic. ANS: C - ANSWER Because of a history of exposure to MRSA, the patient is likely to be colonized and should be treated accordingly. Small lesions may be treated with moist heat, but the likelihood of MRSA requires treatment. Amoxicillin-clavulanate is not effective for MRSA. Treatment should be started empirically. 36.A patient is diagnosed with herpetic whitlow and in a 2 weeks follow-up evaluation, is noted to have paronychial inflammation of the tendon sheath in one finger that has responded to treatment. What is a priority treatment for this patient? a. Begin therapy with an oral antiviral medication. b. Obtain a consult for incision and drainage of the lesion. c. Order a creatinine clearance test to evaluate renal function. d. Refer the patient to the emergency department. ANS: D - ANSWER When paronychial infection of the tendon sheath is suspected in patients with herpetic whitlow, they should be immediately referred to the emergency department for a surgical referral. Oral antiviral medications are given for severe cases and recurrences, but the emergent situation is a priority. Incision and drainage may lead to superinfection of longer healing. Creatinine clearance is ordered when beginning oral antiviral therapy. 37.Movement Disorders and essential tremor - ANSWER Most common conditions Essential tremor RLS Dystonia Tourette's Less common conditions Hemifacial spasms Blepharospasm Ataxias Huntington's disease Etiology Pathological alterations within the CNS/PNS and their connections Conditions such as Parkinson's disease etiology is poorly understood ent disorders PE - ANSWER Complete P.E. Focus on neuro assessment Cognition, cranial nerves, motor function, sensory function, deep tendon reflexes, and gait Focus particularly on distinctive movements Rhythm, duration, and continuity of contractions Type of oscillations (rapid or slow Amplitude (fine or course) Rest or during action Patterned or random or combination Speed, force, complexity, and associated sensory symptoms. ent disorders dx - ANSWER Basic laboratory studies to rule out medical or metabolic abnormalities (CBC with diff, CMP, TSH with reflex T3/T4) If suspected infection or alcohol/drug use, additional focused workup would be warranted (add UA, chest xray, drug or alcohol screening as indicated) Neuro imaging may be warranted if there are specific neurological findings, often in conjunction with a neuro referral Essential Tremor - The specifics Overview: progressive, mainly symmetric, rhythmic, involuntary oscillation movement disorder of the hands and forearms that can be present at rest or with movement Etiology: benign, hereditary, familial, or senile with uncertain etiology. Thought to be caused by focal oscillatory activity within the CNS. S/S: NO OTHER NEURO SYMPTOMS! JUST THE TREMOR!! Clinical Presentation/PE: Tremor at rest that worsens as the movements become purposeful. Difficulty writing, eating, or performing other fine motor tasks. Head, eyelid, facial, voice can be affected Disappears during sleep, decreases with alcohol Increased during periods of emotional distress No weakness or changes in muscle tone, normal DTR's No problems with coordination (e.g. finger to nose test, rapid hand movements normal). Have the patient draw a circle and monitor over time. Diagnostics: No initial test necessary: based on clinical diagnosis (there are no validated serologic, radiologic, or pathologic markers of ET CT or MRI - useful when the patient has a focal neurologic sign, which would not be due to ET Serum ceruloplasmin - indicated for patients 40 years of age with parkinsonism, dysarthria, or dystonia, to rule out other types of tremor. A low serum ceruloplasmin (20mg/dL) is positive for Wilson disease 24 hour urine copper - indicated for patients 40 years of age with parkinsonism, dysarthria, or dystonia, to rule out other types of tremor. A ent disorder management - ANSWER No dysfunction or embarrassment: Observation Dysfunction or embarrassment Medications Primary (Beta Blocker) Propranolol - 10mg/day orally given in 2-4 divided doses initially, increase by 20mg/day increments every 7 days as tolerated and according to response Primidone Secondary Gabapentin, alprazolam, topiramate Deep Brain Stimulation (multidisciplinary approach) Focused Ultrasound Thalamotomy with MRI guidance Gamma knife thalamotomy Annual visits are sufficient to monitor the disease. Contact sooner if medication reactions occur. Prevention? Avoidance of organochlorine pesticides, lead, mercury, and beta-carboline alkaloids is recommended When is referral needed... Specialist referral, likely a neurology referral, is indicated when (1) diagnosis is uncertain, (2) patient is not responding to standard treatment, or (3) patient's condition is deteriorating ED referral is indicated if patient presents with acute focal neurological symptoms or suspicion of a serious medical condition 41.Trigeminal Neuralgia - ANSWER Pain disorder affecting the sensory branches of the trigeminal nerve. It is also known as tic douloureux In primary neuralgia the trigeminal nerve is impaired by a vascular compression resulting in hyperenervation Conduction of sensory impulses from the greater part of the face and head, from the cornea and conjunctiva, and from the nose and mouth In secondary neuralgia, there is a structural cause such as compression, trauma, or multiple sclerosis