mod 3 MSN 621 practice quiz with correct
answers
A |30-year-old |woman |presents |with |complaints |of |abdominal |pain |and |diarrhea |for |6 |months. |
She |describes |her |pain |as |abdominal |cramps. |She |is |unable |to |localize |her |pain. |She |states |it |is
|intermittent, |rated |8/10 |at |its |worst |and |0/10 |currently. |She |says |her |pain |is |worse |right |
before |she |has |a |bowel |movement |and |relieves |after |having |a |bowel |movement. |She |denies |
any |weight |loss, |dietary |changes, |or |recent |travel. |She |describes |her |bowel |movements |as |
loose, |unformed |stools. |Given |the |patient's |most |likely |diagnosis, |which |of |the |following |would
|be |most |likely |in |this |patient? |- |CORRECT |ANSWER✔✔-Recent |problems |with |increased |
marital |stress
A |26-year-old |male |attended |a |picnic |two |days |ago |and |now |presents |with |multiple |episodes |
of |nonbloody, |watery |diarrhea |without |abdominal |pain. |He |is |afebrile, |and |the |other |vital |
signs |and |physical |exam |are |notable |for |signs |of |moderate |dehydration. |Given |the |leading |
cause |of |this |patient's |likely |condition, |what |is |the |best |initial |treatment? |- |CORRECT |
ANSWER✔✔-Oral |rehydration
A |16-year-old |patient |is |hospitalized |for |bloody |diarrhea, |high |fever, |and |abdominal |pain. |The |
patient |recently |returned |from |a |week-long |vacation |to |Mexico, |where |he |enjoyed |many |local |
delicacies. |Complete |blood |count |and |stool |cultures |are |pending, |and |empiric |treatment |for |
the |suspected |enterohemorrhagic |E.coli |O157: |H7 |diarrhea |is |started. |Which |of |the |following |
bacteria |are |part |of |this |patient's |differential, |given |his |clinical |constellation? |- |CORRECT |
ANSWER✔✔-Salmonella, |Shigella, |Yersinia, |Campylobacter
A |34-year-old |African-American |man |presents |with |severe |diarrhea |for |five |days. |He |recalls |
eating |scrambled |eggs |his |neighbor |bought |from |a |local |farm. |Abdominal |bloating |and |cramps |
began |about |one |day |after |eating |the |eggs, |followed |by |watery |stools |about |every |two |hours |
in |frequency. |He |denies |pain |on |defecation |or |blood |or |mucus |in |the |stool. |He |denies |any |
recent |travel |history. |Vital |signs |are |heart |rate |110 |bpm, |blood |pressure |90/64 |mm |Hg, |and |
temperature |101 |°F |(38.3 |°C). |The |abdominal |exam |is |notable |for |diffuse |tenderness |to |
palpation |without |peritoneal |signs. |His |stool |is |negative |for |blood |but |positive |for |white |blood |
cells. |What |is |the |most |reasonable |empiric |treatment? |- |CORRECT |ANSWER✔✔-Ciprofloxacin
, A |19-year-old |African-American |man |presents |with |four |days |of |diarrhea |and |subjective |fever |
for |one |day. |Watery |bowel |movements |occur |5 |to |6 |times |daily |and, |on |one |occasion, |had |
bloody |streaks. |He |has |sickle |cell |disease, |which |is |controlled |with |hydroxyurea, |and |the |last |
crisis |was |eight |months |ago. |He |is |a |college |student |and |eats |chicken |nuggets |at |a |local |fast-
food |place |multiple |times |a |week |when |attending |school. |His |vital |signs |are |blood |pressure |of |
120/80 |mm |Hg, |pulse |rate |100/min, |and |a |temperature |of |101 |°F |(38.3 |°C). |The |abdominal |
exam |shows |no |tenderness |or |peritonitis. |Blood |work |shows |a |mild |decrease |in |white |blood |
cells |at |4500/microL |with |no |anemia. |Electrolytes |are |within |the |normal |range. |What |is |the |
most |likely |underlying |organism |and |the |most |appropriate |treatment? |- |CORRECT |
ANSWER✔✔-Non-typhoidal |Salmonella; |ciprofloxacin
A |35-year-old |man |presents |with |3 |days |of |watery |diarrhea |after |a |trip |to |the |Caribbean |10 |
days |ago. |The |bowel |movements |have |not |been |bloody |or |associated |with |pus, |occur |about |3 |
to |6 |times |daily, |and |are |associated |with |abdominal |cramps. |He |denies |fever, |nausea, |or |
vomiting. |He |is |a |corporate |office |manager, |and |since |he |needed |to |go |to |a |meeting, |he |took |
some |diphenoxylate |that |helped |his |symptoms |and |reduced |the |frequency |of |bowel |
movements |significantly. |On |physical |examination, |his |vital |signs |are |temperature |37 |°C |(98.6 |
°F), |pulse |rate |105 |beats/min, |respiration |16 |breaths/min, |and |blood |pressure |100/65 |mm |Hg. |
Examinations |of |the |heart |and |lungs |are |unremarkable, |apart |from |mild |tachycardia. |The |
abdomen |is |soft |and |not |tender. |What |is |the |next |most |appropriate |step |in |the |management |
of |this |patient? |- |CORRECT |ANSWER✔✔-Recommend |a |course |of |oral |rehydration |salt |
treatment.
A |34-year-old |African-American |man |presents |with |five |days |of |severe |diarrhea. |Loose |stools, |
bloating, |and |abdominal |cramps |started |two |days |after |he |ate |chicken |nuggets |at |a |local |fast |
food |joint. |Abdominal |cramps |are |felt |in |the |whole |abdomen; |they |come |and |go, |lasting |20-30
|minutes |associated |with |nausea. |He |does |not |have |pain |at |defecation |and |has |seen |no |blood |
or |mucus |in |the |stool. |He |denies |any |recent |travel |history. |On |exam, |heart |rate |is |110 |beats |
per |minute, |blood |pressure |is |90/64 |mm |Hg, |and |temperature |of |101 |°F |(38.3 |°C). |His |
abdomen |is |diffusely |tender |to |palpation, |but |there |are |no |peritoneal |signs. |His |stool |is |
negative |for |blood |but |positive |for |white |blood |cells. |Besides |exhibiting |severe |disease, |which |
of |the |following |would |be |an |indication |for |treatment? |- |CORRECT |ANSWER✔✔-
Hemoglobinopathy
answers
A |30-year-old |woman |presents |with |complaints |of |abdominal |pain |and |diarrhea |for |6 |months. |
She |describes |her |pain |as |abdominal |cramps. |She |is |unable |to |localize |her |pain. |She |states |it |is
|intermittent, |rated |8/10 |at |its |worst |and |0/10 |currently. |She |says |her |pain |is |worse |right |
before |she |has |a |bowel |movement |and |relieves |after |having |a |bowel |movement. |She |denies |
any |weight |loss, |dietary |changes, |or |recent |travel. |She |describes |her |bowel |movements |as |
loose, |unformed |stools. |Given |the |patient's |most |likely |diagnosis, |which |of |the |following |would
|be |most |likely |in |this |patient? |- |CORRECT |ANSWER✔✔-Recent |problems |with |increased |
marital |stress
A |26-year-old |male |attended |a |picnic |two |days |ago |and |now |presents |with |multiple |episodes |
of |nonbloody, |watery |diarrhea |without |abdominal |pain. |He |is |afebrile, |and |the |other |vital |
signs |and |physical |exam |are |notable |for |signs |of |moderate |dehydration. |Given |the |leading |
cause |of |this |patient's |likely |condition, |what |is |the |best |initial |treatment? |- |CORRECT |
ANSWER✔✔-Oral |rehydration
A |16-year-old |patient |is |hospitalized |for |bloody |diarrhea, |high |fever, |and |abdominal |pain. |The |
patient |recently |returned |from |a |week-long |vacation |to |Mexico, |where |he |enjoyed |many |local |
delicacies. |Complete |blood |count |and |stool |cultures |are |pending, |and |empiric |treatment |for |
the |suspected |enterohemorrhagic |E.coli |O157: |H7 |diarrhea |is |started. |Which |of |the |following |
bacteria |are |part |of |this |patient's |differential, |given |his |clinical |constellation? |- |CORRECT |
ANSWER✔✔-Salmonella, |Shigella, |Yersinia, |Campylobacter
A |34-year-old |African-American |man |presents |with |severe |diarrhea |for |five |days. |He |recalls |
eating |scrambled |eggs |his |neighbor |bought |from |a |local |farm. |Abdominal |bloating |and |cramps |
began |about |one |day |after |eating |the |eggs, |followed |by |watery |stools |about |every |two |hours |
in |frequency. |He |denies |pain |on |defecation |or |blood |or |mucus |in |the |stool. |He |denies |any |
recent |travel |history. |Vital |signs |are |heart |rate |110 |bpm, |blood |pressure |90/64 |mm |Hg, |and |
temperature |101 |°F |(38.3 |°C). |The |abdominal |exam |is |notable |for |diffuse |tenderness |to |
palpation |without |peritoneal |signs. |His |stool |is |negative |for |blood |but |positive |for |white |blood |
cells. |What |is |the |most |reasonable |empiric |treatment? |- |CORRECT |ANSWER✔✔-Ciprofloxacin
, A |19-year-old |African-American |man |presents |with |four |days |of |diarrhea |and |subjective |fever |
for |one |day. |Watery |bowel |movements |occur |5 |to |6 |times |daily |and, |on |one |occasion, |had |
bloody |streaks. |He |has |sickle |cell |disease, |which |is |controlled |with |hydroxyurea, |and |the |last |
crisis |was |eight |months |ago. |He |is |a |college |student |and |eats |chicken |nuggets |at |a |local |fast-
food |place |multiple |times |a |week |when |attending |school. |His |vital |signs |are |blood |pressure |of |
120/80 |mm |Hg, |pulse |rate |100/min, |and |a |temperature |of |101 |°F |(38.3 |°C). |The |abdominal |
exam |shows |no |tenderness |or |peritonitis. |Blood |work |shows |a |mild |decrease |in |white |blood |
cells |at |4500/microL |with |no |anemia. |Electrolytes |are |within |the |normal |range. |What |is |the |
most |likely |underlying |organism |and |the |most |appropriate |treatment? |- |CORRECT |
ANSWER✔✔-Non-typhoidal |Salmonella; |ciprofloxacin
A |35-year-old |man |presents |with |3 |days |of |watery |diarrhea |after |a |trip |to |the |Caribbean |10 |
days |ago. |The |bowel |movements |have |not |been |bloody |or |associated |with |pus, |occur |about |3 |
to |6 |times |daily, |and |are |associated |with |abdominal |cramps. |He |denies |fever, |nausea, |or |
vomiting. |He |is |a |corporate |office |manager, |and |since |he |needed |to |go |to |a |meeting, |he |took |
some |diphenoxylate |that |helped |his |symptoms |and |reduced |the |frequency |of |bowel |
movements |significantly. |On |physical |examination, |his |vital |signs |are |temperature |37 |°C |(98.6 |
°F), |pulse |rate |105 |beats/min, |respiration |16 |breaths/min, |and |blood |pressure |100/65 |mm |Hg. |
Examinations |of |the |heart |and |lungs |are |unremarkable, |apart |from |mild |tachycardia. |The |
abdomen |is |soft |and |not |tender. |What |is |the |next |most |appropriate |step |in |the |management |
of |this |patient? |- |CORRECT |ANSWER✔✔-Recommend |a |course |of |oral |rehydration |salt |
treatment.
A |34-year-old |African-American |man |presents |with |five |days |of |severe |diarrhea. |Loose |stools, |
bloating, |and |abdominal |cramps |started |two |days |after |he |ate |chicken |nuggets |at |a |local |fast |
food |joint. |Abdominal |cramps |are |felt |in |the |whole |abdomen; |they |come |and |go, |lasting |20-30
|minutes |associated |with |nausea. |He |does |not |have |pain |at |defecation |and |has |seen |no |blood |
or |mucus |in |the |stool. |He |denies |any |recent |travel |history. |On |exam, |heart |rate |is |110 |beats |
per |minute, |blood |pressure |is |90/64 |mm |Hg, |and |temperature |of |101 |°F |(38.3 |°C). |His |
abdomen |is |diffusely |tender |to |palpation, |but |there |are |no |peritoneal |signs. |His |stool |is |
negative |for |blood |but |positive |for |white |blood |cells. |Besides |exhibiting |severe |disease, |which |
of |the |following |would |be |an |indication |for |treatment? |- |CORRECT |ANSWER✔✔-
Hemoglobinopathy
