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A 50-year-old patient presents to their nurse practitioner after their yearly eye
exam with the ophthalmologist. They tell the nurse practitioner that they were
told their vision is 20/200 in both eyes when they are not wearing their prescribed
glasses. They ask what this means. Which of the following is the most appropriate
response?
A.
They are okay to drive short distances without their glasses on
B.
They can see at 200 feet what someone with 20/20 vision can see at 20 feet
C.
They will need surgery in the future to correct their vision
D.
Without their glasses, the patient is considered legally blind ---------CORRECT
ANSWER-----------------D.
Without their glasses, the patient is considered legally blind
,Legal blindness is considered vision that is 20/200 or less (D) without corrective
eyewear. This means that they can see at 20 feet what a person with 20/20
vision sees at 200 feet. Depending on the patient's state of residence, a
corrected vision to a certain degree may be required to be able to operate a
motor vehicle.
A 24-year-old woman presents with concerns of increased anxiety, night terrors,
and feeling as if she is hyperaware of her surroundings. Based on her presenting
symptoms, which of the following diagnoses is the most likely?
A.
Generalized anxiety disorder
B.
Major depressive disorder
C.
Post-traumatic stress disorder
D.
Schizophrenia ---------CORRECT ANSWER-----------------C.
Post-traumatic stress disorder
According to the the fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders, post-traumatic stress disorder (PTSD) (C) is characterized by a
specific set of symptoms that persist for more than 1 month following exposure
,to actual or threatened death, serious injury, or sexual violence. Symptoms may
include flashbacks, nightmares, dissociation, avoidance of people or places that
trigger memories of the event, trouble concentrating, hypervigilance, feeling on-
edge, and sleep disturbances. Given the patient's presentation, this is the only
diagnosis listed that would appropriately capture her symptoms. Individual
therapy is highly recommended for those experiencing PTSD. Cognitive
behavioral therapy, cognitive processing therapy , and prolonged exposure are
the American Psychiatric Association's most strongly recommended
interventions. Medications may also be considered in the treatment plan.
Selective serotonin reuptake inhibitors are typically the first class of
medications used in the treatment of PTSD, though exceptions may occur based
on individual needs and circumstances.
A 6-year-old patient presents to the clinic with his parent, who reports several
blister-like lesions on his child's abdomen. The child reports the lesions are
pruritic and intermittently painful. Physical exam reveals large blisters filled with
clear-yellow fluid. Which of the following is the most likely diagnosis?
A.
Bullous impetigo
B.
Herpes zoster
C.
Nonbullous impetigo
D.
, Varicella ---------CORRECT ANSWER-----------------A.
Bullous impetigo
This patient's clinical presentation is consistent with bullous impetigo (A), which
is a superficial skin infection that most commonly affects children. Bullous
impetigo is characterized by large fluid-filled blisters (bullae) with clear-yellow
fluid that most commonly develop on the trunk.
A 22-year-old man presents to the clinic for a follow-up after starting a low-dose
tretinoin (Retin-A) cream. He states that he has noticed a decrease in blackheads
but reports an increase in pustules along his jawline. Which of the following is the
best next step in treatment?
A.
Increase the tretinoin dosage and follow up in 8 weeks
B.
Instruct him to continue the tretinoin and start him on tetracycline
C.
Instruct him to continue the tretinoin cream and start him on oral isotretinoin
D.
Instruct him to stop his tretinoin and start him on doxycycline (Vibramycin) ---------
CORRECT ANSWER-----------------A.