ADULT BURRANTO EXAMS WITH VERIFIED
QUESTIONS AND CORRECT ANSWERS
A 50-year-old female patient has a blood pressure of 118/72 mm Hg, a negative family
history for breast and ovarian cancer, a normal Pap smear 2 years prior, and a
Framingham risk screening within normal limits. Which should be part of this patient's
routine annual well-patient exams?
- ANSWERS-Breast cancer screening and mammogram
The American Cancer Society recommends yearly mammogram at age 40. Bone mineral
density screening begins at age 50 to 64, based on risk. Cervical cancer screening should
be performed every 3 years unless there is increased risk. Lipid screening and
cholesterol is performed annually if there is increased risk according to the Framingham
guidelines.
A 55-year-old patient who had influenza in the previous influenza season asks about
the flu vaccine. What will the provider tell the patient?
- ANSWERS-The trivalent influenza vaccine is indicated annually
Because the strains of influenza vary from year to year, annual immunization with TIV
is indicated for all persons.
The Flu Mist is used in persons 50 years of age and younger. The Fluzone High-Dose
vaccine is used in patients older than 65 years.
A 60-year-old patient who leads a sedentary lifestyle has expressed an interest in
beginning an aerobic exercise program. What will the provider include when
counseling this patient about this program?
- ANSWERS-Stretching should be performed prior to activity
,The heart rate should be kept between 50% and 80% of the maximum heart rate (220
minus the patient's age = 160), which is 80 to 128 beats per minute. Patients who are not
conditioned should begin with a 20 minute workout; conditioned individuals may
increase up to 60 minutes. The warm up should be 3 to 5 minutes and longer if it is cold.
Stretching is performed after the activity when the muscles are warm.
A 60-year-old patient with a previous history of shingles asks about the herpes zoster
vaccine. What will the provider recommend?
- ANSWERS-All patients 50 years and older should have a single dose of herpes zoster
vaccine regardless of previous herpes zoster infection.
A 65-year-old patient who has not had an influenza vaccine is exposed to influenza and
comes to the clinic the following day with fever and watery, red eyes. What will the
provider do initially?
- ANSWERS-Samples to isolate the virus should be collected within 12 to 36 hours of
onset of illness and this should be performed to confirm the disease --> nasal swab for
RT-PCR assay
Administration of the LAIV influenza vaccine will not prevent symptoms in this
patient, is not recommended in persons over 59 years of age, and is contraindicated
when also giving antiviral medications --> since it's a live vaccine
Antiviral drugs should be started within 48 hours of onset of illness and may be started
empirically while waiting on cultures because this patient is higher risk than younger
patients
Because identification of the virus and effectiveness of treatment are time-limited, it is
not correct to watch and wait for symptoms to worsen
An adult patient who had pertussis immunizations as a child is exposed to pertussis
and develops a runny nose, low-grade fever, and upper respiratory illness symptoms
without a paroxysmal cough. What is recommended for this patient?
- ANSWERS-Adults previously immunized against pertussis may still get the disease
without the classic whooping cough sign seen in children and are contagious from the
beginning of the catarrhal stage of runny nose and common cold symptoms
, Azithromycin or other macrolide antibiotics are useful for reducing symptoms and for
decreasing shedding of bacteria to limit spread of the disease
Patients should be isolated for 5 days from the start of treatment Pertussis vaccine
booster will not alter the course of the disease once exposed
Symptomatic care only will not reduce symptoms or decrease disease spread
Allergic rhinitis
- ANSWERS-Sneezing and itchy, watery eyes tend to occur with allergic rhinitis
Autoimmune vasculitides
- ANSWERS-Autoimmune vasculitides affects upper and lower respiratory tracts as
well as the kidneys
BMI classifications
- ANSWERS-- Underweight: < 18.5
- Normal: 18.5 - 24.9
- Overweight: 25 - 29.9
- Obesity Class 1: 30 - 34.9
- Obesity Class 2: 35 - 39.9
- Obesity Class 3: > 40
- Obesity Class 4: 50 to 59.9
- Obesity Class 5: > 60
Bupropion Hydrochloride (Wellbutrin, Zyban)
- ANSWERS-- Treats smoking addiction
- Prescribed 150 mg PO BID for 7 to 12 weeks
** Contraindications are breastfeeding, seizure, and suicidal ideation
** AEs are tachycardia, insomnia, and weight loss
Chantix (varenicline)
- ANSWERS-- 1 mg PO BID for 11 weeks
- Can cause nausea
- Take med with a full glass of water
** Other severe complications are cardiac problems and mood behaviors --> monitor for
depression and suicidal ideation
QUESTIONS AND CORRECT ANSWERS
A 50-year-old female patient has a blood pressure of 118/72 mm Hg, a negative family
history for breast and ovarian cancer, a normal Pap smear 2 years prior, and a
Framingham risk screening within normal limits. Which should be part of this patient's
routine annual well-patient exams?
- ANSWERS-Breast cancer screening and mammogram
The American Cancer Society recommends yearly mammogram at age 40. Bone mineral
density screening begins at age 50 to 64, based on risk. Cervical cancer screening should
be performed every 3 years unless there is increased risk. Lipid screening and
cholesterol is performed annually if there is increased risk according to the Framingham
guidelines.
A 55-year-old patient who had influenza in the previous influenza season asks about
the flu vaccine. What will the provider tell the patient?
- ANSWERS-The trivalent influenza vaccine is indicated annually
Because the strains of influenza vary from year to year, annual immunization with TIV
is indicated for all persons.
The Flu Mist is used in persons 50 years of age and younger. The Fluzone High-Dose
vaccine is used in patients older than 65 years.
A 60-year-old patient who leads a sedentary lifestyle has expressed an interest in
beginning an aerobic exercise program. What will the provider include when
counseling this patient about this program?
- ANSWERS-Stretching should be performed prior to activity
,The heart rate should be kept between 50% and 80% of the maximum heart rate (220
minus the patient's age = 160), which is 80 to 128 beats per minute. Patients who are not
conditioned should begin with a 20 minute workout; conditioned individuals may
increase up to 60 minutes. The warm up should be 3 to 5 minutes and longer if it is cold.
Stretching is performed after the activity when the muscles are warm.
A 60-year-old patient with a previous history of shingles asks about the herpes zoster
vaccine. What will the provider recommend?
- ANSWERS-All patients 50 years and older should have a single dose of herpes zoster
vaccine regardless of previous herpes zoster infection.
A 65-year-old patient who has not had an influenza vaccine is exposed to influenza and
comes to the clinic the following day with fever and watery, red eyes. What will the
provider do initially?
- ANSWERS-Samples to isolate the virus should be collected within 12 to 36 hours of
onset of illness and this should be performed to confirm the disease --> nasal swab for
RT-PCR assay
Administration of the LAIV influenza vaccine will not prevent symptoms in this
patient, is not recommended in persons over 59 years of age, and is contraindicated
when also giving antiviral medications --> since it's a live vaccine
Antiviral drugs should be started within 48 hours of onset of illness and may be started
empirically while waiting on cultures because this patient is higher risk than younger
patients
Because identification of the virus and effectiveness of treatment are time-limited, it is
not correct to watch and wait for symptoms to worsen
An adult patient who had pertussis immunizations as a child is exposed to pertussis
and develops a runny nose, low-grade fever, and upper respiratory illness symptoms
without a paroxysmal cough. What is recommended for this patient?
- ANSWERS-Adults previously immunized against pertussis may still get the disease
without the classic whooping cough sign seen in children and are contagious from the
beginning of the catarrhal stage of runny nose and common cold symptoms
, Azithromycin or other macrolide antibiotics are useful for reducing symptoms and for
decreasing shedding of bacteria to limit spread of the disease
Patients should be isolated for 5 days from the start of treatment Pertussis vaccine
booster will not alter the course of the disease once exposed
Symptomatic care only will not reduce symptoms or decrease disease spread
Allergic rhinitis
- ANSWERS-Sneezing and itchy, watery eyes tend to occur with allergic rhinitis
Autoimmune vasculitides
- ANSWERS-Autoimmune vasculitides affects upper and lower respiratory tracts as
well as the kidneys
BMI classifications
- ANSWERS-- Underweight: < 18.5
- Normal: 18.5 - 24.9
- Overweight: 25 - 29.9
- Obesity Class 1: 30 - 34.9
- Obesity Class 2: 35 - 39.9
- Obesity Class 3: > 40
- Obesity Class 4: 50 to 59.9
- Obesity Class 5: > 60
Bupropion Hydrochloride (Wellbutrin, Zyban)
- ANSWERS-- Treats smoking addiction
- Prescribed 150 mg PO BID for 7 to 12 weeks
** Contraindications are breastfeeding, seizure, and suicidal ideation
** AEs are tachycardia, insomnia, and weight loss
Chantix (varenicline)
- ANSWERS-- 1 mg PO BID for 11 weeks
- Can cause nausea
- Take med with a full glass of water
** Other severe complications are cardiac problems and mood behaviors --> monitor for
depression and suicidal ideation
