36-year-old man with asthma has been treating his asthma with
albuterol once or twice a week for the last few years. He reports
that for the last month or so he has had to use it much more
often—"not every day, but almost." The nurse practitioner
should consider all of the following except:
Administering the Asthma Control Test questionnaire.
Spirometric assessment.
A complete symptom assessment.
Adding an inhaled long-acting beta2-agonist. Correct Answer
Ans: Adding an inhaled long-acting beta2-agonist.
A 12-day-old infant who is otherwise well presents with a 2-day
history of irritation of both eyes. He was born at a local birth
center and received standard newborn care including ocular
chemoprophylaxis. Examination reveals bilateral lid swelling,
chemosis, and mucoid eye discharge. The most likely cause of
this condition is:
Chemical irritation from neonatal ocular chemoprophylaxis.
Chlamydial (inclusion) conjunctivitis.
Gonococcal conjunctivitis.
,Neonatal adenovirus infection. Correct Answer Ans:
Chlamydial (inclusion) conjunctivitis.
A 12-year-old boy presents with his mother for a well-child
visit. What is the most helpful approach to this visit?
Interview and examine the child in the absence of the mother.
Interview the child with the mother, asking her to leave for the
examination.
Ask the child if he wishes his mother to be there for the
interview and examination.
Ask the mother if she wishes to be included in the interview and
examination Correct Answer Ans: Ask the child if he wishes
his mother to be there for the interview and examination.
A 14-month-old girl is brought in for evaluation by her mother.
She reports that her daughter has been fussy for the past 3 days
and tugging at her left ear. Evaluation reveals moderate bulging
of the tympanic membrane and her temperature is 102.6ºF
(39.2ºC). The child has no reported medication allergies and has
not received any antimicrobials in the past 3 months. You
recommend:
Watchful waiting and follow-up in 3 days.
Amoxicillin (Amoxil®).
,Clarithromycin (Biaxin®).
Levofloxacin (Levaquin®). Correct Answer Ans: Amoxicillin
(Amoxil®).
A 15-week-old infant presents with a fever of 100.5ᵒF (38.1ᵒC)
and bilateral erythematous tympanic membranes. The infant is
alert with excellent skin turgor, no evidence of difficulty
breathing, acknowledges her mother's face, and is wearing a wet
diaper. Her parents report that she is vigorously nursing every 3
hours without vomiting or excessive stooling. The appropriate
management would be to:
Counsel the mother to observe for 72 hours and return to clinic
if there is no improvement.
Start topical therapy with otic antibiotic drops.
Initiate a sepsis workup.
Begin a systemic antibiotic regimen. Correct Answer Ans:
Begin a systemic antibiotic regimen.
A 16-year-old young woman presents to you the day after a
"condom break." She is concerned that she might become
pregnant and is asking about emergency contraception.
Appropriate counseling about the use of hormonal emergency
contraception (EC) includes all of the following except:
An established pregnancy will not be interrupted.
, There is about a 50% reduction in pregnancy risk with properly-
timed use.
There is no increased risk of birth defect if pregnancy occurs.
Ulipristal (ella®) is more effective than levonorgestrel in days
3-5 following unprotected intercourse. Correct Answer Ans:
There is about a 50% reduction in pregnancy risk with properly-
timed use.
A 17-year-old woman presents complaining of left lower
abdominal and groin pain. She admits that she has had a "light
period everyday" for nearly 3 weeks. The presumptive diagnosis
of ectopic pregnancy is supported by which of the following?
Positive urine hCG
Negative pelvic ultrasound
Abdominal rebound tenderness
Breast pain Correct Answer Ans: Positive urine hCG
A 19-year-old female comes to your office to discuss birth
control. She has just become sexually active and wants to be
responsible. She has heard a lot from her friends about "the pill"
(combined oral contraception {COC}) and is asking you for
advice. You tell her that:
Premenstrual syndrome symptoms are often improved with
COC use.