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A 70-year old male patient complains of a bright red-colored spot
in his left eye for 2 days. He denies eye pain, visual changes, or
headaches. He has a new onset of cough from a recent viral
upper respiratory infection. The only medicine he is on Bayer
aspirin, 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage
D. Subconjunctival hemorrhage. Bright red blood in a sharply
defined area surrounded by normal-appearing conjunctiva
indicates subconjunctival hemorrhage.
,You note the following result on a routine urinalysis of a 37-year
old primigravida who is at 30 weeks gestation. Leukocyte=trace,
nitrite=negative, protein=2+, blood=negative. Her weight has
increased by 5 lbs during the past week. Which of the following is
most likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension
B. Pregnancy-induced hypertension (pre-eclampsia). Classic triad
of symptoms of preeclampsia include hypertension, edema
(weight gain), and proteinuria.
An 80 year old Caucasian female has heart failure. What symptom
is an early indicator of failure?
Weight gain.
Early signs of heart failure include weight gain (the most sensitive
indicator), S3 gallop, dyspnea on exertion, peripheral edema.
Moderate signs include nocturnal cough, tachycardia. Late signs
include ascities, frothy sputum, and hypotension.
,A 6 yo had an acute onset of fever, pharyngitis, and headache 2
days ago. Today, he presents with cervical lymphadenopathy and
sandpaper textured rash everywhere except on his face. A rapid
streptococcal antigen test is positive. The remainder of the
assessment in unremarkable. What is the most likely diagnosis and
the most appropriate action?
Scarlet fever; treat with antibiotics.
This disease is due to infection with Group A Beta-hemolytic
streptococcus. The rash is thought to be due to a systemic reaction
to the toxin produced by the microorganism. The rash fades with
pressure and ultimately desquamates. A deep, nonblanching rash
on the flexor surfaces of the skin is referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid
hormone replacement therapy is prescribed. When should the
nurse practitioner check the patient's TSH?
6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid
replacement, is 7 days. The earliest that meaningful changes will be
observed is at 4-6 weeks. Therefore, the NP should wait a minimum
of 4-6 weeks before checking the patient's TSH.
, A 15 yo malue has a history of cryptorchidism which was surgically
repaired. Because of this information, it is essential for the nurse
practitioner to teach him about:
testicular self-examination.
Cryptorchidism, even with surgical repair, is associated with
increased risk for testicular cancer.
In the majority of children, the first permanent teeth start to erupt
at the age of 6 years. Which of the following are the first permanent
teeth to erupt in this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines
A. First Molars