WGU D118 Adult Primary Care: Questions & Answers:
Complete Solution
Which is a modifiable risk factor for melanoma - ANSWERConsiderable sun exposure
and sunburn
A 19 year old female comes to your clinic for a routine visit to obtain birth control
pills. You notice a red sunburn over her body. She states that she stayed a little too
long in the sunbed. She denies pain and appears happy. What is your most
appropriate course of action for skin health promotion and disease prevention? -
ANSWERAsk how often she uses the sun bed and explore why it is important to her
Large, flaccid bullae with honey-colored crusts around the mouth and nose are
characteristic of - ANSWERImpetigo
You examine a patient with a well demarcated erythematous rash with silvery scale.
You diagnose____? - ANSWERPsoriasis
A teenage male comes to your clinic with the chief complaint of foot odor. He notes
"extra" white skin between his toes. He denies pain at this time. On history you find
that he plays on the local high school football team and is sexually active. What will
you include in your plan of care? - ANSWERMiconazole nitrate 2% cream or
Clotrimazole 1% solution twice a day x 4 weeks
A 60 year old male comes to your office with a history of urticaria. He is staying at
home more due to his "rash". The lesions are papular and scabbed on extremities
and trunk. What will you include in your treatment plan? - ANSWERAssess
medication list for ACE inhibitors and NSAIDs
A teenager comes to your clinic with the chief complaint of warts located on her
hands. Which treatment is NOT an evidence-based option? - ANSWERShaving the
warts
Mr. Jackson, age 64, is active and continues to farm as he has all of his adult life. He
is asymptomatic for skin lesions. What should you discuss with him for skin health
promotion and disease prevention course of action in this patient encounter? -
ANSWERShow Mr. Jackson how to inspect his skin using the ABCDE model and
encourage him to do self-skin-inspections
A 40 y/o man comes to the office with a rash of 4-5 months duration. He had bumps
on his shoulders, back and arms. He reports that the bumps are larger, he has
nighttime pruritis and oral and topical corticosteroids have not helped. He has no
pets, lives alone, and recalls no insect bites or contacts with anyone with a rash. On
eaxm there is a symetric eruption with erythematous papules and excorations on his
back, shoulders, axillae, wrists, scrotum, and upper legs. There are a few pustles in
,the axillae. Which of the following is the most appropriate next step? -
ANSWERExamine a skin scraping in mineral oil under a light microscope
A 75 y/o man in a nursing facility has developed a Stage 3 pressure ulcer. He weighs
160 lbs with a 10 lb weight loss in the last month. BMI=20.5, Albumin 3.2, Pre-
albumin 14. Which of the following is most likely to aid healing? - ANSWERProtein
100 GM qd
A 70 y/o patient has a large sacral ulcer measuring 11 by 10 cm, with a depth of 4
cm. There is surrounding erythema, exposed muscle, undermining of the edges and a
tunneling tract that extends another 2 cm. Within the ulcer, there is necrotic
material and a significant amount of exudate with a foul odor. Which of the
following is the next step to reduce odor? - ANSWERPerform surgical debridement
A 60 y/o woman is evaluated because she has erythematous lesions. Initially, the
lesions were on her arms and legs. By the end of week 1, the lesions spread to her
trunk and several large blisters appeared. The lesions are pruritic and cause her to
scratch. On exam, there are areas of erythema with tense blisters and serous
exudate. Some blisters have opened into oval erosions with serous exudate. Some
blisters are covered in scabs. What is the most likely diagnosis? - ANSWERBullous
pemphigoid
A 32 y/o woman comes to the office c/o a bad taste in her mouth. She takes
Metformin and Valsartan. Three weeks ago she took Nitrofuratonin for a UTI. On
exam, there are white plaques on the surface of her cheeks, hard palate, and tongue.
Wiping off some of the plaques reveals an erythematous mucosal surface. Which of
the following is the most likely diagnosis? - ANSWERAcute psuedomembranous
candidiasis
All of the following are true about renal dosing EXCEPT - ANSWERReducing each
dose while maintaining the dose interval presents no risks
When following up on response to treatment for a bite injury which diagnostic test
can be used to evaluate the response to the treatment? - ANSWERC reactive protein
Which of the following factors contributes to the potential for antibiotic resistance? -
ANSWEREnvironment, Patient, Drug
The best description of logical antibiotic prescribing involves which of the following -
ANSWERAnswering the 10 questions of logical prescribing
An example of a disease caused by vector transmission is - ANSWERMalaria
An example of a disease caused by indirect transmission is - ANSWERSalmonella
An example of a disease caused by direct transmission is - ANSWERHerpes Type 1
, Infections are defined as a harmful invasion and spread of a foreign species or
pathogen. Which of the following are sources of infection? - ANSWERAll of the
above: Prions, Fungus & Protists
Epidemiology is defined as - ANSWERThe science of discovering the causes of
illnesses and injury in populations
Which of the following statements is true regarding the first pass metabolism
process? - ANSWERAfter a drug is taken by the oral route, it is absorbed in the small
intestines and enters the liver through the portal circulation before being released
into general circulation.
You would recommend the pneumococcal vaccine to patients with all of the
following conditions EXCEPT - ANSWERG6PD deficiency anemia
Erythromycin inhibits the cytochrome P450 system. The following drugs should be
avoided because of drug interaction EXCEPT - ANSWERLasix
All of the following are included in the criteria used to diagnose patients with AIDS
EXCEPT - ANSWERprofound fatigue
Which of the following is the confirmatory test for the HIV screening test? -
ANSWERWestern blot
Cat and human bites have higher rates of infection than dog bites. A patient comes
to your office with a bite. It does not require sutures or appear infected. You want to
prescribe antibiotic prophylaxsis. The patient has no history of allergies. You
presctibe: - ANSWERAmoxicillin-clavulanate (Augmentin)
74 y/o with a 4 month history of severe stiffness and aching in her neck and both
shoulders and hips that is worsened by movement. She reports having difficulty
getting OOB and dressing. She also has a low grade fever, fatigue, loss of appetite
and weight loss. Yesterday the vision in her right eye has progressively worsened.
Which of the following is the most likely? - ANSWERPolymyalgia rheumatica
Multiple myeloma is a malignancy of the - ANSWERPlasma cells
Which of the following exam findings is most specific for lupus? - ANSWERMalar rash
Which of the following lab tests is positive in a large number of patients with lupus? -
ANSWERAntinuclear antibody
Which of the following is recommended treatment for early Lyme disease? -
ANSWERDoxycycline 100 mg bid x 30 days
Which of the following viral infections is associated with occasional abnormal forms
of lymphocytes during an acute infection? - ANSWEREpstein-Barr
Complete Solution
Which is a modifiable risk factor for melanoma - ANSWERConsiderable sun exposure
and sunburn
A 19 year old female comes to your clinic for a routine visit to obtain birth control
pills. You notice a red sunburn over her body. She states that she stayed a little too
long in the sunbed. She denies pain and appears happy. What is your most
appropriate course of action for skin health promotion and disease prevention? -
ANSWERAsk how often she uses the sun bed and explore why it is important to her
Large, flaccid bullae with honey-colored crusts around the mouth and nose are
characteristic of - ANSWERImpetigo
You examine a patient with a well demarcated erythematous rash with silvery scale.
You diagnose____? - ANSWERPsoriasis
A teenage male comes to your clinic with the chief complaint of foot odor. He notes
"extra" white skin between his toes. He denies pain at this time. On history you find
that he plays on the local high school football team and is sexually active. What will
you include in your plan of care? - ANSWERMiconazole nitrate 2% cream or
Clotrimazole 1% solution twice a day x 4 weeks
A 60 year old male comes to your office with a history of urticaria. He is staying at
home more due to his "rash". The lesions are papular and scabbed on extremities
and trunk. What will you include in your treatment plan? - ANSWERAssess
medication list for ACE inhibitors and NSAIDs
A teenager comes to your clinic with the chief complaint of warts located on her
hands. Which treatment is NOT an evidence-based option? - ANSWERShaving the
warts
Mr. Jackson, age 64, is active and continues to farm as he has all of his adult life. He
is asymptomatic for skin lesions. What should you discuss with him for skin health
promotion and disease prevention course of action in this patient encounter? -
ANSWERShow Mr. Jackson how to inspect his skin using the ABCDE model and
encourage him to do self-skin-inspections
A 40 y/o man comes to the office with a rash of 4-5 months duration. He had bumps
on his shoulders, back and arms. He reports that the bumps are larger, he has
nighttime pruritis and oral and topical corticosteroids have not helped. He has no
pets, lives alone, and recalls no insect bites or contacts with anyone with a rash. On
eaxm there is a symetric eruption with erythematous papules and excorations on his
back, shoulders, axillae, wrists, scrotum, and upper legs. There are a few pustles in
,the axillae. Which of the following is the most appropriate next step? -
ANSWERExamine a skin scraping in mineral oil under a light microscope
A 75 y/o man in a nursing facility has developed a Stage 3 pressure ulcer. He weighs
160 lbs with a 10 lb weight loss in the last month. BMI=20.5, Albumin 3.2, Pre-
albumin 14. Which of the following is most likely to aid healing? - ANSWERProtein
100 GM qd
A 70 y/o patient has a large sacral ulcer measuring 11 by 10 cm, with a depth of 4
cm. There is surrounding erythema, exposed muscle, undermining of the edges and a
tunneling tract that extends another 2 cm. Within the ulcer, there is necrotic
material and a significant amount of exudate with a foul odor. Which of the
following is the next step to reduce odor? - ANSWERPerform surgical debridement
A 60 y/o woman is evaluated because she has erythematous lesions. Initially, the
lesions were on her arms and legs. By the end of week 1, the lesions spread to her
trunk and several large blisters appeared. The lesions are pruritic and cause her to
scratch. On exam, there are areas of erythema with tense blisters and serous
exudate. Some blisters have opened into oval erosions with serous exudate. Some
blisters are covered in scabs. What is the most likely diagnosis? - ANSWERBullous
pemphigoid
A 32 y/o woman comes to the office c/o a bad taste in her mouth. She takes
Metformin and Valsartan. Three weeks ago she took Nitrofuratonin for a UTI. On
exam, there are white plaques on the surface of her cheeks, hard palate, and tongue.
Wiping off some of the plaques reveals an erythematous mucosal surface. Which of
the following is the most likely diagnosis? - ANSWERAcute psuedomembranous
candidiasis
All of the following are true about renal dosing EXCEPT - ANSWERReducing each
dose while maintaining the dose interval presents no risks
When following up on response to treatment for a bite injury which diagnostic test
can be used to evaluate the response to the treatment? - ANSWERC reactive protein
Which of the following factors contributes to the potential for antibiotic resistance? -
ANSWEREnvironment, Patient, Drug
The best description of logical antibiotic prescribing involves which of the following -
ANSWERAnswering the 10 questions of logical prescribing
An example of a disease caused by vector transmission is - ANSWERMalaria
An example of a disease caused by indirect transmission is - ANSWERSalmonella
An example of a disease caused by direct transmission is - ANSWERHerpes Type 1
, Infections are defined as a harmful invasion and spread of a foreign species or
pathogen. Which of the following are sources of infection? - ANSWERAll of the
above: Prions, Fungus & Protists
Epidemiology is defined as - ANSWERThe science of discovering the causes of
illnesses and injury in populations
Which of the following statements is true regarding the first pass metabolism
process? - ANSWERAfter a drug is taken by the oral route, it is absorbed in the small
intestines and enters the liver through the portal circulation before being released
into general circulation.
You would recommend the pneumococcal vaccine to patients with all of the
following conditions EXCEPT - ANSWERG6PD deficiency anemia
Erythromycin inhibits the cytochrome P450 system. The following drugs should be
avoided because of drug interaction EXCEPT - ANSWERLasix
All of the following are included in the criteria used to diagnose patients with AIDS
EXCEPT - ANSWERprofound fatigue
Which of the following is the confirmatory test for the HIV screening test? -
ANSWERWestern blot
Cat and human bites have higher rates of infection than dog bites. A patient comes
to your office with a bite. It does not require sutures or appear infected. You want to
prescribe antibiotic prophylaxsis. The patient has no history of allergies. You
presctibe: - ANSWERAmoxicillin-clavulanate (Augmentin)
74 y/o with a 4 month history of severe stiffness and aching in her neck and both
shoulders and hips that is worsened by movement. She reports having difficulty
getting OOB and dressing. She also has a low grade fever, fatigue, loss of appetite
and weight loss. Yesterday the vision in her right eye has progressively worsened.
Which of the following is the most likely? - ANSWERPolymyalgia rheumatica
Multiple myeloma is a malignancy of the - ANSWERPlasma cells
Which of the following exam findings is most specific for lupus? - ANSWERMalar rash
Which of the following lab tests is positive in a large number of patients with lupus? -
ANSWERAntinuclear antibody
Which of the following is recommended treatment for early Lyme disease? -
ANSWERDoxycycline 100 mg bid x 30 days
Which of the following viral infections is associated with occasional abnormal forms
of lymphocytes during an acute infection? - ANSWEREpstein-Barr
