NR511 WEEK 3 QUIZ MAY 2020

Question 1 Henry, 64 years old, is having difficulty getting rid of a corneal infection. He asks why. How do you respond?

“Systemic antibiotics have difficulty getting to that area of the eye.”

“Because the cornea doesn’t have a blood supply, an infection can’t be fought off as usual.”

“Because the infection was painless, it was not treated early enough.”

“We can’t determine the causative agent.”

 Question 2 A 22-year-old college student presents to your urgent care clinic complaining of a rash. She was recently on spring break and spent every night in the hot tub at her hotel. On physical exam, she has multiple small areas of 1- to 2-mm erythematous pustules that are present mostly where her bathing suit covered her buttocks. What is the most likely pathogen causing these lesions?

Staphylococcus aureus.

Streptococcus.

Pseudomonas aeruginosa.

Klebsiella.

 Question 3 A 3-year-old patient presents to your pediatric office with her mother. She has recently started in day care. Her mother noted slight perioral erythema on the right side of the patient’s mouth last night before bed. The patient awoke today with 3 small, superficial, honey-colored vesicles where the erythema was last night. The patient has no surrounding erythema presently. She had no difficulty eating this morning and is active and energetic and doesn’t appear lethargic or fatigued. She is also afebrile. How would you treat this child?

Oral Keflex for 7 days.

Topical compress with Burow solution and follow-up in 2 to 3 days.

Local debridement and topical compress with Burow solution and close follow-up.

Local debridement and mupirocin for 5 days.

 Question 4 A 20-year-old male presents to your office in the summer complaining of chest discoloration. He is a lifeguard and has been out in the sun without a shirt on for long periods of time. His physical exam shows small, flat, circular, hypopigmented macules on his chest that he states are mildly pruritic. What is the treatment of choice for this diagnosis?

Hydrocortisone cream 1%.

Oral fluconazole.

Selenium sulfide shampoo.

Ketoconazole shampoo.

 Question 5 Mary, age 82, presents with several eye problems. She states that her eyes are always dry and look “sunken in.” What do you suspect?

A detached retina.

Hypothyroidism.

Cushing syndrome.

Normal age-related changes.

 Question 6 A rash that looks like the patient was slapped on the cheeks of the face is the hallmark characteristic for which disease?

Erythema infectiosum (fifth disease).

Rocky Mountain spotted fever.

Rubella.

Rubeola.

Question 7 Which of the following patients does not have an increased risk of Candida infection?

A diabetic patient.

A patient requiring home antibiotics while recovering from an operation for an infected hernia.

A patient using a steroid regimen for asthma control.

A patient with a history of coronary artery disease.

Question 8 Sharon, a 47-year-old bank teller, is seen by the nurse practitioner in the office for a red eye. You are trying to decide between a diagnosis of conjunctivitis and iritis. One distinguishing characteristic between the two is:

No change in or slightly blurred vision.

Eye discomfort.

A ciliary flush.

Slow progression.

 Question 9 You diagnose 46-year-old Mabel with viral conjunctivitis. Your treatment should include:

Ciprofloxacin ophthalmic drops.

Gentamicin ophthalmic ointment.

Supportive measures and lubricating drops (artificial tears).

Oral erythromycin for 14 days.

 Question 10 A 27-year-old female comes in to your primary care office complaining of a perioral rash. The patient noticed burning around her lips a couple days ago that quickly went away. She awoke from sleep yesterday and noticed a group of vesicles with erythematous bases where the burning had been before. There is no burning today. She is afebrile and has no difficulty eating or swallowing. What test would confirm her diagnosis?

Sterile culture sent for aerobic and anaerobic bacteria.

Potassium hydroxide (KOH) prep.

Exam under a Wood lamp.

Tzanck smear.

 Question 11 Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful red eye without discharge. You should suspect:

Allergic conjunctivitis.

Bacterial conjunctivitis.

Iritis.

Viral conjunctivitis.

 Question 12  A 4-year-old male presents to your pediatric clinic with his mother complaining of an itchy rash, mostly between his fingers. This has been going on for multiple days and has been getting worse. The patient recently started at a new day care. On physical exam, the patient is afebrile and has multiple small (1-2 mm) red papules in sets of 3 located in the web spaces between his fingers. He also has signs of excoriation. What is the treatment for this problem?

Ketoconazole cream.

Cold compresses and hydrocortisone cream 1% twice a day.

Over-the-counter Benadryl cream.

Permethrin lotion for the patient and also his family members.

 Question 13 A 10-year-old male presents to the office with his mother with complaints of itchy and red eyes for 1 day. He reports watery drainage in both eyes, associated with repetitive itching. He has no fever or constitutional symptoms. The patient has a sibling that just started day care recently. Upon examination, vision is 20/20 OU with glasses. He has mild to moderate conjunctival hyperemia with bilateral preauricular lymph nodes that are inflamed. What is the patient’s diagnosis?

Viral conjunctivitis.

Allergic conjunctivitis.

Bacterial conjunctivitis.

Blepharitis.

Question 14 A 25-year-old male presents to your urgent care clinic complaining of genital pruritus. On physical exam, the patient has small, erythematous, excoriated papules in his pubic hair. No mites are identified. There is no penile discharge, and the patient has no constitutional symptoms. He is sexually active but wears condoms during all sexual experiences. What is the most likely diagnosis?

Chlamydia.

Gonorrhea.

Pediculosis.

Scabies.

 Question 15  A 25-year-old male presents with “bleeding in my eye” for 1 day. He awoke this morning with a dark area of redness in his eye. He has no visual loss or changes. He denies constitutional symptoms, pruritus, drainage, or recent trauma. The redness presents on physical exam as a dark red area in the patient’s sclera of the right eye only and takes up less than 50% of the eye. The patient’s remaining sclera is clear and white. He also notes he was drinking alcohol last night and vomited afterward. What is the best treatment?

Cold compresses and frequent handwashing.

Sending the patient to the emergency department for immediate ophthalmology consult.

Reassurance that this lesion will resolve without any treatment in 2 to 4 weeks.

Topical steroids and close follow-up with an ophthalmologist.