NURS 6550 Week 8 Board Vitals Quiz

1. A 35-year-old man is for a physical examination. Labs reveal an HIV test that is positive. He undergoes counseling regarding his diagnosis. His CD4 count is 125, and viral load is 36,000; he is Toxoplasma gondii IgG positive. His hepatitis panel shows hepatitis B surface antibody positive and hepatitis C antibody negative. He had a tuberculin skin test (TST) reaction measuring 4 mm. Which of the following prophylaxis treatments for opportunistic infections should you offer? Correct answer: (A) TMP-SMX for Pneumocystis jiroveci prophylaxis. 2. Which of the following is a risk factor for urinary tract infection in sexually active women? Correct answer: (A) Recent spermicide use. 3. A 39-year-old female presents with anxiety and frequent “panic attacks.” She was seen 2 weeks ago, and her examination was unremarkable. The patient is referred to a therapist for a psychological evaluation. She returns today while experiencing a panic attack. She is diaphoretic with a heart rate of 101, blood pressure of 150/90, and papilledema. The patient denies chest pain or dyspnea. She states this is a typical episode. Which of the following tests is the next best step in establishing a diagnosis? Correct answer: (B) 24-hour urinary fractionated metanephrines. 4. Which of the following is true of management goals in sepsis? Correct answer: (D) Urine output of 0.5 mL/kg/hour or more should be targeted in fluid resuscitation in early sepsis. 5. A patient presents with the lesion shown below. Which of the following drugs should be given as post-exposure prophylaxis (PEP) for this disease? Correct Answer: B. Doxycycline 6. A 45-year-old white woman with clinical findings suggestive of Cushing syndrome has 2 elevated late night salivary cortisol levels and 2 elevated urinary free-cortisol tests of 220 and 300 (normal 2-50mg/24 hour); her ACTH level is 55 (normal 5-50pg/mL), and her pituitary MRI shows a 3mm adenoma. Which of the followings is the best next course of action? Correct answer: (D) High-dose dexamethasone suppression test (HDDST) and/or corticotropin-releasing hormone (CRH) stimulation test. 7. A female patient with primary hypothyroidism has been stable (normal TSH) on replacement LT4 (dose 1.6μg/kg of body weight) for several years. On annual follow-up, the following laboratory tests are obtained: T4 = 14.1μg/dL (normal 5.0-10.5) and TSH = 23.4μU/mL (normal 0.4-5.5). Which is the most likely diagnosis?