SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ A middle-age female patient presents to the clinic with a recurrence of mild
hidradenitis suppurativa after topical therapies failed. Which first-line
treatment is recommended?.
Answer: TetracyclineTwelve weeks of oral tetracycline (Sumycin) is the
recommended first-line treatment for hidradenitis
suppurativa.__________________________________________________Hidradeni
suppurativa is a disorder of the terminal follicular epithelium in apocrine
gland-bearing skin. It is a chronic, disabling disorder that progresses, often
causing keloids, contractures, and immobility. It is characterized by
comedone-like follicular occlusion, chronic and relapsing inflammation,
mucopurulent discharge, and progressive scarring.Arthropathy associated
with hidradenitis may be present. Typical presentation includes nodules and
sinus tracts (inflamed or noninflamed), abscesses, and scarring found in the
axilla, genitofemoral area, perineum, gluteal area, and inframammary area in
women.Recommended treatments include antibiotics, steroids, retinoids,
dapsone, and anti-tumor necrosis factor agents. A dermatology consultation
should also be considered.First-line treatment is a 12‑week course of an oral
tetracycline (Sumycin) such as doxycycline. For patients who do not
respond to doxycycline, the next recommended step is a combination of
twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-12 weeks.
If treatment fails, acitretin (Soriatane, for males and nonfertile females) or
dapsone (Aczone) may be considered by a dermatologist. In patients with
moderate to severe hidradenitis suppurativa, adalimumab (Humira) may
possibly be considered.
,◍ When providing culturally competent health care services to an American
Indian elder, the nurse practitioner understands which is traditionally true?.
Answer: The "Medicine Wheel" is used by many for the purpose of health
and healingThe "Medicine Wheel" is traditionally used and contains four
directions; north, south, east, and west. Traditionally each tribe has different
meanings for each direction and they may represent the season of the year or
stage of life. It is aimed at providing a holistic view of
life.________________________________________An understanding of
different cultural preferences leads to cultural competence in healthcare.
Some patients may value traditional culture and preferences as it relates to
healthcare. These individual preferences should be included in the interview
and treatment plan for patients.Traditionally, the American Indian culture
values a holistic approach to health care integrating the person, lifestyle,
environment, family, and religion. Patients adhering to these traditional
cultural practices often feel that illness is due to a lack of harmony with the
physical body, mind, spirit, and emotions. Patients may seek care from
western medicine for specific ailments while also consulting with traditional
healers for spiritual guidance.Healthcare providers should seek to
understand relevant cultural factors and assess each individual's healthcare
literacy in order to provide culturally competent care.
◍ The nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right ear.
The nurse practitioner suspects conductive hearing loss. Which could
contribute to this?.
Answer: Cerumen, commonly called earwax, is a combination of secretions
and sloughed epithelial cells that protects the ears from infection, water, and
insects. It is normally expelled from the ear canal through natural jaw
movement. When this self-cleaning process fails, cerumen can become
impacted. Cerumen impaction occludes the ear canal and can press against
the tympanic membrane, resulting in conductive hearing
loss._________________________________________Conductive hearing
is the transition of sound from the external and middle ear to the inner ear.
, Conductive hearing loss is caused by problems in the external and middle
ear that interfere with the transmission of sound and its conversion to
mechanical vibration. Causes of conductive hearing loss include obstruction
of the external auditory canal by cerumen, foreign bodies, debris from otitis
externa, and large exocytosis and osteomas.Sensorineural hearing loss
involves difficulty converting mechanical vibrations to electrical potential in
the cochlea or in auditory nerve transmission to the brain. It is mostly
caused by permanent damage in the organ of Corti. It can be caused by
age-related hearing loss, noise trauma, medications, autoimmune diseases,
mechanical trauma, Meniere disease, infection, and neoplasm (acoustic
neuroma).Approximately one-third of older adults between the ages of 61
and 70 years have hearing loss. More than 90% of adults older than 85 years
of age have hearing loss. The most common type of hearing loss is
age-related and sensorineural. All adults older than 60 years of age should
be screened for hearing loss at periodic health examinations.
◍ Autism Spectrum Disorder (ASD) is characterized by?.
Answer: 1. deficits in social communication & interaction across multiple
contexts2. restrictive, repetitive patterns of behaviors, interests, and
activities
◍ General clinical findings of ASD.
Answer: -problems with social interactions, communication, and language
skills shown by their unusual ways of relating to people, objects &
events-abnormal responses to sensory stimuli, usually sound -restrictive,
repetitive, or stereotyped behavior and echolalic speech
◍ Clinical findings of ASD in infants.
Answer: -passive, non-engaging, quiet, floppy infant or a difficult, colicky,
stiff baby with poor eye contact-attachment problems, failure to respond to
name or gestures
◍ An otherwise healthy adult patient presents to the clinic with a diagnosis of
community-acquired pneumonia and no recent antibiotic therapy. Which is
the best option for treatment?.
, Answer: AmoxicillinHigh-dose amoxicillin (Amoxil) or doxycycline are
recommended as first-line therapy for adults without
comorbidities._____________________________________________Community-ac
pneumonia (CAP) is pneumonia not acquired in a hospital or long-term care
facility. Patients with suspected CAP should receive a chest X-ray for
diagnosis. The Pneumonia Severity Index should be used to assist in
decisions regarding the need for hospitalization in patients with
CAP.According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial treatment
of CAP for most patients is amoxicillin or doxycycline. Macrolides are an
option for treatment, but are no longer recommended routinely as first-line
treatment, given increased macrolide resistance. This is a change from the
2007 ATS/IDSA guidelines. Respiratory fluoroquinolones and
amoxicillin/clavulanate should be used in patients who fail first-line
medications, have significant comorbidities, have had recent antibiotic
therapy, are allergic to alternative agents, or have a documented infection
with highly drug-resistant pneumococci.
◍ You have a 35-year-old female patient who is complaining of wrist pain.
She is an administrative assistant who does a great deal of computer work in
her job. You will test her for carpal tunnel syndrome. When you tap at the
volar surface of the wrist you are performing which of the following tests?.
Answer: Tinel's sign
◍ Clinical findings of ASD in toddlers.
Answer: -language delays, lack of social relatedness, & severe behavioral
problems-expressive language is delayed-echolalia (repetition of words of
phrases), have trouble modulating tone of voice-social detachment,
decreased eye contact, lack of reciprocity or initiating conversation, lack of
fear, poor creative skills-persistent/excessive temper tantrums, preference to
line, stack or spin toys, insistence on routines
◍ Clinical findings of ASD in school age.
Answer: -lack of reciprocal friendships-continued language, social &