FITZGERALD FINAL EXAM REVIEW 2
QUESTIONS AND CORRECT ANSWERS
A 17-year-old patient with a 6 cm abscess on the left
upper arm presents one week post incision and drainage
for a follow-up appointment. The area is still much
improved, but has some residual erythema and
discomfort. The nurse practitioner correctly interprets
that:
The healing process is proceeding normally and the NP
and patient should continue to monitor progress.
The presence of discomfort one week after incision and
drainage suggests residual infection and antibiotics should
be started.
The wound should be packed with iodoform gauze and
irrigated with normal saline twice daily.
Topical mupirocin (Bactroban) should be initiated and
monitor for development of systemic symptoms. -
correct answer- The healing process is
proceeding normally and the NP and patient should
continue to monitor progress. A 6 cm abscess is a fairly
,large one, and the mainstay of management is incision
and drainage with aggressive irrigation. Antibiotics are not
routinely required. Once the abscess is drained it can
proceed through the normal trajectory of healing, which
will be characterized by decreasing erythema, edema, and
pain. This patient appears to be healing as expected,
which is characterized by the progressive symptom
improvement. No change in treatment is warranted by
this presentation.
A 21-year-old female patient presents with a chief
complaint of a four-day history of rhinorrhea, scratchy
throat, headache, and cough. The patient is diagnosed
with a viral upper respiratory tract infection and is sent
home with recommendations for over-the-counter
symptom control measures. She returns to the office one
week later and reports that her cough and sore throat
resolved a few days ago, but in the past 24 hours, she has
developed a low-grade fever, worsening nasal discharge,
and a sharp pain on the left side, including a "pressure"
headache above her left eye. This patient has likely
developed:
A superimposed bacterial sinusitis.
,Orbital cellulitis.
Dacryocystitis.
Scleritis. - correct answer- A superimposed
bacterial sinusitis. Bacterial sinusitis can develop when an
antecedent circumstance causes sinus inflammation
leading to bacterial stasis and subsequent mucosal
infiltration. Common circumstances include a viral upper
respiratory tract infection (URI) or allergic inflammation.
Sinusitis is characterized by localization of symptoms to
the area of the affected sinus; therefore, a common
presentation is one of typical viral URI followed by
unilateral sinus symptoms. Orbital cellulitis is a bacterial
infection of the soft tissue of the orbit, characterized by
lid edema, erythema, purulent drainage, and high fever.
Dacryocystitis is a bacterial infection of the lacrimal
apparatus, and scleritis is inflammation of the sclera,
usually autoimmune in nature.
A 27-year-old woman presents complaining of pain on her
upper thighs related to spilled hot coffee on her lap.
Physical examination reveals a burn site that is red, dry
and blanches briefly with pressure but without blisters.
The NP categorizes this burn as:
, First degree.
Second degree.
Third degree.
Fourth degree. - correct answer- First degree.
First degree. A first degree burn is a superficial burn that
affects only the epidermis. The appearance of first degree
burns is a burn site that is red, painful, dry, and without
blisters. A second degree burn can involve the upper
layers of papillary dermis (superficial partial thickness) or
deeper layers of the dermis (deep partial thickness).
These burns appear red, blistered, and can be swollen. A
third degree burn can involve the dermis and underlying
fat and can appear white or charred.
A 27-year-old woman presents with a urinary tract
infection. She is otherwise healthy and has no reported
drug allergies. The local E. coli resistance rate to TMP-SMX
is 25%. Which of the following is the most appropriate
first-line treatment choice?
QUESTIONS AND CORRECT ANSWERS
A 17-year-old patient with a 6 cm abscess on the left
upper arm presents one week post incision and drainage
for a follow-up appointment. The area is still much
improved, but has some residual erythema and
discomfort. The nurse practitioner correctly interprets
that:
The healing process is proceeding normally and the NP
and patient should continue to monitor progress.
The presence of discomfort one week after incision and
drainage suggests residual infection and antibiotics should
be started.
The wound should be packed with iodoform gauze and
irrigated with normal saline twice daily.
Topical mupirocin (Bactroban) should be initiated and
monitor for development of systemic symptoms. -
correct answer- The healing process is
proceeding normally and the NP and patient should
continue to monitor progress. A 6 cm abscess is a fairly
,large one, and the mainstay of management is incision
and drainage with aggressive irrigation. Antibiotics are not
routinely required. Once the abscess is drained it can
proceed through the normal trajectory of healing, which
will be characterized by decreasing erythema, edema, and
pain. This patient appears to be healing as expected,
which is characterized by the progressive symptom
improvement. No change in treatment is warranted by
this presentation.
A 21-year-old female patient presents with a chief
complaint of a four-day history of rhinorrhea, scratchy
throat, headache, and cough. The patient is diagnosed
with a viral upper respiratory tract infection and is sent
home with recommendations for over-the-counter
symptom control measures. She returns to the office one
week later and reports that her cough and sore throat
resolved a few days ago, but in the past 24 hours, she has
developed a low-grade fever, worsening nasal discharge,
and a sharp pain on the left side, including a "pressure"
headache above her left eye. This patient has likely
developed:
A superimposed bacterial sinusitis.
,Orbital cellulitis.
Dacryocystitis.
Scleritis. - correct answer- A superimposed
bacterial sinusitis. Bacterial sinusitis can develop when an
antecedent circumstance causes sinus inflammation
leading to bacterial stasis and subsequent mucosal
infiltration. Common circumstances include a viral upper
respiratory tract infection (URI) or allergic inflammation.
Sinusitis is characterized by localization of symptoms to
the area of the affected sinus; therefore, a common
presentation is one of typical viral URI followed by
unilateral sinus symptoms. Orbital cellulitis is a bacterial
infection of the soft tissue of the orbit, characterized by
lid edema, erythema, purulent drainage, and high fever.
Dacryocystitis is a bacterial infection of the lacrimal
apparatus, and scleritis is inflammation of the sclera,
usually autoimmune in nature.
A 27-year-old woman presents complaining of pain on her
upper thighs related to spilled hot coffee on her lap.
Physical examination reveals a burn site that is red, dry
and blanches briefly with pressure but without blisters.
The NP categorizes this burn as:
, First degree.
Second degree.
Third degree.
Fourth degree. - correct answer- First degree.
First degree. A first degree burn is a superficial burn that
affects only the epidermis. The appearance of first degree
burns is a burn site that is red, painful, dry, and without
blisters. A second degree burn can involve the upper
layers of papillary dermis (superficial partial thickness) or
deeper layers of the dermis (deep partial thickness).
These burns appear red, blistered, and can be swollen. A
third degree burn can involve the dermis and underlying
fat and can appear white or charred.
A 27-year-old woman presents with a urinary tract
infection. She is otherwise healthy and has no reported
drug allergies. The local E. coli resistance rate to TMP-SMX
is 25%. Which of the following is the most appropriate
first-line treatment choice?
