MSN 611 FINAL EXAM COMPLETE
QUESTIONS WITH 100% VERIFIED
ANSWERS
A 65-year-old man presents to the office with increased
frequency, urgency, nocturia, and hesitancy in micturition for
the past week. He also complains of pain in ejaculation. He
has no flank pain, dysuria, hematuria, or fever. He is in a
monogamous relationship and uses condoms regularly. His
temperature is 98.6 F (37 C), pulse rate is 77 beats/ minute,
respiration is 14 breaths/minute, and blood pressure is 130/80
mmHg. There is no costovertebral angle tenderness or
suprapubic tenderness, and external genitalia examination is
normal. Digital rectal examination shows normal sphincter
tone and reflexes with slightly enlarged and tender prostate.
Urinalysis shows many WBCs with no RBCs or casts. Urine
culture grows E. coli. Serum prostate-specific antigen is
8ng/mL (reference range of less than 3.5 ng/mL). Which of the
following drug class can be used to treat the patient's
condition?
fluroquinolone
,A 41-year-old G5P4004 at 38 weeks, 0 days pregnant presents
for late prenatal testing. She is found to have IgM-positive
antibodies for HSV-2. The patient desires to deliver vaginally.
Which of the following statements is correct regarding the
treatment of choice for this patient's condition?
it is generally safe in pregnancy
A 25-year-old woman presents to the clinician with complaints
of frequent burning micturition and suprapubic discomfort
from the past two days. The patient is sexually active and has
no significant past medical history. Urinalysis reveals the
presence of leukocyte esterase and a high level of nitrites. The
clinician prescribes her a combination antibiotic that inhibits
two steps in the bacterial biosynthesis of tetrahydrofolate.
Which of the following is a contraindication to the use of this
medication?
pregnancy
A 35-year-old woman comes to the office for pain and burning
during urination for the past few days. She denies fever,
abdominal or flank pain, bloody urine, or passing any stones
while urinating. She has a medical history of gastroesophageal
reflux disease, diabetes mellitus type 2, and hyperlipidemia.
She takes over-the-counter antacids, pantoprazole, metformin,
and atorvastatin. She is para 2 with both normal vaginal
delivery and her last menstrual period was three weeks ago.
,She uses oral contraceptive pills for contraception. Her
temperature is 37.2 C, her pulse is 70 beats/min, her
respiratory rate is 12 breaths/min, and her blood pressure is
130/80 mmHg. On examination, she denies suprapubic pain or
costovertebral angle tenderness. Urinalysis reveals white
blood cells of 20-25/hpf and red blood cells of 5-10/hpf with
no casts. Urinary nitrites and leukocyte esterase are positive,
and glucose and ketone are absent. White blood cell count is
7800/mm3. Serum creatinine is 1.1 mg/dL and blood urea
nitrogen is 17 mg/dL. Urine culture grows Escherichia coli. The
patient is started on a drug that inhibits an enzyme required in
bacterial DNA replication. The patient is counseled about
adherence and the adverse effect of this drug. About which of
her other medications should she be counseled?
antacid
A 27-year-old male with a past medical history of tuberculosis
presents to the outpatient clinic with complaints of diarrhea
and crampy abdominal pain. The patient was diagnosed with
tuberculosis 16 weeks ago and is currently on treatment with
isoniazid and rifampicin. Complete blood count shows an
elevated WBC count. Blood testing shows that liver function
tests are normal. Which of the following is the best next step
in the management of this patient?
testing for clostridium difficle
, A 5-year-old boy presents with a worsening cough and thick
yellow-green nasal discharge for the past two weeks. He has
no chronic medical conditions and is not taking any
medication. His immunizations are up to date. Vital signs show
a temperature of 39.2 C (102.6 F), blood pressure of 120/80
mmHg, pulse of 92/min, and respiratory rate of 20/min. On
examination, nasal turbinates are swollen and erythematous,
and there is a thick purulent discharge from the nares. Lungs
are clear on auscultation. Amoxicillin-clavulanate is prescribed
for acute bacterial sinusitis. What is the role of the clavulanate
component in amoxicillin-clavulanate?
Clavulanate inhibits beta-lactamase produced by bacteria to
prevent the inactivation of amoxicillin
A 65-year-old man starts treatment with linezolid for
methicillin-resistant Staphylococcus aureus (MRSA) infection.
Two days later, he complains of fever, sweating, confusion,
and agitation. His blood pressure is 150/91 mmHg, and his
heart rate is 110/minute. A physical exam reveals diaphoresis,
shivering, and hyperreflexia. The patient has a history of
allergic rhinitis, hypercholesterolemia, depression, and peptic
ulcer disease. His usual medications include lovastatin,
astemizole, phenelzine, and famotidine. Which of the
following most likely caused a drug interaction with linezolid?
Phenelzine
QUESTIONS WITH 100% VERIFIED
ANSWERS
A 65-year-old man presents to the office with increased
frequency, urgency, nocturia, and hesitancy in micturition for
the past week. He also complains of pain in ejaculation. He
has no flank pain, dysuria, hematuria, or fever. He is in a
monogamous relationship and uses condoms regularly. His
temperature is 98.6 F (37 C), pulse rate is 77 beats/ minute,
respiration is 14 breaths/minute, and blood pressure is 130/80
mmHg. There is no costovertebral angle tenderness or
suprapubic tenderness, and external genitalia examination is
normal. Digital rectal examination shows normal sphincter
tone and reflexes with slightly enlarged and tender prostate.
Urinalysis shows many WBCs with no RBCs or casts. Urine
culture grows E. coli. Serum prostate-specific antigen is
8ng/mL (reference range of less than 3.5 ng/mL). Which of the
following drug class can be used to treat the patient's
condition?
fluroquinolone
,A 41-year-old G5P4004 at 38 weeks, 0 days pregnant presents
for late prenatal testing. She is found to have IgM-positive
antibodies for HSV-2. The patient desires to deliver vaginally.
Which of the following statements is correct regarding the
treatment of choice for this patient's condition?
it is generally safe in pregnancy
A 25-year-old woman presents to the clinician with complaints
of frequent burning micturition and suprapubic discomfort
from the past two days. The patient is sexually active and has
no significant past medical history. Urinalysis reveals the
presence of leukocyte esterase and a high level of nitrites. The
clinician prescribes her a combination antibiotic that inhibits
two steps in the bacterial biosynthesis of tetrahydrofolate.
Which of the following is a contraindication to the use of this
medication?
pregnancy
A 35-year-old woman comes to the office for pain and burning
during urination for the past few days. She denies fever,
abdominal or flank pain, bloody urine, or passing any stones
while urinating. She has a medical history of gastroesophageal
reflux disease, diabetes mellitus type 2, and hyperlipidemia.
She takes over-the-counter antacids, pantoprazole, metformin,
and atorvastatin. She is para 2 with both normal vaginal
delivery and her last menstrual period was three weeks ago.
,She uses oral contraceptive pills for contraception. Her
temperature is 37.2 C, her pulse is 70 beats/min, her
respiratory rate is 12 breaths/min, and her blood pressure is
130/80 mmHg. On examination, she denies suprapubic pain or
costovertebral angle tenderness. Urinalysis reveals white
blood cells of 20-25/hpf and red blood cells of 5-10/hpf with
no casts. Urinary nitrites and leukocyte esterase are positive,
and glucose and ketone are absent. White blood cell count is
7800/mm3. Serum creatinine is 1.1 mg/dL and blood urea
nitrogen is 17 mg/dL. Urine culture grows Escherichia coli. The
patient is started on a drug that inhibits an enzyme required in
bacterial DNA replication. The patient is counseled about
adherence and the adverse effect of this drug. About which of
her other medications should she be counseled?
antacid
A 27-year-old male with a past medical history of tuberculosis
presents to the outpatient clinic with complaints of diarrhea
and crampy abdominal pain. The patient was diagnosed with
tuberculosis 16 weeks ago and is currently on treatment with
isoniazid and rifampicin. Complete blood count shows an
elevated WBC count. Blood testing shows that liver function
tests are normal. Which of the following is the best next step
in the management of this patient?
testing for clostridium difficle
, A 5-year-old boy presents with a worsening cough and thick
yellow-green nasal discharge for the past two weeks. He has
no chronic medical conditions and is not taking any
medication. His immunizations are up to date. Vital signs show
a temperature of 39.2 C (102.6 F), blood pressure of 120/80
mmHg, pulse of 92/min, and respiratory rate of 20/min. On
examination, nasal turbinates are swollen and erythematous,
and there is a thick purulent discharge from the nares. Lungs
are clear on auscultation. Amoxicillin-clavulanate is prescribed
for acute bacterial sinusitis. What is the role of the clavulanate
component in amoxicillin-clavulanate?
Clavulanate inhibits beta-lactamase produced by bacteria to
prevent the inactivation of amoxicillin
A 65-year-old man starts treatment with linezolid for
methicillin-resistant Staphylococcus aureus (MRSA) infection.
Two days later, he complains of fever, sweating, confusion,
and agitation. His blood pressure is 150/91 mmHg, and his
heart rate is 110/minute. A physical exam reveals diaphoresis,
shivering, and hyperreflexia. The patient has a history of
allergic rhinitis, hypercholesterolemia, depression, and peptic
ulcer disease. His usual medications include lovastatin,
astemizole, phenelzine, and famotidine. Which of the
following most likely caused a drug interaction with linezolid?
Phenelzine
