N619 Advanced Pathophysiology (all chapters ) Solved Solutions VERIFIED

Question 1 0 / 0 pts Which approaches are among those recommended by the Agency for Healthcare Research and Quality to improve health literacy in patients? (Select all that apply.) You Answered Giving written handouts for all teaching You Answered Highlighting no more than 7 key points Correct! Empowering patients and families Correct! Supplementing teaching with visual aids Correct! Repeating the instructions Question 2 0 / 0 pts The provider sees a child with a history of high fever and sore throat. When entering the exam room, the provider finds the child sitting in the tripod position and notes stridor, drooling, and anxiety. What is the initial action for this patient? Correct! Obtain an immediate consultation with an otolaryngologist Have the child lie down and administer high-flow, humidified oxygen Administer empiric intravenous antibiotics and steroids Perform a thorough examination of the oropharynx Question 3 0 / 0 pts During a routine physical examination, a provider notes a shiny, irregular, painless lesion on the top of one ear auricle and suspects skin cancer. What will the provider tell the patient about this lesion? This is most likely malignant. It is benign and will not need intervention. Immediate surgery is recommended. Correct! A biopsy should be performed. Question 4 0 / 0 pts A school-age child has had 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The child’s parent asks the provider if the child needs a tonsillectomy. What will the provider tell this parent? Correct! Current recommendations do not support tonsillectomy for this child. If there is one more episode in the next 6 months, a tonsillectomy is necessary. The child should have radiographic studies to evaluate the need for tonsillectomy. Tonsillectomy is recommended based on this child’s history. Question 5 0 / 0 pts A patient has an initial episode otitis external associated with swimming. The patient’s ear canal is mildly inflamed and the tympanic membrane is not involved. Which medication will be ordered? Fluconazole Neomycin Correct! Cipro HC Vinegar and alcohol Question 1 1 / 1 pts A patient has gingival inflammation with several areas of ulceration and a small amount of purulent discharge. What is required to diagnose this condition? Culture and sensitivity Microscopic exam of oral scrapings Correct! Physical examination Tzanck smear Question 2 1 / 1 pts A patient is suspected of having vestibular neuritis. Which finding on physical examination is consistent with this diagnosis? Facial palsy and vertigo Fluctuating hearing loss and tinnitus Correct! Spontaneous horizontal nystagmus Vertigo with changes in head position Question 3 0 / 1 pts A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain when manipulating the external ear structures. What is the likely diagnosis? Correct Answer Acute otitis externa You Answered Acute otitis media Chronic otitis externa Otitis media with effusion Question 4 1 / 1 pts A patient reports ear pain after being hit in the head with a baseball. The provider notes a perforated tympanic membrane. What is the recommended treatment? Order antibiotic ear drops if signs of infection occur Prescribe analgesics and follow up in 1 to 2 days Reassure the patient that this will heal without problems Correct! Refer the patient to an otolaryngologist for evaluation Question 5 0.33 / 1 pts What are factors associated with acute suppurative parotitis? (Select all that apply.) Allergies Correct Answer Anticholinergic medications Correct! Diabetes mellitus Hypervolemia Radiotherapy Question 6 1 / 1 pts A child is hit with a baseball bat during a game and sustains an injury to the nose, along with a transient loss of consciousness. A health care provider at the game notes bleeding from the child’s nose and displacement of the septum. What is the most important intervention at this time? Apply ice to the injured site to prevent airway occlusion Correct! Immobilize the child’s head and neck and call 911 Place nasal packing in both nares to stop the bleeding Turn the child’s head to the side to prevent aspiration of blood Question 7 1 / 1 pts A patient has bilateral bleeding from the nose with bleeding into the pharynx. What is the initial intervention for this patient? Apply firm, continuous pressure to the nostrils Correct! Assess airway safety and vital signs Clear the blood with suction to identify site of bleeding Have the patient sit up straight and tilt the head forward Question 8 1 / 1 pts A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A physical examination reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend for this patient? Consultation for immunotherapy Correct! Daily intranasal steroids Oral antihistamines each morning Oral decongestants as needed Question 9 1 / 1 pts An adult patient is seen in clinic with fever, sore throat, and dysphagia. Which diagnostic test will the provider order to confirm a diagnosis of epiglottitis? Blood cultures Complete blood count Correct! Fiberoptic nasopharyngoscopy Lateral neck film Question 10 1 / 1 pts A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with erythema and edema of the surrounding tissues without discharge. Which is the initial course of action by the provider? Perform an incision and drainage of the edematous tissue Correct! Prescribe amoxicillin and refer to a dentist in 2 to 3 days Recommend oral antiseptic rinses and follow up in one week Refer to an oral surgeon for emergency surgery Question 1 1 / 1 pts A patient suffers a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury? Correct! Because the posterior segment is not involved, the prognosis is good Blindness is likely with this type of eye injury Massive hemorrhage and loss of intraocular contents is likely Retinal detachment is almost certain to occur Question 2 1 / 1 pts An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend? Antibiotic eye drops Nasolacrimal duct probing Systemic antibiotics Correct! Warm compresses Question 3 1 / 1 pts A patient who works in a furniture manufacturing shop reports a sudden onset of severe eye pain while sanding a piece of wood and now has copious tearing, redness, and light sensitivity in the affected eye. On examination, the conjunctiva appears injected, but no foreign body is visualized. What is the practitioner’s next step? Administration of antibiotic eye drops Correct! Application of topical fluorescein dye Instillation of cyclopegic eye drops Irrigation of the eye with normal saline Question 4 1 / 1 pts A provider performs an eye examination during a health maintenance visit and notes a difference of 0.5 mm in size between the patient’s pupils. What does this finding indicate? A relative afferent pupillary defect Indication of a difference in intraocular pressure Likely underlying neurological abnormality Correct! Probable benign, physiologic anisocoria Question 5 1 / 1 pts A patient comes to clinic with diffuse erythema in one eye without pain or history of trauma. The examination reveals a deep red, confluent hemorrhage in the conjunctiva of that eye. What is the most likely treatment for this condition? Order lubricating drops or ointments Prescribe ophthalmic antibiotic drops Correct! Reassure the patient that this will resolve Refer to an ophthalmologist Question 6 0 / 1 pts Which is an important protective precaution in a metal fabrication workshop? 2 mm polycarbonate safety glasses You Answered Eyewash stations Glasses with UVB protection Correct Answer Polycarbonate goggles Question 7 1 / 1 pts A patient reports bilateral reports burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. The patient’s eyelids are thickened and discolored. There are no other symptoms. Which type of conjunctivitis is most likely? Correct! Allergic Bacterial Chemical Viral Question 8 0 / 1 pts A patient has dacryocystitis. The provider notes a painful lacrimal sac abscess that appears to be coming to a head. Which treatment will be useful initially? Eyelid scrubs with baby shampoo Correct Answer Incision and drainage Lacrimal bypass surgery You Answered Topical antibiotic ointment Question 9 1 / 1 pts A patient who has an inflamed pterygia lesion has been using loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action? Correct! Consult with an ophthalmologist Continue the medication for 7 more days Prescribe a systemic corticosteroid Refer the patient to the emergency department Question 10 1 / 1 pts A child sustains an ocular injury in which a shard of glass from a bottle penetrated into the eye wall. The emergency department provider notes that the shard has remained in the eye. Which best describes this type of injury? Correct! Intraocular foreign body Penetrating eye injury Perforating eye injury Ruptured globe injury Question 1 0 / 0 pts A patient who has diabetes has a blood pressure of 140/90 mm Hg and albuminuria. Which initial action by the primary care provider is indicated for management of this patient? Prescribing an antihypertensive medication Referring to an ophthalmologist Correct! Consulting with a nephrologist Limiting protein intake Question 2 0 / 0 pts What is important about increased PAI-1 levels in patients with metabolic syndrome? They predispose patients to dyslipidemia. They lower the risk of hypertension. You Answered They cause increased insulin resistance. Correct Answer They increase the risk of arterial thrombosis. Question 3 0 / 0 pts Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary hyperparathyroidism? Prolonged inappropriate secretion of PTH with subsequent hypercalcemia Appropriately high PTH along with hypocalcemia Correct! Inappropriate secretion of PTH along with hypercalcemia Appropriately increased PTH and low or normal serum calcium Question 4 0 / 0 pts A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed? Radionucleotide imaging Correct! Thyroid ultrasound Serum TSH level Serum calcitonin Skip To Content Question 1 1 / 1 pts A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expect to perform once the point of care blood glucose level is known? Dipstick urinalysis for ketones Correct! Giving a rapid-acting carbohydrate Injection of rapid-acting insulin Performing a hemoglobin A1C Question 2 1 / 1 pts A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial diagnostic test will the provider order in the clinic at this visit? C-peptide level Correct! Hemoglobin A1C Random serum glucose Thyroid studies Question 3 0 / 1 pts A patient with type 2 diabetes mellitus becomes insulin dependent after a year of therapy with oral diabetes medications. When explaining this change in therapy, the provider will tell the patient: it is necessary because the patient cannot comply with the previous regimen. that strict diet and exercise measures may be relaxed with insulin therapy. You Answered the use of insulin therapy may be temporary. Correct Answer this is because of the natural progression of the disease. Question 4 0 / 1 pts Which medication given for patients with metabolic syndrome helps to lower PAI-1 levels? You Answered Aspirin Atorvaep Correct Answer Metformin Niacin Question 5 1 / 1 pts What is important about increased PAI-1 levels in patients with metabolic syndrome? They cause increased insulin resistance. Correct! They increase the risk of arterial thrombosis. They lower the risk of hypertension. They predispose patients to dyslipidemia. Question 6 1 / 1 pts A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient? Correct! Annual monitoring of calcium, creatinine, and bone density Avoidance of weight-bearing exercises Decreasing calcium and vitamin D intake until values normal Parathyroidectomy Question 7 0.33 / 1 pts Which findings are symptoms of hyperparathyroidism? (Select all that apply.) You Answered Chvostek’s sign Correct! Cognitive impairment Correct Answer Left ventricular hypertrophy Perioral paresthesias Correct! Renal calculi Question 8 1 / 1 pts A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed? Radionucleotide imaging Serum calcitonin Serum TSH level Correct! Thyroid ultrasound Question 9 1 / 1 pts Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? Correct! 0.2 uIU/L 0.4 uIU/L 2.4 uIU/L 4.2 uIU/L Question 10 0 / 1 pts A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A pregnancy test is negative. What is the initial treatment for this patient? Correct Answer Beta blocker medications Radioiodine therapy Surgical resection of the thyroid gland You Answered Thionamide therapy Skip To Content Question 1 1 / 1 pts A patient suffers a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury? Massive hemorrhage and loss of intraocular contents is likely Correct! Because the posterior segment is not involved, the prognosis is good Retinal detachment is almost certain to occur Blindness is likely with this type of eye injury Question 2 1 / 1 pts A patient who has asthma calls the provider to report having a peak flow measure of 75%, shortness of breath, wheezing, and cough, and tells the provider that the symptoms have not improved significantly after a dose of albuterol. The patient uses an inhaled corticosteroid medication twice daily. What will the provider recommend? Taking an oral corticosteroid Going to the emergency department Coming to the clinic for evaluation Correct! Administering two more doses of albuterol Question 3 1 / 1 pts A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism? D-dimer Arterial blood gases Electrocardiogram Correct! CT angiography Question 4 1 / 1 pts A previously healthy patient develops influenza which is confirmed by RT-PCR testing and begins taking an antiviral medication. The next day, the patient reports increased fever and cough without respiratory distress. The patient’s lungs are clear and oxygen saturations are 97% on room air. What will the provider recommend? Correct! Symptomatic treatment with close follow up in clinic Admission to the hospital for treatment of complications Referral to a specialist for evaluation and treatment Empiric antibiotics to treat a possible secondary infection Question 5 1 / 1 pts A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient? She should be referred to an endocrinologist. She will need lifelong medication. A thyroidectomy will be necessary. Correct! This condition may be transient. Question 6 1 / 1 pts A patient develops a pulmonary embolism after surgery and shows signs of right-sided heart failure. Which drug will be administered to this patient? Unfractionated heparin Warfarin Correct! Tissue plasminogen activator Low molecular heparin Question 7 1 / 1 pts A school-age child has had 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The child’s parent asks the provider if the child needs a tonsillectomy. What will the provider tell this parent? Tonsillectomy is recommended based on this child’s history. Correct! Current recommendations do not support tonsillectomy for this child. If there is one more episode in the next 6 months, a tonsillectomy is necessary. The child should have radiographic studies to evaluate the need for tonsillectomy. Question 8 0 / 1 pts A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this patient? Oral hygiene measures You Answered Nystatin oral suspension Correct Answer Surgical excision Oral acyclovir Question 9 1 / 1 pts A patient has sore throat, a temperature of 38.5° C, tonsillar exudates, and cervical lymphadenopathy. What will the provider do next to manage this patient’s symptoms? Order an antistreptolysin O titer Prescribe empiric penicillin Correct! Perform a rapid antigen detection test Refer to an otolaryngologist Question 10 1 / 1 pts An adult patient who had pertussis immunizations as a child is exposed to pertussis and develops a runny nose, low-grade fever, and upper respiratory illness symptoms without a paroxysmal cough. What is recommended for this patient? Symptomatic care only Correct! Azithromycin daily for 5 days Isolation if paroxysmal cough develops Pertussis vaccine booster Question 11 0.75 / 1 pts Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those with a history of (Select all that apply.) Correct! a 10 year risk score of 8% with an LDL of 80 mg/dL. Correct! a low-density lipoprotein (LDL) level 190 mg/dL. Correct! previous myocardial infarction. Correct Answer a 10 year risk score of 5% and an LDL of 165 mg/dL. diabetes and an LDL between 40 and 70 mg/dL. Question 12 1 / 1 pts A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain when manipulating the external ear structures. What is the likely diagnosis? Otitis media with effusion Correct! Acute otitis externa Chronic otitis externa Acute otitis media Question 13 1 / 1 pts An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend? Nasolacrimal duct probing Correct! Warm compresses Antibiotic eye drops Systemic antibiotics Question 14 1 / 1 pts A provider performs a nasal speculum examination on a patient who sustained nasal trauma in a motor vehicle accident. The provider notes marked swelling of the nose, instability and crepitus of the nasal septum with no other facial bony abnormalities and observes a rounded bluish mass against the nasal septum. Which action is necessary at this time? Surgery to reduce the nasal fracture Correct! Urgent drainage of the mass Ice packs to reduce facial swelling CT scan of facial structures Question 15 1 / 1 pts A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What will the provider tell the patient about this lesion? Spontaneous bleeding is likely Correct! UVB eye protection is especially important Visine may be used for symptomatic relief Artificial tear drops are contraindicated Question 16 1 / 1 pts Which clinical sign is especially worrisome in a patient with a pulmonary embolism? Tachycardia Abnormal lung sounds Correct! Hypotension Dyspnea Question 17 1 / 1 pts An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul-smelling breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What will the primary care provider do? Evaluate for possible epiglottitis Prescribe empiric oral antibiotics Perform a rapid strep and throat culture Correct! Refer the patient to an otolaryngologist Question 18 1 / 1 pts A patient who has acute suppurative parotitis has been taking amoxicillinclavulanate for 4 days without improvement in symptoms. The provider will order an antibiotic for Methicillin-resistant S. aureus. Which other measure may be helpful? Cool compresses Correct! Surgical drainage Discouraging chewing gum Topical corticosteroids Question 19 1 / 1 pts A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What will the provider do? Continue to monitor the patient every 3 years Reassure the patient that these findings are expected Admit the patient to the hospital for evaluation and treatment Correct! Consult with the cardiologist to determine appropriate diagnostic tests Question 20 1 / 1 pts A provider performs an eye examination during a health maintenance visit and notes a difference of 0.5 mm in size between the patient’s pupils. What does this finding indicate? Likely underlying neurological abnormality A relative afferent pupillary defect Correct! Probable benign, physiologic anisocoria Indication of a difference in intraocular pressure Question 21 1 / 1 pts A child sustains an ocular injury in which a shard of glass from a bottle penetrated into the eye wall. The emergency department provider notes that the shard has remained in the eye. Which best describes this type of injury? Correct! Intraocular foreign body Penetrating eye injury Ruptured globe injury Perforating eye injury Question 22 1 / 1 pts A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient? Parathyroidectomy Correct! Annual monitoring of calcium, creatinine, and bone density Avoidance of weight-bearing exercises Decreasing calcium and vitamin D intake until values normal Question 23 1 / 1 pts An adult patient is seen in clinic with fever, sore throat, and dysphagia. Which diagnostic test will the provider order to confirm a diagnosis of epiglottitis? Lateral neck film Correct! Fiberoptic nasopharyngoscopy Complete blood count Blood cultures Question 24 1 / 1 pts A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider determines that the murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur? Aortic stenosis Correct! Hypertrophic cardiomyopathy Tricuspid regurgitation Mitral valve prolapse Question 25 0 / 1 pts A patient with type 2 diabetes mellitus becomes insulin dependent after a year of therapy with oral diabetes medications. When explaining this change in therapy, the provider will tell the patient: You Answered the use of insulin therapy may be temporary. it is necessary because the patient cannot comply with the previous regimen. Correct Answer this is because of the natural progression of the disease. that strict diet and exercise measures may be relaxed with insulin therapy. Skip To Content Dashboard  Account  Dashboard  Courses  Groups  Calendar  Inbox  Help   N675 Care of Acute & Episodic Conditions  Quizzes  Week 6 - Post-Reading Practice Quiz 2019SPRING  Home  Announcements  Syllabus  Modules  Discussions  Assignments  People  Grades  Conferences  Collaborations  Panopto Library Week 6 - Post-Reading Practice Quiz  Due Feb 17 at 11:59pm  Points 0  Questions 5  Available after Feb 10 at 11:59pm  Time Limit None  Allowed Attempts 2 Instructions Complete the 5-question post-reading quiz by 11:59 p.m. (Pacific Time) on Thursday. Take the Quiz Again Attempt History Attempt Time Score LATEST Attempt 1 9 minutes 0 out of 0 Submitted Feb 16 at 11:02pm Question 1 0 / 0 pts A patient with a previous history of liver disease has bile duct obstruction. Which procedure will be used for this patient? You Answered Laparoscopic cholecystectomy Chemical dissolution of the gallstone Correct Answer Open cholecystectomy Lithotripsy Question 2 0 / 0 pts The provider suspects that a patient has chronic pancreatitis. Which diagnostic tests will be most helpful to confirm this diagnosis? You Answered Serum amylase and lipase levels Liver function tests Complete blood count Correct Answer Blood glucose and fecal fat Question 3 0 / 0 pts What is an initial action when admitting a patient to the hospital who has a GI bleed, hypotension, and a hematocrit decrease of 6% from baseline? Correct! Place two large-bore intravenous lines Place a Foley catheter to monitor output Administer packed red blood cells Prepare for surgical repair of the bleed Question 4 0 / 0 pts A patient develops acute diarrhea and then comes to clinic two weeks later reporting profuse watery, bloody diarrheal stools 6 to 8 times daily. The provider notes a toxic appearance with moderate dehydration. Which test is indicated to diagnose this cause? Correct! Stool sample for C. difficile toxin Wright stain of stool for white blood cells Stool collection for 24-hour stool pH Qualitative and quantitative fecal fat Question 5 0 / 0 pts A patient has fever, nausea, vomiting, anorexia, and right upper quadrant abdominal pain. An ultrasound is negative for gallstones. Which action is necessary to treat this patient’s symptoms? Correct Answer Hospitalization for emergent treatment Prescribing ursodeoxycholic acid You Answered Supportive care with close follow-up Empiric treatment with antibiotics Skip To Content Question 1 1 / 1 pts The provider suspects that a patient has chronic pancreatitis. Which diagnostic tests will be most helpful to confirm this diagnosis? Correct! Blood glucose and fecal fat Complete blood count Liver function tests Serum amylase and lipase levels Question 2 0 / 1 pts An adult patient has intermittent, crampy abdominal pain with vomiting. The provider notes marked abdominal distention and hyperactive bowel sounds. What will the provider do initially? Admit the patient to the hospital for consultation with a surgeon Correct Answer Obtain upright and supine radiologic views of the abdomen Prescribe an antiemetic and recommend a clear liquid diet for 24 hours You Answered Schedule the patient for a barium swallow and enema Question 3 0 / 1 pts A patient is in clinic for evaluation of sudden onset of abdominal pain. The provider palpates a pulsatile, painful mass between the xiphoid process and the umbilicus. What is the initial action? Order a CBC, type and crossmatch, electrolytes, and renal function tests Perform an ultrasound examination to evaluate the cause You Answered Schedule the patient for an aortic angiogram Correct Answer Transfer the patient to the emergency department for a surgical consult Question 4 1 / 1 pts A patient reports a decrease in the frequency of stools and asks about treatment for constipation. Which findings are part of the Rome III criteria for diagnosing constipation? (Select all that apply.) Correct! Feeling of incomplete evacuation Fewer than 5 stools per week Correct! Lumpy stools Presence of irritable bowel syndrome Correct! Symptoms present for 3 months Question 5 1 / 1 pts A patient has sudden onset of right upper quadrant and epigastric abdominal pain with fever, nausea, and vomiting. The emergency department provider notes yellowing of the sclerae. What is the probable cause of these findings? Acute acalculous cholecystitis Chronic cholelithiasis Correct! Common bile duct obstruction Infectious cholecystitis Question 6 1 / 1 pts A 50-year-old, previously healthy patient has developed chronic gastritis. What is the most likely cause of this condition? Correct! H. pylori infection NSAID use Parasite infestation Viral gastroenteritis Question 7 0 / 1 pts What is the best treatment for H. pylori-related peptic ulcer disease? H2RA and clarithromycin for 14 days H2RA, bismuth, metronidazole, and tetracycline for 10 to 14 days Correct Answer PPI and clarithromycin for 14 days You Answered PPI, amoxicillin, and clarithromycin for 10 days Question 8 0.33 / 1 pts What are recommendations for patients with chronic pruritis ani? (Select all that apply.) Application of a topical antihistamine You Answered Applying a of 1% hydrocortisone cream for several months Correct! Avoid tight-fitting or non-breathable clothing Correct! Avoiding perfumed soaps and toilet papers Correct Answer Using a hair dryer on the cool setting to control itching Question 9 1 / 1 pts A patient reports anal pruritis and occasional bleeding with defecation. An examination of the perianal area reveals external hemorrhoids around the anal orifice as the patient is bearing down. The provider orders a colonoscopy to further evaluate this patient. What is the treatment for this patient’s symptoms? Correct! A high-fiber diet and increased fluid intake Daily laxatives to prevent straining with stools Infiltration of a local anesthetic into the hemorrhoid Referral for possible surgical intervention Question 10 1 / 1 pts A patient has nausea associated with chemotherapy. Which agent will be prescribed? Diphenhydramine Meclizine Correct! Ondansetron Scopolamine Question 1 0 / 0 pts The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result? The patient probably has a UTI. The patient may have overflow incontinence. Correct! This is a normal result. This represents incomplete emptying. Question 2 0 / 0 pts An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention? Correct! Immediate referral to the emergency department Doppler ultrasound to assess testicular blood flow Transillumination to assess for a “blue dot” sign Prescribing anti-infective agents to treat the infection Question 3 0 / 0 pts An asymptomatic pregnant woman has a positive leukocyte esterase and positive nitrites on a urine dipstick screening. What will the provider do next? Admit to the hospital Prescribe trimethoprim-sulfamethoxazole Order a renal ultrasound Correct! Obtain a urine culture Question 4 0 / 0 pts A 3-month-old male infant has edema and painless swelling of the scrotum. On physical examination, the provider is able to transilluminate the scrotum. What will the provider recommend? A Doppler ultrasound to evaluate the scrotal structures Immediate referral to a genitourinary surgeon for repair A short course of empiric antibiotic therapy Correct! Observation and reassurance that spontaneous resolution may occur Question 5 0 / 0 pts A young adult male reports a dull pain in the right scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient? Correct! Consideration of underlying causes of this finding Reassurance that this is benign and may resolve spontaneously Anti-infective therapy with ceftriaxone or doxycycline Referral to an emergency department for surgical consultation Skip To Content Question 1 1 / 1 pts An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend? Amoxicillin-clavulanate for 10 days Cultures and treatment if symptoms appear Correct! Empiric ceftriaxone and azithromycin Trimethoprim-sulfamethoxazole Question 2 1 / 1 pts An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention? Doppler ultrasound to assess testicular blood flow Correct! Immediate referral to the emergency department Prescribing anti-infective agents to treat the infection Transillumination to assess for a “blue dot” sign Question 3 1 / 1 pts A young adult male reports a dull pain in the right scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient? Anti-infective therapy with ceftriaxone or doxycycline Correct! Consideration of underlying causes of this finding Reassurance that this is benign and may resolve spontaneously Referral to an emergency department for surgical consultation Question 4 1 / 1 pts The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result? The patient may have overflow incontinence. The patient probably has a UTI. Correct! This is a normal result. This represents incomplete emptying. Question 5 1 / 1 pts A 3-month-old male infant has edema and painless swelling of the scrotum. On physical examination, the provider is able to transilluminate the scrotum. What will the provider recommend? A Doppler ultrasound to evaluate the scrotal structures A short course of empiric antibiotic therapy Immediate referral to a genitourinary surgeon for repair Correct! Observation and reassurance that spontaneous resolution may occur Question 6 1 / 1 pts A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the UTI, what testing is indicated for this patient? 24-hour urine collection to evaluate for glomerulonephritis Bladder scan Correct! No testing if hematuria is resolved Voiding cystourethrogram Question 7 1 / 1 pts A patient has acute renal colic, nausea, and vomiting and a urinalysis reveals hematuria, but is otherwise normal. A radiographic exam shows several radiopaque stones in the ureter which are less than 1 mm in diameter. What will the primary provider do initially to manage this patient? Obtain a consultation with a urology specialist Correct! Order a narcotic pain medication and increased oral fluids Prescribe desmopressin and a corticosteroid medication Prescribe nifedipine and hospitalize for intravenous antibiotics Question 8 1 / 1 pts The provider is counseling a patient who has stress incontinence about ways to minimize accidents. What will the provider suggest initially? Increasing fluid intake to dilute the urine Referral to a physical therapist Taking pseudoephedrine daily Correct! Voiding every 2 hours during the day Question 9 1 / 1 pts A pregnant woman at 30 weeks gestation has proteinuria. What will the provider do next? Correct! Evaluate her blood pressure Monitor serum glucose for gestational diabetes Perform a 24-hour urine collection Reassure her that this normal at this stage of pregnancy Question 10 1 / 1 pts The daughter of an elderly, confused female patient reports that her mother is having urinary incontinence several times each day. What will the provider do initially? Correct! Obtain a urine sample for urinalysis and possible culture Order serum creatinine and blood urea nitrogen tests Perform a bladder scan to determine distention and retention Tell the daughter that this is expected given her mother’s age and confusion Skip To Content Question 1 0 / 0 pts A perimenopausal woman reports a recent onset of moderate to severe pain with sexual intercourse. Which treatment will the provider prescribe initially to treat this pain? Topical corticosteroids Botulism injections Correct! Topical estrogen Water-based lubrication Question 2 0 / 0 pts A patient has received methotrexate therapy for treatment of an ectopic pregnancy. What will the provider include when teaching this patient about this therapy? (Select all that apply.) Correct! Do not consume alcohol for at least 3 months Pregnancy should be avoided in the future Correct Answer Avoid sexual intercourse for 3 months Correct! Refrain from taking vitamins containing folic acid Long-term effects include lower fertility Question 3 0 / 0 pts An adolescent female has amenorrhea. The provider notes short stature, neck webbing, and a pigeon chest deformity. Based on these symptoms, what is the underlying disorder causing this patient’s amenorrhea? Polycystic ovarian disease Androgen insensitivity You Answered Hypothyroidism Correct Answer Turner’s syndrome Question 4 0 / 0 pts A 35-year-old woman without a previous history of dysmenorrhea reports lower pelvic pain and irregular bleeding between periods. What is the initial action in managing this patient? Prescribing a trial of nonsteroidal anti-inflammatory medications Ordering a CBC, erythrocyte sedimentation rate, and cultures Obtaining a pelvic transvaginal ultrasound with saline infusion Correct! Performing an abdominal, pelvic, and rectovaginal examination Question 5 0 / 0 pts A previously healthy 22-year-old female reports pain in the rectovaginal area that occurs with sexual intercourse. What is the most likely cause of this patient’s discomfort? Correct! Endometriosis Atherosclerosis Inadequate lubrication Psychologic issues Question 1 1 / 1 pts A patient is determined to have a non-ruptured ectopic pregnancy within 1 week of a missed period. Which treatment will the specialist order? Laparoscopy Leucovorin rescue Correct! Methotrexate Mifepristone Question 2 1 / 1 pts A female patient reports cramping, dysuria, low back pain, and nausea. A dipstick urinalysis is normal and a pregnancy test is negative. What will the provider do next? Correct! Obtain vaginal secretions for testing Refer for radiological studies Schedule for an endometrial biopsy Treat with empiric antibiotics Question 3 1 / 1 pts A patient with primary dysmenorrhea has taken NSAIDs and COX-2 inhibitors without getting relief from symptoms. What will the provider suggest? Correct! A combined oral contraceptive Complementary therapies Intrauterine device implantation Narcotic analgesics as needed Question 4 1 / 1 pts A patient has received methotrexate therapy for treatment of an ectopic pregnancy. What will the provider include when teaching this patient about this therapy? (Select all that apply.) Correct! Avoid sexual intercourse for 3 months Correct! Do not consume alcohol for at least 3 months Long-term effects include lower fertility Pregnancy should be avoided in the future Correct! Refrain from taking vitamins containing folic acid Question 5 1 / 1 pts An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend? Amoxicillin-clavulanate for 10 days Cultures and treatment if symptoms appear Correct! Empiric ceftriaxone and azithromycin Trimethoprim-sulfamethoxazole Question 6 0 / 1 pts A sexually active female has symptoms of PID with fever. Cultures are pending. For outpatient treatment, what will the provider order? Ampicillin and doxycycline You Answered Cefotetan and doxycycline Clindamycin and gentamicin Rocephin, doxycycline, and metronidazole Question 7 1 / 1 pts A female patient has lower abdominal pain, nausea, and vomiting and reports missing a period 3 weeks prior. The patient reports using an intrauterine device for contraception. A serum B-hCG is 1500 mIU/mL. What will the provider do, based on these findings? Correct! Perform a transvaginal ultrasound Recheck the B-hCG level in 4 to 6 weeks Refer for a diagnostic laparoscopy Tell the patient that a viable pregnancy is likely Question 8 0.67 / 1 pts A 15-year-old female who participates in high school track and gymnastics is experiencing amenorrhea after having eight normal periods. A pregnancy test is negative. What may be included in management of this patient’s amenorrhea to restore normal periods? (Select all that apply.) Correct! Calcium and vitamin D supplementation Clomiphene administration Combination oral contraceptives Correct! Dietician consultation Estriol therapy Question 9 0 / 1 pts An adolescent female reports crampy pelvic pain radiating to the back, sacrum, and inner thighs during the first 2 days of each menstrual period, associated with nausea and loose tools. She asks about what causes these symptoms. What will the provider tell her? Correct Answer Excess prostaglandins, vasopressin will cause these symptoms Mechanical cervical obstruction or severe uterine flexion are likely causes Nulliparity and her young age are correlated with these symptoms You Answered The most likely cause at her age is anovulatory menstrual cycles Question 10 0 / 1 pts A postmenopausal woman reports unilateral breast pain that she describes as sharp and burning and localized to one area. A breast examination reveals no dimpling, discharge, or masses. Which diagnostic test will the provider order? Correct Answer Bilateral mammography Focused ultrasound You Answered Hormone levels Needle biopsy Skip To Content Question 1 0 / 0 pts A pregnant woman reports not having had any vaccinations as a child but requests vaccines during her pregnancy. Which vaccines may be given? (Select all that apply.) Correct! Inactivated influenza MMR Correct Answer HPV Correct! Tdap Varicella Live, attenuated influenza Question 2 0 / 0 pts A pregnant woman who is overweight has no previous history of hypertension or diabetes. Her initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL. What will the practitioner do? Initiate insulin therapy Prescribe an antihypertensive medication Correct! Monitor blood pressure and fasting blood glucose closely Refer the patient to a high-risk pregnancy specialist Question 3 0 / 0 pts A woman who is taking oral contraceptive pills (OCPs) to prevent pregnancy calls the provider to report forgetting to take the pills for 4 days. She has not had sexual intercourse during that time. What will the provider recommend? Stop the OCP, use an alternative method, and resume OCPs at the next cycle Use a morning after pill today and resume the OCPs now Correct! Resume the pills and use a backup method the remainder of the cycle Take 2 pills daily for 4 days and use an alternative method for 4 days Question 4 0 / 0 pts A woman who is currently pregnant reports that she has had three previous pregnancies: twins delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at 16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record? You Answered G4P:1213 G5P:1113 Correct Answer G4P:1113 G5P:1213 Question 5 0 / 0 pts An infant who has just begun nursing develops hyperbilirubinemia. What will the provider tell the mother? Correct Answer To use a breast pump to increase her milk supply To switch to formula until the bilirubin level drops You Answered To supplement feedings with extra water To decrease the frequency of breastfeeding Skip To Content Dashboard  Account  Dashboard  Courses  Groups  Calendar  Inbox  Help   N675 Care of Acute & Episodic Conditions  Quizzes  Week 9 - Quiz 2019SPRING  Home  Announcements  Syllabus  Modules  Discussions  Assignments  People  Grades1  Conferences  Collaborations  Panopto Library Week 9 - Quiz  Due Mar 10 at 11:59pm  Points 10  Questions 10  Available after Mar 3 at 10:59pm  Time Limit None Instructions Complete this week’s quiz. Attempt History Attempt Time Score LATEST Attempt 1 19 minutes 9 out of 10 Score for this quiz: 9 out of 10 Submitted Mar 10 at 6:17pm This attempt took 19 minutes. Question 1 1 / 1 pts A woman has a history of migraines with aura and request oral contraceptives to prevent pregnancy. Which type of contraceptive will the provider recommend? Combination oral contraceptive Contraceptive implant Correct! Progestin-only contraception Transdermal combination product Question 2 1 / 1 pts A pregnant woman who is overweight has no previous history of hypertension or diabetes. Her initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL. What will the practitioner do? Initiate insulin therapy Correct! Monitor blood pressure and fasting blood glucose closely Prescribe an antihypertensive medication Refer the patient to a high-risk pregnancy specialist Question 3 1 / 1 pts A pregnant woman reports not having had any vaccinations as a child but requests vaccines during her pregnancy. Which vaccines may be given? (Select all that apply.) Correct! HPV Correct! Inactivated influenza Live, attenuated influenza MMR Correct! Tdap Varicella Question 4 1 / 1 pts A woman who is currently pregnant reports that she has had three previous pregnancies: twins delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at 16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record? Correct! G4P:1113 G4P:1213 G5P:1113 G5P:1213 Question 5 0 / 1 pts The mother of a 3-day-old newborn reports that her infant nurses every 4 hours during the day and sleeps 6 hours at night. What will the provider recommend? Correct Answer Awakening the baby every 3 hours to nurse Continuing this schedule until the infant is 6 months old Ensuring that her infant nurses for 15 to 20 minutes each time You Answered Pumping her breasts to maintain her milk supply Question 6 1 / 1 pts An infant who has just begun nursing develops hyperbilirubinemia. What will the provider tell the mother? To decrease the frequency of breastfeeding To supplement feedings with extra water To switch to formula until the bilirubin level drops Correct! To use a breast pump to increase her milk supply Question 7 1 / 1 pts A woman who is currently pregnant reports that she has had three previous pregnancies: twins delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at 16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record? Correct! G4P:1113 G4P:1213 G5P:1113 G5P:1213 Question 8 1 / 1 pts A woman who is taking oral contraceptive pills (OCPs) to prevent pregnancy calls the provider to report forgetting to take the pills for 4 days. She has not had sexual intercourse during that time. What will the provider recommend? Correct! Resume the pills and use a backup method the remainder of the cycle Stop the OCP, use an alternative method, and resume OCPs at the next cycle Take 2 pills daily for 4 days and use an alternative method for 4 days Use a morning after pill today and resume the OCPs now Question 9 1 / 1 pts A female calls the provider to report having unprotected sexual intercourse approximately 4 days prior. Which regimen will the provider recommend? Plan-B One-Step twice daily for 5 days Plan-B One-Step daily for 5 days Correct! Ulipristal Acetate taken one time Ulipristal Acetate twice daily for 3 days Question 10 1 / 1 pts A mother who has been breastfeeding her infant for several weeks develops a fever, breast warmth, and breast tenderness. What will the provider recommend? Ice packs and decreased frequency of nursing Ice packs and increased frequency of nursing Warm packs and decreased frequency of nursing Correct! Warm packs and increased frequency of nursing