Acute and Episodic Exam 1 - Complete Solutions (Answered) A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rat
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Acute and Episodic Exam 1 - Complete Solutions (Answered) 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 CT angiography Arterial blood gases Electrocardiogram A 65-year-old patient who has not had an influenza vaccine is exposed to influenza and comes to the clinic the following day with fever and watery, red eyes. What will the provider do initially? Perform a nasal swab for RT-PCR assay Administer LAIV influenza vaccine Observe for improvement or worsening for 24 hours Begin treatment with an antiviral medication A patient complains of shortness of breath when in a recumbent position and reports coughing and pain associated with inspiration. The provider notes distended neck veins during the exam. What is the likely cause of these findings? Pulmonary infection Congestive heart failure Pulmonary embolus Hepatic disease 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? Symptomatic treatment with close follow up in clinic Referral to a specialist for evaluation and treatment Admission to the hospital for treatment of complications Empiric antibiotics to treat a possible secondary infection A patient is seen in clinic for an asthma exacerbation. The provider administers three nebulizer treatments with little improvement, noting a pulse oximetry reading of 90% with 2 L of oxygen. A peak flow assessment is 70%. What is the next step in treating this patient? Administer three more nebulizer treatments and reassess Give epinephrine injections and monitor response Admit to the hospital with specialist consultation Prescribe an oral corticosteroid medication A patient with a smoking history of 35 pack years reports having a chronic cough with recent symptoms of pink, frothy blood on a tissue. The chest radiograph shows a possible nodule in the right upper lobe. Which diagnostic test is indicated? Coagulation studies Computerized tomography Fiberoptic bronchoscopy Needle biopsy 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? CT angiography D-dimer Arterial blood gases Electrocardiogram A patient develops a pulmonary embolism after surgery and shows signs of right-sided heart failure. Which drug will be administered to this patient? Low molecular heparin Warfarin Tissue plasminogen activator Unfractionated heparin A patient develops a dry, nonproductive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms? Antibiotic therapy Bronchodilator treatment Mucokinetic agents Antitussive medication 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? Because the posterior segment is not involved, the prognosis is good 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? Allergic Bacterial Chemical viral 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? Probable benign, physiologic anisocoria A relative afferent pupillary defect Likely underlying neurological abnormality Indication of a difference in intraocular pressure Which patients should be referred immediately to an ophthalmologist after eye injury and initial treatment? (Select all that apply.) A patient who was sprayed by lawn chemicals A patient with irrigation secondary to wood dust A patient who works in a metal fabrication shop A patient with a full-thickness corneal laceration A patient with a corneal abrasion 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? Prescribe ophthalmic antibiotic drops Reassure the patient that this will resolve Refer to an ophthalmologist Order lubricating drops or ointments A child has a localized nodule on one eyelid which is warm, tender, and erythematous. On examination, the provider notes clear conjunctivae and no discharge. What is the recommended treatment? Warm compress and massage of the lesion Surgical incision and drainage Referral to ophthalmologist Systemic antibiotics
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