Question: A 20-year-old male presents to your primary care clinic. This patient is a college student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose and throat exam shows mild erythema of the nasal mucosa and edematous, enlarged tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar exudates. He has inflamed posterior cervical lymph nodes. He has a mild nonproductive cough and clear lung exam. What is his most likely diagnosis?
Question: Which of the following is not a complication of untreated group A streptococcal pharyngitis?
Question: Jonathan, age 19, has just been given a diagnosis of mononucleosis. Which of the following statements is true?
Question: Mario, a 17-year-old high school student, came to the office for evaluation. He is complaining of persistent sore throat, fever, and malaise not relieved by the penicillin therapy prescribed recently at the urgent care center. As the nurse practitioner, what would you order next?
Question: Marcia, age 4, is brought in to the office by her mother. She has a sore throat, difficulty swallowing, copious oral secretions, respiratory difficulty, stridor, and a temperature of 102°F but no pharyngeal erythema or cough. What do you suspect?
Question: You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergency room. Which of the following symptoms would indicate that an airway obstruction is imminent?
Question: A patient asks how to avoid contracting pharyngitis and tonsillitis. Which piece of advice is not appropriate for this patient?
Question: Which of the following is not recommended for hoarseness (Dysphonia)?
Question: Samantha, age 12, presents with ear pain. When you begin to assess her ear, you tug on her normal- appearing auricle, eliciting severe pain. This leads you to suspect:
Question: Kathleen, age 54, has persistent pruritus of the external auditory canal. External otitis and dermatological conditions, such as seborrheic dermatitis and psoriasis, have been ruled out. What can you advise her to do?
Question: Jill, a 34-year-old bank teller, presents with symptoms of hay fever. She complains of nasal congestion, runny nose with clear mucus, and itchy nose and eyes. On physical assessment, you observe that she has pale nasal turbinates. What is your diagnosis?
Question: A 75-year-old African American male presents to your family practice office complaining of visual impairment. He has worn corrective lenses for many years but has noticed that his vision has gotten progressively worse the past 6 months. He denies pain. He states his vision is worse in both eyes in the peripheral aspects of his visual field. He also notes trouble driving at night and halos around street lights at night. You test his intraocular pressure, and it is 23 mm Hg. What is his most likely diagnosis?
Question: What significant finding(s) in a 3-year-old child with otitis media with effusion would prompt more aggressive treatment and referral?
Question: In a young child, unilateral purulent rhinitis is most often caused by:
Question: Marjorie, age 37, has asthma and has been told she has nasal polyps. What do you tell her about them?
Question: Kevin, age 26, has AIDS and presents to the clinic with complaints of a painful tongue covered with what look like creamy white, curd like patches overlying erythematous mucosa. You are able to scrape off these “curds” with a tongue depressor, which assists you in making which of the following diagnoses?
Question: You diagnose 46-year-old Mabel with viral conjunctivitis. Your treatment should include:
Question: The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is:
Question: An 80-year-old woman comes in to the office with complaints of a rash on the left side of her face that is blistered and painful and accompanied by left-sided eye pain. The rash broke out 2 days ago, and she remembers being very tired and feeling feverish for a week before the rash appeared. On examination, the rash follows the trigeminal nerve on the left, and she has some scleral injection and tearing. You suspect herpes zoster ophthalmicus. Based on what you know to be complications of this disease, you explain to her that she needs:
Question: A 70-year-old client with herpes zoster has a vesicle on the tip of the nose. This may indicate:
Question: Dan, age 57, has just been given a diagnosis of herpes zoster. He asks you about exposure to others. You tell him:
Question: Mr. Swanson, age 67, presents to the clinic for his annual health exam. He asks you if there is anything he can do to prevent the painful, blistering sores that develop on his lip in the summertime when he plays golf. You explain to Mr. Swanson that the way to prevent the development of these lesions is to:
Question: Elizabeth, age 83, presents with a 2-day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules at that site. What do you suspect?
Question: Which condition is not included in the atopic triad?
Question: A 16-year-old male presents to your office. He was sent by an orthopedist. He has recently had surgical fixation of a humerus fracture. The patient has been going to physical therapy and has been developing a rash on his arm after therapy that disappears shortly after returning home. He does not have the rash prior to therapy. The patient denies fevers and chills, and his incision is well healed, with no signs of infection. Of note, the patient has been experiencing more hand edema than the average patient and has had edema wraps used at the end of therapy to help with his swelling. The wraps are made of a synthetic plastic material. The rash the patient gets is erythematous and blotchy, not raised; it is on the operative upper extremity. What is the most likely diagnosis?
Question: Which of the following statements about malignant melanomas is true?
Question: Lee brings her 13-year-old son to your clinic. He has been complaining of a rash on the buttocks, anterior thighs, and posterolateral aspects of his upper arms. He tells you it is mildly pruritic and looks like “gooseflesh.” On examination, the rash appears as small, pinpoint, follicular papules on a mildly erythematous base. You explain to Lee that the benign condition is likely to resolve by the time her son reaches adulthood, and it is known as:
Question: Jim, age 59, presents with recurrent, sharply circumscribed red papules and plaques with powdery white scale on the extensor aspects of his elbows and knees. What do you suspect?
Question: Which of the following statements about psoriasis is not true?
Question: Which presentation is most concerning for skin cancer?
Question: A 4-year-old male presents to your pediatric clinic with his mother complaining of an itchy rash, mostly between his fingers. This has been going on for multiple days and has been getting worse. The patient recently started at a new day care. On physical exam, the patient is afebrile and has multiple small (1-2 mm) red papules in sets of 3 located in the web spaces between his fingers. He also has signs of excoriation. What is the treatment for this problem?
Question: Which of the following patients would not be at risk of Candida infection?
Question: A 3-year-old patient presents to your pediatric office with her mother. She has recently been started in day care. Her mother noted slight perioral erythema on the right side of the patient’s mouth prior to bed last night. The patient awoke today with 3 small, superficial, honey-colored vesicles where the erythema was last night. The patient has no surrounding erythema. She had no difficulty eating this morning and is active and energetic and doesn’t appear lethargic or fatigued. She is also afebrile. How would you treat this child?
Question: A 22-year-old college student presents to your urgent care clinic complaining of a rash. She was recently on spring break and spent every night in the hot tub at her hotel. On physical exam, she has multiple small areas of 1- to 2-mm erythematous pustules that are present mostly where her bathing suit covered her buttocks. What is the most likely pathogen causing these lesions?
Question: A 10-year-old male in 5th grade presents to the pediatric office with his mother complaining of itchy and red eyes for 1 day. The patient complains of watery drainage in both eyes, associated with repetitive itching. On physical exam, he has no fever or constitutional symptoms. His vision is normal, with no decrease in extraocular movements. The patient has a sibling that just started day care recently. He also has bilateral preauricular lymph nodes that are inflamed. What is the patient’s diagnosis?
Question: Justin, an obese 42-year-old, cut his right leg 3 days ago while climbing a ladder. Today his right lower leg is warm, reddened, and painful, without a sharply demarcated border. What do you suspect?
Question: Danny, age 18, presents with a pruritic rash on his upper trunk and shoulders. You observe flat to slightly elevated brown papules and plaques that scale when they are rubbed. You also note areas of hypopigmentation. What is your initial diagnosis?
Question: Buddy, age 13, presents with annular lesions with scaly borders and central clearing on his trunk. What do you suspect?
Question: You’re teaching Mitch, age 18, about his tinea pedis. You know he doesn’t understand your directions when he tells you which of the following?
Question: Thomas, age 35, uses a high-potency corticosteroid cream for a dermatosis. He also currently has tinea corporis. You tell him the following regarding the cream:
Question: Jill, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?
Question: Martin, age 13, just started taking amoxicillin for otitis media. His mother said that he woke up this morning with a rash on his trunk. What is your first action?
Question: Sandra, age 69, is complaining of dry skin. What do you advise her to do?
Question: Sandy asks what she can do for Dolores, her 90-year-old mother, who takes a bath every day and who has extremely dry skin. You respond:
Question: Candidiasis may occur in many parts of the body. James, age 29, has it in the glans of his penis. What is your diagnosis?
Question: Cataracts are a common occurrence in patients over 60 years of age. You counsel your patient that the best cure for cataracts is:
Question: A 62-year-old woman presents to your clinic with a sudden right-sided headache that is worse in her right eye. She states that her vision seems blurred, and her right pupil is dilated and slow to react. The right conjunctiva is markedly injected, and the eyeball is firm. You screen her vision and find that she is 20/30 OS and 20/30 OD. She most likely has:
Question: Alexandra, age 34, was treated with oral antibiotics 2 weeks ago for a urinary tract infection. She is seen in the office today for a follow-up visit. On physical examination, the nurse practitioner notices that she has some painless, white, slightly raised patches in her mouth. This is probably caused by:
Question: You are teaching Harvey, age 55, about the warts on his hands. What is included in your teaching?
Question: Which of the following should be used with all acne medications?
Question: A 55-year-old landscaper presents to your primary care office complaining of a small skin lesion on his face. The patient states the lesion causes no pain or other symptoms. On physical exam, you notice a small (3 mm) papule that is flesh-colored and irregular. To palpation, the lesion feels hard and like sandpaper. What type of malignancy is this patient at risk for given the appearance of this lesion?
Question: Your 24-year-old client whose varicella rash just erupted yesterday asks you when she can go back to work. What do you tell her?
Question: Clients should avoid contact with pregnant women and children who have not been exposed to varicella. Client teaching is an integral part of successfully treating pediculosis. Which of the following statements would you incorporate into your teaching plan?
Question: Tom, age 50, is complaining of an itchy rash that occurred about a half hour after putting on his leather jacket. He recalls having a slightly similar rash last year when he wore his jacket. The annular lesions are on his neck and both arms. They are erythematous, sharply circumscribed, and both flat and elevated. His voice seems a little raspy, although he states that his breathing is normal. What is your first action?
Question: When palpating the skin over the clavicle of Norman, age 84, you notice tenting, which is:
Question: Which disease usually starts on the cheeks and spreads to the arms and trunk?
Question: A 27-year-old female comes in to your primary care office complaining of a perioral rash. The patient noticed burning around her lips a couple days ago that quickly went away. She awoke from sleep yesterday and noticed a group of vesicles with erythematous bases where the burning had been before. There is no burning today. She is afebrile and has no difficulty eating or swallowing. What test would confirm her diagnosis?
Question: Caroline has a 13-year-old daughter who has had 2 recent infestations of lice. She asks you what she can do to prevent this. You respond:
Question: Sharon, a 47-year-old bank teller, is seen by the nurse practitioner in the office for a red eye. You are trying to decide between a diagnosis of conjunctivitis and iritis. One distinguishing characteristic between the two is:
Question: Susan is a 19-year-old college student and avid swimmer. She frequently gets swimmer’s ear and asks if there is anything she can do to help prevent it other than wearing earplugs, which do not really work for her. What do you suggest?
Question: Mary, age 82, presents with several eye problems. She states that her eyes are always dry and look “sunken in.” What do you suspect?
Question: What is the most common bacterial pathogen associated with acute otitis media?
Question: You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergency room. Which of the following symptoms would indicate that an airway obstruction is imminent?
Question: Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful red eye without discharge. You should suspect
