Author: Anonymous

A 27 year old woman presents with 24 hours of worsening abdominal pain that began periumbilically and migrated to the right lower quadrant. She has nausea, anorexia, a temperature of 38.3 °C (101 °F), and localized rebound tenderness. She is not pregnant. What is the most appropriate next step in management?

A 19 year old college student presents to the clinic with complaints of fatigue, sore throat, and swollen lymph nodes for the past week. She reports a low-grade fever and occasional headaches. On physical examination, you note pharyngeal erythema, tonsillar exudates, and significant cervical lymphadenopathy. The patient mentions that several of her friends have had similar symptoms recently. Based on the patient’s presentation, which of the following is the most likely diagnosis?

The NP is reviewing CBC results from a 28 yr old female with fatigue and palpitations for four weeks. The NP knows that the most common cause of this type of anemia in this female age group is:    Lab Results: Hemoglobin: 9.2 g/dL (Normal: 13.5-17.5 g/dL) Hematocrit: 30% (Normal: 41-53%) Mean Corpuscular Volume (MCV): 70 fL (Normal: 80-100 fL) MCHC: 28g/dl (Normal 32-36 g/dl)  

A 34 year old female with history of heavy menses and iron deficiency anemia should also be evaluated for which underlying metabolic pathology? 

The most common findings in patients who have S pneumoniae is/are: Select all that apply:   2 correct responses

A 19 year old college student presents to the clinic with 7 days of fever, sore throat, malaise, and fatigue. He reports difficulty swallowing and notes that several classmates have been ill recently. He denies cough or rhinorrhea. On physical exam: Temperature: 38.6°C (101.5°F) Oropharynx: tonsillar exudates Neck: posterior cervical lymphadenopathy Abdomen: mild left upper quadrant tenderness Laboratory studies reveal: WBC count: 14,500/µL AST and ALT: mildly elevated A rapid antigen detection test for Group A Streptococcus is negative. What is the next step in making a diagnosis? 

You are evaluating a 32 yr old female with a painful left breast for 5 days. She is 6 weeks post partum and is breast feeding. On exam, the breast tissue near the areola is inflamed, erythematous, hot to touch without a palpable abscess or discharge. She appears uncomfortable, with non -toxic appearance. You diagnose Acute Mastitis. Your treatment recommendations include:      Select all that apply: 4 correct responses

The NP is evaluating a 45 yo female in the office with chief complaint of intermittent dizziness for the past 2 weeks. Upon further questioning,  she describes a “spinning” sensation which is worse with movement and has caused her to vomit.  She denies headaches, tinnitus, or hearing loss.  PMH is negative. No home medications. Which test may the NP perform to support the diagnosis of BPPV (Benign Paroxysmal Positional Vertigo)?

The NP is evaluating a 55 yo female in the Emergency Dept with a severe L parietal headache, Nausea/vomiting, Photophobia. She states it started “all of a sudden” while shopping. She has no prior history of Migraine.  What is the priority action the NP will take? 

The NP is evaluating a 66 yr old female with LLQ abdominal pain for one week. She also admits to non-bloody diarrhea. On exam, she is tender to palpation to left lower quadrant of abdomen. A leading differential diagnosis for this patient is: