NSG 6420 Week 3 Final Exam/ NSG 6420 Week 3 Final Exam. Latest 2021| South University.Susan P., a 60-year-old woman with a 30 pack year history, presents
... [Show More] to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process?
Seasonal allergies
Acute bronchitis
Bronchial asthma
Chronic bronchitis
2.
The pulmonary component includes an abnormal inflammatory response to noxious stimuli, principally tobacco, but also occupational and environmental pollutants. The hallmark of chronic bronchitis is a daily chronic cough with increased sputum production lasting for at least 3 consecutive months in at least 2 consecutive years, usually worse on awakening; this may or may not be
associated with COPD (GOLD, 2011). Emphysema is characterized by
obstruction to airflow caused by abnormal airspace enlargement distal to terminal bronchioles.
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file. (page 206)
3.
A patient presents complaining of a 5 day history of upper respiratory symptoms including nasal congestion and drainage. On the day the symptoms began he had a low-grade fever that has now resolved. His nasal congestion persisted and he has had yellow nasal drainage for three days associated with mild headaches. On exam he is afebrile and in no distress. Examination of his tympanic membranes and throat are normal. Examination of his nose is unremarkable although a slight yellowish-clear drainage is noted. There is tenderness when you lightly percuss his maxillary sinus. What would your treatment plan for this patient be?
Observation and reassurance
Treatment with an antibiotic such as amoxicillin
Treatment with an antibiotic such as a fluoroquinoline or amoxicillin-clavulanate
Combination of a low dose inhaled corticosteroid and a long acting beta2 agonist inhaler.
4.
A previously healthy 24 year old man presents at a clinic in Southern New England ten days after a weekend camping trip. He reports the appearance of a painless skin lesion on his right thigh five days previously. He now notes malaise, low-grade fever, and migrating joint pain of 48 hours duration. Careful questioning fails to elicit any recent history of an insect bite. The lesion on the thigh had begun to fade, but you recognize an area of central clearing with an erythematous margin. Further examination reveals a second, similar lesion near the right axilla. Question: The patient referred to in the scenario returns three days later complaining of worsening weakness and lightheadedness. His pulse is 42 and his pressure in the supine position is 90/40. You quickly obtain an EKG, which reveals third degree heart block. The best management at this point would include: A) Add oral cefuroxime 500mg po bid to his antibiotic regimen. B) Stop all antibiotics immediately and administer Benadryl 50mg intramuscularly stat. C) Administer atropine 1mg intravenously, observe the patient for 4 hours and discharge if he remains stable. D) Admit the patient for cardiac monitoring and begin intravenous ceftriaxone 2g per day. E) Stop all antibiotics immediately and admit the patient for electrophysiological studies.
The correct answer is: D About 8% of patients with Lyme disease will develop cardiac involvement, usually some form of atrioventricular block. Patients with third degree heart block should be treated with intravenous ceftriaxone until the heart block resolves and then complete a 30-day course of oral antibiotics. The [Show Less]