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A 4-year-old child is brought into the clinic for bilateral eye redness associated with a clear, watery discharge. The mother noticed symptoms approximately 2 days ago, after she picked the child up from daycare. The mom denies signs of itching, but states "she did have a sore throat last week", now resolved. The most appropriate next action by the FNP is?
- Advise patient's mother that her daughter's symptoms are likely due to inadequate
- Give the patient a prescription for (Viroptic) trifluridine 1% ophthalmic drops x 5 days
- Prescribe dexamethasone sodium phosphate 0.1% ophthalmic drops 1-2 drops PRN
- Instruct the patient's mother to keep her daughter out of school until her symptoms
sleep and she should put her to bed early, and send her to school tomorrow.
eye irritation
have resolved and use cool compresses for eye discomfort. - ANSWER✔✔*d. Instruct the patient's mother to keep her daughter out of school until her symptoms have resolved and use cool compresses for eye discomfort.
Rationale: According to Current diagnosis & treatment: Pediatrics (Braverman, 2014, p.466)-The child's symptoms are most consistent with viral conjunctivitis, which presents with redness in one or both eyes and a clear, watery discharge. The lack of itching and persistent, prolonged course distinguishes viral from allergic conjunctivitis, which often has a stringy or ropey watery discharge as well. *d. This condition is usually self-limited and resolves with symptomatic treatment. However, viral conjunctivitis is very contagious and child should not return to school until symptoms have completely resolved. Also instruct parent to adhere to strict hand hygiene. 2 / 4
A 34-year-old with a history of asthma presents to the office complaining of increased shortness of breath and coughing; the symptoms wake her up about 2-3 times per month, and reports having to use her rescue inhaler at least 1-2 times per week. What should the FNP add to this patient's existing treatment regimen based on her current symptoms?
- ProAir HFA (albuterol) 90mcg/spray, Sig: 2 puffs inhaled q 4-6 hours prn wheezing or
- Serevent Diskus (salmeterol) 50 mcg/actuation DPI, Sig: 1 puff inhaled q 12 hours
- Prednisone 40 mg/day divided BID x 5 days
shortness of breath
daily
d. Pulmicort Flexhaler 200 mcg/actuation DPI, Sig: 2 puffs inhaled BID daily -
ANSWER✔✔*d. Pulmicort Flexhaler 200 mcg/actuation DPI, Sig: 2 puffs inhaled BID daily
*Rationale: According to Current Medical Diagnosis & Treatment 2015, pgs. 242-246 (Chestnutt & Prendergast, 2015, p. 242-246) Based on this patient's symptoms her asthma is classified as mild and persistent, therefore requiring step 2 treatment; the addition of a low dose ICS, in addition to her existing SABA rescue inhaler. The only correct choice from the options provided would be *d. Pulmicort is an ICS recommended daily low adult doses: 180-600mcg). None of the other choices are ICS.A-is a SABA (which she is already using); B-is a LABA (not recommended at Stage 2); C-Oral CCS-recommended for exacerbations.A mastectomy and radiation of the breast to remove localized cancer is an example of which of the following preventative medicine options?
- Tertiary 3 / 4
- Secondary
- Primary
- Elective - ANSWER✔✔* a. Tertiary
Rationale: None given
Which risk factor is considered a modifiable risk factor regarding coronary disease and stroke?
- occasional EOTH use (< 2 glasses wine every month)
- Age
- Family History of early coronary disease
- Tobacco abuse - ANSWER✔✔*d. Tobacco abuse
Rationale: None given
A patient presents with complaints of left sided, pulsatile head pain accompanied by nausea and photophobia. What type of headache would the nurse practitioner suspect this patient is experiencing?
- Tension
- Migraine
- Cluster
- musculoskeletal - ANSWER✔✔*b. Migraine
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