A 17-year-old is diagnosed with mild bronchospasm. Which of the following would provide relief?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Inhaled levalbuterol (Xopenex) to provide relief for mild bronchospasm in a 17-year-old. Levalbuterol is a selective beta2-adrenergic agonist that acts quickly to dilate the airways, making it an effective bronchodilator for acute bronchospasm. Option A) Inhaled mometasone (Asmanex) is a corticosteroid used for long-term control of asthma symptoms, not for immediate relief of bronchospasm. Option C) Oral montelukast (Singulair) is a leukotriene receptor antagonist used for asthma maintenance therapy, not for acute bronchospasm relief. Option D) Oral dextromethorphan/guaifenesin product is used for cough suppression and mucus thinning, not for bronchospasm relief. In an educational context, it is crucial for healthcare providers to understand the pharmacological mechanisms of different medications to make appropriate treatment decisions for patients with respiratory conditions like bronchospasm. Understanding which medications provide quick relief versus long-term control is essential for effective management of respiratory disorders.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Assess the patient for iron deficiency anemia. The Hispanic woman's craving for ice chips, known as pagophagia, is a common symptom of iron deficiency anemia, especially during pregnancy. Iron deficiency anemia is prevalent among pregnant women due to increased iron requirements for fetal development. By assessing for anemia, healthcare providers can identify and address the underlying cause of the ice cravings, ensuring the well-being of both the mother and the developing fetus. Option A) Having the patient checked for diabetes is incorrect in this context because the symptoms described (craving for ice chips) are more indicative of iron deficiency anemia rather than diabetes. Option C) Encouraging the patient to eat more at meal times does not address the potential underlying medical condition causing the ice cravings. It is important to investigate the root cause rather than simply increasing food consumption. Option D) Telling the patient that this cultural practice can be harmful is incorrect because the ice craving is a symptom that warrants further investigation for a potential medical condition rather than being inherently harmful. Educationally, understanding the relationship between cravings and underlying medical conditions is crucial for healthcare providers to provide comprehensive care to pregnant patients. Recognizing common symptoms like pagophagia can help in early detection and management of conditions like iron deficiency anemia, ultimately promoting positive outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dullness. During an abdominal examination, when a bulging area is percussed and a dull sound is heard, it suggests the presence of solid organs or masses. This indicates a potential abnormality such as an enlarged liver or spleen, fluid accumulation, or a mass within the abdomen. Option A) Tympanic sounds are typically heard over air-filled structures like the stomach. Option C) Hyperresonant sounds are more characteristic of excessive air in the abdomen, which could be seen in conditions like bowel obstruction or free air under the diaphragm. Option D) Normal resonance would be heard over a healthy, air-filled abdomen without any abnormalities. Understanding the different percussive sounds in abdominal examinations is crucial for healthcare providers to accurately assess and diagnose abdominal conditions. Recognizing these sounds helps in identifying potential issues and guiding further diagnostic evaluations or treatment interventions.

Correct Answer: B

Rationale: The correct answer is B) Have you thought about hurting yourself? In this scenario, the 74-year-old man is exhibiting signs of depression, such as expressing feelings of hopelessness and lack of purpose. Asking about thoughts of self-harm is crucial because it assesses suicidal ideation, which is a serious concern in individuals experiencing significant life stressors like the loss of a spouse. Option A) Have you told your family how you feel? While communication with family is important, it does not directly address the immediate risk of self-harm that the patient may be facing. Option C) Are you taking your medication? This option is not the most appropriate response in this situation as the patient's emotional distress is the primary concern rather than medication adherence. Option D) Do you have any friends? While social support is beneficial for mental health, it does not address the urgency of assessing the patient's risk of self-harm. Educationally, this question highlights the importance of assessing for suicidal ideation in patients experiencing significant life stressors and demonstrates the need for healthcare providers to be vigilant in recognizing and addressing mental health concerns in their patients, even in non-psychiatric settings like primary care.

Correct Answer: D

Rationale: In the context of pharmacology and the treatment of anorectal and pharyngeal gonorrhea, the recommended combination therapy of ceftriaxone and azithromycin (Option D) is based on current guidelines from the Centers for Disease Control and Prevention (CDC). Ceftriaxone is the preferred treatment for gonorrhea due to increasing antibiotic resistance, and azithromycin is typically added to provide dual coverage and to combat potential co-infection with Chlamydia trachomatis. Option A, ceftriaxone and benzathine penicillin, is incorrect because penicillin is no longer recommended as monotherapy for gonorrhea due to high rates of resistance. Option B, benzathine penicillin and doxycycline, is also incorrect as doxycycline is not the preferred agent for treating uncomplicated gonorrhea. Option C, doxycycline and ciprofloxacin, is not recommended due to high rates of resistance to ciprofloxacin in gonorrhea strains. This question highlights the importance of staying current with treatment guidelines and understanding the rationale behind combination therapies for infectious diseases to ensure effective management and prevent the development of antibiotic resistance. It also emphasizes the need for healthcare providers to be aware of evolving treatment protocols and to adapt their practice accordingly to provide optimal care for patients with sexually transmitted infections.