A 2-year-old presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging; The right TMs is perforated and draining. The child's parents states, “this is the fifth ear infection this year. What can we do?” What action will the provider take to address the child's ear problems?

Correct Answer: D

Rationale: The correct answer is D: Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist. Rationale: 1. Amoxicillin/clavulanate is a recommended first-line antibiotic for recurrent otitis media due to its broad spectrum coverage. 2. Referring the child to an otolaryngologist is necessary for further evaluation and management of recurrent ear infections, as this child has had multiple episodes in a year. Summary of other choices: A: Prescribing both high dose amoxicillin and the influenza vaccine is not the best option as the child already has recurrent ear infections and needs a more comprehensive approach. B: Beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole is not recommended as a first-line treatment for recurrent otitis media. C: Prescribing ceftriaxone IV with benzocaine ear drops is not the optimal choice for managing recurrent ear infections in a 2-year-old.

Correct Answer: C

Rationale: The correct answer is C: Valacyclovir. Valacyclovir is a prodrug of acyclovir, which is the first-line treatment for genital herpes simplex virus infection. Acyclovir inhibits viral DNA synthesis by competing with deoxyguanosine triphosphate for viral DNA polymerase. This leads to the termination of viral replication. Lamivudine (A) is used for HIV and hepatitis B infections. Cidofovir (B) is used for cytomegalovirus and other DNA virus infections, but not for herpes simplex virus. Zanamivir (D) is used for influenza viruses, not herpes simplex virus.

Correct Answer: C

Rationale: Rationale: Choice C is correct because consuming fiber-rich foods can interfere with the absorption of statins, leading to decreased effectiveness and potential elevation in cholesterol levels. Fiber binds to statins in the gastrointestinal tract, reducing their absorption. Choices A, B, and D are incorrect because cyclosporine, grapefruit juice, and amiodarone are known to interact with statins but do not directly cause rhabdomyolysis or elevated cholesterol levels in this scenario.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): 1. The patient stating "I will remove the patch each month and replace it with a new patch 1 week later" indicates understanding of the correct usage of the contraceptive patch. 2. Ethinyl estradiol and norelgestromin are combined hormonal contraceptives that require a once-weekly application for 3 weeks followed by a patch-free week to allow for menstruation. 3. This statement reflects proper adherence to the dosing schedule, ensuring continuous contraceptive efficacy and hormone levels. Summary of Incorrect Choices: A. The patch does not act as a physical barrier; it releases hormones to prevent pregnancy. B. Ethinyl estradiol and norelgestromin are combined hormonal contraceptives, not progestin-only, so side effects may vary. D. The patch should be applied to the skin, not in the vaginal area, and is not meant for immediate use before intercourse.

Correct Answer: B

Rationale: The correct answer is B because Sumatriptan, a triptan medication used for migraine treatment, can cause vasoconstriction of blood vessels including the coronary arteries. This vasoconstriction can lead to reduced blood flow to the heart, potentially precipitating an anginal attack in a patient with angina. Choices C and D are incorrect as they also mention vasoconstriction but do not specifically link it to triggering an anginal attack. Choice A is incorrect as it does not provide any relevant information.