Tom reports a history of carpal tunnel syndrome. What else would you expect to find in his history?

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Pain and numbness or tingling sensation in the hand over the palmar surface of the thumb, index, and middle fingers, and lateral aspect of the ring finger, that is worse at night. This is because carpal tunnel syndrome commonly presents with these symptoms due to compression of the median nerve in the wrist. Patients with carpal tunnel syndrome often report worsening symptoms at night due to positioning of the hand during sleep. Option A is incorrect because crepitus is not typically associated with carpal tunnel syndrome. It is more indicative of osteoarthritis where there is loss of articular cartilage and bony overgrowth in the joint. Option B is incorrect as excessive forward curvature of the thoracic spine (kyphosis) is not a typical finding in carpal tunnel syndrome. It is more commonly seen in conditions like osteoporosis leading to pathologic vertebral fractures. Option D is incorrect as acute onset of excruciating pain in the joint due to accumulation of uric acid within the joint is characteristic of gout, not carpal tunnel syndrome. Educationally, understanding the specific symptoms and signs associated with different conditions is crucial for accurate diagnosis and management in healthcare settings. This rationale highlights the importance of recognizing the key features of carpal tunnel syndrome to differentiate it from other conditions with similar manifestations, aiding in providing appropriate care for patients.

Correct Answer: B

Rationale: In the context of a patient experiencing exacerbations of systemic lupus erythematosus (SLE), the physician would likely prescribe corticosteroids (Option B). This is because corticosteroids are commonly used in the treatment of SLE to help reduce inflammation and suppress the overactive immune response that characterizes the disease. They are effective in managing symptoms such as joint pain, fatigue, and skin rashes associated with SLE. Option A, antiemetics, are medications used to manage nausea and vomiting, which are not typically primary symptoms of SLE exacerbations. Option C, antineoplastics, are used to treat cancer and are not indicated for SLE. Option D, antibiotics, are used to treat bacterial infections and do not target the underlying autoimmune mechanisms involved in SLE. From an educational perspective, understanding the rationale behind the choice of corticosteroids for SLE exacerbations helps reinforce the principles of autoimmune disease management and pharmacological interventions. It highlights the importance of targeting the specific pathophysiology of a condition to achieve optimal treatment outcomes. This knowledge is essential for healthcare professionals caring for patients with autoimmune disorders like SLE.

Correct Answer: A

Rationale: In the context of patient teaching for skin cancer risk reduction, option A, which advises having suspicious moles checked by a dermatologist, is the correct choice. This is because early detection of skin cancer is crucial for successful treatment and improved outcomes. By regularly monitoring moles and seeking professional evaluation, patients can identify any potential signs of skin cancer early on, leading to prompt intervention if needed. Options B and C, advocating for daily sun exposure either every half hour or for an hour to build tolerance, are incorrect and potentially harmful. Excessive sun exposure is a well-known risk factor for skin cancer development, particularly melanoma. Encouraging prolonged sun exposure without protection or in excess can increase the risk of skin damage and skin cancer, rather than reducing it. Option D, which suggests applying moisturizer, is also not directly related to skin cancer risk reduction. While moisturizing the skin is important for overall skin health, it does not specifically address the primary preventive measures needed to reduce the risk of developing skin cancer. In an educational setting, it is crucial to emphasize evidence-based practices for skin cancer prevention. Teaching patients about the importance of regular skin self-exams, seeking professional evaluation of suspicious moles, using sun protection measures like sunscreen, protective clothing, and seeking shade, are fundamental components of skin cancer prevention education. By focusing on these key strategies, patients can actively participate in their skin health and reduce their risk of skin cancer.

Correct Answer: C

Rationale: The correct answer is option C: First thing in the morning on an empty stomach with a full glass of water, 30 to 60 minutes before eating, and without lying down. This is because bisphosphonate medications have specific instructions for optimal absorption and effectiveness. Taking them on an empty stomach ensures proper absorption as food can interfere with the absorption of these medications. Additionally, the patient should remain upright for at least 30 minutes after taking bisphosphonates to prevent esophageal irritation. Option A (On a full stomach) is incorrect as taking bisphosphonates with food can decrease their absorption and effectiveness. Option B (Just before getting into bed) is also incorrect as lying down immediately after taking bisphosphonates can increase the risk of esophageal irritation. Educationally, it is crucial for healthcare professionals to understand the administration guidelines for medications to ensure their therapeutic effects. Teaching patients the correct timing and conditions for taking bisphosphonates is essential for optimal treatment outcomes in osteoporosis management. This knowledge helps prevent potential side effects and ensures the medication works as intended to improve bone health.

Correct Answer: B

Rationale: In treating cellulitis, the appropriate option is B) Antibiotics, such as cephalexin, and over-the-counter analgesics. Cellulitis is a bacterial skin infection that requires antibiotics to target and eradicate the bacterial infection. Antibiotics like cephalexin are effective against the most common bacteria causing cellulitis. Over-the-counter analgesics help manage pain and inflammation associated with the infection. Option A) Petrolatum and vitamin A and D ointment is incorrect because these do not treat the underlying bacterial infection in cellulitis. Option C) Weight-bearing exercises and diuretics like furosemide are unrelated and not appropriate for treating cellulitis. Option D) Wet to dry dressings and steroids are not recommended for cellulitis treatment as wet to dry dressings can be too harsh on the skin, and steroids can suppress the immune response needed to fight the infection. Educationally, understanding the appropriate treatment for cellulitis is crucial for healthcare providers to effectively manage and treat patients with this condition. It is important to recognize the signs and symptoms of cellulitis, initiate proper treatment promptly, and monitor the patient's response to therapy to prevent complications and promote recovery.