The 24-year-old patient presents to the emergency department complaining of malaise and intractable sore throat with onset 24 hours previously. Upon assessment, the nurse notes swollen cervical lymph nodes and a temperature of 39.3°C. The patient denies nasal discharge or cough. Which question by the nurse is most important?

“Are you allergic to penicillin?”. The patient is exhibiting signs of acute pharyngitis caused by group A streptococcus (GAS). It is treated with penicillin, so assessing for PCN allergy is the most important question. Penicillin can be given during pregnancy, so this question is less important. Sequelae of GAS infection include acute glomerulonephritis and acute rheumatic fever. These can be assessed for by asking about hematuria and polyarthritis. However, these conditions do not occur until 2-3 weeks after the initial GAS pharyngitis infection has subsided. Therefore, these questions are not important 24 hours after symptom onset.

The 24-year-old patient presents to the emergency department comp...

Category: Physiological Adaptation
Difficulty: 9

Topics: Communication & Documentation HEENT Immunity Infection Inflammation Medication and Blood Products

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Hemolytic anemia can have which etiologies? Select all that apply.

Question Type: Multiple Choice - Select All
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A 4-year-old child presents for a well-child visit. The parents report the child is doing well, has a good appetite, and has been meeting developmental milestones appropriately. Two months ago, the child was treated with antibiotics for an upper respiratory tract infection. Otherwise, the child is quite healthy. Upon assessment, the nurse notes a left-sided flank mass. The child denies urinary issues including pain or frequency, and the parents report that the child has had no incontinence episodes for a full year. The urinalysis is normal with the exception of 2+ blood. The nurse prepares to educate the family on which condition that most likely explains the child’s symptoms?

Question Type: Multiple Choice - Select One
Difficulty: 8

The patient has been diagnosed with Rocky Mountain spotted fever (RMSF). The nurse is aware this patient’s symptoms are caused by which microorganism?

Question Type: Multiple Choice - Select One
Difficulty: 4

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