Author Question: A primary care NP is performing a well-child checkup on an adolescent patient and notes ... (Read 102 times)

pepyto · **on:** Jul 24, 2018

A primary care NP is performing a well-child checkup on an adolescent patient and notes approximately 20 papules and comedones and 10 pustules on the patient's face, chest, and back.

The patient has not tried any over-the-counter products to treat these lesions. The NP should begin treatment with: a. salicylic acid.
b. topical tretinoin.
c. oral antibiotics.
d. benzoyl peroxide and topical clindamycin.

Question 2

A patient comes to the clinic with a history of syncope and weakness for 2 to 3 days. The primary care NP notes thready, rapid pulses and 3-second capillary refill. An ECG reveals a heart rate of 198 beats per minute with a regular rhythm.

The NP should: a. administer intravenous fluids and obtain serum electrolytes.
b. administer amiodarone in the clinic and observe closely for response.
c. order digoxin and verapamil and ask the patient to return for a follow-up examination in 1 week.
d. send the patient to an emergency department for evaluation and treatment.

missalyssa26 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
Mild acne consists of a lesion count of less than 30 with less than 15 pustules. Benzoyl peroxide and topical clindamycin are both indicated for treatment of mild to moderate acne and are first-line choices. Topical tretinoin is used as a second-line or third-line treatment. Oral antibiotics are used when topical antibiotics fail. Salicylic acid is an appropriate first-line treatment, but because this patient has pustular lesions, topical antibiotics must be included.

Answer to Question 2

D
Paroxysmal supraventricular tachycardia (PSVT) is a very fast regular rate and rhythm. This patient is becoming decompensated and should be referred to the emergency department for evaluation and treatment. The primary care NP should not treat this in the clinic or as an outpatient until the patient is stable.