MSN 620 Stat Pearls Quiz Study Guide All Answers Correct
A 17-year-old boy presents with a sore throat that started yesterday afternoon. He denies any
congestion or cough but reports a temperature of 102° F (38.8° C) and generalized fatigue. He has pain
with swallowing but can speak normally and manage his saliva. On physical examination, the clinician
sees yellow-white plaques on his tonsils and anterior cervical lymphadenopathy that is tender to
palpation. What is the most appropriate next step in care? ✔️Point-of-care streptococcal antigen
testing
A 17-year-old boy presents to the hospital with a severe sore throat and fatigue that has been ongoing
for 3 days. He has a high-grade fever for which he has been taking ibuprofen at home. The pain in his
throat has been making it difficult for him to swallow, though he can take cold drinks with care, which
helps with the pain. He does not feel throat congestion and does not have a cough. On physical
examination, the clinician notes exudates and tender cervical lymphadenopathy. The clinician treats him
empirically for strep throat with amoxicillin 500 mg twice daily for 10 days. The patient returns two 2
days later, reporting a full-body, blotchy, bumpy rash and no change in his symptoms. He stopped taking
the antibiotics after the rash began. What is the most appropriate next step in care? ✔️Send a throat
swab for culture and order a complete blood count and heterophile antibodies
An 8-year-old girl presents with a 4-day history of fever and sore throat. A review of systems is negative
for cough. Her past medical and family history is insignificant. She is allergic to penicillin. Vital signs are
temperature 101 °F (38.3 °C), heart rate 88 bpm, and blood pressure 110/70 mm Hg. On physical
examination, some exudates are seen on the posterior pharyngeal wall, and tender anterior cervical
nodes are palpated. Findings on heart and lung examination are normal. Which of the following is the
recommended treatment ✔️Clindamycin
A 17-year-old boy presents with a sore throat. Associated symptoms include fever and chills, difficulty in
swallowing, referred ear pain, headache, and muscle aches. The vital signs are temperature 39 °C (102.2
°F), heart rate 105 bpm, and respiratory rate 22 breaths/min. The physical examination reveals a dry
tongue, erythematous enlarged tonsils, pharyngeal exudate, and tender cervical lymphadenopathy.
Which of the following is the diagnostic test of choice? ✔️Rapid antigen detection test (RADT)
A 17-year-old girl presents with a thick discharge from her eyes that started 5 days ago. Associated
symptoms include redness and a feeling of dirt in her eyes. Her eyes are usually matted in the morning.
Her medical history is significant for multiple similar episodes. She has been using contact lenses for the
past 2 years. Her vital signs are blood pressure 120/80 mm Hg, heart rate 88 bpm, respiratory rate 14
breaths/min, and temperature 37 °C (98.6 °F). An ocular examination reveals hyperemia and elevated
,yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in management?
✔️Topical ciprofloxacin
A 6-year-old girl is brought in with a 5-day history of sore throat and fever. Other children at school have
had similar symptoms. She has not had any cough during this time. Her medical and family history is
insignificant. Her vitals are currently within normal limits. On physical examination, her anterior cervical
nodes are palpable and tender. There are no exudates seen on the posterior pharyngeal wall. What is
the next best step in the management of this patient? ✔️Rapid antigen testing
A 46-year-old man presents with symptoms consistent with allergic rhinitis. He has a history of
depression and is treated with a selective serotonin reuptake inhibitor. He works as a school bus driver.
Which of the following should be used to treat his symptoms? ✔️Fexofenadine
A 5-year-old boy is brought for evaluation of a sore throat for the past 5 days. His parents report no
cough during this period. His medical and family history is insignificant. Vitals show blood pressure
120/80 mm Hg, temperature of 100.4 °F (38 °C), and heart rate 78 bpm. On physical examination,
anterior cervical nodes are palpable and tender. Exudates are seen on the posterior pharyngeal wall. A
rapid antigen test was performed, which came back negative. Which of the following is the next best
step in management? ✔️Perform a throat culture
A 16-year-old male presents with a 2 day history of sore throat, fever, and cough. He has been
experiencing difficulty swallowing food for the last two days. He has otherwise been in good health and
is up to date with his immunizations. On examinations, he has a temperature of 100.6 F, pulse rate of
100 bpm, blood pressure of 110/80 mmHg. Oral exam reveals bilateral tonsillar exudates and diffuse
pharyngeal erythema. Which of the following would be the next best step in the management of this
patient? ✔️Order a rapid strep test
A 27-year-old man presents with fever, sore throat, and a generalized maculopapular erythematous
rash. He reports having sexual relations with other men. His rapid antigen test for Group A beta
hemolytic streptococcus is negative. What is the next best step in the management of this patient?
✔️Obtain testing for human immunodeficiency virus (HIV), syphilis, chlamydia, and gonorrhea
A 2-year-old boy presents with a fever of 102 °F (38.9 °C). His physical examination reveals bilateral otitis
media with effusion with noted erythema on the right side. His parents state that this is his sixth
diagnosis of otitis media in the past 12 months. His parents also note that he only has 2 words that are
intelligible to them. Following the treatment of this p ✔️Tympanostomy tube placement
, Despite trying to manage a child diagnosed with otitis media with effusion conservatively, it is decided
an intervention is necessary. Following consultation with an otolaryngologist, it is decided to proceed
with the placement of bilateral ventilation tubes. Informed consent is obtained from the parents. Which
of the following is the most likely complication of tympanostomy tube placement? ✔️The development
of otorrhea
A 35-year-old man with nasal congestion continues to use an over-the-counter intranasal decongestant
for four weeks. He complains that he is dependant on the intranasal decongestant spray and that he
needs to use it more frequently to obtain relief. Which of the following is the best approach to the
management of this patient? ✔️Gradually discontinue the nasal decongestant and consider the use of
short-course oral corticosteroids during this withdrawal period
A 28-year-old male patient with a history of asthma presents complaining of eye discharge, morning
matting, and redness. He denies eye itching, burning, or recent upper respiratory symptoms. On
examination, there is a bilateral diffuse conjunctival injection, purulent discharge, and conjunctival
papillae. What is the most likely etiological agent for this patient's presentation? ✔️Staphylococcal
aureus
A 6-day-old girl presents with significant redness and copious discharge from her eyes. She was born via
spontaneous vaginal delivery to a gravida three, para two mother. Thick, purulent discharge is noted
from both eyes on examination. Which of the following is the most appropriate treatment? ✔️Hospital
admission, intravenous administration of ceftriaxone, and saline solution irrigation
A 17-year-old female presents to the office with a severe sore throat. The symptoms, which began four
days ago, have become unilateral and much worse over the last day. She has had fevers of 101-103 F at
home and was taking over-the-counter medications but now cannot tolerate swallowing even liquid
ibuprofen. She has no trouble breathing, but reports that it is very difficult to open her mouth because
of pain in her jaw and the clinician struggles to visualize her throat but notes unilateral tonsillar swelling.
The clinician also notes tender cervical lymphadenopathy and some right-sided facial swelling but only
minimal tenderness to palpation over the right jaw. What is the most appropriate next step in care?
✔️Referral to the emergency department for imaging and aspiration
A 10-year-old boy presents to the provider with complaints of left eye tearing. He states that when he
woke up this morning, his left eye was crusted with his eyelids glued together. He adds that he has
noticed some redness and mild discomfort over the previous 2 days. The patient also reports left ear
pain and fullness. On further examination, his visual acuity is 20/25 on the right and 20/90 in the left
eye. There is left-sided conjunctival erythema and clear discharge, but there does not appear to be any
