NURS 623 Exam 1 with Complete Solutions
Which symptoms may present with stage 1 (early localized) Lyme disease? Correct Ans-
Erythema migrans with bulls eye appearance, flu like symptoms such as fever, chills, joint and
muscle pain, stiff neck and headache, general feeling of illness, and swollen lymph glands
A circular rash that may expand over time which may also have a bulls eye appearance.
Correct Ans-Erythema migrans
What is treatment for stage 1 (early localized) Lyme disease? Correct Ans-Doxycycline,
Cefuroxime, or amoxicillin
How soon may stage 2 (early disseminated) Lyme disease present after initial infection?
Correct Ans-Weeks to months
With this stage of Lyme disease, symptoms can range from mild to severe, or not at all. Flu
like symptoms may be similar to or worse than stage 1 and includes fever, chills, joint and
muscle pain, stiff neck and headache, swollen lymph nodes or glands, fatigue, sore throat,
visual disturbances such as blurry vision, paralysis or weakness in the face, pain or numbness
in the bite area, and heart palpitations. Correct Ans-Stage 2 (early disseminated) Lyme
disease
What is treatment of stage 2 (early disseminated) Lyme disease if IV treatment is needed?
Correct Ans-Azithromycin, doxycycline, amoxicillin, cefuroxime, or ceftriaxone. (Most
commonly is doxycycline except for children 8 years old and younger or nursing/pregnant
women).
, NURS 623 Exam 1 with Complete Solutions
What are oral antibiotic choices for treatment of stage 2 (early disseminated) Lyme disease?
Correct Ans-Azithromycin, doxycycline (except in children <8 years old, nursing or pregnant
women), amoxicillin, and cefuroxime. (Most common is doxycycline except for <8 y.o.,
pregnant, or nursing).
When does stage 3 (late disseminated) Lyme disease typically present? Correct Ans-When
the infection has not been treated during stages 1 and 2. It starts months or even years after
the original tick bite.
What are symptoms of stage 3 (late disseminated) Lyme disease? Correct Ans-Severe
headaches, arthritis of the large joints (knees, hips, etc.), heart arrhythmia, brain disturbances
(memory loss, mood disturbances, sleep interruptions), difficulty concentrating and mental
fogginess, temporary amnesia, difficulty following conversations or speaking, numbness or
tingling in the limbs (arms, legs, feet, or hands), extreme fatigue, and temporary paralysis of
facial muscles
With this stage of Lyme disease, presentation is a recurrent form of joint inflammation which
may include episodes of severe arthritis symptoms. The most common joint affected is the
knee joint but it may also occur in other large or small joints as well. Correct Ans-Stage 4-
late stage or chronic Lyme arthritis
Which symptoms will present with stage 4 late stage or chronic Lyme arthritis? Correct
Ans-Swelling, redness, and fluid buildup with episodes lasting greater than 6 months
, NURS 623 Exam 1 with Complete Solutions
How long may symptoms of stage 4 late stage or chronic Lyme arthritis last? Correct Ans-
Months to years
Is transmission of Lyme disease likely if the thick attachment is less than 48 hours? Correct
Ans-No
What is the incubation period of Lyme disease? Correct Ans-3 to 31 days but typically
around 7 to 14 days
How many stages does Lyme disease have? Correct Ans-4
What is the first stage of Lyme disease called? Correct Ans-Early localized Lyme disease
What is the second stage of Lyme disease called? Correct Ans-Early disseminated Lyme
disease
What is the third stage of Lyme disease called? Correct Ans-Late disseminated Lyme
disease
What is the fourth stage of Lyme disease called? Correct Ans-Late stage or chronic Lyme
arthritis
Which pathogen causes Lyme disease? Correct Ans-Borrelia burgdorferi
, NURS 623 Exam 1 with Complete Solutions
What may the patient present with that makes you suspect Lyme disease? Correct Ans-
Fever, rash, facial paralysis, arthritis, chills, headache, fatigue, muscle and joint aches, and
swollen lymph nodes
Which test is most commonly used to diagnose Lyme disease? Correct Ans-ELISA
Which test is performed to confirm ELISA results with Lyme disease? Correct Ans-
Immunoblot test
How long may stage 1 Lyme disease (early localized Lyme disease) last for? Correct Ans-1
to 4 weeks
What history is important for assisting with the diagnosis of Lyme disease? Correct Ans-
Exposure to tick bites, recent camping trips, frequent yard work, pets that go outside and
have contact with the patient, duration and characteristics of lesion(s).
What is the dosage and duration and first line treatment for an adult with early Lyme disease?
Correct Ans-Doxycycline 100 mg PO BID for 14-21 days
What is the second line treatment for adults with early Lyme disease? Correct Ans-Amoxil
500 mg TID for 14-21 days