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Pediatric Nurse Practitioner Questions (Board Vitals) Answered Correctly!!
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Pediatric Nurse Practitioner Questions (Board Vitals) Answered Correctly!!
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Pediatric Nurse Practitioner Questions (Board Vitals ) Answered Correctly!!A 15-year-old female presents to her regular doctor with concerns over acne. Upon inspection, she has more than 10 cyst-like, erythematous lesions, approximately 40 open and closed comedones, and no scarring. Up to this point, she has been using a
sensitive skin face wash 2-3 times daily and applying a non-comedogenic makeup once daily. What would be the best next step?
A. Reassurance and discontinue makeup use due to risk of exacerbation B. Start a topical benzoyl peroxide C. Prescribe oral minocycline D. Start a topical retinoid + benzoyl peroxide + oral antibiotic Answer - D. Start a topical retinoid + benzoyl peroxide + oral antibiotic
Medication for treatment of acne should be effective but limited in order to avoid unnecessary adverse effects. Treatment is directed at modification of one or more of four primary factors that promote the development of acne. These factors include follicular hyperproliferation and abnormal desquamation; increased sebum production; Proionbacterium acnes proliferation; and inammation. Therapies include topical retinoids, azelaic acid, salicylic acid, hormonal therapy, benzoyl peroxide, topical and oral antibiotics, and oral isotretinoin. The patient described in this case has moderate acne. Treatment of moderate papulopustular and mixed acne includes
topical retinoid plus oral antibiotic plus topical benzoyl peroxide. With respect to interaction between benzyl peroxide and tretinoin, tretinoin and BP should not be applied simultaneously to the skin due to the oxidizing effect of BP on tretinoin. If both agents are prescribed, benzoyl peroxide should be applied in the morning and tretinoin in the evening. Adapalene, the microsphere formulation of tretinoin, is stable
in presence of BP.
A 17-year-old male presents to the emergency department after cutting his leg on a metal fence outside of his neighbor's house while mowing the lawn. On examination, he has a 4cm gash that is 2cm deep with dirt and gravel inside the wound and will require debridement and suturing. You ask when his last tetanus vaccine was he states that he has always received his vaccines on schedule and got his booster when he was 11 years old. Which of the following is correct?
A. He is up-to-date on his tetanus vaccine and only needs wound care B. In addition to wound care he should receive a Td or Tdap vaccine today C. In addition to wound care he should receive a Td or Tdap vaccine today and Human Tetanus Immune Globulin (TIG) should be given, with part of the dose infiltrated around the wound and the remaining given intramuscularly D. In addition to wound care, he should receive Human Tetanus Immune Globulin (TIG) with part of the dose infiltrated around the wound and the remaining given intramuscularly but he does not need a Td or Tdap vaccine as he is up-to-date on his
tetanus vaccines Answer - B. In addition to wound care he should receive a Td or Tdap vaccine today
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