NR 603 week 2 Quiz

tick bites. Physical exam reveals petechial rash on the wrists and ankles. Laboratory tests show thrombocytopenia and elevated liver enzymes. Which of the following is the most appropriate next step in management? A. Start doxycycline empirically B. Order serologic testing and wait for results before starting treatment C. Initiate corticosteroids for possible autoimmune encephalitis D. Refer for lumbar puncture to rule out meningitis Answer: A 5. A 56-year-old male presents with a new-onset headache that is progressively worsening. He denies nausea or vomiting but does report recent unintentional weight loss and persistent fatigue. He smokes 3 cigarettes a day and drinks no alcohol. On physical examination, there is mild papilledema. Which of the following combinations of clinical features raises the GREATEST concern for a secondary headache disorder requiring further evaluation? A. Smoking and normal fundoscopy exam B. Headache in a male patient over 50 C. Progressive headache, systemic symptoms, and papilledema D. Sudden onset headache described with nausea and vomiting Answer: C 6. A patient reports new-onset confusion and difficulty recalling recent events along with a worsening headache. Which of the following best explains why these symptoms require immediate evaluation? A. They may indicate intracranial pathology or evolving neurological dysfunction B. They are common signs of medication noncompliance in elderly patients C. These symptoms are expected after bereavement and should be monitored over time D. They are likely related to dehydration and should improve with fluids Answer: A 7. A 29-year-old patient presents for follow-up care one week after experiencing a spontaneous miscarriage. She reports feeling emotionally overwhelmed, fatigued, and having little appetite. In addition to gynecologic care, which of the following assessments is the most critical to prioritize at this stage to ensure comprehensive care without complications? B. Difficulty initiating urination and lower extremity paresthesias C. Radiation of pain to the leg and history of heavy periods D. Tingling in the foot and menstrual irregularity Answer: B 11. Which pelvic exam finding at a follow-up visit would prompt urgent evaluation for retained products of conception? A. Cervix is closed, uterus is non-tender, and lochia is minimal B. Cervix is open with ongoing bleeding and uterine tenderness C. Cervix is firm and os is closed with no bleeding D. Cervix is soft with scant clear vaginal discharge Answer: B 12. A 66-year-old patient presents with a sudden onset, severe headache described as "the worst headache of my life." His vital signs are stable, and there are no focal neurologic deficits on exam. What is the MOST appropriate next step in the management of this patient? A. Refer patient to ED for emergent CT B. Initiate migraine treatment and monitor response C. Order an outpatient MRI with contrast D. Perform fundoscopy and defer imaging if papilledema is absent Answer: A 13. A patient returning for post-miscarriage care states, “I just want to feel like myself again. I’m not sure what to do next.” What is the MOST appropriate provider response to align care with the patient’s goals? A. “You’ll feel better