TEST BANK; Buttaro: Primary Care Interprofessional Collaborative Practice 6TH EDITION. All Chapters

TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO

Chapter 47: Infections and Infestations Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A previously healthy patient has an area of inflammation on one leg which has

well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? a. Amoxicillin-clavulanate b. Clindamycin c. Doxycycline d. Sulfamethoxazole-trimethoprim ANS: A

This patient has symptoms consistent with erysipelas, which is commonly caused by staphylococcal or streptococcal bacteria. These may be treated empirically with penicillinase-resistant penicillin if not allergic. Clindamycin, doxycycline, and sulfamethoxazole-trimethoprim are used for methicillin-resistant staphylococcus aureus infections.

2. A patient has vesiculopustular lesions around the nose and mouth with areas of honey-colored

crusts. The provider notes a few similar lesions on the patient’s hands and legs. Which treatment is appropriate for this patient? a. Mupirocin, 2% ointment b. Culture and sensitivity of the lesions c. Sulfamethoxazole-trimethoprim NURSINGTB.COM d. Surgical referral ANS: A

This patient has symptoms of impetigo which has spread to the hands and legs. Mupirocin, 2% ointment, should be applied three times a day for 10 days. It is not necessary to obtain a culture since this can be treated empirically in most cases. MRSA is unlikely, so sulfamethoxazole-trimethoprim is not indicated. Surgical referrals are generally not indicated.

3. A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous

MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? a. Apply moist heat until symptoms resolve. b. Begin treatment with amoxicillin-clavulanate. c. Prescribe trimethoprim-sulfamethoxazole. d. Wait for culture results before ordering an antibiotic.

ANS: C

Because of a history of exposure to MRSA, the patient is likely to be colonized and should be treated accordingly. Small lesions may be treated with moist heat, but the likelihood of MRSA requires treatment. Amoxicillin-clavulanate is not effective for MRSA. Treatment should be started empirically.

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