Your next patient is a 19-year-old female with abdominal pain. She states the pain has been bothering her for the last week, and has progressively become worse. She denies nausea, vomiting, any episodes of diarrhea, or chest pain. She is sexually active with her boyfriend, and admits to having some pain during sex. She states she does not feel comfortable telling her boyfriend that she does not want to have sex. Her last menstrual period was two weeks ago. She reports no history of sexually transmitted infections, but says that she has not questioned her significant other because “he would be upset.” VS 37.1 C (98.7 F), BP 120/70 mmHg, HR 82 beats/minute, RR 18 breaths/minute.  PE:  The patient is visibly uncomfortable during the physical exam, which reveals a few bruises on her abdomen and lower back that are at different stages of healing. What is an appropriate technique for screening for intimate partner violence in this patient?

Your next patient is a 34-year-old female with a “twisted ankle.” She stepped off a curb 3 days ago and came down “wrong”. She has had moderate pain, moderate swelling and it has been difficult to bear weight. She has slightly limited ROM and stability.  After reviewing the clinical guidelines, you know that:

Diagnosing a patient with a fever is based on many factors. Which of the following statements is incorrect regarding facts about body temperature?

Your next patient is a 52-year-old female patient with a BMI of 31.5. She drinks 1-2 alcoholic beverages/day, 2-4 cups of coffee/day and eats fatty foods 3x/week. She smokes ½ pack of cigarettes/day. Her medication list includes asa 325 mg PO every day and Advil PRN as needed for pain. She states that she has had frequent recurrent epigastric pain and burning sensation for the past few months.  She describes the pain as occurring mostly after meals and sometimes it wakes her up during the middle of the night.  She occasionally experiences regurgitation of a sour-tasting fluid. She denies dysphagia, weight loss, or blood in her stool.  PE findings were unremarkable. What is the most appropriate initial management for this patient?

You prescribed ferrous sulfate, PO, 325 mg TID X 90 days for the diagnosis of iron deficiency anemia. Which of the following statements would NOT be included in patient and family education?

A patient has a gradually enlarging nodule on one lower eyelid and reports that the lesion is painful. On examination, the lesion appears warm, erythematous, edematous and painful to touch.  The APRN knows that this is likely to be which type of lesion?

A 54-year-old male has come to your clinic after a weekend of playing touch football with his children at a family function. He planted his foot and twisted his knee. His knee has been painful since the injury. You suspect a meniscus injury. The following is true for this type of injury:

Your next patient is a 41-year-old male.  He is healthy and does not have any significant chronic conditions. He fell to the ground in the middle of a pick-up basketball game with friends. He neither lost consciousness nor hit his head when he fell.  He recalls hearing a popping sound followed by immediate pain in the posterior right ankle as he landed on the ball of his foot after having taken a shot,   Physical exam (PE) demonstrates edema around the patient’s posterior right ankle and tenderness to palpation. He is unable to plantarflex his right foot. What is the most likely diagnosis of his current condition?

A patient reports a sudden onset of sore throat, fever, malaise, and cough. The APRN notes mild erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most likely cause of these symptoms?

A patient presenting with nasal congestion, fever, purulent nasal discharge, headache, and facial pain has been diagnosed with sinusitis and began treatment with amoxicillin (a penicillin class antibiotic).  At a follow-up visit 10 days after initiation of treatment, the patient continues to have purulent discharge, congestion, and facial pain without fever. What will the APRN order next?