Kelsey is a 17-year-old girl whose mother brings her to the primary care clinic worried about an eating disorder. Kelsey has lost 14 pounds since her last visit 6 months ago. Her BMI has changed from 29 to 23. She complains that she gets dizzy when she gets up and has times where “my heart feels like it’s racing.” Her last period was 2 months ago and a pregnancy test today is negative. Her mother reports that Kelsey has been avoiding going to parties, going out with friends, and refuses to be in any photos. Her mother also reports that she found chewable over-the counter-laxatives in Kelsey’s purse. Upon exam you note erosion of her dental enamel and calluses on the back of her hands. Despite explaining to Kelsey that her BMI is in the normal range she says she still needs to lose weight. Based on these findings, which of the following treatments or combinations of treatments should be considered for this patient?

A 55-year-old male patient presents to the family nurse practitioner complaining of a painful, tingling rash across the right side of the abdomen. Exam reveals vesicles with erythemous bases; some of the vesicles are draining cloudy fluid, whereas others are crusted (see photo). The patient states that the rash is very painful and first appeared about 48 hours ago following a day of pain and itching/burning of the skin over this area. What is the recommended treatment for this patient?

Which accurately defines incidence rate?

Caroline, a 5-year-old girl presented to the primary care clinic with a generalized rash present for 5 weeks. Pruritis was minimal and has now resolved. There has been no fever. The parents noted that the rash began as a single lesion on the abdomen that grew in size as the rash progressed elsewhere and is now the largest lesion present. Examination revealed an otherwise well, afebrile child with a generalized rash consisting of scaly, reddish-pink plaques. A single lesion on the abdomen was the largest with a Christmas tree pattern on her trunk. The likely differential and treatment of choice is:

Carson, a 10-year-old is brought to the primary care clinic for a rash that is all over her skin. According to her mother, she suffered symptoms of fever, malaise, sore throat, headache, and loss of appetite for a few days, and then as her symptoms improved, she started exhibiting a rash. The rash began a day after her initial symptoms and started with oral-cavity blisters. Over the last few days, the rash has progressed to small red dots on the face and scalp and spread quickly to her torso and limbs within a day. There are now blisters and pustules that accompany the initial papules seen. Carson’s temperature= 100.2 degrees F, HR= 90, RR= 20, BP= 110/80. The child is on a modified vaccine schedule (per family choice) and has only received DtaP, Hepatitis B, HIB, and Pneumococcal vaccines. Physical exam reveals approximately 300 macules, pustules, and blisters all over her body (including pharynx vagina, and anus in different stages (see photo below). What is the most likely diagnosis?

Which one of the following skin findings should be treated with topical antifungals?

You were evaluating a male at a well-child-visit. Prenatal and past medical histories were unremarkable. Examination was normal. You noted that he can hop on either foot and knows his primary colors. His mother states that he climbs well and can use scissors to cut across paper. These milestones are met by children who are:

The mother of a 10-year-old girl, says that she is worried because the child is developing breast buds and fears that she may be entering puberty too early. The FNP’s response is based on the following:

Eric, a 13-year-old boy is in the clinic today for a sports physical. Physical findings include the following: curly hair starting to spread over the pubis, but not completely covering the pubis, and not on the thighs; testes and scrotum are enlarged and the penis is notably longer. This patient would be classified on the Tanner scale (stages) as:

Extra credit Question (2pts) Describe the medical condition, gestational diabetes, and explain two main symptoms of someone with this condition