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QuestionQuestion 1 2 / 2 pointsJim presents with complaints of “heartburn” that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:Question options:Omeprazole (Prilosec) twice a dayRanitidine (Zantac) twice a dayFamotidine (Pepcid) once a dayMetoclopramide (Reglan) four times a dayQuestion 2 2 / 2 pointsAn elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:Question options:Electrolytes, including potassium and chlorideBone mineral density for osteoporosisMagnesium levelLiver functionQuestion 3 2 / 2 pointsThe next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:Question options:Add a prokinetic (metoclopramide)Referral for endoscopySwitch to another proton pump inhibitorAdd a cytoprotective drugQuestion 4 2 / 2 pointsIf a patient with H. pylori-positive peptic ulcer disease fails first-line therapy, the second-line treatment is:Question options:Proton pump inhibitor bid plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 daysTest H. pylori for resistance to common treatment regimensProton pump inhibitor plus clarithromycin plus amoxicillin for 14 daysProton pump inhibitor and levofloxacin for 14 daysQuestion 5 2 / 2 pointsErika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck’s Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point?Question options:Prescribe a select serotonin reuptake inhibitor (SSRI) antidepressantRefer her to a mental health therapistContact her dermatologist about discontinuing the isotretinoinReassure her that mood swings are normal and schedule follow up in a weekQuestion 6 2 / 2 pointsJesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:Question options:That tazarotene is applied in a thin film to the psoriasis plaque lesionsTo apply it liberally to all psoriatic lesionsTo apply tazarotene to nonaffected areas to prevent breakoutThat tazarotene may cause hypercalcemia if it is overusedQuestion 7 2 / 2 pointsNicolas is a football player who presents to the clinic with athlete’s foot. Patients with tinea pedis may be treated with:Question options:OTC miconazole cream for 4 weeksOral ketoconazole for 6 weeksMupirocin ointment for 2 weeksNystatin cream for 2 weeksQuestion 8 2 / 2 pointsVanessa has been diagnosed with scabies. Her education would include:Question options:She should apply the scabies treatment cream for an hour and wash it off.Scabies may need to be retreated in a week after initial treatment.All members of the household and close personal contacts should be treated.Malathion is flammable and she should take care until the solution dries.Question 9 2 / 2 pointsCiprofloxacin otic drops are contraindicated in:Question options:ChildrenPatients with acute otitis externaPatients with a perforated tympanic membraneSwimmer’s earQuestion 10 2 / 2 pointsJanie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include:Question options:Moisten a cotton swab (Q-tip) and swab the ear canal twice daily.Instill tap water in both ears while bathing.Squirt hydrogen peroxide into ears with each bath.Instill carbamide peroxide (Debrox) twice daily until canals are clear.