NCCPA Emergency Medicine 5

Question 1

A 40-year-old female presents with acute-onset severe pelvic pain, cervical motion tenderness, and adnexal tenderness with mucopurulent cervical discharge. What is the first-line outpatient treatment?

Accepted Answer

Ceftriaxone 500mg IM plus doxycycline 100mg BID x 14 days with metronidazole

Answer

CDC guidelines for outpatient PID treatment include a single dose of ceftriaxone plus doxycycline for 14 days, with metronidazole added for anaerobic coverage.

Question 2

During resuscitation of a PEA arrest, which reversible cause should be considered if the patient recently started dialysis and has hyperkalemia?

Accepted Answer

Hyperkalemia (Electrolyte abnormality)

Answer

The 'Hs and Ts' of PEA include electrolyte abnormalities; hyperkalemia in dialysis patients can cause PEA arrest and should be treated with calcium gluconate and dialysis.

Question 3

A construction worker presents with an embedded nail in his foot from stepping on a board. He is immunized and the wound is cleaned. What additional management is indicated?

Accepted Answer

Oral ciprofloxacin to cover Pseudomonas aeruginosa

Answer

Puncture wounds through rubber-soled shoes have high risk of Pseudomonas osteomyelitis; ciprofloxacin provides appropriate gram-negative coverage.

Question 4

A patient presents with a blood pressure of 220/130 mmHg and new-onset visual changes, headache, and confusion. Fundoscopy shows papilledema. What is the correct blood pressure management target in the first hour?

Accepted Answer

Reduce mean arterial pressure (MAP) by no more than 20-25% in the first hour

Answer

Hypertensive emergency management targets a MAP reduction of no more than 20-25% in the first hour to avoid cerebral hypoperfusion and ischemia.

Question 5

Which of the following is the most reliable clinical sign of compartment syndrome?

Accepted Answer

Pain out of proportion to injury with pain on passive stretch of muscles in the compartment

Answer

Pain out of proportion to the injury and pain with passive stretch of the involved muscles are the earliest and most reliable signs of compartment syndrome.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

NCCPA Emergency Medicine 5