11-07-2008, 10:18 PM
A 58-year-old woman comes to the office for her periodic health maintenance examination. She has
mild hypertension controlled with hydrochlorothiazide and no other medical problems. She has never
smoked cigarettes, denies drug use, and drinks approximately 2 drinks each week. She works as an
office manager in a bank. She has been married for 33 years to the same partner, who is also your
patient. She tells you that she is doing well and has no complaints. She is excited about a trip to
Western Europe that she is planning for November and was told by her coworkers that she may require
vaccinations since she is traveling abroad. You review her chart and note that she recently received
boosters of MMR and Td. The most appropriate next step is to administer
A. hepatitis A vaccination prior to her trip
B. hepatitis B vaccination prior to her trip
C. influenza vaccination prior to her trip
D. no further vaccinations at this time
E. pneumococcal polysaccharide vaccination prior to her trip
A 17-year-old boy is brought to the clinic by his father for a routine sports physical clearance. He has no
current complaints. He is a junior in high school and plans to participate on the football, basketball, and
track teams. He has no chronic medical conditions. He had an appendectomy at age 8. He takes no
medications and develops a skin rash after taking penicillin. After his father leaves the room, you elicit
more information regarding his health habits. He tells you that he lives at home and hopes to go to
college on an athletic scholarship. He has smoked marijuana twice with his friends, but says that he
does not like it. Almost every weekend he consumes between 4 and 10 beers at parties with his
friends. He denies any feelings of anxiety or depression. He has a girlfriend and has had intercourse
with her several times without using condoms. Physical examination is unremarkable. The intervention
at this time that is most likely, if successful, to prevent the death of this patient within the next 5 years is
A. counseling regarding the dangers of tobacco use
B. discussion about avoidance of drinking and driving
C. education about proper use of condoms to prevent sexually transmitted infections
D. promoting a well-balanced diet high in anti-oxidants and monounsaturated fats
E. recommending daily exercise and maintenance of a healthy weight
mild hypertension controlled with hydrochlorothiazide and no other medical problems. She has never
smoked cigarettes, denies drug use, and drinks approximately 2 drinks each week. She works as an
office manager in a bank. She has been married for 33 years to the same partner, who is also your
patient. She tells you that she is doing well and has no complaints. She is excited about a trip to
Western Europe that she is planning for November and was told by her coworkers that she may require
vaccinations since she is traveling abroad. You review her chart and note that she recently received
boosters of MMR and Td. The most appropriate next step is to administer
A. hepatitis A vaccination prior to her trip
B. hepatitis B vaccination prior to her trip
C. influenza vaccination prior to her trip
D. no further vaccinations at this time
E. pneumococcal polysaccharide vaccination prior to her trip
A 17-year-old boy is brought to the clinic by his father for a routine sports physical clearance. He has no
current complaints. He is a junior in high school and plans to participate on the football, basketball, and
track teams. He has no chronic medical conditions. He had an appendectomy at age 8. He takes no
medications and develops a skin rash after taking penicillin. After his father leaves the room, you elicit
more information regarding his health habits. He tells you that he lives at home and hopes to go to
college on an athletic scholarship. He has smoked marijuana twice with his friends, but says that he
does not like it. Almost every weekend he consumes between 4 and 10 beers at parties with his
friends. He denies any feelings of anxiety or depression. He has a girlfriend and has had intercourse
with her several times without using condoms. Physical examination is unremarkable. The intervention
at this time that is most likely, if successful, to prevent the death of this patient within the next 5 years is
A. counseling regarding the dangers of tobacco use
B. discussion about avoidance of drinking and driving
C. education about proper use of condoms to prevent sexually transmitted infections
D. promoting a well-balanced diet high in anti-oxidants and monounsaturated fats
E. recommending daily exercise and maintenance of a healthy weight