Because hypothalamic-pituitary-adrenal axis suppression can occur up to four days after an injection,

Question 1 Because hypothalamic-pituitary-adrenal axis suppression can occur up to four days after an injection,

1.Inject only one large joint at a time

2. chances are high that an infection is likely to occur

3. inject as many joints as necessary

4. prophylactic oral antibiotics are recommended 24 hours prior to injection

Question 2The application of phenol during partial toenail removal does which of the following?

1.Prevents infection

2. Provides pain relief up to 12 hours

3. Prevents nail regrowth

4. Aids in the regrowth of the nail

Question 3Joint aspirations are contraindicated in patients who are

1. anticoagulated or have a major clotting disorder

2.pregnant

3. diabetics

4. vascularly compromised

Question 4  When doing an intra-articular injection,

1. inject the medication into the jointdespite resistance

2. use a 3 cc syringe and a 25 gaugeneedle to draw up 2.5 cc of 1% lidocaine and 0.5 cc of corticosteroid

3. do not mix the syringe prior to injecting

4. keep the joint immobile to preventextravasation after the injection

Question 5 What is the correct sequence for wound or laceration treatment?

1. Obtain informed written consent, assess the wound for more serious underlying disorders, assess the neuro function, cleanse the wound with aseptic solution, provide the patient with appropriate anesthesia, and explore, irrigate, debride, and prepare the wound for suturing.

2.Cleanse the wound with aseptic solution, obtain informed written consent, assess the wound for more serious underlying disorders, provide the patient with appropriate anesthesia, and explore, irrigate, debride, and prepare the wound for suturing.

3.Provide the patient with appropriate anesthesia; explore, irrigate, debride, and prepare the wound for suturing; obtain informed written consent; and assess the wound for more serious underlying disorders.

4. Assess the wound for more serious underlying disorders, cleanse the wound with aseptic solution, provide the patient with appropriate anesthesia, and explore, irrigate, debride, and prepare wound for suturing.

Question 6 A 40-year-old male presents to your clinic and has a suspicious lesion on his back. You believe the lesion may be a basal cell carcinoma. After obtaining consent from your patient, you remove the lesion with an elliptical incision and send the specimen to the lab. The lesion has left a 2.5 cm long laceration that is wide and shallow. Which of the following is the most appropriate type of suture technique?

1. Horizontal mattress

2. Dermabond

3. Running interrupted sutures

4. Duct tape

Question 7One of the critical steps when performing an intra-articular injection is to pull back on the syringe prior to injecting the corticosteroid solution. The purpose of this is to? Edmunds and Mayhew page 320.

1. remove any excess fluid

2. check the plunger movement prior to injection

3. aspirate to make sure you are not injecting into the vascular bed

4. remove any air which may be in the intra-articular space

Question 8 What is the correct sequence for a toenail removal procedure?

1.Position the patient comfortably in a supine position. Clean the toe with an aseptic solution. Administer a bilateral digital nerve block with 2% lidocaine. Use a nail elevator to free the nail sulcus and eponychium from the nail plate.

2.The patient may soak the foot the night before the procedure by wrapping the toe or foot in a wet cloth. Position the patient comfortably in a supine position. Administer a bilateral digital nerve block with 2% lidocaine. Clean the toe with an aseptic solution. Use a nail elevator to free the nail sulcus and eponychium from the nail plate.

3.The patient may soak the foot the night before the procedure by wrapping the toe or foot in a wet cloth. Position the patient comfortably in a supine position. Use a nail elevator to free the nail sulcus and eponychium from the nail plate. Clean the toe with an aseptic solution. Administer a bilateral digital nerve block with 2% lidocaine. Clean the toe with an aseptic solution.

Question 9Which of the following patients has an increased risk of infection following toenail removal?

1. A type I labile Diabetic

2. Immune-competent patient

3. A 78-year-old male

4. Patient just recovering from a viral upper respiratory infection

Question 10Suturing a laceration or a wound prior to aseptic cleansing and debridement may result in?

1. lower chance of infection

2. increased scarring

3. less pain

4. dermatological pigmentation changes

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