An 85-year-old man is transferred from an acute care hospital to your long-term care (LTC) facility. He has a fever, fatigue, myalgia, and malaise. His test result is positive for influenza A virus. Two other residents and 1 LTC staff member have experienced the same symptoms. Which one of the following is the best next step to prevent further infections at the LTC facility?

• A. Order symptomatic LTC staff to stay home.
• B. Ask all visitors to wear a mask.
• C. Enforce mandatory influenza vaccination for LTC staff.
• D. Ensure that all visitors are immunized.

A 42-year-old woman presents to the emergency department with a 24-hour history of severe pain in her right eye. On examination, you notice a right conjunctival injection that is worst adjacent to the iris. Direct and consensual responses to light are intact but sluggish, with severe photophobia in the right pupil is slightly smaller than the left. The patient's visual acuity is 20/20 on the left and 20/40 on the right. Visual field testing results are normal. Intraocular pressure findings are normal. Slit-lamp examination findings of the cornea are normal, and there are no cells in the anterior chamber. You are unable to visualize her fundus. Which one of the following is the most likely diagnosis?

• A. Optic neuritis.
• B. Acute angle-closure glaucoma.
• C. Acute uveitis.
• D. Viral conjunctivitis.
• E. Scleritis.

A 42-year-old woman presents to your clinic requesting an increase in her stimulant dosage for the treatment of her adult attention-deficit/hyperactivity disorder. Her medical history includes hypertension and type 1 diabetes with associated nephropathy. She has been taking methylphenidate daily for 15 years. Which one of the following would need to be addressed before the dosage can be increased?

• A. Estimated glomerular filtration rate of less than 30 mL/min/1.73 m² (#60).
• B. Average home blood pressure reading of 150/80 mm Hg.
• C. Random glucose level that is often higher than 18.0 mmol/L (4.0-11.0).

A couple is diagnosed with primary infertility secondary to azoospermia. They are not interested in in vitro fertilization techniques, so you recommend insemination with a sperm donor. The male partner is hesitant. He thinks he might have difficulty accepting raising a child who is not biologically his. Which one of the following is the best next step?

• A. Propose a trial of ovulation induction with gonadotropins
• B. Recommend that the donor be a person who is known and significant to the couple
• C. Suggest transfer of care to another physician
• D. Tell the couple adoption is a better option
• E. Arranging a consultation with a psychologist