Directions: Try the USMLE (Step 3) question(s) below, pick one answer from the choices below and then check your answer by clicking on get answer button.
Question
As you are making afternoon rounds in the hospital, you are informed that one of your patients has a fever of 38.2 C (100.8 F). The patient is a 71-year-old man who is postoperative day 6 from a right hemicolectomy for colon cancer. Upon questioning. The patient tells you that he feels well other than a small amount of pain at his incision site. He has been tolerating his regular diet for 24 hours without any nausea or vomiting. He has passed flatus, but has not had a bowel movement. He has been ambulatory since postoperative day 3. He denies any cough, chest pain, shortness of breath, or dysuria. His Foley catheter has been removed for 3 days now. Physical examination reveals clear lungs with good inspiratory effort and no crackles, normal heart sounds, and nondistended and soft abdomen. There is erythema and increased tenderness around the distal half of the incision site. A small amount of purulent drainage is seen near the erythematous portion of the wound. He has no calf tenderness or lower extremity swelling. The most appropriate next step in the management of this patient’s fever is to
A. Apply a dressing to the incision site drainage
B. Begin antibiotic therapy
C. Open, drain, and pack the incision site
D. Order a chest x-ray
E. Schedule a lower extremity venous Doppler study
