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A 34-Year-Old Man Comes to the Emergency Department After Coughing

question 578

Multiple Choice

A 34-year-old man comes to the emergency department after coughing up blood-streaked, white sputum this morning, following a week of malaise and productive cough. Two months ago, he was evaluated for weight loss and oral thrush and was diagnosed with HIV infection. His initial CD4 count was 55/mm³, and HIV viral load was 1 million copies/mL. Interferon-gamma release assay testing was indeterminate at that time, and he was started on combination antiretroviral therapy and trimethoprim/sulfamethoxazole. The patient is adherent with his medication regimen.
Temperature is 38 C (100.4 F) , blood pressure is 110/70 mm Hg, pulse is 96/min, and respirations are 16/min. BMI is 17 kg/m². Oxygen saturation is 95% on room air. No thrush is present and no enlarged lymph nodes are palpable. Coarse rhonchi are heard over the left upper lung field. There are no skin rashes or edema. Leukocyte count is 5,500/mm³, and chest x-ray reveals a dense consolidation in the left upper lobe. CD4 count is now 240/mm³.
Which of the following is the best next step in management of this patient?

Definitions:

Allowance for Doubtful Accounts

A contra-asset account that reduces the total receivables on the balance sheet to reflect the amount expected to be uncollectible.

Adjusting Entry

An adjustment recorded in the bookkeeping records at the end of an accounting period to allocate income and expenditure to the period in which they actually occurred.

Bad Debt Expense

The estimated amount of credit sales that are not expected to be collected, recognized as an expense in the income statement.

Uncollectible Accounts

Accounts receivable that a company does not expect to collect and writes off as a bad debt expense.