ABIM IM Practice Test 15

A 23-year-old woman is evaluated in the emergency department for 4 days of migratory pain in the wrists and knees, followed by pain and swelling over the back of the right hand. Her last menstrual period began 1 week ago. She has a new male sexual partner and uses condoms inconsistently. Temperature is 38.2 °C (100.8 °F), blood pressure is 116/70 mm Hg, and pulse rate is 102/min. Examination shows swelling and tenderness along the extensor tendon sheaths of the right wrist and hand with pain on finger extension, and five small painless pustules on erythematous bases on the forearms and ankles. There is no joint effusion. A pregnancy test is negative. Blood cultures and nucleic acid amplification tests of urine, pharyngeal and rectal specimens have been obtained, with results pending. Which of the following is the most appropriate treatment?