, NURS 5433 FNP II MIDTERM EXAM REVIEW - UTA STUDY
GUIDE QUESTIONS WITH CORRECT DETAILED ANSWERS A+
VERIFIED
Question 1: Acute Otitis Media (AOM) in Pediatrics
A 2-year-old previously healthy child presents with 2 days of fever (39°C), irritability, and tugging at the
right ear. On otoscopic exam, the right tympanic membrane is bulging, erythematous, and immobile
with pneumatic otoscopy. The left ear appears normal. What is the most appropriate initial treatment?
A. Amoxicillin 45 mg/kg/day divided BID
B. Amoxicillin 90 mg/kg/day divided BID
C. Azithromycin 10 mg/kg on day 1, then 5 mg/kg for 4 days
D. Observation without antibiotics
Correct Answer: B. Amoxicillin 90 mg/kg/day divided BID
Explanation:
According to the American Academy of Pediatrics (AAP) 2023 guidelines, high-dose amoxicillin (80–90
mg/kg/day divided BID, max 2000 mg/day) is first-line therapy for AOM in children:
With severe symptoms (fever ≥39°C, moderate-severe otalgia)
Age <2 years with bilateral or unilateral AOM
Or if symptoms persist >48–72 hours
High-dose amoxicillin achieves adequate middle ear concentrations to overcome Streptococcus
pneumoniae with intermediate penicillin resistance.
Azithromycin is not recommended due to high resistance rates in S. pneumoniae and H. influenzae.
Observation may be considered in mild, unilateral AOM in children ≥2 years, but this child is <2 years
with high fever and clear signs, warranting immediate antibiotics.
Question 2: Acute Bronchitis in Adults
A 32-year-old otherwise healthy woman presents with a 5-day history of cough, initially dry but now
productive of yellow sputum. She has mild fatigue but no fever, dyspnea, or chest pain. Lung exam is
clear. She requests antibiotics. What is the best next step?
GUIDE QUESTIONS WITH CORRECT DETAILED ANSWERS A+
VERIFIED
Question 1: Acute Otitis Media (AOM) in Pediatrics
A 2-year-old previously healthy child presents with 2 days of fever (39°C), irritability, and tugging at the
right ear. On otoscopic exam, the right tympanic membrane is bulging, erythematous, and immobile
with pneumatic otoscopy. The left ear appears normal. What is the most appropriate initial treatment?
A. Amoxicillin 45 mg/kg/day divided BID
B. Amoxicillin 90 mg/kg/day divided BID
C. Azithromycin 10 mg/kg on day 1, then 5 mg/kg for 4 days
D. Observation without antibiotics
Correct Answer: B. Amoxicillin 90 mg/kg/day divided BID
Explanation:
According to the American Academy of Pediatrics (AAP) 2023 guidelines, high-dose amoxicillin (80–90
mg/kg/day divided BID, max 2000 mg/day) is first-line therapy for AOM in children:
With severe symptoms (fever ≥39°C, moderate-severe otalgia)
Age <2 years with bilateral or unilateral AOM
Or if symptoms persist >48–72 hours
High-dose amoxicillin achieves adequate middle ear concentrations to overcome Streptococcus
pneumoniae with intermediate penicillin resistance.
Azithromycin is not recommended due to high resistance rates in S. pneumoniae and H. influenzae.
Observation may be considered in mild, unilateral AOM in children ≥2 years, but this child is <2 years
with high fever and clear signs, warranting immediate antibiotics.
Question 2: Acute Bronchitis in Adults
A 32-year-old otherwise healthy woman presents with a 5-day history of cough, initially dry but now
productive of yellow sputum. She has mild fatigue but no fever, dyspnea, or chest pain. Lung exam is
clear. She requests antibiotics. What is the best next step?
