HEENT Board Vitals Quiz 2020 latest

HEENT Board Vitals Quiz: 1. When examining the eyes, the nurse practitioner determines that the pupils change size when the client focuses from a close object to a distant object. This is interpreted as: a. Normal visual accommodation b. Intact extra ocular motor response c. Appropriate consensual response d. Visual acuity within normal limits 2. A 21-year-old man presents to his health care provider for a 2-week history of ear pain and pruritus. On further questioning, he reports ear fullness and trouble hearing. He is a senior in college on a swimming scholarship. He has had these episodes in the past but not to this extent. On physical exam, his TM is difficult to visualize, but it is mobile without any inflammation. There is pain on palpation of the tragus. Pain is also elicited with traction of the pinna. Which of the following treatments should be prescribed for this patient? a. Hydrocortisone/neomycin/polymyxin B b. Amoxicillin c. Amoxicillin/clavulanate d. Tacrolimus cream 3. An elderly client presents to the nurse practitioner’s office with fever and complaints of right facial pain, copious yellow nasal drainage, and acute pain and headache when bending over. The symptoms have been occurring for about 5 days. There is not trans illumination of the right maxillary sinus and that area is very tender to palpation. The client’s diagnosis is: This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseH. Chronic sinusitis b. Acute sinusitis c. Dental abscess d. Temporal arteritis 4. Which of the following organisms is least likely to cause otitis media? a. Moraxella catarrhalis b. Streptococcus pneumonia c. Chlamydia trachomatis d. Haemophilus influenzae 5. An adult make client is being evaluated at an EENT clinic for a complaint of a sore throat. He has difficulty swallowing and has some mouth pain. On exam the nurse practitioner finds that the clients’ mouth, tongue, and pharynx are coated with white curdlike plaques that are difficult to remove and leave a red surface when scraped with a tongue blade. What would be the best action for the nurse practitioner to take at this time? a. Refer him to an ear, nose, and throat specialist for evaluation b. Prescribe Amoxicillin 500 mg PO Tid x 10 days c. Encourage the client to have the HIV screening done d. Recommend clear fluids only for the next few days 6. A 19-year-old female presents with a one-week of red and itchy eyes. She mentions that she’s noticed a stringy white discharge and extra tearing from both eyes. She reports that her vision is unchanged and denies pain. She denies any recent illnesses or use of contact lenses. Based on her history, what is the most likely diagnosis? a. Allergic conjunctivitis This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseH. Corneal abrasion c. Viral conjunctivitis d. Bacterial conjunctivitis 7. A geriatric client is given a diagnosis of chronic open-angle glaucoma. She has a history of bradycardia and first degree AV block. In consideration of her treatment, what medication should be avoided? a. Pilocarpine (Isopto Carpine) b. Timolol (Timoptic) c. Spironolactone (Aldactone) d. Acetazolamide (Diamox) 8. Which of the following antibiotics if first line recommendation for outpatient treatment of acute bacterial Rhinosinusitis in a patient without any drug allergies and no recent antibiotic use? a. Moxifloxacin b. Amoxicillin-clavulanate c. Ciprofloxacin d. Azithromycin 9. Which structure of the eye is responsible for the color vision? a. Macula b. Cones c. Rods d. Sclera This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseH10. Which of the following clinical findings is associated with bacterial streptococcal pharyngitis? a. Rhinorrhea b. Cough c. Enlarged tonsils with exudate d. Small oral vesicles 11. A 43 year old woman with a history of hypertension and gestational diabetes presents to your office for treatment of her upper respiratory infection (URI) symptoms. What medications do you teach her to avoid when choosing for symptomatic treatment? a. Acetaminophen b. Corticosteroid nasal spray c. Pseudoephedrine d. Guaifenesin 12. What is the best test for diagnosing congenital glaucoma? a. Tonometery b. Fluorescein stain c. The refractive index d. Snellen vision exam 13. What vaccine does not help prevent acute otitis media (AOM)? a. Influenza b. Hib c. Prevnar (PCV13) d. DTaP This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseH14. A 65 year old patient presents with complaints of a bright red spot in his right eye for the last few days. He denies pain or visual changes. He does not report any headaches but has had a recent upper respiratory infection with cough. His only routine medications are aspirin daily. How would you diagnose and treat this patient? a. Acute uveitis; Referral to an ophthalmologist b. Corneal abrasion; erythromycin ointment TID c. Subconjunctival hemorrhage; nothing d. Bacterial conjunctivitis; antibiotic eye drops 15. On ophthalmic examination, there appears to be a narrowing or blocking of the vein at the point where an arteriole crosses over it. The significance of this finding is: a. The client needs to be evaluated for chronic hypertension. b. This may be indicative of increased ocular pressure associated with glaucoma c. The finding is associated with papilledema causing decreased venous drainage. d. This may represent a small embolus in the retinal vessels. 16. A fleshy wedge shaped growth extending to the cornea on the nasal side that may impair vision or eye movement best describes which eye condition? a. Pterygium b. Pinguecula c. Corneal arcus d. Hordeolum 17. A 49-year-old man presents to your clinic with left eye pain that started this morning. He also has been seeing halos around light since the start of the symptoms and is nauseated but denies vomiting or diarrhea. He denies any discharge or crusting. He denies any This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseHstory of eye injury or foreign body in eye and does not use corrective lenses. He has no history for migraines. On exam: left eye conjunctiva is injected, left pupil I slightly more deflated and not reactive to light. Screening with the Snellen chart is 20/80 OS and 20/20 OD. He is not able to complete the field of vision testing due to pain. His neuro exam is normal, limited eye movement on the right side. Normal bowel sounds in all four quadrants and no abdominal pain with palpation. What is your plan based on this patient’s presentation? a. Fluoroscopy b. Send to the ophthalmologist immediately for emergent evaluation c. Send to the ER for CT scan d. Start on high dose corticosteroids to decrease inflammation 18. Laryngeal neoplasia has been associated with which of the following infections? a. Streptococcal b. H. Influenzae c. Epstein Barr Virus d. Human Papilloma Virus 19. The most common pathogen seen in an otitis media infection is: a. Moraxella catarrhalis b. Streptococcus pneumoniae c. Streptococcus pyogenes d. Pseudomonas aeroginosa This study source was downloaded by from CourseH on :58:17 GMT -05:00 This study resource was shared via CourseH Powered by TCPDF (