CMN 568 UNIT 1 QUESTIONS & VERIFIED ANSWERS
The test used to check for corneal light reflex in each eye, and its symmetry is called -
Answers - hirshberg test
What is the difference in recurrent sinusitis and chronic sinusitis - Answers - recurrent is
defined as successive episodes of bacterial infections of the sinuses each lasting less
than 30 days and separated by intervals of at least 10 days.
Chronic is defined as episodes of inflammation of the paranasal sinuses lasting more
than 90 days.
First line of treatment of AOM in children? - Answers - amoxicillin 80-90mg/kg/day
divided by 2 doses
A 3 y/o presents with AOM and mother reports severe allergy to PCN. What is an
alternative? - Answers - A macrolide, Bactrim, or clindamycin
5 y/o presents w/AOM and mother reports a mild rash w/PCN medication. What is an
alternative for treatment? - Answers - 2nd or 3rd generation cephalosporins
What disease process may be observed by unequal pupils (anisocoria), eyelid ptosis,
iris heterochromia, and anhidrosis? - Answers - horners syndrome
What trait can quickly lead to optic atrophy and permanent vision loss with even
moderate elevations of intraocular pressure AND should be tested for all African
Americans whose status is unknown when hyphema is observed? - Answers - sickle
cell
What would be your treatment plan for an anaphylactic reaction due to a bee sting on
an upper limb? - Answers - -For anaphylaxis you'll give EPI 1:1000 ).01 mg/kg (max
dose 0.3 in Peds and 0.5 in adults) IM
-Benadryl 1-2mg/kg peds w/max dose 50 mg IV
-ranitidine max dose 1 mg/kd peds w/max dose 50mg/kd IV
-crystalloid bolus (20mg/kg over 1 hour)
-solumedeol 1mg/kg for Peds IV
-sometimes also an albuterol neb
What are the most common antibiotics to cause anaphylaxis - Answers - amoxicillin
Ampicillin
TMP-SMZ (trimethoprim-sulfonamide)
What is the 1st line of treatment for allergic rhinitis - Answers - -non-sedating
antihistamines: LORATADINE, CETRIZINE
-intranasal corticosteroids
,-mast cell stabilizers: CROMOLYN
-Montelukast: SINGULAR
What is the 1st line treatment for Bacterial Rhinosinusitis in adults? - Answers - OTC
NSAIDS or acetaminophen
Nasal corticosteroids
Decongestants
-diagnosis is made when symptoms last longer than 10 days w/o improvement OR
worsening of symptoms w/in 20 days after initial improvement of symptoms.
-for pts w/focal signs such as periorbital edema, severe sinus tenderness, or severe
headache--do not wait 10 days for antibiotics
------1st line therapy: amoxicillin, bactrim, doxycycline, amoxicillian-clavulanate
------1st line therapy after recent abx use: levofloxacin, amoxicillain-clavulanate
What antibiotic do you avoid if you think the patient may have mono? - Answers -
amoxicillin b/c drug often precipitates a rash
Every pt who complains of hearing loss should be referred for audiologic evaluation
except in what scenario? - Answers - when the cause is easily remediable.
Example: cerumen impaction or otitis media. Have child return at 4 wk intervals to check
progress of effusion. Refer for audiology after 3 mo of continuous effusion in children
<3yr or at risk of language delay
What is the 1st line treatment for acute bacterial pharyngitis in adults? In peds? -
Answers - Adults & children > 27kg: Penicillin VK 250 mg orally TID or 500 mg BID for
10 days. Penicillin G IM if compliance or amoxicillin
--erythromycin/azithromycin or cephalosporins are used if PCN allergy.
PEDS: penicillin VK 50-70 mg/kg/d in 3 divided doses, benzathine penicillin 600,000
units IM in <27kg, 1.2 million units if >27kg, single dose. For PCN allergy use
azithromycin
A nurse practitioner is examining the eyes of a 5-year-old. On shining a light onto the
cornea so that it is seen on both eyes, the NP notes that is it at the 10 o'clock in the
right eye and 2 o'clock in the left eye. Interpretation of this finding is:
A. Nystagmus
B. Myopia
C. Normal
D. Strabismus - Answers - strabismus
The following statement of strabismus is true except:
A. Esotropia may be intermittent up to age 6 months
B. Exotropia is normal after age 2 months
C. Strabismus may be latent (occurs only under binocular vision)
D. Strabismus requires ophthalmological referral if present after age 1 year - Answers -
--exotropia is normal after 2 mo of age
, --strabismus requires an ophthalmological referral if present after the age of 1 yr (earlier
tx is better)
A 45 yo mail comes the clinic with c/o right eye pain. It has been occuring constantly
over the last two days and is associated with redness. There has been no increase
lacrimation, purulent discharge, or HA. In addition to the fundusocpic exam, it is crucial
that the NP access:
A. Visual fields
B. Cranial nerve 7,
C. Visual acuity,
D. The corneal reflex - Answers - visual acuity
A 75 yo pt c/o intense eye pain and generalized HA, after watching a movie in the
theater. The NP records the following findings OD with red sclera and dilated pupil, OD
> OS, decreased VA OD, OS WNL, no temporal tenderness. These findings are most
appropriately suggest: A. Acute glaucoma,
B. Open angle glaucoma,
C. Temporal arteritis,
D. Retinal detachment - Answers - acute glaucoma
A NP suspects that a scratchy feeling in a pt's eye is a corneal abrasion. There is
photophobia and erythema, but no drainage or change in visual acuity. PERRLA is
noted. An appropriate NP intervention at this time would include:
A. Immediate referral
B. Instillation of anesthetic ocular drops,
C. Opthalmic antibiotic gtts and patching the eye
D. Instillation of mydriatic gtts - Answers - instillation of anesthetic ocular drops
A pt is suspected to have bacterial conjunctivitis OU. The NP performs flourescein test
and notes a dendritic appearance on the cornea. This is probably:
A. Glaucoma,
B herpes,
C a neisseria gonorrhea infection
D. Hyphema - Answers - herpes
On exam of a pt with epistaxis the NP note that there is oozing of blood from the
Kisselbach's plexus. This is:
A. Often managed by pinching the nasal ala together for 10 minutes while the pt leans
backward
B. Can be managed with pheylephrine 0.125-1% solution 1 or 2 sprays C. Requires
immediate ENT consult
D. Signaling an intrinsic coagulation defect - Answers - can be managed
w/phenylephrine 0.125-1% solution 1 or 2 sprays
Pt complains of worsening nasal congestion. He reports symptoms started to get worse
a few days after he ran of phenylephrine nasal spray, which he has been using for the
The test used to check for corneal light reflex in each eye, and its symmetry is called -
Answers - hirshberg test
What is the difference in recurrent sinusitis and chronic sinusitis - Answers - recurrent is
defined as successive episodes of bacterial infections of the sinuses each lasting less
than 30 days and separated by intervals of at least 10 days.
Chronic is defined as episodes of inflammation of the paranasal sinuses lasting more
than 90 days.
First line of treatment of AOM in children? - Answers - amoxicillin 80-90mg/kg/day
divided by 2 doses
A 3 y/o presents with AOM and mother reports severe allergy to PCN. What is an
alternative? - Answers - A macrolide, Bactrim, or clindamycin
5 y/o presents w/AOM and mother reports a mild rash w/PCN medication. What is an
alternative for treatment? - Answers - 2nd or 3rd generation cephalosporins
What disease process may be observed by unequal pupils (anisocoria), eyelid ptosis,
iris heterochromia, and anhidrosis? - Answers - horners syndrome
What trait can quickly lead to optic atrophy and permanent vision loss with even
moderate elevations of intraocular pressure AND should be tested for all African
Americans whose status is unknown when hyphema is observed? - Answers - sickle
cell
What would be your treatment plan for an anaphylactic reaction due to a bee sting on
an upper limb? - Answers - -For anaphylaxis you'll give EPI 1:1000 ).01 mg/kg (max
dose 0.3 in Peds and 0.5 in adults) IM
-Benadryl 1-2mg/kg peds w/max dose 50 mg IV
-ranitidine max dose 1 mg/kd peds w/max dose 50mg/kd IV
-crystalloid bolus (20mg/kg over 1 hour)
-solumedeol 1mg/kg for Peds IV
-sometimes also an albuterol neb
What are the most common antibiotics to cause anaphylaxis - Answers - amoxicillin
Ampicillin
TMP-SMZ (trimethoprim-sulfonamide)
What is the 1st line of treatment for allergic rhinitis - Answers - -non-sedating
antihistamines: LORATADINE, CETRIZINE
-intranasal corticosteroids
,-mast cell stabilizers: CROMOLYN
-Montelukast: SINGULAR
What is the 1st line treatment for Bacterial Rhinosinusitis in adults? - Answers - OTC
NSAIDS or acetaminophen
Nasal corticosteroids
Decongestants
-diagnosis is made when symptoms last longer than 10 days w/o improvement OR
worsening of symptoms w/in 20 days after initial improvement of symptoms.
-for pts w/focal signs such as periorbital edema, severe sinus tenderness, or severe
headache--do not wait 10 days for antibiotics
------1st line therapy: amoxicillin, bactrim, doxycycline, amoxicillian-clavulanate
------1st line therapy after recent abx use: levofloxacin, amoxicillain-clavulanate
What antibiotic do you avoid if you think the patient may have mono? - Answers -
amoxicillin b/c drug often precipitates a rash
Every pt who complains of hearing loss should be referred for audiologic evaluation
except in what scenario? - Answers - when the cause is easily remediable.
Example: cerumen impaction or otitis media. Have child return at 4 wk intervals to check
progress of effusion. Refer for audiology after 3 mo of continuous effusion in children
<3yr or at risk of language delay
What is the 1st line treatment for acute bacterial pharyngitis in adults? In peds? -
Answers - Adults & children > 27kg: Penicillin VK 250 mg orally TID or 500 mg BID for
10 days. Penicillin G IM if compliance or amoxicillin
--erythromycin/azithromycin or cephalosporins are used if PCN allergy.
PEDS: penicillin VK 50-70 mg/kg/d in 3 divided doses, benzathine penicillin 600,000
units IM in <27kg, 1.2 million units if >27kg, single dose. For PCN allergy use
azithromycin
A nurse practitioner is examining the eyes of a 5-year-old. On shining a light onto the
cornea so that it is seen on both eyes, the NP notes that is it at the 10 o'clock in the
right eye and 2 o'clock in the left eye. Interpretation of this finding is:
A. Nystagmus
B. Myopia
C. Normal
D. Strabismus - Answers - strabismus
The following statement of strabismus is true except:
A. Esotropia may be intermittent up to age 6 months
B. Exotropia is normal after age 2 months
C. Strabismus may be latent (occurs only under binocular vision)
D. Strabismus requires ophthalmological referral if present after age 1 year - Answers -
--exotropia is normal after 2 mo of age
, --strabismus requires an ophthalmological referral if present after the age of 1 yr (earlier
tx is better)
A 45 yo mail comes the clinic with c/o right eye pain. It has been occuring constantly
over the last two days and is associated with redness. There has been no increase
lacrimation, purulent discharge, or HA. In addition to the fundusocpic exam, it is crucial
that the NP access:
A. Visual fields
B. Cranial nerve 7,
C. Visual acuity,
D. The corneal reflex - Answers - visual acuity
A 75 yo pt c/o intense eye pain and generalized HA, after watching a movie in the
theater. The NP records the following findings OD with red sclera and dilated pupil, OD
> OS, decreased VA OD, OS WNL, no temporal tenderness. These findings are most
appropriately suggest: A. Acute glaucoma,
B. Open angle glaucoma,
C. Temporal arteritis,
D. Retinal detachment - Answers - acute glaucoma
A NP suspects that a scratchy feeling in a pt's eye is a corneal abrasion. There is
photophobia and erythema, but no drainage or change in visual acuity. PERRLA is
noted. An appropriate NP intervention at this time would include:
A. Immediate referral
B. Instillation of anesthetic ocular drops,
C. Opthalmic antibiotic gtts and patching the eye
D. Instillation of mydriatic gtts - Answers - instillation of anesthetic ocular drops
A pt is suspected to have bacterial conjunctivitis OU. The NP performs flourescein test
and notes a dendritic appearance on the cornea. This is probably:
A. Glaucoma,
B herpes,
C a neisseria gonorrhea infection
D. Hyphema - Answers - herpes
On exam of a pt with epistaxis the NP note that there is oozing of blood from the
Kisselbach's plexus. This is:
A. Often managed by pinching the nasal ala together for 10 minutes while the pt leans
backward
B. Can be managed with pheylephrine 0.125-1% solution 1 or 2 sprays C. Requires
immediate ENT consult
D. Signaling an intrinsic coagulation defect - Answers - can be managed
w/phenylephrine 0.125-1% solution 1 or 2 sprays
Pt complains of worsening nasal congestion. He reports symptoms started to get worse
a few days after he ran of phenylephrine nasal spray, which he has been using for the
