NURS 676 FINAL EXAM VERSION 3 NEWEST 2024
COMPLETE STUDYGUIDE WITH VERIFIED ANSWERS
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve
the pain. What is the next action?
Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST
segment elevation MI (STEMI). The nearest hospiral that can perform a PCI is
three hours away, what is the initial treatment for this patient.
Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner
elicits pain when manipulating the ear structures, what is likely the diagnosis?
acute otitis externa
Which are risk factors for developing otitis externa?
having underlying DM, use of ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the
patient's ear canal is mildly inflamed and the TM is not involved. Which
medication will be ordered?
Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring
system to determine the severity of pain in children with OM?
Appetite, Difficulty sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up
assessment without initial antibiotic therapy?
A 36 month old with fever of 38.5, mild otalgia, and red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the
examiner is unable to visualize the TM in the right ear because of the presence of
cerumen. The left TM is dull gray with fluid levels present. What is the correct
action?
Remove the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals
a small tear in the TM of the affected ear with purulent d/c. What is the initial
treatment for this patient?
Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider
notes a perforated TM. What is recommended treatment?
Refer the patient to an Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider
notes foul-smelling breath and a muffled voice with marked edema and erythema
of the peritonsillar tissue. What should you do?
Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's
symptoms.
, Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the
provider notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause?
viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes
the previous year. The child's parents ask the provider if the child needs a
tonsillectomy. What will the provider say?
Current recommendations do not support tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with
Amoxicillin. On the third day of treatment, the patient develops a rash. A
urinalysis is normal. what does this indicate?
A reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious
Mono and is noted to have splenomegaly. What will the provider recommend to
this patient about returning to sports?
ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy
and has negative GAS culture. A cbc shows absolute lymphocytosis, but a
heterophil antibody test is negative for EBV. What will the provider tell the
patient?
The likelihood of EBV is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on
the right side for 4 months. There is no hx of sneezing or eye involvement, The
patient has a hx of seasonal allergies and takes a non-sedating antihistamine.
What does the provider suspect is the cause of these symptoms?
chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal
polyps. What is first-line treatment?
Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy
eyes, and thin, clear nasal secretions. The provider notes puffiness around the
eyes. The patient;s vital signs are normal. What is likely diagnosis?
allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity
to trees and grasses. What is first line treatment for this patient?
intranasal steroids
A patient is concerned about frequent nasal stuffiness and congestion that
begins shortly after getting out of bed in the morning. The patient denies itching
and sneezing. A PE reveals erythematous nasal mucosa with scant watery
discharge. What treatment will the provider recommend?
daily intranasal steroids
What are potential complications of chronic or recurrent sinusitis?
Meningitis, orbital infection, and osteomyleitis.
COMPLETE STUDYGUIDE WITH VERIFIED ANSWERS
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve
the pain. What is the next action?
Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST
segment elevation MI (STEMI). The nearest hospiral that can perform a PCI is
three hours away, what is the initial treatment for this patient.
Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner
elicits pain when manipulating the ear structures, what is likely the diagnosis?
acute otitis externa
Which are risk factors for developing otitis externa?
having underlying DM, use of ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the
patient's ear canal is mildly inflamed and the TM is not involved. Which
medication will be ordered?
Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring
system to determine the severity of pain in children with OM?
Appetite, Difficulty sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up
assessment without initial antibiotic therapy?
A 36 month old with fever of 38.5, mild otalgia, and red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the
examiner is unable to visualize the TM in the right ear because of the presence of
cerumen. The left TM is dull gray with fluid levels present. What is the correct
action?
Remove the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals
a small tear in the TM of the affected ear with purulent d/c. What is the initial
treatment for this patient?
Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider
notes a perforated TM. What is recommended treatment?
Refer the patient to an Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider
notes foul-smelling breath and a muffled voice with marked edema and erythema
of the peritonsillar tissue. What should you do?
Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's
symptoms.
, Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the
provider notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause?
viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes
the previous year. The child's parents ask the provider if the child needs a
tonsillectomy. What will the provider say?
Current recommendations do not support tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with
Amoxicillin. On the third day of treatment, the patient develops a rash. A
urinalysis is normal. what does this indicate?
A reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious
Mono and is noted to have splenomegaly. What will the provider recommend to
this patient about returning to sports?
ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy
and has negative GAS culture. A cbc shows absolute lymphocytosis, but a
heterophil antibody test is negative for EBV. What will the provider tell the
patient?
The likelihood of EBV is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on
the right side for 4 months. There is no hx of sneezing or eye involvement, The
patient has a hx of seasonal allergies and takes a non-sedating antihistamine.
What does the provider suspect is the cause of these symptoms?
chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal
polyps. What is first-line treatment?
Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy
eyes, and thin, clear nasal secretions. The provider notes puffiness around the
eyes. The patient;s vital signs are normal. What is likely diagnosis?
allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity
to trees and grasses. What is first line treatment for this patient?
intranasal steroids
A patient is concerned about frequent nasal stuffiness and congestion that
begins shortly after getting out of bed in the morning. The patient denies itching
and sneezing. A PE reveals erythematous nasal mucosa with scant watery
discharge. What treatment will the provider recommend?
daily intranasal steroids
What are potential complications of chronic or recurrent sinusitis?
Meningitis, orbital infection, and osteomyleitis.
