NUR-652 GCU COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS NEWEST UPDATE 2024 GRADE
A+
A 5-year-old child is hit in the face with a baseball bat and is brought to the clinic by a
parent. An exam reveals three avulsed front teeth. Radiologic studies are negative for facial
fractures. What is the recommended treatment?
Refer the child to the dentist immediately for further evaluation
A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media is seen for follow-up. The primary care nurse practitioner notes dull-gray tympanic
membranes with a visible air-fluid level. The child is afebrile and without pain. What is the
next course of action?
Monitoring ear fluid levels for 3 months
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What will the
primary care nurse practitioner recommend to promote dental health in this child?
Daily chlorhexidine gluconate
A primary care provider may suspect cataract formation in a patient with which finding?
Asymmetric red reflex
A patient has chronically dry eyes, sometimes with a foreign body sensation, burning, and
itching. A Schirmer test is abnormal. What is the suspected cause of this patient's
symptoms?
Aqueous Deficiency
A teen who has otitis externa has severe swelling of the external auditory canal that persists
after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step
in treatment for this child?
Insert a wick into the external auditory canal
A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with
erythema and edema of the surrounding tissues without discharge. Which is the initial
course of action by the provider?
Prescribe amoxicillin and refer to a dentist in 2-3 days
An elderly patient has a permanent loss of the sense of smell and diminished taste. What
will be included in teaching this patient about managing these symptoms?
1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
2.
,A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary
nurse practitioner will refer to a pediatric ophthalmologist to initiate which treatment?
Patching of the unaffected eye for 2 hours each day
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the
mouth reveals the presence of plaque and calculus on the teeth which are not loose. What
will the primary care nurse practitioner recommend?
Consistently brushing and flossing the teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic cerumen
buildup. The provider notes that the patient has dry skin in the ear canal. Which
preparation is FDA approved for this use?
Carbamide peroxide
A parent asks about ways to promote dental health in school-aged children while on family
vacation that are convenient while camping and picnicking. What will the primary care
nurse practitioner recommend?
Offering gum containing xylitol after meals
A patient reports several episodes of acute vertigo, some lasting up to an hour with
associated nausea and vomiting. What is part of the initial diagnostic workup for this
patient?
Audiogram and MRI
A teen with a history of otitis externa asks about ways to prevent this condition. What will
the primary care nurse practitioner recommend?
Drying the ear canal with a hair dryer
A 7-month-old infant has had two prior acute ear infections and is currently on the 10th
day of therapy with amoxicillin-clavulanate after a failed course of amoxicillin. The
primary care nurse practitioner notes marker middle ear effusion and erythema of the TM.
The child is irritable and has a temperature of 99.8. What is the next step in management
of this child's infection?
Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes. The
provider notes a mass in the salivary gland region. What is the likely cause of these
symptoms?
Sialolithiasis
A child complains of itching in both ears and is having trouble hearing. The primary care
nurse practitioner notes periauricular edema and marked swelling of the external auditory
canal and elicits severe pain when manipulating the external ear structures. Which is an
appropriate intervention?
Order ototopical antibiotic/corticosteroid drops
During a well child assessment of an African American infant, the primary care nurse
practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-
orange light reflex in the right eye. The nurse practitioner will...
Refer the infant to an opthalmologist
Which are risk factors for development of cataracts?
1. Smoking
2. Advancing Age
3. UV Light
, A preschool age child who attend daycare has a 2 day history of matted eyelids in the
morning and burning and itching of the eyes. The primary care NP notes yellow-green
purulent discharge from both eyes, conjunctival erythema and mild URI symptoms. Which
action is correct?
Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the night with
right ear pain. The primary care NP notes an axillary temperature of 100.5 and an
erythematous, bulging TM. A tympanogram reveals a peak of +15-mm H2O. What is the
recommended treatment for this child?
An analgesic medication and watchful waiting
A patient complains of otalgia and difficulty hearing from one ear. The provider performs
an otoscopic exam and notes a dark brown mass in the lower portion of the external canal
blocking the patient's TM. What is the initial action?
Ask the patient about previous problems with the ear
The primary care NP is treating an infant with lacrimal duct obstruction who has
developed bacterial conjunctivitis. After 2 weeks of treatment with topical antibiotics along
with massage and frequent cleaning of secretions, the infant's symptoms have not
improved. Which action is correct?
Refer to an ophthalmologist
A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and
which has not increased in size. Which diagnostic test is indicated?
Fine needle aspiration
During a well-child exam on a 4-year-old child, the primary care NP notes that the clinic
nurse recorded 20/50 for the child's vision and noted that the child has difficulty
cooperating with the exam. What will the NP recommend?
Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues
Allergies, GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female whose
weight is at the 95th percentile for her age. What is the goal for this patient?
Maintenance of her current weight
The primary care NP is performing a well child examination on a 12-year-old child who
was diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10 with an LDL
cholesterol <100mg/dL. What will the NP recommend as part of ongoing management for
this child?
Comprehensive ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a school-aged
child whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80-
90mg/dL. The NP will consult with the child's endocrinologist to consider which therapy?
Continuous glucose monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week checkup.
What will the NP suspect?
Phenylketonuria
A patient who is obese has recurrent UTIs and reports feeling tired most of the time. What
initial diagnostic test will the provider order in the clinic at this visit?
HbA1C
VERIFIED ANSWERS NEWEST UPDATE 2024 GRADE
A+
A 5-year-old child is hit in the face with a baseball bat and is brought to the clinic by a
parent. An exam reveals three avulsed front teeth. Radiologic studies are negative for facial
fractures. What is the recommended treatment?
Refer the child to the dentist immediately for further evaluation
A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media is seen for follow-up. The primary care nurse practitioner notes dull-gray tympanic
membranes with a visible air-fluid level. The child is afebrile and without pain. What is the
next course of action?
Monitoring ear fluid levels for 3 months
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What will the
primary care nurse practitioner recommend to promote dental health in this child?
Daily chlorhexidine gluconate
A primary care provider may suspect cataract formation in a patient with which finding?
Asymmetric red reflex
A patient has chronically dry eyes, sometimes with a foreign body sensation, burning, and
itching. A Schirmer test is abnormal. What is the suspected cause of this patient's
symptoms?
Aqueous Deficiency
A teen who has otitis externa has severe swelling of the external auditory canal that persists
after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step
in treatment for this child?
Insert a wick into the external auditory canal
A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with
erythema and edema of the surrounding tissues without discharge. Which is the initial
course of action by the provider?
Prescribe amoxicillin and refer to a dentist in 2-3 days
An elderly patient has a permanent loss of the sense of smell and diminished taste. What
will be included in teaching this patient about managing these symptoms?
1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
2.
,A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary
nurse practitioner will refer to a pediatric ophthalmologist to initiate which treatment?
Patching of the unaffected eye for 2 hours each day
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the
mouth reveals the presence of plaque and calculus on the teeth which are not loose. What
will the primary care nurse practitioner recommend?
Consistently brushing and flossing the teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic cerumen
buildup. The provider notes that the patient has dry skin in the ear canal. Which
preparation is FDA approved for this use?
Carbamide peroxide
A parent asks about ways to promote dental health in school-aged children while on family
vacation that are convenient while camping and picnicking. What will the primary care
nurse practitioner recommend?
Offering gum containing xylitol after meals
A patient reports several episodes of acute vertigo, some lasting up to an hour with
associated nausea and vomiting. What is part of the initial diagnostic workup for this
patient?
Audiogram and MRI
A teen with a history of otitis externa asks about ways to prevent this condition. What will
the primary care nurse practitioner recommend?
Drying the ear canal with a hair dryer
A 7-month-old infant has had two prior acute ear infections and is currently on the 10th
day of therapy with amoxicillin-clavulanate after a failed course of amoxicillin. The
primary care nurse practitioner notes marker middle ear effusion and erythema of the TM.
The child is irritable and has a temperature of 99.8. What is the next step in management
of this child's infection?
Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes. The
provider notes a mass in the salivary gland region. What is the likely cause of these
symptoms?
Sialolithiasis
A child complains of itching in both ears and is having trouble hearing. The primary care
nurse practitioner notes periauricular edema and marked swelling of the external auditory
canal and elicits severe pain when manipulating the external ear structures. Which is an
appropriate intervention?
Order ototopical antibiotic/corticosteroid drops
During a well child assessment of an African American infant, the primary care nurse
practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-
orange light reflex in the right eye. The nurse practitioner will...
Refer the infant to an opthalmologist
Which are risk factors for development of cataracts?
1. Smoking
2. Advancing Age
3. UV Light
, A preschool age child who attend daycare has a 2 day history of matted eyelids in the
morning and burning and itching of the eyes. The primary care NP notes yellow-green
purulent discharge from both eyes, conjunctival erythema and mild URI symptoms. Which
action is correct?
Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the night with
right ear pain. The primary care NP notes an axillary temperature of 100.5 and an
erythematous, bulging TM. A tympanogram reveals a peak of +15-mm H2O. What is the
recommended treatment for this child?
An analgesic medication and watchful waiting
A patient complains of otalgia and difficulty hearing from one ear. The provider performs
an otoscopic exam and notes a dark brown mass in the lower portion of the external canal
blocking the patient's TM. What is the initial action?
Ask the patient about previous problems with the ear
The primary care NP is treating an infant with lacrimal duct obstruction who has
developed bacterial conjunctivitis. After 2 weeks of treatment with topical antibiotics along
with massage and frequent cleaning of secretions, the infant's symptoms have not
improved. Which action is correct?
Refer to an ophthalmologist
A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and
which has not increased in size. Which diagnostic test is indicated?
Fine needle aspiration
During a well-child exam on a 4-year-old child, the primary care NP notes that the clinic
nurse recorded 20/50 for the child's vision and noted that the child has difficulty
cooperating with the exam. What will the NP recommend?
Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues
Allergies, GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female whose
weight is at the 95th percentile for her age. What is the goal for this patient?
Maintenance of her current weight
The primary care NP is performing a well child examination on a 12-year-old child who
was diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10 with an LDL
cholesterol <100mg/dL. What will the NP recommend as part of ongoing management for
this child?
Comprehensive ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a school-aged
child whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80-
90mg/dL. The NP will consult with the child's endocrinologist to consider which therapy?
Continuous glucose monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week checkup.
What will the NP suspect?
Phenylketonuria
A patient who is obese has recurrent UTIs and reports feeling tired most of the time. What
initial diagnostic test will the provider order in the clinic at this visit?
HbA1C
