CMN 568 unit 1 study questions
the test used to check for corneal light reflex in each eye, and its symmetry is
called - CORRECT ANSWER-hirschberg test
What is the difference in recurrent sinusitis and chronic sinusitis - CORRECT
ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-2nd or 3rd generation
cephalosporins
what disease process may be observed by unequal pupils (anisocoria), eyelid
ptosis, iris heterochromia, and anhidrosis? - CORRECT ANSWER-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? - CORRECT
ANSWER-sickle cell
what would be your treatment plan for an anaphylactic reaction due to a bee
sting on an upper limb? - CORRECT ANSWER--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 - CORRECT
ANSWER-amoxicillin
ampicillin
TMP-SMZ (trimethoprim-sulfonamide)
what is the 1st line of treatment for allergic rhinitis - CORRECT
ANSWER--non-sedating antihistamines: LORATADINE, CETRIZINE
-intranasal corticosteroids
-mast cell stabilizers: CROMOLYN
-Montelukast: SINGULAR
what is the 1st line treatment for Bacterial Rhinosinusitis in adults? - CORRECT
ANSWER-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? -
CORRECT ANSWER-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? - CORRECT ANSWER-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? -
CORRECT ANSWER-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 - CORRECT ANSWER-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 -
CORRECT ANSWER---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 - CORRECT ANSWER-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
the test used to check for corneal light reflex in each eye, and its symmetry is
called - CORRECT ANSWER-hirschberg test
What is the difference in recurrent sinusitis and chronic sinusitis - CORRECT
ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-2nd or 3rd generation
cephalosporins
what disease process may be observed by unequal pupils (anisocoria), eyelid
ptosis, iris heterochromia, and anhidrosis? - CORRECT ANSWER-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? - CORRECT
ANSWER-sickle cell
what would be your treatment plan for an anaphylactic reaction due to a bee
sting on an upper limb? - CORRECT ANSWER--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 - CORRECT
ANSWER-amoxicillin
ampicillin
TMP-SMZ (trimethoprim-sulfonamide)
what is the 1st line of treatment for allergic rhinitis - CORRECT
ANSWER--non-sedating antihistamines: LORATADINE, CETRIZINE
-intranasal corticosteroids
-mast cell stabilizers: CROMOLYN
-Montelukast: SINGULAR
what is the 1st line treatment for Bacterial Rhinosinusitis in adults? - CORRECT
ANSWER-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? -
CORRECT ANSWER-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? - CORRECT ANSWER-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? -
CORRECT ANSWER-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 - CORRECT ANSWER-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 -
CORRECT ANSWER---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 - CORRECT ANSWER-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
