SARAH MICHELLE LIVE REVIEW STUDY GUIDE/
716 Q&A/ 2024-2025.
A new graduate nurse practitioner has a patient presents with a hearing
complaint. The patient states that they have had decreased hearing on the right
side for the last month that is continuing to get worse. The NP completes both the
Rinne and Weber tests. If the patient has Ménière's disease, what would be the
expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - Answer: 4. The tuning fork lateralizes
to the left ear
Page 1 of 103
,What are common signs and symptoms of Meniere's Disease? - Answer: Vertigo,
tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? - Answer: There is a
possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? - Answer: Drug-induced rebound nasal
congestion, this can happen after use of nasal decongestants like Afrin. These
nasal decongestants should ideally not be used for greater than 3-5 days because
of this risk.
What is herpes keratitis? - Answer: This is an infection of the cornea due to herpes
simplex virus
How is herpes keratitis diagnosed? - Answer: By examining the eye under a black
lamp and visualized the cornea, in herpes keratitis, fern like lines will be seen on
the cornea
A child that has a history of mononucleosis is at increased risk for development for
what cancer later in life? And why? - Answer: Hodgkin's Lymphoma and Burkitt's
Lymphoma, this is due to the exposure of the Epstein-Barr virus
What types of patients will be at a higher risk of pneumonia? - Answer: Patient
with chronic lung diseases: asthma, COPD, cystic fibrosis.
Page 2 of 103
,Why are cough suppressants not helpful in pneumonia patients? - Answer:
Because we WANT them to get that gunk out, we do not want them to hold it in
their lungs, an expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed after treatment of
pneumonia? - Answer: Around 8 week mark
What is COPD? - Answer: Chronic Obstructive Pulmonary Disease. This is a chronic
condition that is made up of chronic bronchitis and emphysema. It is a progressive
inflammatory lung disease that makes it hard for the patients to breathe, because
the chronic bronchitis leads to mucous build up and the emphysema portion
destroys areas of the lungs.
What signs and symptoms are common in COPD patients? - Answer: Chronic
cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? - Answer:
Neurological symptoms, paresthesia (numbness and tingling in hands and feet),
unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? - Answer: Vegan- oral supplements can be
used for treatment
Page 3 of 103
, What surgery can result in B12 deficiency? - Answer: Gastric surgery- patient will
lose intrinsic factor that is required to absorb B12- these patients will require life
long IM B12 injections
What patient population is lupus commonly seen? - Answer: Women of
childbearing age- ages 15-45, African Americans are going to be at higher risk
What is the diagnostic criteria for Lupus? - Answer: Must have 4/11 diagnostic
criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
Page 4 of 103
716 Q&A/ 2024-2025.
A new graduate nurse practitioner has a patient presents with a hearing
complaint. The patient states that they have had decreased hearing on the right
side for the last month that is continuing to get worse. The NP completes both the
Rinne and Weber tests. If the patient has Ménière's disease, what would be the
expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - Answer: 4. The tuning fork lateralizes
to the left ear
Page 1 of 103
,What are common signs and symptoms of Meniere's Disease? - Answer: Vertigo,
tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? - Answer: There is a
possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? - Answer: Drug-induced rebound nasal
congestion, this can happen after use of nasal decongestants like Afrin. These
nasal decongestants should ideally not be used for greater than 3-5 days because
of this risk.
What is herpes keratitis? - Answer: This is an infection of the cornea due to herpes
simplex virus
How is herpes keratitis diagnosed? - Answer: By examining the eye under a black
lamp and visualized the cornea, in herpes keratitis, fern like lines will be seen on
the cornea
A child that has a history of mononucleosis is at increased risk for development for
what cancer later in life? And why? - Answer: Hodgkin's Lymphoma and Burkitt's
Lymphoma, this is due to the exposure of the Epstein-Barr virus
What types of patients will be at a higher risk of pneumonia? - Answer: Patient
with chronic lung diseases: asthma, COPD, cystic fibrosis.
Page 2 of 103
,Why are cough suppressants not helpful in pneumonia patients? - Answer:
Because we WANT them to get that gunk out, we do not want them to hold it in
their lungs, an expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed after treatment of
pneumonia? - Answer: Around 8 week mark
What is COPD? - Answer: Chronic Obstructive Pulmonary Disease. This is a chronic
condition that is made up of chronic bronchitis and emphysema. It is a progressive
inflammatory lung disease that makes it hard for the patients to breathe, because
the chronic bronchitis leads to mucous build up and the emphysema portion
destroys areas of the lungs.
What signs and symptoms are common in COPD patients? - Answer: Chronic
cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? - Answer:
Neurological symptoms, paresthesia (numbness and tingling in hands and feet),
unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? - Answer: Vegan- oral supplements can be
used for treatment
Page 3 of 103
, What surgery can result in B12 deficiency? - Answer: Gastric surgery- patient will
lose intrinsic factor that is required to absorb B12- these patients will require life
long IM B12 injections
What patient population is lupus commonly seen? - Answer: Women of
childbearing age- ages 15-45, African Americans are going to be at higher risk
What is the diagnostic criteria for Lupus? - Answer: Must have 4/11 diagnostic
criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
Page 4 of 103
