NUR 621 FINAL EXAM UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

NUR 621 FINAL EXAM UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS

Question:
1. In children and adolescents, what should the follow up intervention be for a negative RADT strep test
but continued symptoms?
Answer:
A throat culture should be performed

Question:
2. Does a positive RADT for GAS pharyngitis require back up culture?
Answer:
no, positive RADT is highly specific

Question:
3. If an adult is symptomatic but has a negative RADT for GAS, should throat cultures be performed?
Answer:
No. risk for rheumatic fever is low so back up culture is not required

Question:
4. If patient has acute pharyngitis with cough, rhinorrhea, and oral ulcers should patient be tested for GAS?
Answer:
No- other symptoms suggest viral etiology.

Question:
5. What is recommended drug of choice for GAS pharyngitis?
Answer:
Penicillin or Amoxicillin 10 day course

Question:
6. Treatment of GAS pharyngitis in penicillin-allergic (not anaphylaxis)
Answer:
1st gen cephalosporin 10 days (Keflex of cefadroxil), clindamycin or clarithromycin 10 days, or
azithromycin 5 days.

Question:
7. If patient has recurrent GAS pharyngitis, should a tonsillectomy be performed?
Answer:
Tonsillectomy should not be done solely to reduce frequency of GAS

Question:
8. Most common pathogen that causes pharyngitis among college students and adults?
Answer:
Group C strep

,Question:
9. Which test is more sensitive for detecting GAS? RADT or blood agar plate culture?
Answer:
Blood agar is more sensitive.

Question:
10. T/F Diagnostic studies are not usually indicated for children <3?
Answer:
True. Unless the child has an older sibling with confirmed GAS. This is because the risk of rheumatic fever
is rare in children <3

Question:
11. Tonsillectomy is indicated for patients who have had ________ or more throat infections in one year
Answer:
7 or more infections.

Question:
12. Tonsillectomy is indicated for patients who have had ______ or more throat infections per year in the
past 2 years.
Answer:
5 or more per year

Question:
13. What might be the diagnosis for a patient that is experiencing fluctuating, unilateral, hearing loss and
feels dizzy
Answer:
meniere's disease

Question:
14. Patient complains of unilateral progressive hearing loss and frequent headaches. What is the most
likely diagnosis?
a. acoustic neuroma
b. menieres disease
c. prebycusis
d. conductive hearing loss
Answer:
Acoustic neuroma

Question:
15. Which of the following are causes of sensorineural hearing loss?
a. cerumen impaction
b. presbycusis
c. acustic neuroma
d.otosclerosis
e. aminoglycoside induced hearing loss
f.congential abnormalities

,Answer:
b. presbycusis
c. acustic neuroma
e. aminoglycoside induced hearing loss
All others are conductive hearing loss

Question:
16. Patient presents with sudden, sensorineural hearing loss. What is the next step for the provider?
Answer:
refer to otorhinolaryngologist

Question:
17. What else should be included in the assessment of patients with presbycusis?
Answer:
Mental health assessment. high risk for suicide

Question:
18. Which type of hearing loss is considered reversible? Sensorineural or conductive?
Answer:
Conductive

Question:
19. What is the best treatment for acute attack of menieres disease?
Answer:
resting with the eyes closed and protection from falling.

Question:
20. A patient with Meniere's disease has sound lateralization to the non affected ear when a tuning fork is
placed midline on the top of the head. What is the name of this test?
Answer:
Weber test

Question:
21. What are two medications safe to prescribe in patients with bacterial otitis externa and perforated
tympanic membrane?
Answer:
1. ciprofloxacin drops
2. ofloxacin drops

Question:
22. A patient with otitis externa asks when they can return to swimming. How would you advise?
Answer:
The ear must be kept dry without being submerged in water for 4-6 weeks.

Question:
23. Medications of choice for a pediatric patient with AOM and has a hx of an anaphylaxis reaction to
penicillin? (3)

, Answer:
clarithromycin, bactrim, or azithromycin

Question:
24. Pediatric patient recently completed course of amoxicillin but continues to have symptoms of AOM.
What is the next step?
Answer:
Augmentin

Question:
25. Patient with a history of HTN on metoprolol presents with rhinitis. Which medication should be
avoided for this patient?
Answer:
patients on beta blockers should avoid pseudophedrine. Also should be avoided in patients with diabetes,
BPH,

Question:
26. Patient presents with purulent gray exudate on tongue and excessive salivation, what is most likely
diagnosis?
Answer:
St. Vincent stomatitis.

Question:
27. A patient hurt their ankle playing basketball. They present with pain in the malleolar zone. they are
able to bear weight for 6 steps but are limping. Are ankle radiographs indicated?
Answer:
No. Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar zone
and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear weight both
immediately and in the emergency department.

Question:
28. A patient hurt their ankle playing basketball. They present with pain in the malleolar zone and pain at
the posterior edge of the lateral malleolus. Are ankle radiographs indicated?
Answer:
Yes! Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar zone
and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear weight both
immediately and in the emergency department.

Question:
29. When assessing for bone tenderness in an ankle injury, where should you palpate?
Answer:
Palpate the distal 6 cm of the posterior edge of the fibula when assessing for bone tenderness

Question:
30. first line treatment for RA?
Answer:
Methotrexate