CMN 568 UNIT 1 STUDY QUESTIONS WITH 100% CORRECT ANSWERS ALREADY GRADED A+.

the test used to check for corneal light reflex in each eye, and its symmetry is called hirshberg test What is the difference in recurrent sinusitis and chronic sinusitis 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? 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? 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? 2nd or 3rd generation cephalosporins what disease process may be observed by unequal pupils (anisocoria), eyelid ptosis, iris heterochromia, and anhidrosis? 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? sickle cell what would be your treatment plan for an anaphylactic reaction due to a bee sting on an upper limb? -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 amoxicillin ampicillin TMP-SMZ (trimethoprim-sulfonamide) what is the 1st line of treatment for allergic rhinitis -non-sedating antihistamines: LORATADINE, CETRIZINE -intranasal corticosteroids -mast cell stabilizers: CROMOLYN -Montelukast: SINGULAR what is the 1st line treatment for Bacterial Rhinosinusitis in adults? 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? 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? 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? 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 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 --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 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 pupil, OD > OS, decreased VA OD, OS WNL, no temporal tenderness. These findings are most appropriately suggest: A. Acute glaucoma, B. Open angle glaucoma, C. Temporal arteritis, D. retinal detachment acute glaucoma A NP suspects that a scratchy feeling in a pt's eye is a corneal abrasion. There is photophobia and erythema, but no drainage or change in visual acuity. PERRLA is noted. An appropriate NP intervention at this time would include: A. immediate referral B. instillation of anesthetic ocular drops, C. opthalmic antibiotic gtts and patching the eye D. instillation of mydriatic gtts instillation of anesthetic ocular drops A pt is suspected to have bacterial conjunctivitis OU. The NP performs flourescein test and notes a dendritic appearance on the cornea. This is probably: A. glaucoma, B herpes, C a neisseria gonorrhea infection D. hyphema herpes On exam of a pt with epistaxis the NP note that there is oozing of blood from the Kisselbach's plexus. This is: A. often managed by pinching the nasal ala together for 10 minutes while the pt leans backward B. can be managed with pheylephrine 0.125-1% solution 1 or 2 sprays C. requires immediate ENT consult D. signaling an intrinsic coagulation defect can be managed w/phenylephrine 0.125-1% solution 1 or 2 sprays pt complains of worsening nasal congestion. he reports symptoms started to get worse a few days after he ran of phenylephrine nasal spray, which he has been using for the past couple of weeks. what is the probable cause? rhinitis medicamentosa (rebound congestion due o using phenylephrine nasal spray longer than the recommended 3 days) what is the significance of the triad of asthmas (Samter triad) and what should be avoided? bronchospasm, aspirin should be avoided as it may precipitate severe bronchospasms due to an immunologic salicylate sensitivity Treatment for allergic rhinitis is most appropriately: A. Bactrim DS B. dextromethorpan, C. intranasal corticosteroid D. amoxicillin intranasal corticosteroid During examination of the posterior pharynx of an adult pt, the NP notes a thick exudative purulent pharyngitis with petechiae on the mucous membranes of the mouth. The most likely cause is: A. diptheria B. group a beta-hemolytic strep, C. Coxsackie virus A D. Neisseria gonorrhea b. group a beta-hemolytic strep The medical term used to refer to pain on swallowing: A. Odynophagia, B. Dysphagia, C. Dysarthria, D. otalgia odynophagia in assessing the hearing of an elderly pt the NP notes the Weber lateralizes to the right. this could signify that: A. it is normal B. there is a sensorineural deficit in the right ear C. there is a conduction loss in the right ear D. there is conduction loss in the left ear there is a conduction loss in the right ear during the otoscopic examination of the right ear, the NP notes that the short process of the malleus at: A. 12 o'clock B. 9 o'clock, C. 7 o'clock, D. 5 o'clock a. 12 o'clock in order to make a diagnosis of Meniere's disease the NP should note in the hx or assessment: A. loss of high frequency sounds, B. loss of low frequency sounds, C. constant episodes without relief D. normal audiography loss of low frequency of sounds Serous otitis media is suspected on examination when: A. Bulging of the TM with loss of bony landmarks B. Air bubbles are behind the TM C. Increased cone of light is seen D. A history of otorrhea is obtained b. Air bubbles are behind the TM The test used to check for corneal light reflex in each eye, and its symmetry is called the: A. cover/uncover test B. Hirshberg test C. EOMs D. Red reflex Hirshberg test During examination for cataracts, the NP would suspect cataracts if during the eye examination it is noted that? A. The red reflex is seen B. The pupil appears white on gross inspection C. The pupil is miotic D. The pupil is unresponsive The pupil appears white on gross inspection On data gathering the NP notes that the patient with a cataract will usually complain of any of the following except: A. Loss of visual acuity B. Loss of color perception C. Difficulty with the colors blue, green, and purple, D. Eye pain eye pain