NURS 6531 Final EXAM 2024

Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and occasional epistaxis. What do you do? A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit B. Prescribe an antihistamine C. You do nothing except for client teaching D. Refer the client to an ear, nose and throat specialist - C. You do nothing except for client teaching - Can occur with pregnancy because of increased vascularization in the upper respiratory tract David, age 32, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action? A. Prescribe nasal steroids and oral decongestants B. Prescribe antibiotic eardrops C. Prescribe systemic eardrops D. Refer David to an ear, nose, and throat specialist - A. Prescribe nasal steroids and oral decongestants A sexual history of oral-genital contact in a client presenting with pharyngitis is significant when which of the following organisms is suspected? A. Escherichia coli B. Haemophilus influenzae C. Neisseria gonorrhoeae D. Streptococcus pneumoniae- C. Neisseria gonorrhoeae - Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease The most common cause of sensorineural hearing loss is A. Trauma B. Tympanic membrane sclerosis and scarring C. Otosclerosis D. Presbycusis - D. Presbycusis How do you describe the cervical lymphadenopathy associated with asymptomatic HIV infection? A. Movable, discrete, soft, and nontender lymph nodes B. Enlarged, warm, tender, firm, but freely movable lymph nodes C. Hard, unilateral, nontender, and fixed lymph nodes D. Firm but not hard, nontender, and mobile lymph nodes - D. Firm but not hard, nontender, and mobile lymph nodes You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergency room. Which of the following symptoms would indicate that an airway obstruction is imminent? A. Reddened face B. Screaming C. Grabbing her throat D. Stridor - D. Stridor Purulent matter in the anterior chamber of the eye is calledA. Hyphema B. Hypopyon C. Anisocoria D. Pterygium - B. Hypopyon A 42-year-old stockbroker comes to your office for evaluation of a pulsating headache over the left temporal region and he rates the pain as an 8 on a scale of 1- 10. The pain has been constant for the past several hours and is accompanied by nausea and sensitivity to light. He has had frequent headaches for many years but not as severe and they are usually relieved by over-the-counter medicines. He is unclear as to a precipitating event but notes that he has had visual disturbances before each headache and has been under a lot of stress in his job. Based on this description, what is the most likely diagnosis of this type of headache? A. Tension B. Migraine C. Cluster D. Temporal arteritis - B. Migraine The trachea deviates toward the affected side in all of the following except A. Aortic aneurysm B. Unilateral thyroid lobe enlargement C. Large atelectasis D. Pneumothorax - C. Large atelectasis Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his symptoms. He is taking cimetidine (Tagamet) for gastroesophageal reflux disease. Which medication would you not order? A. A first-generation antihistamineB. A second-generation antihistamine C. A decongestant D. A topical nasal corticosteroid - B. A second-generation antihistamine Jessica, an 8-year-old third grader is broght to the office by her grandmother, who is the child's babysitter. She has complained of fever and sore throat for the past 2 days. Five other children in her class have been sick with sore throats. She denies difficulty swallowing and has been drinking fluids but has no appetite. ROS reveals that she has clear nasal drainage, hoarseness, and nonproductive cough. She denies vomiting but has had mild diarrhea. On examination she has a temperature of 101.5 F, 3+ erythematous tonsils, and palpable, tender cervical lymph nodes. Based on these findings, what is the most likely diagnosis? A. Mono B. Sinusitis C. Strep pharyingitis D. Viral pharyngitis - D. Viral pharyngitis Marcia, age 4, is brought into the office by her mother. She has a sore throat, difficulty swallowing, copious oral secretions, respiratory difficulty, stridor, and a temperature of 102 F but no pharyngeal erythema or cough. What do you suspect? A. Epiglottitis B. Group A beta-hemolytic streptococcal infection pharyngitis C. Tonsillitis D. Diphtheria - A. Epiglottitis You note a completely split uvula in Noi, a 42 year old Asian. What is your next course of action? A. Do nothing B. Refer Noi to a specialistC. Perform a throat culture D. Order a CBC - A. Do nothing Claude, age 78, is being treated with timolol maleate (Timoptic) drops for his chronic open-angle glaucoma. While performing a new client history and physical, you note that he is taking other medications. Which medication would you be most concerned about? A. Apsirin therapy as prophylaxis for heart attack B. Ranitidine (Zantac) for gastroesophageal reflux disease C. Alprazolam (Xanax), an anxiolytic for anxiety D. Atenolol (Tenormin), a beta blocker for high blood pressure - D. Atenolol (Tenormin), a beta blocker for high blood pressure Harry, age 69, has had Meniere's disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? A. A labyrinthectomy B. Pharmacological therapy C. A vestibular neurectomy D. Wearing an earplug in the ear with the most hearing loss - C. A vestibular neurectomy