NR511 / NR 511 Midterm Exam
Differential Diagnosis & Primary Care Practicum
Questions and Answers (Verified Answers)
1. What is the most common bacterial pathogen associated with acute otitis media
ANS Streptococcus pneumoniae.
2. When the Weber test is performed with a tuning fork to assess hearing and there
is no lateralization, the nurse practitioner should document this finding as
ANS a normal finding
3. You are assessing a first grader and find that the tonsils are touching the uvula.
How would you grade this finding
ANS Grade 3
4. Which of the following is not a cause of conductive hearing loss
ANS presby- cusis
,5. Jill, a 34-year-old bank teller, presents with symptoms of hay fever. She
complains of nasal congestion, runny nose with clear mucus, and itchy nose and eyes.
On physical assessment, you observe that she has pale nasal turbinates. What is your
diagnosis
ANS allergic rhinitis
6. Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful
red eye without discharge. You should suspect
ANS Iritis.
7. April, age 50, presents with soft, raised, yellow plaques on her eyelids at the
inner canthi. She is concerned that they may be cancerous skin lesions. You tell her
that they are probably
ANS Xanthelasmas.
8. A 62-year-old woman presents to your clinic with a sudden right-sided headache
that is worse in her right eye. She states that her vision seems blurred, and her right
pupil is dilated and slow to react. The right conjunctiva is
, markedly injected, and the eyeball is firm. You screen her vision and find that she is
20/30 OS and 20/30 OD. She most likely has
ANS angle-closure glaucoma
9. A 25-year-old male presents with "bleeding in my eye" for 1 day. He awoke this
morning with a dark area of redness in his eye. He has no visual loss
or changes. He denies constitutional symptoms, pruritus, drainage, or recent trauma.
The redness presents on physical exam as a dark red area in the patient's sclera of
the right eye only and takes up less than 50% of the eye. The patient's remaining
sclera is clear and white. He also notes he was drinking alcohol last night and vomited
afterward. What is the best treatment
ANS Reas- surance that this lesion will resolve without any treatment in 2 to 4 weeks.
10.A 20-year-old male presents to your primary care clinic. This patient is a college
student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On
physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose
and throat exam shows mild erythema of the nasal mucosa and edematous, enlarged
tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar exudates. He
has inflamed posterior cervical lymph nodes. He has a mild nonproductive cough and
clear lung exam. What is his most likely diagnosis
ANS Mononucleosis.
11. When you are assessing the internal structure of the eye of your
59-year-old patient, the absence of a red reflex may indicate
Differential Diagnosis & Primary Care Practicum
Questions and Answers (Verified Answers)
1. What is the most common bacterial pathogen associated with acute otitis media
ANS Streptococcus pneumoniae.
2. When the Weber test is performed with a tuning fork to assess hearing and there
is no lateralization, the nurse practitioner should document this finding as
ANS a normal finding
3. You are assessing a first grader and find that the tonsils are touching the uvula.
How would you grade this finding
ANS Grade 3
4. Which of the following is not a cause of conductive hearing loss
ANS presby- cusis
,5. Jill, a 34-year-old bank teller, presents with symptoms of hay fever. She
complains of nasal congestion, runny nose with clear mucus, and itchy nose and eyes.
On physical assessment, you observe that she has pale nasal turbinates. What is your
diagnosis
ANS allergic rhinitis
6. Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful
red eye without discharge. You should suspect
ANS Iritis.
7. April, age 50, presents with soft, raised, yellow plaques on her eyelids at the
inner canthi. She is concerned that they may be cancerous skin lesions. You tell her
that they are probably
ANS Xanthelasmas.
8. A 62-year-old woman presents to your clinic with a sudden right-sided headache
that is worse in her right eye. She states that her vision seems blurred, and her right
pupil is dilated and slow to react. The right conjunctiva is
, markedly injected, and the eyeball is firm. You screen her vision and find that she is
20/30 OS and 20/30 OD. She most likely has
ANS angle-closure glaucoma
9. A 25-year-old male presents with "bleeding in my eye" for 1 day. He awoke this
morning with a dark area of redness in his eye. He has no visual loss
or changes. He denies constitutional symptoms, pruritus, drainage, or recent trauma.
The redness presents on physical exam as a dark red area in the patient's sclera of
the right eye only and takes up less than 50% of the eye. The patient's remaining
sclera is clear and white. He also notes he was drinking alcohol last night and vomited
afterward. What is the best treatment
ANS Reas- surance that this lesion will resolve without any treatment in 2 to 4 weeks.
10.A 20-year-old male presents to your primary care clinic. This patient is a college
student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On
physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose
and throat exam shows mild erythema of the nasal mucosa and edematous, enlarged
tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar exudates. He
has inflamed posterior cervical lymph nodes. He has a mild nonproductive cough and
clear lung exam. What is his most likely diagnosis
ANS Mononucleosis.
11. When you are assessing the internal structure of the eye of your
59-year-old patient, the absence of a red reflex may indicate
