NUR 676 Final Exam with complete
solutions
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve the
pain. What is the next action? - ANSWER-Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment
elevation MI (STEMI). The nearest hospiral that can perform a PCI is three hours away,
what is the initial treatment for this patient. - ANSWER-Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits
pain when manipulating the ear structures, what is likely the diagnosis? - ANSWER-
acute otitis externa
Which are risk factors for developing otitis externa? - ANSWER-having underlying DM,
use of ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's
ear canal is mildly inflamed and the TM is not involved. Which medication will be
ordered? - ANSWER-Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to
determine the severity of pain in children with OM? - ANSWER-Appetite, Difficulty
sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment
without initial antibiotic therapy? - ANSWER-A 36 month old with fever of 38.5, mild
otalgia, and red, non-bulging TM
, A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is
unable to visualize the TM in the right ear because of the presence of cerumen. The left
TM is dull gray with fluid levels present. What is the correct action? - ANSWER-Remove
the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a
small tear in the TM of the affected ear with purulent d/c. What is the initial treatment for
this patient? - ANSWER-Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes
a perforated TM. What is recommended treatment? - ANSWER-Refer the patient to an
Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes
foul-smelling breath and a muffled voice with marked edema and erythema of the
peritonsillar tissue. What should you do? - ANSWER-Perform a rapid strep and throat
culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's symptoms. -
ANSWER-Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider
notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause? - ANSWER-viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the
previous year. The child's parents ask the provider if the child needs a tonsillectomy.
What will the provider say? - ANSWER-Current recommendations do not support
tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin.
On the third day of treatment, the patient develops a rash. A urinalysis is normal. what
does this indicate? - ANSWER-A reaction to the amoxicillin
solutions
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve the
pain. What is the next action? - ANSWER-Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment
elevation MI (STEMI). The nearest hospiral that can perform a PCI is three hours away,
what is the initial treatment for this patient. - ANSWER-Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits
pain when manipulating the ear structures, what is likely the diagnosis? - ANSWER-
acute otitis externa
Which are risk factors for developing otitis externa? - ANSWER-having underlying DM,
use of ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's
ear canal is mildly inflamed and the TM is not involved. Which medication will be
ordered? - ANSWER-Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to
determine the severity of pain in children with OM? - ANSWER-Appetite, Difficulty
sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment
without initial antibiotic therapy? - ANSWER-A 36 month old with fever of 38.5, mild
otalgia, and red, non-bulging TM
, A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is
unable to visualize the TM in the right ear because of the presence of cerumen. The left
TM is dull gray with fluid levels present. What is the correct action? - ANSWER-Remove
the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a
small tear in the TM of the affected ear with purulent d/c. What is the initial treatment for
this patient? - ANSWER-Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes
a perforated TM. What is recommended treatment? - ANSWER-Refer the patient to an
Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes
foul-smelling breath and a muffled voice with marked edema and erythema of the
peritonsillar tissue. What should you do? - ANSWER-Perform a rapid strep and throat
culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's symptoms. -
ANSWER-Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider
notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause? - ANSWER-viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the
previous year. The child's parents ask the provider if the child needs a tonsillectomy.
What will the provider say? - ANSWER-Current recommendations do not support
tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin.
On the third day of treatment, the patient develops a rash. A urinalysis is normal. what
does this indicate? - ANSWER-A reaction to the amoxicillin
