MSN 620- possible questions with correct answers

MSN 620- possible questions with correct answers A 4-year-old girl presents with a history of recurrent otitis media requiring antibiotics. She has no significant history, though both parents had recurrent ear infections as children. She had 4 episodes of otitis media this year and 4 episodes in the prior year. Her language development is appropriate for her age. What is the next best step in management? 1. Myringotomy tubes 2. Observation 3. Three weeks of antibiotics 4. Ototopical antibiotics - Correct Answer️️ -1. Myringotomy tubes A 17-year-old boy presents with purulent discharge from his right ear for 3 days. He is recovering from a recent upper respiratory illness, with no fever over the past 3 days. His ear was painful initially but is not currently. The tympanic membrane appears to have a small perforation with copious purulent discharge. The external auditory canal shows very faint erythema. There is no tragus tenderness and no nasopharyngeal mass. What is the most appropriate management for this patient? 1. Ear wick 2. Culture of the discharge 3. Oral antibiotics TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 2/62 4. Ototopical corticosteroids - Correct Answer️️ -3. Oral antibiotics A 6-year old boy presents to the clinician with his mother. The mother says that the child has been complaining about pain in the left ear and is unable to sleep well for eight days. He has not been febrile. Upon further questioning, the mother reveals that his younger brother and the patient recovered recently from the "flu" they had last week. He is in daycare. On examination, the child is uncooperative but oral examination reveals no dental pathology. There is no overt otorrhea, and both tympanic membranes appear erythematous. He has no history of drug allergies. Which of the following is the best choice of therapy to alleviate his condition? 1. Symptomatic management with analgesics only 2. Cephalexin 3. Amoxicillin 4. Doxycycline - Correct Answer️️ -3. Amoxicillin A 3-year-old child was brought in by her mother with complaints of right ear discharge and fever. The child has a history of recurrent otitis media. Which of the following would be the appropriate technique for assessing the tympanic membrane in this patient? 1. Pull the pinnae of the ear upward and forward. 2. Pull the pinnae of the ear upward and backward. 3. Pull the pinnae of the ear downward and forward. TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 3/62 4. Pull the pinnae of the ear downward and backward. - Correct Answer️️ -2. Pull the pinnae of the ear upward and backward. A 9-year-old male is brought by his mother, who states that he has had a stuffy and runny nose for around eight months. The patient admits to occasional sneezing and congestion to the point that he has to breathe through his mouth. He denies fever, wheezing, or ear discomfort. On physical examination, he is noted to have mild darkening under both eyes, a small crease above the tip of his nose, clear rhinorrhea bilaterally, mild turbinate swelling with pale blue mucosa, and some cobblestoning in the posterior pharynx. His lungs are clear on auscultation. Which of the following physical signs of his condition is commonly found in children but not adults? 1. Darkening around the eyes 2. Cobblestoning of the posterior pharynx 3. Nasal supratip crease 4. Mouth breathing - Correct Answer️️ -3. Nasal supratip crease A 46-year-old man presents with symptoms consistent with allergic rhinitis. He has a history of depression and is treated with a selective serotonin reuptake inhibitor. He works as a school bus driver. Which of the following should be used to treat his symptoms? 1. Fexofenadine 2. Hydroxyzine TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 4/62 3. Diphenhydramine 4. Chlorpheniramine - Correct Answer️️ -1. Fexofenadine A 38-year-old male patient complains of chronic nasal allergies. He has used over-the- counter antihistamines without much success. He believes he is allergic to ragweed but has had no testing. His past medical history is remarkable for hypertension that is controlled on hydrochlorothiazide. He does not drink, smoke, or use illicit drugs. He works in a relatively new office, but he lives in a 60-year-old house with his family. They have carpets, drapes, and a cat. Exam shows pale and boggy nasal mucosa and cobblestoning of the posterior pharynx. Lungs are clear on auscultation. Skin prick testing shows allergies to cat dander, dust mites, ragweed, and tree pollen. Which of the following would be an appropriate step to take? 1. Intranasal corticosteroids 2. Send carpet fiber for analysis 3. Immunotherapy for cat dander 4. Wash and keep carpets and drapes - Correct Answer️️ -1. Intranasal corticosteroids A 17-year-old male patient presents with a complaint of watery discharge from his eyes for the past three days. He also complains of itching and redness associated with it. Upon further questioning, he reveals a history of upper respiratory tract infections. His vital signs show blood pressure of 120/80 mmHg, heart rate of 80 beats per minute, respiratory rate of 14 breaths per minute, and temperature of 98.6 F (37 C). Ocular TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 5/62 examination findings are shown in the image. A polymerase chain reaction (PCR) performed confirms the diagnosis. What is the most common causative organism? (Click Image to Enlarge) 1. Adenovirus 2. Herpes simplex 3. Herpes zoster 4. Enterovirus - Correct Answer️️ -1. Adenovirus A 17-year-old female patient presents with a complaint of thick discharge from her eyes that started five days ago. She also complains of redness and a feeling of dirt in her eyes. On further questioning, she reveals that her eyes are usually matted in the morning. A detailed medical history reveals that she has had multiple similar episodes previously. She has been using contact lenses for the past two years. Her vital signs show blood pressure 120/80 mmHg, heart rate 88/min, respiratory rate 14 breaths/min, and temperature 37 C (98.6 F). An ocular examination reveals hyperemia and elevated yellow-white lesions at the lower cul-de-sac. What is the most appropriate next step in the management of her condition? 1. Topical neomycin 2. Topical bacitracin 3. Topical ciprofloxacin 4. Oral azithromycin - Correct Answer️️ -3. Topical ciprofloxacin TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD OWNER: EMILLYCHARLOTTE COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED FIRST PUBLISHED: SEPTEMBER 2024 6/62 A 28-year-old male patient with a history of asthma presents complaining of eye discharge, morning matting, and redness. He denies eye itching, burning, or recent upper respiratory symptoms. On examination, there is a bilateral diffuse conjunctival injection, purulent discharge, and conjunctival papillae. What is the most likely etiological agent for this patient's presentation? 1. Neisseria gonorrhoeae 2. Staphylococcal aureus 3. Herpes simplex virus 4. House dust mite - Correct Answer️️ -2. Staphylococcal aureus A 7-year-old African American male presents with his mother complaining of redness in the left eye. The redness has been present for two days and is associated with pain and itching. The patient's mother reports that this morning, his eye was matted and crusted, and there has been a white discharge. He has never had a similar episode previously. No fever is reported. Which of the following elements of the