Albany State University | Feedback Davis Edge #5/Wk 8 Score: 15 / 16 2025/2026

Albany State University | NURS 5410 Feedback Davis Edge #5/Wk 8 Score: 15 / 16 Questions 1 to 16 of 16  1  Feedback Davis Edge #5/Wk 8 Score: 15 / 16 Feedback Report Question 1. Susan is a 19-year-old college student and avid swimmer. She frequently gets swimmer's ear and asks if there is anything she can do to help prevent it other than wearing earplugs, which do not really work for her. What do you suggest? Rationales [Page Reference: 341] Course Topic: HEENT Problems | Area of Practice: Family Practice, Pediatrics, Adult-Gerontology Primary Care | APN Knowledge Area: Health Promotion and Patient Education, Population Health and Epidemiology | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 2. In a young child, what most often causes unilateral purulent rhinitis? Rationales [Page Reference: 354]  1. Start using a cotton-tipped applicator to dry the ears after swimming.  2. Use ear drops made of a solution of equal parts alcohol and vinegar in each ear after swimming. 3. Use a hair dryer on the highest setting to dry the ears. 4. Stop swimming. Option 1: The adage "You shouldn't put anything smaller than your elbow in your ear" holds true today. Option 2: Using ear drops made of a solution of equal parts alcohol and vinegar in each ear after swimming is effective in drying the ear canal and maintaining an acidic environment, therefore preventing a favorable medium for the growth of bacteria, the cause of swimmer's ear. Option 3: A hair dryer operated on the lowest setting several inches from the ear may be used to dry the canal. Option 4: There is no reason for the patient to stop swimming.   1. A foreign body 2. A viral infection 3. A bacterial infection 4. An allergic reaction Option 1: In a young child, unilateral purulent rhinitis is most often caused by a foreign body. The key word here is unilateral. Option 2: Viral infections usually affect both nares. Option 3: Bacterial infections usually affect both nares. Option 4: Allergic reactions usually affect both nares. 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 Testing Domain: Assess | Cognitive Level: Comprehension [Understanding] Question 3. Aaron, age 4, is brought to the clinic by his father. His tympanic membrane is perforated from otitis media. His father asks about repair of the eardrum. How do you respond? Rationales [Page Reference: 348] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Health Promotion and Patient Education | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 4. A 12-year-old male presents to your pediatric clinic with his mother complaining of ear pain. He has a membership to a local swim club and spends multiple days there a week. He has had purulent drainage from his ear for 1 day. The patient had no constitutional symptoms and normal vital signs. He is painful to palpation of his tragus, and on exam you cannot see his tympanic membrane. His ear canal is edematous and erythematous, with purulent discharge present. What is the likely pathogen causing these symptoms? Rationales [Page Reference: 334] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Adult-Gerontology Acute Care, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Pathophysiology | Testing Domain: Assess | Cognitive Level: Knowledge [Remembering]   1. "The eardrum, in most cases, heals within several weeks." 2. "We need to schedule Aaron for a surgical repair." 3. "He must absolutely stay out of the water for 3 to 6 months." 4. "If the eardrum is not healed in several months, it can be surgically repaired." Option 1: Most perforated tympanic membranes seen with acute otitis media heal within several weeks. Option 2: If the eardrum has not healed within 3 to 6 months, a surgical repair can be done, but not until age 7 to 9 years. Option 3: Aaron can swim on the surface with the use of an ear mold but must not dive, jump, or swim underwater. Option 4: If the eardrum has not healed within 3 to 6 months, a surgical repair can be done, but not until age 7 to 9 years.  1. Staphylococcus aureus  2. Pseudomonas aeruginosa 3. Streptococcus pyogenes 4. Malassezia pachydermatis Option 1: This rarely causes otitis externa. Option 2: This is the most common cause of otitis externa. Option 3: This rarely causes otitis externa. Option 4: This rarely causes otitis externa. 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 treatment failure in children? Rationales [Page Reference: 347] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Pharmacologic Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Comprehension [Understanding] Question 6. Ellen, a 56-year-old social worker, is seen by the nurse practitioner for complaints of fever; left-sided facial pain; moderate amounts of purulent, malodorous nasal discharge; and pain and headache when bending forward. The symptoms have been occurring for approximately 6 days. On physical assessment, there is marked redness and swelling of the nasal passages and tenderness/pain on palpation over the cheekbones. What should the nurse practitioner suspect? Rationales [Page Reference: 368] Course Topic: HEENT Problems | Area of Practice: Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Differential Diagnosis Clinical Decision-Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 7. What is the most common bacterial pathogen associated with acute otitis media?  1. Amoxicillin (Amoxil)  2. Amoxicillin and potassium clavulanate (Augmentin) 3. Azithromycin (Zithromax) 4. Prednisone (Deltasone) Option 1: Amoxicillin (Amoxil) is used as the first-line treatment of AOM. However, it is not used in patients with recurrent AOM or treatment failure. Option 2: The antibiotic of choice for recurrent AOM or treatment failure is amoxicillin and potassium clavulanate (Augmentin). Option 3: Azithromycin (Zithromax) for otitis media is usually reserved for patients with penicillin allergy. Option 4: Prednisone (Deltasone) is not an antibiotic.  1. Dental abscess  2. Acute rhinosinusitis 3. Chronic rhinosinusitis 4. Nasal tumor Option 1: Dental abscesses do not cause purulent nasal discharge. Option 2: The patient is exhibiting classic characteristics of acute rhinosinusitis. Option 3: Chronic rhinosinusitis lasts more than 30 days. Option 4: Nasal tumors do not cause purulent nasal discharge.   1. Streptococcus pneumoniae 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 [Page Reference: 342] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Pathophysiology | Testing Domain: Assess | Cognitive Level: Knowledge [Remembering] Question 8. Martin, age 24, presents to the office with an erythematous ear canal and pain on manipulation of the auricle. He is on vacation and has been swimming daily at the resort. What is your diagnosis? Rationales [Page Reference: 335] Course Topic: HEENT Problems | Area of Practice: Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Differential Diagnosis Clinical Decision-Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 9. Sally, age 19, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which sinus to be affected? Rationales 2. Haemophilus influenzae 3. Streptococcus pyogenes 4. Moraxella (Branhamella) catarrhalis Option 1: This causes 40% to 50% of cases. Option 2: This causes 10% to 30% of cases. Option 3: This is an uncommon cause of otitis media. Option 4: This is an uncommon cause of otitis media.  1. Acute otitis media 2. Chronic otitis media  3. External otitis 4. Temporomandibular joint (TMJ) syndrome Option 1: Acute otitis media is painful, is usually a result of cotton swab use or physical trauma, and usually follows an upper respiratory infection. Option 2: Chronic otitis media is usually not painful, although the ear may be painful during an exacerbation. Option 3: With external otitis, there is pain, an erythematous ear canal, and usually a history of recent swimming. Option 4: Ear pain may also be the result of TMJ dysfunction. It is usually made worse by chewing or grinding the teeth.   1. Maxillary sinus 2. Ethmoid sinus 3. Sphenoid sinus 4. Frontal sinus Option 1: The maxillary sinus is the largest of the paranasal sinuses and is the most commonly affected sinus. There is usually pain and pressure over the cheek. Inability to transilluminate the cavity usually indicates a cavity filled with purulent material. Discolored nasal 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 Course Topic: HEENT Problems | Area of Practice: Pediatrics, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Differential Diagnosis Clinical Decision-Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 10. Samantha, age 12, presents with ear pain. When you begin to assess her ear, you tug on her normal-appearing auricle, eliciting severe pain. What does this lead you to suspect? Rationales [Page Reference: 336] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Differential Diagnosis Clinical Decision-Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 11. A patient has been treated for acute otitis media and presents 2 weeks later for follow-up. Things are much improved, there is no pain, and there is no lymphadenopathy. Physical examination reveals air-fluid levels, and the patient does admit to a sense of ear fullness. What is the most appropriate approach to help this patient? Rationales discharge and a poor response to decongestants may also indicate sinusitis. Option 2: The ethmoid sinuses are usually nonpalpable and may not be transilluminated. Option 3: The sphenoid sinuses are usually nonpalpable and may not be transilluminated. Option 4: The frontal sinuses are just below the eyebrows. Frontal sinusitis also includes pain and tenderness of the forehead.  1. Otitis media 2. Otitis media with effusion  3. Otitis externa 4. Primary otalgia Option 1: Otitis media, with or without effusion, cannot be diagnosed without examining the tympanic membrane. Option 2: Otitis media, with or without effusion, cannot be diagnosed without examining the tympanic membrane. Option 3: When severe pain is elicited by tugging on a normal-appearing auricle, an acute infection of the external ear canal (otitis externa) is suspected. Option 4: Otalgia is simply ear pain.  1. Refer to audiology.  2. Reassure that this is a normal finding. 3. Order an antihistamine. 4. Begin corticosteroids. Option 1: This is not appropriate at this point; only appropriate if no change in >6 weeks. Option 2: This is true; effusion after acute infection is very normal and may produce irritative symptoms for >6 weeks. Option 3: Although often done, there is no evidence that this is helpful. 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 Course Topic: HEENT Problems | Area of Practice: Pediatrics, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Health Promotion and Patient Education | Testing Domain: Plan | Cognitive Level: Application [Applying] | IsInstructorOnly: Yes Question 12. What significant finding(s) in a 3-year-old child with otitis media with effusion would prompt more aggressive treatment and referral? Rationales [Page Reference: 347] Course Topic: HEENT Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Health Assessment | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 13. A 6-year-old female presents to your pediatric office with her mother complaining of right ear pain for 3 days. This pain resolved with Tylenol. The patient has also had noted fevers of 101.3°F over the last 2 nights. The patient had a nonproductive cough for 7 days before the ear pain. On physical exam, the patient has tenderness with tugging on the auricle of the ear. The tympanic membrane is not mobile with pneumatic otoscopy and is erythematous and full. The patient has no drainage from the ear and no mastoid tenderness. What is the next step? Rationales Option 4: Although often done, there is no evidence that this is helpful.   1. The effusion persists >12 weeks 2. The child has become a fussy eater.  3. The child's speech and language skills seem slightly delayed. 4. Persistent rhinitis is present. Option 1: If otitis media with effusion persists >12 weeks, more aggressive evaluation and treatment is indicated. Option 2: A child with otitis media with effusion might become irritable during meals. Option 3: A slight delay in language and speech does not warrant aggressive treatment or referral. Option 4: Persistent rhinitis does not warrant aggressive treatment or referral.  1. Symptom management and reassurance that symptoms will resolve with time. 2. Computed tomography (CT) of the head.  3. Amoxicillin 80 to 90 mg/kg/d. 4. Augmentin 45 mg/kg/d. Option 1: For viral cases, this is appropriate. This situation is likely acute otitis media and needs medication. Option 2: This is used to evaluate for mastoiditis. The patient has no drainage or signs of chronic infection or mastoid pain, so there is no reason to consider this. Option 3: This is the treatment of choice for acute otitis media. Option 4: This is the treatment of choice for chronic/treatment-resistant otitis media. 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 Course Topic: HEENT Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Disease Management | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 14. Mia, a 27-year-old schoolteacher, has a 2-day history of severe left ear pain that began after 1 week of upper respiratory infection (URI) symptoms. On physical examination, you find that she has acute otitis media (AOM). She has a severe allergy to penicillin. What is the most appropriate antimicrobial option for this patient? Rationales [Page Reference: 347] Course Topic: HEENT Problems | Area of Practice: Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Pharmacologic Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 15. 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? Rationales [Page Reference: 352]  1. Ciprofloxacin (Cipro)  2. Azithromycin (Zithromax) 3. Amoxicillin (Amoxil) 4. Cephalexin (Keflex) Option 1: Ciprofloxacin, a fluoroquinolone antibiotic, is not recommended for the treatment of acute otitis media. Option 2: Azithromycin is not a perfect option for treating otitis media; however, it is preferred for patients with severe penicillin allergy. Option 3: Amoxicillin is a penicillin-based antibiotic and should not be given to a patient with a penicillin allergy. Option 4: Cephalexin is a penicillin-based antibiotic and should not be given to a patient with a penicillin allergy.   1. Allergic rhinitis 2. Viral rhinitis 3. Nasal polyps 4. Nasal vestibulitis from folliculitis Option 1: The symptoms of hay fever, also called allergic rhinitis, are similar to those of viral rhinitis but usually persist and are seasonal in nature. When assessing the nasal mucosa, you will observe that the turbinates are usually pale or violaceous because of venous engorgement. Option 2: With viral rhinitis, the mucosa is usually erythematous. Option 3: With nasal polyps, there are usually yellowish, boggy masses of hypertrophic mucosa. Option 4: Nasal vestibulitis usually results from folliculitis of the hairs that line the nares. 3/6/25, 8:47 PM Feedback This study source was downloaded by from CourseH on :53:10 GMT -05:00 Course Topic: HEENT Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Differential Diagnosis Clinical Decision-Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 16. When prescribing antibiotic therapy for a patient with acute bacterial rhinosinusitis, when would you consider Levaquin (levofloxacin)? Rationales [Page Reference: 371] Course Topic: HEENT Problems | Area of Practice: Adult-Gerontology Acute Care, Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Pharmacologic Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying]  1. The patient is less likely to be adherent to b.i.d. therapy. 2. The patient is allergic to penicillin. 3. The patient has a beta lactamase producing organism.  4. The patient has serious illness and is allergic to beta lactams. Option 1: This is not an appropriate reason to use a fluoroquinolone. Option 2: In this circumstance, a cephalosporin would be a safer alternative. Option 3: A beta lactamase-resistant antibiotic would be the more appropriate choice here. Option 4: This is among the clinical indications for a fluoroquinolone for acute bacterial rhinosinusitis. 3/6/25, 8:47 PM Feedback This study source was downloaded by from