NR 511 POSSIBLE MIDTERM EXAM QUESTIONS AND
POSSIBLE MID TERM QUESTIONS
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?
• Viral pharyngitis.
Mononucleosis (This presentation could be a viral pharyngitis; however, with posterior cervical
lymphadenitis, you would suspect mononucleosis)
• Streptococcal pharyngitis.
• Upper respiratory infection.
Which of the following is not a complication of untreated group A streptococcal pharyngitis?
• Glomerulonephritis.
• Rheumatic heart disease.
• Scarlet fever.
Hemolytic anemia (This is a complication of mononucleosis)
Jonathan, age 19, has just been given a diagnosis of mononucleosis. Which of the following statements
is true?
Antibiotic therapy should be instructed to avoid stress and that convalescence may take several weeks)
utensils. Bed rest is necessary only in severe cases)
The virus that causes mononucleosis is transmitted through saliva,
hence the nickname the “kissing disease.” It is contagious and can be transmitted through kissing or
sharing
Jonathan should avoid contact sports and heavy lifting ( When teaching clients about mononucleosis, or
Epstein-Barr virus (EBV), tell them to avoid contact sports and heavy lifting because of splenomegaly
and
a threat of rupture)
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,Mario, a 17-year-old high school student, came to the office for evaluation. He is complaining of
persistent sore throat, fever, and malaise not relieved by the penicillin therapy prescribed recently at
the urgent care center. As the nurse practitioner, what would you order next?
A Monospot test (If a client has a persistent sore throat, fever, and malaise not relieved by penicillin
therapy, a Monospot test should be performed to rule out mononucleosis (Epstein-Barr virus)
Marcia, age 4, is brought in to 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?
Epiglottitis (A symptom cluster of severe throat pain with difficulty swallowing, copious oral secre tions,
respiratory difficulty, stridor, and fever but without pharyngeal erythema or cough is indicative of
epiglottitis)
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, 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?
• Reddened face.
• Screaming.
• Grabbing her throat.
Stridor (In a pediatric client with acute epiglottitis, a number of symptoms can indicate that airway
obstruction is imminent: stridor, restlessness, nasal flaring, as well as the use of accessory muscles of
respiration)
A patient asks how to avoid contracting pharyngitis and tonsillitis. Which piece of advice is not
appropriate for this patient?
“Take antibiotics when well to avoid future infections.” (Patients should only be prescribed antibiotics if
a throat culture confirms disease of bacterial origin)
Which of the following is not recommended for hoarseness (Dysphonia)?
• Vocal rest.
• Tobacco cessation.
• Decrease in caffeine use.
Oral steroids (Oral steroids are not routinely used to treat hoarseness)
Samantha, age 12, presents with ear pain. When you begin to assess her ear, you tug on her normal-
appearing auricle, eliciting severe pain. This leads you to suspect:
• Otitis media ( membrane)
• Otitis media with effusion (Otitis media, with or without effusion, cannot be diagnosed without
examining Otitis media, with or without effusion, cannot be diagnosed without examining the tympanic
the tympanic membrane).
Otitis externa (When severe pain is elicited by tugging on a normal-appearing auricle, an acute infection
of the external ear canal (otitis externa) is suspected)
• Primary otalgia (Otalgia is ear pain)
Kathleen, age 54, has persistent pruritus of the external auditory canal. External otitis and
dermatological conditions, such as seborrheic dermatitis and psoriasis, have been ruled out. What can
you advise her to do?
• Use a cotton-tipped applicator daily to remove all moisture and potential bacteria.
• Wash daily with soap and water.
Apply mineral oil to counteract dryness (Pruritus of the external ear canal is a common problem. In
most cases, the pruritus is self-induced from overenthusiastic cleaning or excoriation. The protective
cerumen covering must be allowed to regenerate and may be helped to do so by application of a small
amount of mineral oil, which helps counteract dryness and reject moisture. Often, the use of isopropyl
alcohol may relieve ear canal pruritus as well)
• Avoid topical corticosteroids.
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POSSIBLE MID TERM QUESTIONS
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?
• Viral pharyngitis.
Mononucleosis (This presentation could be a viral pharyngitis; however, with posterior cervical
lymphadenitis, you would suspect mononucleosis)
• Streptococcal pharyngitis.
• Upper respiratory infection.
Which of the following is not a complication of untreated group A streptococcal pharyngitis?
• Glomerulonephritis.
• Rheumatic heart disease.
• Scarlet fever.
Hemolytic anemia (This is a complication of mononucleosis)
Jonathan, age 19, has just been given a diagnosis of mononucleosis. Which of the following statements
is true?
Antibiotic therapy should be instructed to avoid stress and that convalescence may take several weeks)
utensils. Bed rest is necessary only in severe cases)
The virus that causes mononucleosis is transmitted through saliva,
hence the nickname the “kissing disease.” It is contagious and can be transmitted through kissing or
sharing
Jonathan should avoid contact sports and heavy lifting ( When teaching clients about mononucleosis, or
Epstein-Barr virus (EBV), tell them to avoid contact sports and heavy lifting because of splenomegaly
and
a threat of rupture)
mailto:https://www.stuvia.com/user/techgrades
,Mario, a 17-year-old high school student, came to the office for evaluation. He is complaining of
persistent sore throat, fever, and malaise not relieved by the penicillin therapy prescribed recently at
the urgent care center. As the nurse practitioner, what would you order next?
A Monospot test (If a client has a persistent sore throat, fever, and malaise not relieved by penicillin
therapy, a Monospot test should be performed to rule out mononucleosis (Epstein-Barr virus)
Marcia, age 4, is brought in to 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?
Epiglottitis (A symptom cluster of severe throat pain with difficulty swallowing, copious oral secre tions,
respiratory difficulty, stridor, and fever but without pharyngeal erythema or cough is indicative of
epiglottitis)
mailto:https://www.stuvia.com/user/techgrades
, 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?
• Reddened face.
• Screaming.
• Grabbing her throat.
Stridor (In a pediatric client with acute epiglottitis, a number of symptoms can indicate that airway
obstruction is imminent: stridor, restlessness, nasal flaring, as well as the use of accessory muscles of
respiration)
A patient asks how to avoid contracting pharyngitis and tonsillitis. Which piece of advice is not
appropriate for this patient?
“Take antibiotics when well to avoid future infections.” (Patients should only be prescribed antibiotics if
a throat culture confirms disease of bacterial origin)
Which of the following is not recommended for hoarseness (Dysphonia)?
• Vocal rest.
• Tobacco cessation.
• Decrease in caffeine use.
Oral steroids (Oral steroids are not routinely used to treat hoarseness)
Samantha, age 12, presents with ear pain. When you begin to assess her ear, you tug on her normal-
appearing auricle, eliciting severe pain. This leads you to suspect:
• Otitis media ( membrane)
• Otitis media with effusion (Otitis media, with or without effusion, cannot be diagnosed without
examining Otitis media, with or without effusion, cannot be diagnosed without examining the tympanic
the tympanic membrane).
Otitis externa (When severe pain is elicited by tugging on a normal-appearing auricle, an acute infection
of the external ear canal (otitis externa) is suspected)
• Primary otalgia (Otalgia is ear pain)
Kathleen, age 54, has persistent pruritus of the external auditory canal. External otitis and
dermatological conditions, such as seborrheic dermatitis and psoriasis, have been ruled out. What can
you advise her to do?
• Use a cotton-tipped applicator daily to remove all moisture and potential bacteria.
• Wash daily with soap and water.
Apply mineral oil to counteract dryness (Pruritus of the external ear canal is a common problem. In
most cases, the pruritus is self-induced from overenthusiastic cleaning or excoriation. The protective
cerumen covering must be allowed to regenerate and may be helped to do so by application of a small
amount of mineral oil, which helps counteract dryness and reject moisture. Often, the use of isopropyl
alcohol may relieve ear canal pruritus as well)
• Avoid topical corticosteroids.
mailto:https://www.stuvia.com/user/techgrades
