NUR 621 FINAL EXAM QUESTIONS
& ANSWERS RATED 100%
CORRECT
Does a positive RADT for GAS pharyngitis require back up culture? - correct answer ✔✔no,
positive RADT is highly specific
If an adult is symptomatic but has a negative RADT for GAS, should throat cultures be
performed? - correct answer ✔✔No. risk for rheumatic fever is low so back up culture is not
required
In children and adolescents, what should the follow up intervention be for a negative RADT
strep test but continued symptoms? - correct answer ✔✔A throat culture should be performed
If patient has acute pharyngitis with cough, rhinorrhea, and oral ulcers should patient be tested
for GAS? - correct answer ✔✔No- other symptoms suggest viral etiology.
What is recommended drug of choice for GAS pharyngitis? - correct answer ✔✔Penicillin or
Amoxicillin 10 day course
Treatment of GAS pharyngitis in penicillin-allergic (not anaphylaxis) - correct answer ✔✔1st gen
cephalosporin 10 days (Keflex of cefadroxil), clindamycin or clarithromycin 10 days, or
azithromycin 5 days.
If patient has recurrent GAS pharyngitis, should a tonsillectomy be performed? - correct answer
✔✔Tonsillectomy should not be done solely to reduce frequency of GAS
,Most common pathogen that causes pharyngitis among college students and adults? - correct
answer ✔✔Group C strep
Which test is more sensitive for detecting GAS? RADT or blood agar plate culture? - correct
answer ✔✔Blood agar is more sensitive.
T/F Diagnostic studies are not usually indicated for children <3? - correct answer ✔✔True.
Unless the child has an older sibling with confirmed GAS. This is because the risk of rheumatic
fever is rare in children <3
Tonsillectomy is indicated for patients who have had ________ or more throat infections in one
year - correct answer ✔✔7 or more infections.
Tonsillectomy is indicated for patients who have had ______ or more throat infections per year
in the past 2 years. - correct answer ✔✔5 or more per year
What might be the diagnosis for a patient that is experiencing fluctuating, unilateral, hearing
loss and feels dizzy - correct answer ✔✔meniere's disease
Patient complains of unilateral progressive hearing loss and frequent headaches. What is the
most likely diagnosis?
a. acoustic neuroma
b. menieres disease
c. prebycusis
d. conductive hearing loss - correct answer ✔✔Acoustic neuroma
Which of the following are causes of sensorineural hearing loss?
a. cerumen impaction
b. presbycusis
,c. acustic neuroma
d.otosclerosis
e. aminoglycoside induced hearing loss
f.congential abnormalities - correct answer ✔✔b. presbycusis
c. acustic neuroma
e. aminoglycoside induced hearing loss
All others are conductive hearing loss
Patient presents with sudden, sensorineural hearing loss. What is the next step for the
provider? - correct answer ✔✔refer to otorhinolaryngologist
What else should be included in the assessment of patients with presbycusis? - correct answer
✔✔Mental health assessment. high risk for suicide
Which type of hearing loss is considered reversible? Sensorineural or conductive? - correct
answer ✔✔Conductive
What is the best treatment for acute attack of menieres disease? - correct answer ✔✔resting
with the eyes closed and protection from falling.
A patient with Meniere's disease has sound lateralization to the non affected ear when a tuning
fork is placed midline on the top of the head. What is the name of this test? - correct answer
✔✔Weber test
What are two medications safe to prescribe in patients with bacterial otitis externa and
perforated tympanic membrane? - correct answer ✔✔1. ciprofloxacin drops
2. ofloxacin drops
, A patient with otitis externa asks when they can return to swimming. How would you advise? -
correct answer ✔✔The ear must be kept dry without being submerged in water for 4-6 weeks.
Medications of choice for a pediatric patient with AOM and has a hx of an anaphylaxis reaction
to penicillin? (3) - correct answer ✔✔clarithromycin, bactrim, or azithromycin
Pediatric patient recently completed course of amoxicillin but continues to have symptoms of
AOM. What is the next step? - correct answer ✔✔Augmentin
Patient with a history of HTN on metoprolol presents with rhinitis. Which medication should be
avoided for this patient? - correct answer ✔✔patients on beta blockers should avoid
pseudophedrine. Also should be avoided in patients with diabetes, BPH,
Patient presents with purulent gray exudate on tongue and excessive salivation, what is most
likely diagnosis? - correct answer ✔✔St. Vincent stomatitis.
A patient hurt their ankle playing basketball. They present with pain in the malleolar zone. they
are able to bear weight for 6 steps but are limping. Are ankle radiographs indicated? - correct
answer ✔✔No.
Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar
zone and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
A patient hurt their ankle playing basketball. They present with pain in the malleolar zone and
pain at the posterior edge of the lateral malleolus. Are ankle radiographs indicated? - correct
answer ✔✔Yes!
Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar
zone and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
& ANSWERS RATED 100%
CORRECT
Does a positive RADT for GAS pharyngitis require back up culture? - correct answer ✔✔no,
positive RADT is highly specific
If an adult is symptomatic but has a negative RADT for GAS, should throat cultures be
performed? - correct answer ✔✔No. risk for rheumatic fever is low so back up culture is not
required
In children and adolescents, what should the follow up intervention be for a negative RADT
strep test but continued symptoms? - correct answer ✔✔A throat culture should be performed
If patient has acute pharyngitis with cough, rhinorrhea, and oral ulcers should patient be tested
for GAS? - correct answer ✔✔No- other symptoms suggest viral etiology.
What is recommended drug of choice for GAS pharyngitis? - correct answer ✔✔Penicillin or
Amoxicillin 10 day course
Treatment of GAS pharyngitis in penicillin-allergic (not anaphylaxis) - correct answer ✔✔1st gen
cephalosporin 10 days (Keflex of cefadroxil), clindamycin or clarithromycin 10 days, or
azithromycin 5 days.
If patient has recurrent GAS pharyngitis, should a tonsillectomy be performed? - correct answer
✔✔Tonsillectomy should not be done solely to reduce frequency of GAS
,Most common pathogen that causes pharyngitis among college students and adults? - correct
answer ✔✔Group C strep
Which test is more sensitive for detecting GAS? RADT or blood agar plate culture? - correct
answer ✔✔Blood agar is more sensitive.
T/F Diagnostic studies are not usually indicated for children <3? - correct answer ✔✔True.
Unless the child has an older sibling with confirmed GAS. This is because the risk of rheumatic
fever is rare in children <3
Tonsillectomy is indicated for patients who have had ________ or more throat infections in one
year - correct answer ✔✔7 or more infections.
Tonsillectomy is indicated for patients who have had ______ or more throat infections per year
in the past 2 years. - correct answer ✔✔5 or more per year
What might be the diagnosis for a patient that is experiencing fluctuating, unilateral, hearing
loss and feels dizzy - correct answer ✔✔meniere's disease
Patient complains of unilateral progressive hearing loss and frequent headaches. What is the
most likely diagnosis?
a. acoustic neuroma
b. menieres disease
c. prebycusis
d. conductive hearing loss - correct answer ✔✔Acoustic neuroma
Which of the following are causes of sensorineural hearing loss?
a. cerumen impaction
b. presbycusis
,c. acustic neuroma
d.otosclerosis
e. aminoglycoside induced hearing loss
f.congential abnormalities - correct answer ✔✔b. presbycusis
c. acustic neuroma
e. aminoglycoside induced hearing loss
All others are conductive hearing loss
Patient presents with sudden, sensorineural hearing loss. What is the next step for the
provider? - correct answer ✔✔refer to otorhinolaryngologist
What else should be included in the assessment of patients with presbycusis? - correct answer
✔✔Mental health assessment. high risk for suicide
Which type of hearing loss is considered reversible? Sensorineural or conductive? - correct
answer ✔✔Conductive
What is the best treatment for acute attack of menieres disease? - correct answer ✔✔resting
with the eyes closed and protection from falling.
A patient with Meniere's disease has sound lateralization to the non affected ear when a tuning
fork is placed midline on the top of the head. What is the name of this test? - correct answer
✔✔Weber test
What are two medications safe to prescribe in patients with bacterial otitis externa and
perforated tympanic membrane? - correct answer ✔✔1. ciprofloxacin drops
2. ofloxacin drops
, A patient with otitis externa asks when they can return to swimming. How would you advise? -
correct answer ✔✔The ear must be kept dry without being submerged in water for 4-6 weeks.
Medications of choice for a pediatric patient with AOM and has a hx of an anaphylaxis reaction
to penicillin? (3) - correct answer ✔✔clarithromycin, bactrim, or azithromycin
Pediatric patient recently completed course of amoxicillin but continues to have symptoms of
AOM. What is the next step? - correct answer ✔✔Augmentin
Patient with a history of HTN on metoprolol presents with rhinitis. Which medication should be
avoided for this patient? - correct answer ✔✔patients on beta blockers should avoid
pseudophedrine. Also should be avoided in patients with diabetes, BPH,
Patient presents with purulent gray exudate on tongue and excessive salivation, what is most
likely diagnosis? - correct answer ✔✔St. Vincent stomatitis.
A patient hurt their ankle playing basketball. They present with pain in the malleolar zone. they
are able to bear weight for 6 steps but are limping. Are ankle radiographs indicated? - correct
answer ✔✔No.
Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar
zone and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
A patient hurt their ankle playing basketball. They present with pain in the malleolar zone and
pain at the posterior edge of the lateral malleolus. Are ankle radiographs indicated? - correct
answer ✔✔Yes!
Ottawa ankle: A series of ankle radiograph films is required only if there is any pain in malleolar
zone and any of these findings: bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
