6531 Final Deck 2
Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and
occasional epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist - ANS-C. You do nothing except
for client teaching
- Can occur with pregnancy because of increased vascularization in the upper
respiratory tract
David, age 32, states that he thinks he has an ear infection because he just flew back
from a business trip and feels unusual pressure in his ear. You diagnose barotrauma.
What is your next action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist - ANS-A. Prescribe nasal steroids
and oral decongestants
A sexual history of oral-genital contact in a client presenting with pharyngitis is
significant when which of the following organisms is suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae - ANS-C. Neisseria gonorrhoeae
- Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis - ANS-D. Presbycusis
How do you describe the cervical lymphadenopathy associated with asymptomatic HIV
infection?
A. Movable, discrete, soft, and nontender lymph nodes
B. Enlarged, warm, tender, firm, but freely movable lymph nodes
,C. Hard, unilateral, nontender, and fixed lymph nodes
D. Firm but not hard, nontender, and mobile lymph nodes - ANS-D. Firm but not hard,
nontender, and mobile lymph nodes
You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local
emergeny room. Which of the following symptoms would indicate that an airway
obstruction is imminent?
A. Reddened face
B. Screaming
C. Grabbing her throat
D. Stridor - ANS-D. Stridor
Purulent matter in the anterior chamber of the eye is called
A. Hyphema
B. Hypopyon
C. Anisocoria
D. Pterygium - ANS-B. Hypopyon
A 42 year old stockbroker comes to your office for evaluation of a pulsating headache
over the left temporal region and he rates the pain as an 8 on a scale of 1-10. The pain
has been constant for the past several hours and is accompanied by nausea and
sensitivity to light. He has had frequent headaches for many years but not as severe
and they are usually relieved by over the counter medicines. He is unclear as to a
precipitating event but notes that he has had visual disturbances before each headache
and has been under a lot of stress in his job. Based on this description, what is the most
likely diagnosis of this type of headaache?
A. Tension
B. Migraine
C. Cluster
D. Temporal arteritis - ANS-B. Migraine
The trachea deviates toward the affected side in all of the following except
A. Aortic aneurysm
B. Unilateral thyroid lobe enlargement
C. Large atelectasis
D. Pneumothorax - ANS-C. Large atelectasis
Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his
symptoms. He is taking cimetidine (Tagamet) for gastroesophageal reflux disease.
Which medication would you not order?
,A. A first-generation antihistamine
B. A second-generation antihistamine
C. A decongestant
D. A topical nasal corticosteroid - ANS-B. A second-generation antihistamine
Jessica, an 8 year old third grader is broght to the office by her grandmother, who is the
child's babysitter. She has complained of fever and sore throat for the past 2 days. Five
other children in her class have been sick with sore throats. She denies difficulty
swallowing and has been drinking fluids but has no appetite. ROS reveals that she has
clear nasal drainage, hoarseness, and nonproductive cough. She denies vomiting but
has had mild diarrhea. On examination she has a temperature of 101.5 F, 3+
erythematous tonsils, and palpable, tender cervical lymph nodes. Based on these
findings, what is the most likely diagnosis?
A. Mono
B. Sinusitis
C. Strep pharyingitis
D. Viral pharyngitis - ANS-D. Viral pharyngitis
Marcia, age 4, is brought into 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?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal infection pharyngitis
C. Tonsillitis
D. Diphtheria - ANS-A. Epiglottitis
You note a completely split uvula in Noi, a 42 year old Asian. What is your next course
of action?
A. Do nothing
B. Refer Noi to a specialist
C. Perform a throat culture
D. Order a CBC - ANS-A. Do nothing
Claude, age 78, is being treated with timolol maleate (Timoptic) drops for his chronic
open-angle glaucoma. While performing a new client history and physical, you note that
he is taking other medications. Which medication would you be most concerned about?
A. Apsirin therapy as prophylaxis for heart attack
B. Ranitidine (Zantac) for gastroesophageal reflux disease
C. Alprazolam (Xanax), an anxiolytic for anxiety
, D. Atenolol (Tenormin), a beta blocker for high blood pressure - ANS-D. Atenolol
(Tenormin), a beta blocker for high blood pressure
Harry, age 69, has had Meniere's disease for several years. He has some hearing loss
but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
A. A labyrinthectomy
B. Pharmacological therapy
C. A vestibular neurectomy
D. Wearing an earplug in the ear with the most hearing loss - ANS-C. A vestibular
neurectomy
A 65 year old man presents complaining of left sided deep, throbbing headache along
with mild fatigue. On examination the client has a tender, tortuous temporal artery. You
suspect temporal arteritis. How do you confirm your diagnosis?
A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
D. Otoscopy - ANS-B. Erythrocyte sedimentation rate (ESR)
Marty has a hordeolum in his right eye. You suspect that the offending organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli - ANS-B. Staphylococcus
The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity - ANS-A. Pollens of grasses, trees, and weeds
Cydney, age 7, is complaining that she feels as though something is stuck in her ear.
What action is contraindicated?
A. Inspecting the ear canal with an otoscope
B. Using a small suction device to try to remove the object
C. Flushing the ear with water
D. Instilling several drops of mineral oil in the ear - ANS-C. Flushing the ear with water
Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and
occasional epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist - ANS-C. You do nothing except
for client teaching
- Can occur with pregnancy because of increased vascularization in the upper
respiratory tract
David, age 32, states that he thinks he has an ear infection because he just flew back
from a business trip and feels unusual pressure in his ear. You diagnose barotrauma.
What is your next action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist - ANS-A. Prescribe nasal steroids
and oral decongestants
A sexual history of oral-genital contact in a client presenting with pharyngitis is
significant when which of the following organisms is suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae - ANS-C. Neisseria gonorrhoeae
- Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis - ANS-D. Presbycusis
How do you describe the cervical lymphadenopathy associated with asymptomatic HIV
infection?
A. Movable, discrete, soft, and nontender lymph nodes
B. Enlarged, warm, tender, firm, but freely movable lymph nodes
,C. Hard, unilateral, nontender, and fixed lymph nodes
D. Firm but not hard, nontender, and mobile lymph nodes - ANS-D. Firm but not hard,
nontender, and mobile lymph nodes
You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local
emergeny room. Which of the following symptoms would indicate that an airway
obstruction is imminent?
A. Reddened face
B. Screaming
C. Grabbing her throat
D. Stridor - ANS-D. Stridor
Purulent matter in the anterior chamber of the eye is called
A. Hyphema
B. Hypopyon
C. Anisocoria
D. Pterygium - ANS-B. Hypopyon
A 42 year old stockbroker comes to your office for evaluation of a pulsating headache
over the left temporal region and he rates the pain as an 8 on a scale of 1-10. The pain
has been constant for the past several hours and is accompanied by nausea and
sensitivity to light. He has had frequent headaches for many years but not as severe
and they are usually relieved by over the counter medicines. He is unclear as to a
precipitating event but notes that he has had visual disturbances before each headache
and has been under a lot of stress in his job. Based on this description, what is the most
likely diagnosis of this type of headaache?
A. Tension
B. Migraine
C. Cluster
D. Temporal arteritis - ANS-B. Migraine
The trachea deviates toward the affected side in all of the following except
A. Aortic aneurysm
B. Unilateral thyroid lobe enlargement
C. Large atelectasis
D. Pneumothorax - ANS-C. Large atelectasis
Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his
symptoms. He is taking cimetidine (Tagamet) for gastroesophageal reflux disease.
Which medication would you not order?
,A. A first-generation antihistamine
B. A second-generation antihistamine
C. A decongestant
D. A topical nasal corticosteroid - ANS-B. A second-generation antihistamine
Jessica, an 8 year old third grader is broght to the office by her grandmother, who is the
child's babysitter. She has complained of fever and sore throat for the past 2 days. Five
other children in her class have been sick with sore throats. She denies difficulty
swallowing and has been drinking fluids but has no appetite. ROS reveals that she has
clear nasal drainage, hoarseness, and nonproductive cough. She denies vomiting but
has had mild diarrhea. On examination she has a temperature of 101.5 F, 3+
erythematous tonsils, and palpable, tender cervical lymph nodes. Based on these
findings, what is the most likely diagnosis?
A. Mono
B. Sinusitis
C. Strep pharyingitis
D. Viral pharyngitis - ANS-D. Viral pharyngitis
Marcia, age 4, is brought into 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?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal infection pharyngitis
C. Tonsillitis
D. Diphtheria - ANS-A. Epiglottitis
You note a completely split uvula in Noi, a 42 year old Asian. What is your next course
of action?
A. Do nothing
B. Refer Noi to a specialist
C. Perform a throat culture
D. Order a CBC - ANS-A. Do nothing
Claude, age 78, is being treated with timolol maleate (Timoptic) drops for his chronic
open-angle glaucoma. While performing a new client history and physical, you note that
he is taking other medications. Which medication would you be most concerned about?
A. Apsirin therapy as prophylaxis for heart attack
B. Ranitidine (Zantac) for gastroesophageal reflux disease
C. Alprazolam (Xanax), an anxiolytic for anxiety
, D. Atenolol (Tenormin), a beta blocker for high blood pressure - ANS-D. Atenolol
(Tenormin), a beta blocker for high blood pressure
Harry, age 69, has had Meniere's disease for several years. He has some hearing loss
but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
A. A labyrinthectomy
B. Pharmacological therapy
C. A vestibular neurectomy
D. Wearing an earplug in the ear with the most hearing loss - ANS-C. A vestibular
neurectomy
A 65 year old man presents complaining of left sided deep, throbbing headache along
with mild fatigue. On examination the client has a tender, tortuous temporal artery. You
suspect temporal arteritis. How do you confirm your diagnosis?
A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
D. Otoscopy - ANS-B. Erythrocyte sedimentation rate (ESR)
Marty has a hordeolum in his right eye. You suspect that the offending organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli - ANS-B. Staphylococcus
The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity - ANS-A. Pollens of grasses, trees, and weeds
Cydney, age 7, is complaining that she feels as though something is stuck in her ear.
What action is contraindicated?
A. Inspecting the ear canal with an otoscope
B. Using a small suction device to try to remove the object
C. Flushing the ear with water
D. Instilling several drops of mineral oil in the ear - ANS-C. Flushing the ear with water
