NR 602 FINAL EXAM 150 QUESTIONS
AND VERIFIED ANSWERS 2024\2025
GRADED A+
Step 1 Asthma approach-Intermittent - ANSWER- symptoms 2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - ANSWER- Symptoms >2 x a week,
less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
,Step 3 Asthma Approach-Moderate Persistant - ANSWER- daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - ANSWER- continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma - ANSWER- Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach - ANSWER-
Bulbar/palpebral conjunctival infection - ANSWER- May be unilateral or bilateral
, Leukocoria - ANSWER- abnormal appearance of a white film in the pupil;
immediate referral to pediatric ophthalmologist warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma
Visual screening in children - ANSWER- At least once between ages 3-5 y/o
according to USPSTF
AOM - ANSWER- RF: genetics, males, Native American, siblings, low economic
status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
S/S of AOM - ANSWER- erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - ANSWER- Audiometry, tympanometry, possible lateral neck xray to
r/o mass
TX of AOM - ANSWER- uncomplicated: supportive with tylenol/ibuprofen;
watchful waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis - ANSWER- Preceded by URI-typically worsens after 5-7
days- not resolved in 2 weeks
Sx of bacterial rhinosinusitis - ANSWER- Purulant nasal congestion, drainage,
facial pain, headache, fever
No imaging required- if no improvement refer to ENT
AND VERIFIED ANSWERS 2024\2025
GRADED A+
Step 1 Asthma approach-Intermittent - ANSWER- symptoms 2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - ANSWER- Symptoms >2 x a week,
less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
,Step 3 Asthma Approach-Moderate Persistant - ANSWER- daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - ANSWER- continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma - ANSWER- Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach - ANSWER-
Bulbar/palpebral conjunctival infection - ANSWER- May be unilateral or bilateral
, Leukocoria - ANSWER- abnormal appearance of a white film in the pupil;
immediate referral to pediatric ophthalmologist warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma
Visual screening in children - ANSWER- At least once between ages 3-5 y/o
according to USPSTF
AOM - ANSWER- RF: genetics, males, Native American, siblings, low economic
status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
S/S of AOM - ANSWER- erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - ANSWER- Audiometry, tympanometry, possible lateral neck xray to
r/o mass
TX of AOM - ANSWER- uncomplicated: supportive with tylenol/ibuprofen;
watchful waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis - ANSWER- Preceded by URI-typically worsens after 5-7
days- not resolved in 2 weeks
Sx of bacterial rhinosinusitis - ANSWER- Purulant nasal congestion, drainage,
facial pain, headache, fever
No imaging required- if no improvement refer to ENT
