NR 511 ACUTE OTITIS EXTERNA CPG STUDY
GUIDE WITH DETAILED EXPLANATIONS 2026
◉ What does a well-rounded clinical experience mean? Answer:
Includes seeing kids from birth through young adult visits for well
child and acute visits, as well as adults for wellness or acute/routine
visits.
Seeing a variety of pt's, including 15% of peds and 15% of women's
health of total time in the program.
◉ What are the maximum number of hours that time can be spent
"rounding" in a facility? Answer: No more than 25% of total
practicum hours in the program
◉ What are 9 things that must be documented when inputting data
into clinical encounter logs? Answer: Date of service
Age
Gender and ethnicity
Visit E&M code
CC
Procedures
Tests performed/ordered
,Dx
Level of involvement
◉ What does the acronym SNAPPS stand for? Answer: S: summarize
(present pt's H&P findings)
N: narrow (based on H&P, narrow down top 2-3 differentials)
A: analyze (compare/contrast H&P findings for each differential and
narrow it down to most likely one)
P: probe (ask preceptor questions of anything you are unsure of)
P: plan (come up with specific management plan)
S: Self-directed learning (opportunity to investigate more about
topics you are uncertain of)
◉ What is the most common type of pathogen responsible for acute
gastroenteritis? Answer: Viral (can be viral, bacterial, or parasitic),
usually norovirus
◉ T/F
Assessing for prior antibiotic use is a critical part of the history in
pt's presenting with diarrhea. Answer: True
◉ What is the difference between irritable bowel disease (IBD) and
irritable bowel syndrome (IBS)? Answer: IBS: disorder of bowel
function (as opposed to being due to an anatomic abnormality).
,Changes in bowel habits (diarrhea, constipation, abd pain, bloating,
rectal urgency w/diarrhea).
Symptoms fall into two categories: abd pain/altered bowel habits,
and painless diarrhea. Usually pain is LLQ.
PE: normal except for tenderness in colon.
Labs: CBC, ESR. Most other labs and radiology/scopes are normal.
Dx made on careful H&P.
May be associated with nonintestinal (extra-intestinal) symptoms
(sexual function difficulty, muscle aches/pains, fatigue, fibromyalgia,
HAs, back pain, urinary symptoms).
Not associate with serious medical consequences. Not a risk factor
for other serious GI dz's.
Does not put extra stress on other organs.
Overall prognosis is excellent.
Major problem: changes quality of life.
Treatment: based on symptom pattern. May include diet, education,
pharm (for mod-severe pt's)/other supportive interventions. Usually
focuses on lifestyle, diet, and stress reduction. NO PROVEN
TREATMENT! Antidiarrheals: use temporarily, reserve for severe.
Loperamide (Imodium) or diphenoxylate (Lomotil) 2.5-5mg q6h
usually works. Constipation: high fiber diet, hydration, exercise,
bulking agents. If these don't work, intermittent use of stimulant
laxatives (lactulose or mag hydroxide); don't use long-term! Linzess
(linaclotide), Trulance (plecanatide), and Amitiza (lubiprostone):
newer for constipation, work locally on apical membrane of GI tract
to increase intestinal fluid secretion and improve fecal transit. Abd
, pain: dicloclymine (Bentyl), hyoscyamine (avoid anticholinergics in
glaucoma and BPH, especially in elderly). TCAs and SSRIs can relieve
symptoms in some pt's.
Can be managed by PCP, but if not responsive to tx, refer to GI.
IBD: chronic immunological dz that manifests in intestinal
inflammation.
UC and Crohn
◉ What are two common IBD's? Answer: Ulcerative colitis
Crohn's disease
◉ Describe the characteristics of acute diverticulitis. Answer:
Subjective:
S/S of infection (fever, chills, tachycardia)
Localized pain LLQ
Anorexia, n/v
If fistula present, additional s/s will be present associated
w/affected organ (dysuria, pneumaturia, hematachzia, frank rectal
bleeding, etc)
Objective:
Tenderness in LLQ
GUIDE WITH DETAILED EXPLANATIONS 2026
◉ What does a well-rounded clinical experience mean? Answer:
Includes seeing kids from birth through young adult visits for well
child and acute visits, as well as adults for wellness or acute/routine
visits.
Seeing a variety of pt's, including 15% of peds and 15% of women's
health of total time in the program.
◉ What are the maximum number of hours that time can be spent
"rounding" in a facility? Answer: No more than 25% of total
practicum hours in the program
◉ What are 9 things that must be documented when inputting data
into clinical encounter logs? Answer: Date of service
Age
Gender and ethnicity
Visit E&M code
CC
Procedures
Tests performed/ordered
,Dx
Level of involvement
◉ What does the acronym SNAPPS stand for? Answer: S: summarize
(present pt's H&P findings)
N: narrow (based on H&P, narrow down top 2-3 differentials)
A: analyze (compare/contrast H&P findings for each differential and
narrow it down to most likely one)
P: probe (ask preceptor questions of anything you are unsure of)
P: plan (come up with specific management plan)
S: Self-directed learning (opportunity to investigate more about
topics you are uncertain of)
◉ What is the most common type of pathogen responsible for acute
gastroenteritis? Answer: Viral (can be viral, bacterial, or parasitic),
usually norovirus
◉ T/F
Assessing for prior antibiotic use is a critical part of the history in
pt's presenting with diarrhea. Answer: True
◉ What is the difference between irritable bowel disease (IBD) and
irritable bowel syndrome (IBS)? Answer: IBS: disorder of bowel
function (as opposed to being due to an anatomic abnormality).
,Changes in bowel habits (diarrhea, constipation, abd pain, bloating,
rectal urgency w/diarrhea).
Symptoms fall into two categories: abd pain/altered bowel habits,
and painless diarrhea. Usually pain is LLQ.
PE: normal except for tenderness in colon.
Labs: CBC, ESR. Most other labs and radiology/scopes are normal.
Dx made on careful H&P.
May be associated with nonintestinal (extra-intestinal) symptoms
(sexual function difficulty, muscle aches/pains, fatigue, fibromyalgia,
HAs, back pain, urinary symptoms).
Not associate with serious medical consequences. Not a risk factor
for other serious GI dz's.
Does not put extra stress on other organs.
Overall prognosis is excellent.
Major problem: changes quality of life.
Treatment: based on symptom pattern. May include diet, education,
pharm (for mod-severe pt's)/other supportive interventions. Usually
focuses on lifestyle, diet, and stress reduction. NO PROVEN
TREATMENT! Antidiarrheals: use temporarily, reserve for severe.
Loperamide (Imodium) or diphenoxylate (Lomotil) 2.5-5mg q6h
usually works. Constipation: high fiber diet, hydration, exercise,
bulking agents. If these don't work, intermittent use of stimulant
laxatives (lactulose or mag hydroxide); don't use long-term! Linzess
(linaclotide), Trulance (plecanatide), and Amitiza (lubiprostone):
newer for constipation, work locally on apical membrane of GI tract
to increase intestinal fluid secretion and improve fecal transit. Abd
, pain: dicloclymine (Bentyl), hyoscyamine (avoid anticholinergics in
glaucoma and BPH, especially in elderly). TCAs and SSRIs can relieve
symptoms in some pt's.
Can be managed by PCP, but if not responsive to tx, refer to GI.
IBD: chronic immunological dz that manifests in intestinal
inflammation.
UC and Crohn
◉ What are two common IBD's? Answer: Ulcerative colitis
Crohn's disease
◉ Describe the characteristics of acute diverticulitis. Answer:
Subjective:
S/S of infection (fever, chills, tachycardia)
Localized pain LLQ
Anorexia, n/v
If fistula present, additional s/s will be present associated
w/affected organ (dysuria, pneumaturia, hematachzia, frank rectal
bleeding, etc)
Objective:
Tenderness in LLQ
