SARAH MICHELLE LIVE REVIEW
STUDY GUIDE Exam Questions and
Answers (Latest 2026).
A new graduate nurse practitioner has a patient presents with a hearing complaint. The patient states
that they have had decreased hearing on the right side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - CORRECT ANSWERS 4. The tuning fork lateralizes
to the left ear
What are common signs and symptoms of Meniere's Disease? - CORRECT ANSWERS Vertigo,
tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? - CORRECT ANSWERS There is a
possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? - CORRECT ANSWERS Drug-induced rebound nasal
congestion, this can happen after use of nasal decongestants like Afrin. These nasal decongestants
should ideally not be used for greater than 3-5 days because of this risk.
What is herpes keratitis? - CORRECT ANSWERS This is an infection of the cornea due to
herpes simplex virus
,How is herpes keratitis diagnosed? - CORRECT ANSWERS By examining the eye under a black
lamp and visualized the cornea, in herpes keratitis, fern like lines will be seen on the cornea
A child that has a history of mononucleosis is at increased risk for development for what cancer later in
life? And why? - CORRECT ANSWERS Hodgkin's Lymphoma and Burkitt's Lymphoma, this is
due to the exposure of the Epstein-Barr virus
What types of patients will be at a higher risk of pneumonia? - CORRECT ANSWERS Patient
with chronic lung diseases: asthma, COPD, cystic fibrosis.
Why are cough suppressants not helpful in pneumonia patients? - CORRECT ANSWERS
Because we WANT them to get that gunk out, we do not want them to hold it in their lungs, an
expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed after treatment of pneumonia? - CORRECT
ANSWERS Around 8 week mark
What is COPD? - CORRECT ANSWERS Chronic Obstructive Pulmonary Disease. This is a chronic
condition that is made up of chronic bronchitis and emphysema. It is a progressive inflammatory lung
disease that makes it hard for the patients to breathe, because the chronic bronchitis leads to mucous
build up and the emphysema portion destroys areas of the lungs.
What signs and symptoms are common in COPD patients? - CORRECT ANSWERS Chronic
cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? - CORRECT ANSWERS
Neurological symptoms, paresthesia (numbness and tingling in hands and feet), unsteady gait, memory
issues
Beefy red tongue
,What diet can result in B12 deficiency? - CORRECT ANSWERS Vegan- oral supplements can be
used for treatment
What surgery can result in B12 deficiency? - CORRECT ANSWERS Gastric surgery- patient will
lose intrinsic factor that is required to absorb B12- these patients will require life long IM B12 injections
What patient population is lupus commonly seen? - CORRECT ANSWERS Women of
childbearing age- ages 15-45, African Americans are going to be at higher risk
What is the diagnostic criteria for Lupus? - CORRECT ANSWERS Must have 4/11 diagnostic
criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
What is Sjogren's Syndrome and what is the treatment? - CORRECT ANSWERS Dry eyes and
dry mouth- treatment revolves around symptom management- artificial tears, hard candies, etc.
, Common in lupus patients
What is a major concern for lupus patients? How do we monitor this? - CORRECT ANSWERS
Impact on the kidneys- Lupus nephritis
Be on the look out for glomerularnephritis as well as proteinuria
These patients will require routine UA for assessment of their kidneys and protect them
What is the function of the thyroid? - CORRECT ANSWERS Viral hormone gland
Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? - CORRECT ANSWERS Pituitary gland
What is the function of TSH? - CORRECT ANSWERS Tells your thyroid when to produce and
release those critical thyroid hormones- T3 and T4.
What disorders include hypothyroidism? - CORRECT ANSWERS Iodine deficiency,
Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies indicates that? - CORRECT ANSWERS
Hypothyroidism is caused by an autoimmune process of some sort
What are some signs and symptoms of hypothyroidism? - CORRECT ANSWERS Weight gain,
constipation, dry skin, cold intolerance, fatigue, course hair, facial puffiness, thick tongue, and maybe
some cardiac side effects
What patient education must be included regarding Synthroid administration? - CORRECT ANSWERS
Must be taken on an empty stomach before other medications
STUDY GUIDE Exam Questions and
Answers (Latest 2026).
A new graduate nurse practitioner has a patient presents with a hearing complaint. The patient states
that they have had decreased hearing on the right side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - CORRECT ANSWERS 4. The tuning fork lateralizes
to the left ear
What are common signs and symptoms of Meniere's Disease? - CORRECT ANSWERS Vertigo,
tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? - CORRECT ANSWERS There is a
possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? - CORRECT ANSWERS Drug-induced rebound nasal
congestion, this can happen after use of nasal decongestants like Afrin. These nasal decongestants
should ideally not be used for greater than 3-5 days because of this risk.
What is herpes keratitis? - CORRECT ANSWERS This is an infection of the cornea due to
herpes simplex virus
,How is herpes keratitis diagnosed? - CORRECT ANSWERS By examining the eye under a black
lamp and visualized the cornea, in herpes keratitis, fern like lines will be seen on the cornea
A child that has a history of mononucleosis is at increased risk for development for what cancer later in
life? And why? - CORRECT ANSWERS Hodgkin's Lymphoma and Burkitt's Lymphoma, this is
due to the exposure of the Epstein-Barr virus
What types of patients will be at a higher risk of pneumonia? - CORRECT ANSWERS Patient
with chronic lung diseases: asthma, COPD, cystic fibrosis.
Why are cough suppressants not helpful in pneumonia patients? - CORRECT ANSWERS
Because we WANT them to get that gunk out, we do not want them to hold it in their lungs, an
expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed after treatment of pneumonia? - CORRECT
ANSWERS Around 8 week mark
What is COPD? - CORRECT ANSWERS Chronic Obstructive Pulmonary Disease. This is a chronic
condition that is made up of chronic bronchitis and emphysema. It is a progressive inflammatory lung
disease that makes it hard for the patients to breathe, because the chronic bronchitis leads to mucous
build up and the emphysema portion destroys areas of the lungs.
What signs and symptoms are common in COPD patients? - CORRECT ANSWERS Chronic
cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? - CORRECT ANSWERS
Neurological symptoms, paresthesia (numbness and tingling in hands and feet), unsteady gait, memory
issues
Beefy red tongue
,What diet can result in B12 deficiency? - CORRECT ANSWERS Vegan- oral supplements can be
used for treatment
What surgery can result in B12 deficiency? - CORRECT ANSWERS Gastric surgery- patient will
lose intrinsic factor that is required to absorb B12- these patients will require life long IM B12 injections
What patient population is lupus commonly seen? - CORRECT ANSWERS Women of
childbearing age- ages 15-45, African Americans are going to be at higher risk
What is the diagnostic criteria for Lupus? - CORRECT ANSWERS Must have 4/11 diagnostic
criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
What is Sjogren's Syndrome and what is the treatment? - CORRECT ANSWERS Dry eyes and
dry mouth- treatment revolves around symptom management- artificial tears, hard candies, etc.
, Common in lupus patients
What is a major concern for lupus patients? How do we monitor this? - CORRECT ANSWERS
Impact on the kidneys- Lupus nephritis
Be on the look out for glomerularnephritis as well as proteinuria
These patients will require routine UA for assessment of their kidneys and protect them
What is the function of the thyroid? - CORRECT ANSWERS Viral hormone gland
Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? - CORRECT ANSWERS Pituitary gland
What is the function of TSH? - CORRECT ANSWERS Tells your thyroid when to produce and
release those critical thyroid hormones- T3 and T4.
What disorders include hypothyroidism? - CORRECT ANSWERS Iodine deficiency,
Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies indicates that? - CORRECT ANSWERS
Hypothyroidism is caused by an autoimmune process of some sort
What are some signs and symptoms of hypothyroidism? - CORRECT ANSWERS Weight gain,
constipation, dry skin, cold intolerance, fatigue, course hair, facial puffiness, thick tongue, and maybe
some cardiac side effects
What patient education must be included regarding Synthroid administration? - CORRECT ANSWERS
Must be taken on an empty stomach before other medications
