SARAH MICHELLE LIVE REVIEW
STUDY GUIDE 2026 BRAND NEW
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 --Verified--Solution----4. The
tuning fork lateralizes to the left ear
What are common signs and symptoms of Meniere's Disease? --Verified--
Solution----Vertigo, tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? --Verified--
Solution----There is a possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? --Verified--Solution----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? --Verified--Solution----This is an infection of the
cornea due to herpes simplex virus
How is herpes keratitis diagnosed? --Verified--Solution----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? --Verified--Solution----
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? --Verified--
Solution----Patient with chronic lung diseases: asthma, COPD, cystic
fibrosis.
Why are cough suppressants not helpful in pneumonia patients? --Verified--
Solution----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? --Verified--Solution----Around 8 week mark
What is COPD? --Verified--Solution----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? --Verified--
Solution----Chronic cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? --Verified--
Solution----Neurological symptoms, paresthesia (numbness and tingling in
hands and feet), unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? --Verified--Solution----Vegan- oral
supplements can be used for treatment
,What surgery can result in B12 deficiency? --Verified--Solution----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? --Verified--Solution----
Women of childbearing age- ages 15-45, African Americans are going to be
at higher risk
What is the diagnostic criteria for Lupus? --Verified--Solution----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? --Verified--
Solution----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? --
Verified--Solution----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? --Verified--Solution----Viral hormone
gland
, Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? --Verified--Solution----Pituitary gland
What is the function of TSH? --Verified--Solution----Tells your thyroid when
to produce and release those critical thyroid hormones- T3 and T4.
What disorders include hypothyroidism? --Verified--Solution----Iodine
deficiency, Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies indicates that? --Verified--
Solution----Hypothyroidism is caused by an autoimmune process of some
sort
What are some signs and symptoms of hypothyroidism? --Verified--
Solution----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?
--Verified--Solution----Must be taken on an empty stomach before other
medications
What are signs and symptoms of a myxedema coma? --Verified--Solution----
Low body temperature, edema, confusion, lethargy, tongue thickening,
difficulty breathing
What medications can precipitate myxedema coma? --Verified--Solution----
Lithium or amiodarone
Your patient who is on 75 mcg Synthroid PO daily comes in for a 6 week
follow up to check their TSH level. When you get the results, their TSH is
0.1. What should you do next as the NP? --Verified--Solution----Assess how
the patient is taking their Synthroid
STUDY GUIDE 2026 BRAND NEW
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 --Verified--Solution----4. The
tuning fork lateralizes to the left ear
What are common signs and symptoms of Meniere's Disease? --Verified--
Solution----Vertigo, tinnitus, ear pressure, nystagmus
What is our biggest worry for a Meniere's Disease patient? --Verified--
Solution----There is a possibility for a potential, permanent hearing loss.
What is rhinitis meidcamentosa? --Verified--Solution----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? --Verified--Solution----This is an infection of the
cornea due to herpes simplex virus
How is herpes keratitis diagnosed? --Verified--Solution----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? --Verified--Solution----
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? --Verified--
Solution----Patient with chronic lung diseases: asthma, COPD, cystic
fibrosis.
Why are cough suppressants not helpful in pneumonia patients? --Verified--
Solution----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? --Verified--Solution----Around 8 week mark
What is COPD? --Verified--Solution----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? --Verified--
Solution----Chronic cough
Sputum production
Dyspnea- difficulty breathing
What signs and symptoms are specific to B12 deficiency anemia? --Verified--
Solution----Neurological symptoms, paresthesia (numbness and tingling in
hands and feet), unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? --Verified--Solution----Vegan- oral
supplements can be used for treatment
,What surgery can result in B12 deficiency? --Verified--Solution----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? --Verified--Solution----
Women of childbearing age- ages 15-45, African Americans are going to be
at higher risk
What is the diagnostic criteria for Lupus? --Verified--Solution----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? --Verified--
Solution----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? --
Verified--Solution----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? --Verified--Solution----Viral hormone
gland
, Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? --Verified--Solution----Pituitary gland
What is the function of TSH? --Verified--Solution----Tells your thyroid when
to produce and release those critical thyroid hormones- T3 and T4.
What disorders include hypothyroidism? --Verified--Solution----Iodine
deficiency, Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies indicates that? --Verified--
Solution----Hypothyroidism is caused by an autoimmune process of some
sort
What are some signs and symptoms of hypothyroidism? --Verified--
Solution----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?
--Verified--Solution----Must be taken on an empty stomach before other
medications
What are signs and symptoms of a myxedema coma? --Verified--Solution----
Low body temperature, edema, confusion, lethargy, tongue thickening,
difficulty breathing
What medications can precipitate myxedema coma? --Verified--Solution----
Lithium or amiodarone
Your patient who is on 75 mcg Synthroid PO daily comes in for a 6 week
follow up to check their TSH level. When you get the results, their TSH is
0.1. What should you do next as the NP? --Verified--Solution----Assess how
the patient is taking their Synthroid
