NR 569 Differential Diagnosis in Acute Care Practicum Exam with Q and A

NR 569 Differential Diagnosis in Acute Care Practicum Exam with Q and A A 29-year-old patient presents with recurrent sneezing, nasal itching, clear rhinorrhea, and nasal congestion that worsen every spring. Which assessment finding most strongly supports a diagnosis of allergic rhinitis rather than an infectious cause? a. Purulent nasal discharge and fever b. Pale, boggy nasal mucosa with watery secretions c. Unilateral facial pain and foul-smelling discharge d. Erythematous nasal mucosa with thick mucus Correct Answer: b. Pale, boggy nasal mucosa with watery secretions Rationale: Allergic rhinitis is characterized by pale, edematous (boggy) nasal mucosa and clear watery nasal drainage. Purulent discharge, fever, and facial pain are more suggestive of infectious rhinosinusitis. A nurse practitioner is evaluating a patient with suspected perennial allergic rhinitis. Which trigger is most commonly associated with year-round symptoms? a. Ragweed pollen b. Tree pollen c. House dust mites d. Grass pollen Correct Answer: c. House dust mites Rationale: Perennial allergic rhinitis is commonly triggered by indoor allergens such as dust mites, pet dander, mold, and cockroaches. Seasonal allergens such as tree, grass, and ragweed pollens produce symptoms during specific times of the year.