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Exam (elaborations)

Nr 569 Final Study Guide Questions And Correct Answers..

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This study guide covers NR 569 final-exam material focused on ear, nose, throat, eye, musculoskeletal, neurologic, and vascular conditions. It includes clinical presentations, differential diagnoses, physical-exam findings, diagnostic tests, treatment options, and case-based questions covering conditions such as sinusitis, otitis media/externa, carpal tunnel syndrome, plantar fasciitis, ankle sprains, spinal stenosis, pharyngitis, allergic rhinitis, and shoulder disorders. The guide also includes multiple patient scenarios with answers and treatment rationales.

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Leg pain with exercise


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Pain that develops during walking occurs in patients with arterial
insufficiency, venous insufficiency, spinal stenosis, and thrombophlebitis.




Ear pain/infection: Management


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, ear pain may be treated with OTC analgesics
avoid scratching, tugging, or inserting anything in the ear, including cotton-
tipped swabs
reinforce water precautions with TM ruptured
avoid getting water in the ear during bathing/shower
avoid submerging ear under water




What is the correct treatment for Zhang? Select all that apply.


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Surgery




Sinusitis presentation


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Erythema/edema over periorbital cheek region
Upper teeth/molar tenderness to percussion
Purulent drainage in nasal cavity or posterior pharynx
Examine ears to assess for coexisting disease
Assess for complications of sinusitis
Meningitis
Intracranial abscess
Periorbital and orbital cellulitis
Subperiosteal abscess
Osteomyelitis of sinus bones
Septic cavernous sinus thrombosis; presence of cranial nerve palsy




Otitis barotrauma

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aggravated by URI
hay fever
middle ear effusions
stuffy nose
decent in airplane




Phalen's test


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Patient maximally flexes both wrist holding them against each other for 1
minute.
(+) TEST: Reproduces tingling and/or paresthesia into hand following
median nerve distribution




Tinel's sign


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A distal tingling sensation on percussion of median nerve of the inner wrist;
characteristic of carpal tunnel syndrome




Cervical spine spondylosis


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, Pain and stiffness in the neck and a radicular distribution of pain in one or
both arms.
Compression of the cervical cord can cause weakness, wasting, and
fibrillations in the upper limbs; paresthesias in the arms or legs; and
occasional evidence of pyramidal involvement (e.g., weakness, spasticity,
increased deep tendon reflexes, and presence of Babinski's sign).




Plantar Fasciitis


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​Plantar fasciitis is an overuse injury that affects the thick band of tissue
(fascia) connecting the heel bone to the base of the toes. The condition
typically starts gradually with mild pain at the heel bone that is often
referred to as a "stone bruise" and is more likely to be felt after exercise.
The condition is most common in women from ages 40-70 years, compared
to men.




otits media


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usually after URI
Pain is unilateral, deep, and severe
Irritability
Restlessness
Fever
Ear feels full
Physical findings:
tympanic membrane inflamed and bulging
Decreased light reflex
Decreased mobility on insufflation

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