Final Exam: NR569/ NR 569 (Latest 2023/ 2024 Update) Differential Diagnosis in Acute Care Practicum Exam Review| Week 5-8| Questions and Verified Answers| 100% Correct| Grade A- Chamberlain

Final Exam: NR569/ NR 569 (Latest 2023/ 2024 Update) Differential Diagnosis in Acute Care Practicum Exam Review| Week 5-8| Questions and Verified Answers| 100% Correct| Grade A- Chamberlain Q: ROS: EAR Have you noticed any drainage or blood coming from the ear? Answer: Purulent drainage is a commonly reported finding with AOE and cholesteatoma but may not be present. Drainage is not associated with AOM and OME unless the TM has ruptured. Q: Otitis media with effusion (OME) Answer: Otitis media with effusion (OME) is fluid in the middle ear, without the presence of infection. Causes: URI, barotrauma, allergies, or a recent AOM infection. Mild pain, conductive hearing loss may be present. Air bubbles are seen behind the TM. Q: Ear pain/infection: Management Answer: 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 Q: Acute Mastoiditis Answer: *Bacterial infection of the mastoid process* presents clinically with the same signs and symptoms as acute otitis medial with the addition of *inflammation and palpatory tenderness over the mastoid*, hearing loss is commonly associated with it, tympanic membrane is red, bulging, and immobile bc associated otitis media, should be suspected when discharge from middle ear is continuous for >10 days Q: TMJ Dysfunction Answer: referred ear pain acute: pain with opening mouth extremely wide chronic: malocclusion (from enlarged masseter muscles)/arthritis of TMJ clicking palpable crepitus Q: impacted cerumen Answer: rarely bilateral recurrent problem normal otologic findings Q: Some clients who present with throat pain may be at risk for airway compromise. The following signs/symptoms indicate the need for immediate intervention? Answer: respiratory distress drooling upper airway obstruction stridor Q: Mono treatment Answer: Serum diagnostics: Lymphocytosis Possible thrombocytopenia, mild relative and absolute neutropenia Elevated aminotransferases. Consider rapid strep test as symptoms mirror Group A Beta Hemolytic Streptococ- cus Monospot test will not become positive until symptoms present about 10 days. Heterophile antibody tests or EBV specific antibodies. There is no specific antiviral therapy used to treat the disease. Confirmatory testing is utilized to acknowledge disease and explain symptoms. Risks of splenic rupture are concerning. Educate patient and family on when to seek healthcare. Avoid contact sports. If EBV testing is negative, further evaluation is warranted to rule out HIV, cy- tomegalovirus, and toxoplasmosis. Q: Antibiotic resistance is rising to dangerously high levels in all parts of the world, including the United States. Which of the following diagnoses does NOT require antibiotics? Answer: peritonsillar abscess strep throat epiglottitis Ludwig's angina Wrong answer. mononucleosis Rationale: Mononucleosis is a viral illness, for which antibiotics are unnecessary. Peritonsillar abscess, Ludwig's angina, and epiglottitis may be bacterial or viral. Strep throat (GABHS) is bacterial, and antibiotics are appropriate. Q: Claudette is a 79-year-old who presents to urgent care with red, itchy eyes, itchy palate, and runny nose. She states she has had these symptoms at times in the past, but they have gotten "very bad" since moving to the Midwest to live with her daughter this fall. She has a past medical history of hypertension and is currently on Lisinopril 10 mg PO daily. Select all of the pharmacologic interventions you would recommend for Claudette Answer: The following medications should be recommended to patients with allergic rhinitis : Loratadine 10 mg PO once daily Antihistamine nasal spray Fluticasone nasal spray Cromolyn nasal spray . Q: Viral Pharyngitis Answer: Sore throat and the presence of a low-grade fever, myalgia, conjunctivitis, coryza, malaise, diarrhea, or fatigue Q: Diagnostic algorithm for the patient with a sore throat. RPA, Retro geal abscess. Answer: Q: Candidiasis Answer: Most prevalent in diabetic patients and in patients taking broad-spectrum antibiotics. Inhaled and nasal steroids predispose an individual to Candida pharyngitis. Q: Aphthous stomatitis Answer: Associated with Behçet's disease, Crohn's disease, ul- cerative colitis, malabsorption syndrome, gluten-sensitive enteropathy, PFAPA syn- drome, and human immunodeficiency virus (HIV) infection.