6531 Final Deck 2
Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and occasional
epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist - ANSC. You do nothing except for client
teaching
- Can occur with pregnancy because of increased vascularization in the upper respiratory tract
David, age 32, states that he thinks he has an ear infection because he just flew back from a
business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next
action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist - ANSA. Prescribe nasal steroids and oral
decongestants
A sexual history of oral-genital contact in a client presenting with pharyngitis is significant when
which of the following organisms is suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae - ANSC. Neisseria gonorrhoeae
- Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis - ANSD. Presbycusis
How do you describe the cervical lymphadenopathy associated with asymptomatic HIV
infection?
A. Movable, discrete, soft, and nontender lymph nodes
B. Enlarged, warm, tender, firm, but freely movable lymph nodes
C. Hard, unilateral, nontender, and fixed lymph nodes
D. Firm but not hard, nontender, and mobile lymph nodes - ANSD. Firm but not hard, nontender,
and mobile lymph nodes
,You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergeny
room. Which of the following symptoms would indicate that an airway obstruction is imminent?
A. Reddened face
B. Screaming
C. Grabbing her throat
D. Stridor - ANSD. Stridor
Purulent matter in the anterior chamber of the eye is called
A. Hyphema
B. Hypopyon
C. Anisocoria
D. Pterygium - ANSB. Hypopyon
A 42 year old stockbroker comes to your office for evaluation of a pulsating headache over the
left temporal region and he rates the pain as an 8 on a scale of 1-10. The pain has been
constant for the past several hours and is accompanied by nausea and sensitivity to light. He
has had frequent headaches for many years but not as severe and they are usually relieved by
over the counter medicines. He is unclear as to a precipitating event but notes that he has had
visual disturbances before each headache and has been under a lot of stress in his job. Based
on this description, what is the most likely diagnosis of this type of headaache?
A. Tension
B. Migraine
C. Cluster
D. Temporal arteritis - ANSB. Migraine
The trachea deviates toward the affected side in all of the following except
A. Aortic aneurysm
B. Unilateral thyroid lobe enlargement
C. Large atelectasis
D. Pneumothorax - ANSC. Large atelectasis
Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his symptoms. He
is taking cimetidine (Tagamet) for gastroesophageal reflux disease. Which medication would
you not order?
A. A first-generation antihistamine
B. A second-generation antihistamine
C. A decongestant
D. A topical nasal corticosteroid - ANSB. A second-generation antihistamine
Jessica, an 8 year old third grader is broght to the office by her grandmother, who is the child's
babysitter. She has complained of fever and sore throat for the past 2 days. Five other children
in her class have been sick with sore throats. She denies difficulty swallowing and has been
drinking fluids but has no appetite. ROS reveals that she has clear nasal drainage, hoarseness,
and nonproductive cough. She denies vomiting but has had mild diarrhea. On examination she
,has a temperature of 101.5 F, 3+ erythematous tonsils, and palpable, tender cervical lymph
nodes. Based on these findings, what is the most likely diagnosis?
A. Mono
B. Sinusitis
C. Strep pharyingitis
D. Viral pharyngitis - ANSD. Viral pharyngitis
Marcia, age 4, is brought into the office by her mother. She has a sore throat, difficulty
swallowing, copious oral secretions, respiratory difficulty, stridor, and a temperature of 102 F but
no pharyngeal erythema or cough. What do you suspect?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal infection pharyngitis
C. Tonsillitis
D. Diphtheria - ANSA. Epiglottitis
You note a completely split uvula in Noi, a 42 year old Asian. What is your next course of
action?
A. Do nothing
B. Refer Noi to a specialist
C. Perform a throat culture
D. Order a CBC - ANSA. Do nothing
Claude, age 78, is being treated with timolol maleate (Timoptic) drops for his chronic open-angle
glaucoma. While performing a new client history and physical, you note that he is taking other
medications. Which medication would you be most concerned about?
A. Apsirin therapy as prophylaxis for heart attack
B. Ranitidine (Zantac) for gastroesophageal reflux disease
C. Alprazolam (Xanax), an anxiolytic for anxiety
D. Atenolol (Tenormin), a beta blocker for high blood pressure - ANSD. Atenolol (Tenormin), a
beta blocker for high blood pressure
Harry, age 69, has had Meniere's disease for several years. He has some hearing loss but now
has persistent vertigo. What treatment might be instituted to relieve the vertigo?
A. A labyrinthectomy
B. Pharmacological therapy
C. A vestibular neurectomy
D. Wearing an earplug in the ear with the most hearing loss - ANSC. A vestibular neurectomy
A 65 year old man presents complaining of left sided deep, throbbing headache along with mild
fatigue. On examination the client has a tender, tortuous temporal artery. You suspect temporal
arteritis. How do you confirm your diagnosis?
A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
, D. Otoscopy - ANSB. Erythrocyte sedimentation rate (ESR)
Marty has a hordeolum in his right eye. You suspect that the offending organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli - ANSB. Staphylococcus
The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity - ANSA. Pollens of grasses, trees, and weeds
Cydney, age 7, is complaining that she feels as though something is stuck in her ear. What
action is contraindicated?
A. Inspecting the ear canal with an otoscope
B. Using a small suction device to try to remove the object
C. Flushing the ear with water
D. Instilling several drops of mineral oil in the ear - ANSC. Flushing the ear with water
June, age 50, presents with soft, raised, yellow plaques on her eyelids at the inner canthus. She
is concerned that they may be cancerous skin lesions. You tell her they are probably
A. Xanthelasmas
B. Pingueculae
C. The result of arcus senilis
D. Actinic keratoses - ANSA. Xanthelasmas
Mavis is 70 years old and wonders if she can donate her corneas when she dies. How do you
respond?
A. "As long as you don't have any chronic illness, you corneas may be harvested."
B. "They will use corneas only from persons younger than age 65."
C. "What makes you feel like you are dying?"
D. "Don't think about such terrible things now." - ANSB. "They will use corneas only from
persons younger than age 65."
Manny, age 16, was hit in the eye with a baseball. He developed pain in the eye, decreased
visual acuity, and injection of the globe. You confirm the diagnosis of hyphema by finding blood
in the anterior chamber. What treatment would you recommend while Manny is waiting to see
the ophthalmologist?
A. Apply bilateral eye patches
B. Have Manny lie flat
C. Refer him to an ophthalmologist within a week
Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and occasional
epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist - ANSC. You do nothing except for client
teaching
- Can occur with pregnancy because of increased vascularization in the upper respiratory tract
David, age 32, states that he thinks he has an ear infection because he just flew back from a
business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next
action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist - ANSA. Prescribe nasal steroids and oral
decongestants
A sexual history of oral-genital contact in a client presenting with pharyngitis is significant when
which of the following organisms is suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae - ANSC. Neisseria gonorrhoeae
- Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis - ANSD. Presbycusis
How do you describe the cervical lymphadenopathy associated with asymptomatic HIV
infection?
A. Movable, discrete, soft, and nontender lymph nodes
B. Enlarged, warm, tender, firm, but freely movable lymph nodes
C. Hard, unilateral, nontender, and fixed lymph nodes
D. Firm but not hard, nontender, and mobile lymph nodes - ANSD. Firm but not hard, nontender,
and mobile lymph nodes
,You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergeny
room. Which of the following symptoms would indicate that an airway obstruction is imminent?
A. Reddened face
B. Screaming
C. Grabbing her throat
D. Stridor - ANSD. Stridor
Purulent matter in the anterior chamber of the eye is called
A. Hyphema
B. Hypopyon
C. Anisocoria
D. Pterygium - ANSB. Hypopyon
A 42 year old stockbroker comes to your office for evaluation of a pulsating headache over the
left temporal region and he rates the pain as an 8 on a scale of 1-10. The pain has been
constant for the past several hours and is accompanied by nausea and sensitivity to light. He
has had frequent headaches for many years but not as severe and they are usually relieved by
over the counter medicines. He is unclear as to a precipitating event but notes that he has had
visual disturbances before each headache and has been under a lot of stress in his job. Based
on this description, what is the most likely diagnosis of this type of headaache?
A. Tension
B. Migraine
C. Cluster
D. Temporal arteritis - ANSB. Migraine
The trachea deviates toward the affected side in all of the following except
A. Aortic aneurysm
B. Unilateral thyroid lobe enlargement
C. Large atelectasis
D. Pneumothorax - ANSC. Large atelectasis
Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his symptoms. He
is taking cimetidine (Tagamet) for gastroesophageal reflux disease. Which medication would
you not order?
A. A first-generation antihistamine
B. A second-generation antihistamine
C. A decongestant
D. A topical nasal corticosteroid - ANSB. A second-generation antihistamine
Jessica, an 8 year old third grader is broght to the office by her grandmother, who is the child's
babysitter. She has complained of fever and sore throat for the past 2 days. Five other children
in her class have been sick with sore throats. She denies difficulty swallowing and has been
drinking fluids but has no appetite. ROS reveals that she has clear nasal drainage, hoarseness,
and nonproductive cough. She denies vomiting but has had mild diarrhea. On examination she
,has a temperature of 101.5 F, 3+ erythematous tonsils, and palpable, tender cervical lymph
nodes. Based on these findings, what is the most likely diagnosis?
A. Mono
B. Sinusitis
C. Strep pharyingitis
D. Viral pharyngitis - ANSD. Viral pharyngitis
Marcia, age 4, is brought into the office by her mother. She has a sore throat, difficulty
swallowing, copious oral secretions, respiratory difficulty, stridor, and a temperature of 102 F but
no pharyngeal erythema or cough. What do you suspect?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal infection pharyngitis
C. Tonsillitis
D. Diphtheria - ANSA. Epiglottitis
You note a completely split uvula in Noi, a 42 year old Asian. What is your next course of
action?
A. Do nothing
B. Refer Noi to a specialist
C. Perform a throat culture
D. Order a CBC - ANSA. Do nothing
Claude, age 78, is being treated with timolol maleate (Timoptic) drops for his chronic open-angle
glaucoma. While performing a new client history and physical, you note that he is taking other
medications. Which medication would you be most concerned about?
A. Apsirin therapy as prophylaxis for heart attack
B. Ranitidine (Zantac) for gastroesophageal reflux disease
C. Alprazolam (Xanax), an anxiolytic for anxiety
D. Atenolol (Tenormin), a beta blocker for high blood pressure - ANSD. Atenolol (Tenormin), a
beta blocker for high blood pressure
Harry, age 69, has had Meniere's disease for several years. He has some hearing loss but now
has persistent vertigo. What treatment might be instituted to relieve the vertigo?
A. A labyrinthectomy
B. Pharmacological therapy
C. A vestibular neurectomy
D. Wearing an earplug in the ear with the most hearing loss - ANSC. A vestibular neurectomy
A 65 year old man presents complaining of left sided deep, throbbing headache along with mild
fatigue. On examination the client has a tender, tortuous temporal artery. You suspect temporal
arteritis. How do you confirm your diagnosis?
A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
, D. Otoscopy - ANSB. Erythrocyte sedimentation rate (ESR)
Marty has a hordeolum in his right eye. You suspect that the offending organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli - ANSB. Staphylococcus
The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity - ANSA. Pollens of grasses, trees, and weeds
Cydney, age 7, is complaining that she feels as though something is stuck in her ear. What
action is contraindicated?
A. Inspecting the ear canal with an otoscope
B. Using a small suction device to try to remove the object
C. Flushing the ear with water
D. Instilling several drops of mineral oil in the ear - ANSC. Flushing the ear with water
June, age 50, presents with soft, raised, yellow plaques on her eyelids at the inner canthus. She
is concerned that they may be cancerous skin lesions. You tell her they are probably
A. Xanthelasmas
B. Pingueculae
C. The result of arcus senilis
D. Actinic keratoses - ANSA. Xanthelasmas
Mavis is 70 years old and wonders if she can donate her corneas when she dies. How do you
respond?
A. "As long as you don't have any chronic illness, you corneas may be harvested."
B. "They will use corneas only from persons younger than age 65."
C. "What makes you feel like you are dying?"
D. "Don't think about such terrible things now." - ANSB. "They will use corneas only from
persons younger than age 65."
Manny, age 16, was hit in the eye with a baseball. He developed pain in the eye, decreased
visual acuity, and injection of the globe. You confirm the diagnosis of hyphema by finding blood
in the anterior chamber. What treatment would you recommend while Manny is waiting to see
the ophthalmologist?
A. Apply bilateral eye patches
B. Have Manny lie flat
C. Refer him to an ophthalmologist within a week
