M4 Dunphy Exam Questions and Answers 100% Correct

M4 Dunphy Exam Questions and Answers 100% Correct A 64-year-old obese woman comes in complaining of difficulty swallowing for the past 3 weeks. She states that "some foods get stuck" and she has been having "heartburn" at night when she lies down, especially if she has had a heavy meal. Occasionally, she awakes at night coughing. She denies weight gain and/or weight loss, vomiting, or change in bowel movements or color of stools. She denies alcohol and tobacco use. There is no pertinent family history or findings on review of systems (ROS). Physical examination is normal, with no abdominal tenderness, and the stool is occult blood (OB) negative. What is the most likely diagnosis? - Correct Answer ️️ -GERD The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is: - Correct Answer ️️ -Amoxicillin and potassium clavulanate (Augmentin) Which of the following statements about macular degeneration is not true? - Correct Answer ️️ -Macular degeneration is characterized by gradual loss of peripheral vision *central vision You are the nurse practitioner caring for Martha, a 47-year-old accountant. You have made a diagnosis of acute sinusitis based on Martha's history and the fact that she complains of pain behind her eye. Which sinuses are affected? - Correct Answer ️️ - Ethmoid A 62-year-old woman presents to your clinic with a sudden right-sided headache that is worse in her right eye. She states that her vision seems blurred, and her right pupil is dilated and slow to react. The right conjunctiva is markedly injected, and the eyeball is firm. You screen her vision and find that she is 20/30 OS and 20/30 OD. She most likely has: - Correct Answer ️️ -Angle-closure glaucoma *sudden onset Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful red eye without discharge. You should suspect: - Correct Answer ️️ -Iritis *rarely discharge A 44-year-old banker 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 to 10. The pain has been constant for the past several hours and is accompanied by nausea and sensitivity to light. He has had frequent, though less severe, headaches for many years, 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 he has been under a lot of stress in his job. Based on this description, what is the most likely diagnosis of this type of headache? - Correct Answer ️️ -Migraine What is the most common cause of epistaxis? - Correct Answer ️️ -Digital trauma Which of the following is not a cause of conductive hearing loss? - Correct Answer ️️ - Presbycusis Which of the following is not recommended for hoarseness? - Correct Answer ️️ -Oral steroids Jill, a 34-year-old bank teller, presents with symptoms of hay fever. She complains of nasal congestion, runny nose with clear mucus, and itchy nose and eyes. On physical assessment, you observe that she has pale nasal turbinates. What is your diagnosis? - Correct Answer ️️ -Allergic rhinitis (aka hay fever) Mario, a 17-year-old high school student, came to the office for evaluation. He is complaining of persistent sore throat, fever, and malaise not relieved by the penicillin therapy prescribed recently at the urgent care center. As the nurse practitioner, what would you order next? - Correct Answer ️️ -A Monospot test A 65-year-old man presents complaining of a left-sided, deep, throbbing headache and mild fatigue. On examination, the client has a tender, tortuous temporal artery. You suspect giant cell arteritis (GCA), or temporal arteritis. What is the least invasive procedure to help with diagnosis? - Correct Answer ️️ -Erythrocyte sedimentation rate (ESR) When you are assessing the internal structure of the eye of your 59-year-old patient, the absence of a red reflex may indicate: - Correct Answer ️️ -A cataract or hemorrhage into the vitreous humor Kevin, age 26, has AIDS and presents to the clinic with complaints of a painful tongue covered with what look like creamy white, curdlike patches overlying erythematous mucosa. You are able to scrape off these "curds" with a tongue depressor, which assists you in making which of the following diagnoses? - Correct Answer ️️ -Oral candidiasis Kevin, a 56-year-old lawyer, has throbbing pain in the left eye, an irregular pupil shape, marked photophobia, and redness around the iris. What is your initial diagnosis? - Correct Answer ️️ -Iritis Mattie, age 64, presents with blurred vision in 1 eye and states that it felt like "a curtain came down over my eye." She doesn't have any pain or redness. What do you suspect? - Correct Answer ️️ -Retinal detachment You prescribe Levaquin (levofloxacin) for a severe sinus infection. What is not a possible adverse reaction to this medication? - Correct Answer ️️ -Stevens-Johnson syndrome *usually caused by allopurinol and beta-lactam abx A 6-year-old female presents to your pediatric office with her mother complaining of right ear pain for 3 days. This pain resolved with Tylenol. The patient has also had noted fevers of 101.3°F over the last 2 nights. The patient had a nonproductive cough for 7 days prior to the ear pain. On physical exam, the patient has tenderness with tugging on the auricle of the ear. The tympanic membrane is not mobile with pneumatic otoscopy and is erythematous and full. The patient has no drainage from the ear and no mastoid tenderness. What is the next step? - Correct Answer ️️ -Amoxicillin 80 to 90 mg/kg/d