Eye, ear, nose, throat disorders (physical assessment, pharm and pathophysiology)exam study guide/questions and answers/verified 100%

Eye, ear, nose, throat disorders (physical assessment, pharm and pathophysiology)exam study guide/questions and answers/verified 100% 1. The nurse practitioner performs a fundoscopic exam on a patient who has recently been diagnosed with hypertension. What is significance of AV nicking? A. This is indicative of retinal detachment. B. This is indicative of long-standing hypertension. C. The patient should be screened for diabetes. D. This is a variant of normal. - correct answers-B. This is indicative of long-standing hypertension. (AV -arteriovenous- nicking can be observed as arteries cross veins when the arteries have narrowed secondary to hypertension. Generally, AV nicking takes time to develop and would be expected in patients with long-standing hypertension; especially when it is poorly controlled. Normally, veins are larger than arteries in the eyes. The vessels in the eyes are particularly susceptible to increased blood pressure. In severe hypertension, the retina can become detached.) 2. Mr. O has been diagnosed with hearing loss secondary to exposure to an ototoxic medication. Which one may be associated with ototoxicity? A. Digoxin B. Aspirin C. Ramipril D. Metoprolol - correct answers-B. Aspirin (Many medication's are otoxic in patients who are otherwise healthy. Some patients are at increased risk - for ototoxicity - when they consume ototoxic medications if they have impaired renal function. Renal impairment makes excretion of the ototoxic drug more difficult, and ototoxicity becomes more likely. Hearing loss secondary to use of the following medications should always be assessed: aspirin, aminoglycosides, vancomycin, erythromycin, loop diuretics (like Furosemide), the anti-malarial medication, sildenafil (tadalafil, vardenafil) and cisplatin. ACE Inhibitors, digoxin, and beta blockers are not associated with ototoxicity.) 3. A 70-year-old male has a yellowish, triangular nodule near the Iris. This is probably: A. a stye. B. a chalazion C. a pinguecula D. subconjunctival hemorrhage. - correct answers-C. a pinguecula (Pinguecula are common as patient's age. They usually appear on the nasal side first and then on the temporal side. This is a completely benign finding. A stye is also called a hordeolum. It is a tender, painful infection of a gland at the eyelid margin. These are self-limiting. A chalazion is a nontender enlargement of a meibomian gland. A subconjunctival hemorrhage is a blood red colored area on the sclera that does not affect vision. It occurs and resolve spontaneously.) A 93-year-old demented adult has been recently treated for an upper respiratory infection (URI) but drainage from the right nostril persists. What should the NP suspect? A. Allergic rhinitis B. Presence of a foreign body C. Unresolved URI D. Dental caries - correct answers-B. Presence of a foreign body (two clinical clues should make the examiner suspect a foreign body. First, the patient has continued drainage despite treatment. Second, the drainage is unilateral. Unilateral drainage from a nostril should prompt the examiner to visualize the turbinates. In this case, a foreign body could probably be visualized.) 5. A 70-year-old patient has begun to have hearing loss. She relates that her elderly parents had difficulty hearing. Which complaint below is typical of presbycusis? A. Inability to hear consonants B. asymmetrical loss of hearing C. Inability to hear low pitched sounds D. Pulsatile noise in the ear - correct answers-A. Inability to hear consonants. (Presbycusis is age related hearing loss. The significance of this patient's parental hearing loss is important for history. Presbycusis is influenced by genetics as well as noise exposure, medications, and infections. Loss of ability to hear speech in crowded rooms or noisy areas, inability to understand consonants, and loss of high-pitched sounds is typical. Hearing loss is symmetrical. Asymmetrical hearing loss is a red flag, regardless of the age at which it occurs. Tinnitus is common and is an annoying sensation associated with presbycusis. A pulsatile noise in the ear raises suspicion of a tumor or arteriovenous malformation.) 6. A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus toward nose. Tearing is present and when pressure is applied to the lacrimal sac, a purulent drainage from the puncta is noted. This is suggestive of: A. blepharitis B. dacrocystitis C. a hordeolum D. a chalazion - correct answers-B. dacrocystitis (dacrocystitis is infection and blockage of the lacrimal sac and duct. Symptoms include pain, warmth, redness, and swelling below the inner canthus toward nose. Tearing is present and when pressure is applied to lacrimal duct, a purulent drainage from the puncta is noted. Red, scaly, greasy flakes and thickened, crusted lid margins are consistent with blepharitis. Symptoms include burning, itching, tearing, foreign body sensation, and some pain. Hordeolum is a localized staphylococcal infection of the hair follicles at the lid margin. A beady nodule protruding on the lid, chalazion is an infection or retention cyst of a meibomian gland and if infected, it points inside and not on lid margin.) 7. A 58 year old farmer presents with a wedge shaped, pinkish, clear growth on the nasal side of his eye. He states that it has been present for a while, but only recently began to feel as if a foreign body was in the eye. This is probably a: A. Stye B. Pinguecula C. Xanthelasma D. Pterygium - correct answers-A. Pterygium (pterygia can occur in children, but it is more prevalent in older adults