NR 602 Final Exam
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1. A mother presents with her 3 month old child and complains of goopy eye
that is sometimes matted shut after naps. Upon exam the conjunctiva is clear
with some mild crusting to eye lashes. What is the diagnosis and patient
teaching?: Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, erythemic bump to eye-
lid. What is the diagnosis and patient education?: Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
3. What is blepharitis?: inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
4. What is the treatment for blepharitis?: Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult teeth, can cause discoloration.
Pediatrics can have Bactrim.
5. A 9 year old patient presents with acute swelling and erythema to eyelid with
flaky, scaly debris to eyelid margins. Patient reports gritty, burning feeling to
eyes. She has already attempted warm compresses and washing eyelids with
baby soap with minimal relief. What is the diagnosis and treatment?: Patient has
anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for kids <8
, NR 602 Final Exam
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6. What organism is likely to cause viral conjunctivitis?: -Adenovirus
-HSV
-Herpes
7. What organism is likely to cause bacterial conjunctivitis?: -Staph aureus
-strep pneumoniae
-H. Influenza
8. A 10-year-old patient presents with unilateral conjunctivitis with watery dis-
charge x 2 days along with itching of the eye. Mother denies any other associ-
ated symptoms. What is the diagnosis and treatment?: Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
9. What is herpes keratitis?: Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge, photo-
phobia, and eye redness. Upon exam you note fern-like lines under the woods
lamp. What is the diagnosis and tx?: Herpes Keratitis
Tx: Antivirals
11. A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye. Upon
inspection you visualize a n erythemic lesion to the eye. When using woods
lamp you note a small superficial laceration. What is the dx and tx?: Corneal abrasion,
refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with com-
plaints of pain to the groin, knee, and right hip. She reports patient has been
walking with a limp for the last couple days but unable to ambulate today.
Mother denies any recent trauma. Upon inspection there is external rotation
of the right foot. What is the dx and tx?: Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
, NR 602 Final Exam
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13. Father presents with his four-year-old son and states that patient has been
limping since this morning and was crying all night complaining of left hip
pain. Upon exam you appreciate decreased range of motion of left hip but
no external rotation or signs of trauma. What is the probable diagnostics, and
treatment?: Toxic transient syndrome- most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
-advise father that will resolve in 2-6 weeks.
- patient needs bed rest, NWB to left leg, and NSAIDS.
- return if develops fever, swelling, pain that is unrelieved by rest or medication
14. What degree is scoliosis is considered functional?: 5-10 degrees, continue to monitor.
15. What degree of scoliosis is considered mild?: <20 degrees, monitor every 3-4 months
16. A 13-year-old female presents to the office after having an x-ray order by you
for her scoliosis. The reading on the x-ray reports a 30° curvature. What is the
treatment plan?: Milwaukee brace for 23 hours per day
Back exercises
17. At what point does scoliosis become a surgical case?: Curves greater than 45°
18. A 16-year-old female presents to the office with complaint of right knee pain
with intermittent swelling. Upon questioning patient endorses pain is worse
when walking up or down stairs, kneeling, squatting, or sitting cross legged.
Patient denies any trauma but reports being active in cheer. What is the dx and
tx?: Chondromalacia petella "runners knee"
RICE and PT consult to strengthen quadriceps.
19. A five-year-old boy presents with his father for a complaint of pain in the
right knee that radiates to right groin. Father endorses that patient has been
ambulating with a intermittent limp, especially after exertion, and is refusing
to play baseball due to pain. Father denies any trauma. Upon inspection you
notice that patient is small for his age. There is no signs of infection or trauma
and no external rotation but pain when rolling the leg internally. What is the
Study online at https://quizlet.com/_bojgzq
1. A mother presents with her 3 month old child and complains of goopy eye
that is sometimes matted shut after naps. Upon exam the conjunctiva is clear
with some mild crusting to eye lashes. What is the diagnosis and patient
teaching?: Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, erythemic bump to eye-
lid. What is the diagnosis and patient education?: Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
3. What is blepharitis?: inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
4. What is the treatment for blepharitis?: Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult teeth, can cause discoloration.
Pediatrics can have Bactrim.
5. A 9 year old patient presents with acute swelling and erythema to eyelid with
flaky, scaly debris to eyelid margins. Patient reports gritty, burning feeling to
eyes. She has already attempted warm compresses and washing eyelids with
baby soap with minimal relief. What is the diagnosis and treatment?: Patient has
anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for kids <8
, NR 602 Final Exam
Study online at https://quizlet.com/_bojgzq
6. What organism is likely to cause viral conjunctivitis?: -Adenovirus
-HSV
-Herpes
7. What organism is likely to cause bacterial conjunctivitis?: -Staph aureus
-strep pneumoniae
-H. Influenza
8. A 10-year-old patient presents with unilateral conjunctivitis with watery dis-
charge x 2 days along with itching of the eye. Mother denies any other associ-
ated symptoms. What is the diagnosis and treatment?: Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
9. What is herpes keratitis?: Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge, photo-
phobia, and eye redness. Upon exam you note fern-like lines under the woods
lamp. What is the diagnosis and tx?: Herpes Keratitis
Tx: Antivirals
11. A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye. Upon
inspection you visualize a n erythemic lesion to the eye. When using woods
lamp you note a small superficial laceration. What is the dx and tx?: Corneal abrasion,
refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with com-
plaints of pain to the groin, knee, and right hip. She reports patient has been
walking with a limp for the last couple days but unable to ambulate today.
Mother denies any recent trauma. Upon inspection there is external rotation
of the right foot. What is the dx and tx?: Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
, NR 602 Final Exam
Study online at https://quizlet.com/_bojgzq
13. Father presents with his four-year-old son and states that patient has been
limping since this morning and was crying all night complaining of left hip
pain. Upon exam you appreciate decreased range of motion of left hip but
no external rotation or signs of trauma. What is the probable diagnostics, and
treatment?: Toxic transient syndrome- most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
-advise father that will resolve in 2-6 weeks.
- patient needs bed rest, NWB to left leg, and NSAIDS.
- return if develops fever, swelling, pain that is unrelieved by rest or medication
14. What degree is scoliosis is considered functional?: 5-10 degrees, continue to monitor.
15. What degree of scoliosis is considered mild?: <20 degrees, monitor every 3-4 months
16. A 13-year-old female presents to the office after having an x-ray order by you
for her scoliosis. The reading on the x-ray reports a 30° curvature. What is the
treatment plan?: Milwaukee brace for 23 hours per day
Back exercises
17. At what point does scoliosis become a surgical case?: Curves greater than 45°
18. A 16-year-old female presents to the office with complaint of right knee pain
with intermittent swelling. Upon questioning patient endorses pain is worse
when walking up or down stairs, kneeling, squatting, or sitting cross legged.
Patient denies any trauma but reports being active in cheer. What is the dx and
tx?: Chondromalacia petella "runners knee"
RICE and PT consult to strengthen quadriceps.
19. A five-year-old boy presents with his father for a complaint of pain in the
right knee that radiates to right groin. Father endorses that patient has been
ambulating with a intermittent limp, especially after exertion, and is refusing
to play baseball due to pain. Father denies any trauma. Upon inspection you
notice that patient is small for his age. There is no signs of infection or trauma
and no external rotation but pain when rolling the leg internally. What is the
