NR 511 MIDTERM + FINAL EXAM – QUESTIONS AND ANSWERS - NEW, GRADED A+

A 20-year-old male presents to your primary care clinic. This patient is a college student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose and throat exam shows mild erythema of the nasal mucosa and edematous, enlarged tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar exudates. He has inflamed posterior cervical lymph nodes. He has a mild nonproductive cough and clear lung exam. What is his most likely diagnosis? • Viral pharyngitis. Mononucleosis (This presentation could be a viral pharyngitis; however, with posterior cervical lymphadenitis, you would suspect mononucleosis) • Streptococcal pharyngitis. • Upper respiratory infection. Which of the following is not a complication of untreated group A streptococcal pharyngitis? • Glomerulonephritis. • Rheumatic heart disease. • Scarlet fever. Hemolytic anemia (This is a complication of mononucleosis) Jonathan, age 19, has just been given a diagnosis of mononucleosis. Which of the following statements is true? Antibiotic therapy should be instructed to avoid stress and that convalescence may take several weeks) utensils. Bed rest is necessary only in severe cases) The virus that causes mononucleosis is transmitted through saliva, hence the nickname the “kissing disease.” It is contagious and can be transmitted through kissing or sharing Jonathan should avoid contact sports and heavy lifting (When teaching clients about mononucleosis, or Epstein-Barr virus (EBV), tell them to avoid contact sports and heavy lifting because of splenomegaly and a threat of rupture) 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? A Monospot test (If a client has a persistent sore throat, fever, and malaise not relieved by penicillin therapy, a Monospot test should be performed to rule out mononucleosis (Epstein-Barr virus)