Conductive hearing loss involves what part of the ear? - ANSWER Middle ear
A potential complication of streptococcal pharyngitis that leads to contralateral uvular devia-
tion, asymmetric tonsillar hypertrophy, muffled voice on exam but no stridor, drooling, or
dyspnea or dysphagia is recognized as what? - ANSWER Peritonsillar abscess
A 64 year old woman presents to the office with complains of vision loss. Funduscopic exam-
ination reveals cupping of the optic nerve. Which action should you take? - AN-
SWER Send the pt to the ER
A 39 year old female presents with complaints of sudden onset of blurry vision. She states
that she sees flashing lights and it sensation that she is "looking through a curtain." Which
dx finding would the NP expect to find in this patient? - ANSWER Hemoglobin A1C of
12
Retinal detachment is a potential outcome of retinopathy of diabetes
A 16 year old presents to the urgent care clinic after a hard hit in football practice. During
the physical exam, the NP observes "battle's sign" and immediately refers the patient to the
ED. Which dx is the NP concerned about? - ANSWER Basal skull fx
A 4 year old male is brought into a clinic with complaints of fever and sore throat for 2 days.
the NP suspects a peritonsilar abscess and refers the pt to the ED. Which finding is most con-
sistent with this dx? - ANSWER Fever, sore throat, dysphagia, drooling, "hot potato"
voice
1
, A 40 year old female presents with complaints of soreness when eating spicy foods. The NP
observes that the patient has a "geographic tongue." What would be the most appropriate
for the patient's plan of care? - ANSWER Tell pt to rinse with salt water and avoid spicy
food until s/s resolve
A 2 year old boy presents to the clinic with a fever. During the physical exam the NP observes
Koplik's spots inside of his buccal mucosa. Which would be the most important to assess on
the pt to aid in an appropriate dx? - ANSWER Vaccination status
Koplik spots are seen with measles: small white spots on a reddened background that occur
on the inside of the cheeks
A 26 year old presents to a clinic with complaints of left eye pain. the NP performs fluores-
cent dye staining which reveals fern-like lines in the corneal surface. Which would be the
most appropriate hx question to ask the pt? - ANSWER have you ever had a cold sore?
A 17 year old female was dx with angular cheilitis. She had tx failure after a course of topical
abx, topical steroids, moisture barrier creams, and antifungals were rxed. What would be the
most appropriate next step in the pt's plan of care? - ANSWER Check vitamin B12 lev-
els
Most common cause is a fungal infection but can be from vitamin B12 deficiency and bacte-
rial infections
Which finding is most consistent with acute otitis externa? - ANSWER Pruritis and hx
of recent swimming
Otitis externa is referred to as "swimmers ear"
A 15 year old male pt presents to the clinic with abd pain and fatigue, and is dx with mono.
Which is the most important part of this patient's plan of care? - ANSWER Avoid con-
tact sports for up to 4 weeks
2
A potential complication of streptococcal pharyngitis that leads to contralateral uvular devia-
tion, asymmetric tonsillar hypertrophy, muffled voice on exam but no stridor, drooling, or
dyspnea or dysphagia is recognized as what? - ANSWER Peritonsillar abscess
A 64 year old woman presents to the office with complains of vision loss. Funduscopic exam-
ination reveals cupping of the optic nerve. Which action should you take? - AN-
SWER Send the pt to the ER
A 39 year old female presents with complaints of sudden onset of blurry vision. She states
that she sees flashing lights and it sensation that she is "looking through a curtain." Which
dx finding would the NP expect to find in this patient? - ANSWER Hemoglobin A1C of
12
Retinal detachment is a potential outcome of retinopathy of diabetes
A 16 year old presents to the urgent care clinic after a hard hit in football practice. During
the physical exam, the NP observes "battle's sign" and immediately refers the patient to the
ED. Which dx is the NP concerned about? - ANSWER Basal skull fx
A 4 year old male is brought into a clinic with complaints of fever and sore throat for 2 days.
the NP suspects a peritonsilar abscess and refers the pt to the ED. Which finding is most con-
sistent with this dx? - ANSWER Fever, sore throat, dysphagia, drooling, "hot potato"
voice
1
, A 40 year old female presents with complaints of soreness when eating spicy foods. The NP
observes that the patient has a "geographic tongue." What would be the most appropriate
for the patient's plan of care? - ANSWER Tell pt to rinse with salt water and avoid spicy
food until s/s resolve
A 2 year old boy presents to the clinic with a fever. During the physical exam the NP observes
Koplik's spots inside of his buccal mucosa. Which would be the most important to assess on
the pt to aid in an appropriate dx? - ANSWER Vaccination status
Koplik spots are seen with measles: small white spots on a reddened background that occur
on the inside of the cheeks
A 26 year old presents to a clinic with complaints of left eye pain. the NP performs fluores-
cent dye staining which reveals fern-like lines in the corneal surface. Which would be the
most appropriate hx question to ask the pt? - ANSWER have you ever had a cold sore?
A 17 year old female was dx with angular cheilitis. She had tx failure after a course of topical
abx, topical steroids, moisture barrier creams, and antifungals were rxed. What would be the
most appropriate next step in the pt's plan of care? - ANSWER Check vitamin B12 lev-
els
Most common cause is a fungal infection but can be from vitamin B12 deficiency and bacte-
rial infections
Which finding is most consistent with acute otitis externa? - ANSWER Pruritis and hx
of recent swimming
Otitis externa is referred to as "swimmers ear"
A 15 year old male pt presents to the clinic with abd pain and fatigue, and is dx with mono.
Which is the most important part of this patient's plan of care? - ANSWER Avoid con-
tact sports for up to 4 weeks
2
