NUR 676 Final Exam Questions and
Correct Answers
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve the
pain. What is the next action? ✅Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment
elevation MI (STEMI). The nearest hospiral that can perform a PCI is three hours away,
what is the initial treatment for this patient. ✅Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits
pain when manipulating the ear structures, what is likely the diagnosis? ✅acute otitis
externa
Which are risk factors for developing otitis externa? ✅having underlying DM, use of
ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's
ear canal is mildly inflamed and the TM is not involved. Which medication will be
ordered? ✅Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to
determine the severity of pain in children with OM? ✅Appetite, Difficulty sleeping, and
tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment
without initial antibiotic therapy? ✅A 36 month old with fever of 38.5, mild otalgia, and
red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is
unable to visualize the TM in the right ear because of the presence of cerumen. The left
TM is dull gray with fluid levels present. What is the correct action? ✅Remove the
cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a
small tear in the TM of the affected ear with purulent d/c. What is the initial treatment for
this patient? ✅Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes
a perforated TM. What is recommended treatment? ✅Refer the patient to an
Otolaryngologist for eval
, An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes
foul-smelling breath and a muffled voice with marked edema and erythema of the
peritonsillar tissue. What should you do? ✅Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's symptoms.
✅Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider
notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause? ✅viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the
previous year. The child's parents ask the provider if the child needs a tonsillectomy.
What will the provider say? ✅Current recommendations do not support tonsillectomy
for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin.
On the third day of treatment, the patient develops a rash. A urinalysis is normal. what
does this indicate? ✅A reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious Mono and
is noted to have splenomegaly. What will the provider recommend to this patient about
returning to sports? ✅ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy and has
negative GAS culture. A cbc shows absolute lymphocytosis, but a heterophil antibody
test is negative for EBV. What will the provider tell the patient? ✅The likelihood of EBV
is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on the right
side for 4 months. There is no hx of sneezing or eye involvement, The patient has a hx
of seasonal allergies and takes a non-sedating antihistamine. What does the provider
suspect is the cause of these symptoms? ✅chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal polyps.
What is first-line treatment? ✅Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and
thin, clear nasal secretions. The provider notes puffiness around the eyes. The patient;s
vital signs are normal. What is likely diagnosis? ✅allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity to trees
and grasses. What is first line treatment for this patient? ✅intranasal steroids
Correct Answers
A patient reports recurrent chest pain that occurs regardless of activity and is not
relieved by rest. The provider administers one NG tablet which does not relieve the
pain. What is the next action? ✅Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment
elevation MI (STEMI). The nearest hospiral that can perform a PCI is three hours away,
what is the initial treatment for this patient. ✅Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits
pain when manipulating the ear structures, what is likely the diagnosis? ✅acute otitis
externa
Which are risk factors for developing otitis externa? ✅having underlying DM, use of
ear plugs or hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's
ear canal is mildly inflamed and the TM is not involved. Which medication will be
ordered? ✅Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to
determine the severity of pain in children with OM? ✅Appetite, Difficulty sleeping, and
tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment
without initial antibiotic therapy? ✅A 36 month old with fever of 38.5, mild otalgia, and
red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is
unable to visualize the TM in the right ear because of the presence of cerumen. The left
TM is dull gray with fluid levels present. What is the correct action? ✅Remove the
cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a
small tear in the TM of the affected ear with purulent d/c. What is the initial treatment for
this patient? ✅Prescribe antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes
a perforated TM. What is recommended treatment? ✅Refer the patient to an
Otolaryngologist for eval
, An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes
foul-smelling breath and a muffled voice with marked edema and erythema of the
peritonsillar tissue. What should you do? ✅Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical
lymphadenopathy. What will the provider do next to manage this patient's symptoms.
✅Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider
notes mild erythema of the pharynx and clear rhinorrhea without cervical
lymphadnopathy. what is most likely cause? ✅viral pharyngitis
A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the
previous year. The child's parents ask the provider if the child needs a tonsillectomy.
What will the provider say? ✅Current recommendations do not support tonsillectomy
for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin.
On the third day of treatment, the patient develops a rash. A urinalysis is normal. what
does this indicate? ✅A reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious Mono and
is noted to have splenomegaly. What will the provider recommend to this patient about
returning to sports? ✅ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy and has
negative GAS culture. A cbc shows absolute lymphocytosis, but a heterophil antibody
test is negative for EBV. What will the provider tell the patient? ✅The likelihood of EBV
is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on the right
side for 4 months. There is no hx of sneezing or eye involvement, The patient has a hx
of seasonal allergies and takes a non-sedating antihistamine. What does the provider
suspect is the cause of these symptoms? ✅chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal polyps.
What is first-line treatment? ✅Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and
thin, clear nasal secretions. The provider notes puffiness around the eyes. The patient;s
vital signs are normal. What is likely diagnosis? ✅allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity to trees
and grasses. What is first line treatment for this patient? ✅intranasal steroids
