NR 602 FINAL EXAM/NR 602 WEEK 8 FINAL EXAM 2023 ACTUAL EXAM
COMPLETE 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
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? - ANSWER:
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.
Nine-year-old patient presents with tender, swollen, erythemic bump to eyelid.
What is the diagnosis and patient education? - ANSWER: 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.
What is blepharitis? - ANSWER: inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
What is the treatment for blepharitis? - ANSWER: 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.
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? - ANSWER: 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
What organism is likely to cause viral conjunctivitis? - ANSWER: -Adenovirus
-HSV
,-Herpes
What organism is likely to cause bacterial conjunctivitis? - ANSWER: -Staph aureus
-strep pneumoniae
-H. Influenza
A 10-year-old patient presents with unilateral conjunctivitis with watery discharge x
2 days along with itching of the eye. Mother denies any other associated symptoms.
What is the diagnosis and treatment? - ANSWER: Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis? - ANSWER: Herpes viral infection to the eye caused by HSV.
A 19-year-old male presents with blurred vision, watery discharge, photophobia, and
eye redness. Upon exam you note fern-like lines under the woods lamp. What is the
diagnosis and tx? - ANSWER: Herpes Keratitis
Tx: Antivirals
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? - ANSWER: Corneal abrasion, refer to
optho emergently or send to ER.
A mother brings her nine-year-old overweight son to the clinic with complaints 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? - ANSWER: Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
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? - ANSWER: 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
What degree is scoliosis is considered functional? - ANSWER: 5-10 degrees, continue
to monitor.
What degree of scoliosis is considered mild? - ANSWER: <20 degrees, monitor every
3-4 months
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? - ANSWER: Milwaukee brace for 23 hours per day
Back exercises
At what point does scoliosis become a surgical case? - ANSWER: Curves greater than
45°
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? - ANSWER:
Chondromalacia petella "runners knee"
RICE and PT consult to strengthen quadriceps.
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 dx and tx? - ANSWER: Legg-Calve Perthes
disease- hip joint slips out of socket. Affects boys 4-10
Dx: X-ray (AP pelvis and frog-leg lateral views)
Tx: refer to ortho, NWB, Rest, NSAIDs, PT
LAST RESORT: surgery <6 years old or casting
A newborn presents to the office for a well-check, you are concerned about Cystic
Fibrosis, what test should be ordered? - ANSWER: 1st- IRT
2nd- if IRT positive then sweat test or gene analysis.
What is systems of cystic fibrosis? - ANSWER: -persistent diarrhea
-poor weight gain
-chronic cough
-respiratory problems
COMPLETE 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
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? - ANSWER:
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.
Nine-year-old patient presents with tender, swollen, erythemic bump to eyelid.
What is the diagnosis and patient education? - ANSWER: 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.
What is blepharitis? - ANSWER: inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
What is the treatment for blepharitis? - ANSWER: 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.
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? - ANSWER: 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
What organism is likely to cause viral conjunctivitis? - ANSWER: -Adenovirus
-HSV
,-Herpes
What organism is likely to cause bacterial conjunctivitis? - ANSWER: -Staph aureus
-strep pneumoniae
-H. Influenza
A 10-year-old patient presents with unilateral conjunctivitis with watery discharge x
2 days along with itching of the eye. Mother denies any other associated symptoms.
What is the diagnosis and treatment? - ANSWER: Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
What is herpes keratitis? - ANSWER: Herpes viral infection to the eye caused by HSV.
A 19-year-old male presents with blurred vision, watery discharge, photophobia, and
eye redness. Upon exam you note fern-like lines under the woods lamp. What is the
diagnosis and tx? - ANSWER: Herpes Keratitis
Tx: Antivirals
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? - ANSWER: Corneal abrasion, refer to
optho emergently or send to ER.
A mother brings her nine-year-old overweight son to the clinic with complaints 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? - ANSWER: Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
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? - ANSWER: 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
What degree is scoliosis is considered functional? - ANSWER: 5-10 degrees, continue
to monitor.
What degree of scoliosis is considered mild? - ANSWER: <20 degrees, monitor every
3-4 months
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? - ANSWER: Milwaukee brace for 23 hours per day
Back exercises
At what point does scoliosis become a surgical case? - ANSWER: Curves greater than
45°
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? - ANSWER:
Chondromalacia petella "runners knee"
RICE and PT consult to strengthen quadriceps.
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 dx and tx? - ANSWER: Legg-Calve Perthes
disease- hip joint slips out of socket. Affects boys 4-10
Dx: X-ray (AP pelvis and frog-leg lateral views)
Tx: refer to ortho, NWB, Rest, NSAIDs, PT
LAST RESORT: surgery <6 years old or casting
A newborn presents to the office for a well-check, you are concerned about Cystic
Fibrosis, what test should be ordered? - ANSWER: 1st- IRT
2nd- if IRT positive then sweat test or gene analysis.
What is systems of cystic fibrosis? - ANSWER: -persistent diarrhea
-poor weight gain
-chronic cough
-respiratory problems
