2024 NUR 652 MIDTERM WITH
CORRECT ANSWERS
A 5-year-old child is hit in the face with a baseball bat and is brought to the
clinic by a parent. An exam reveals three avulsed front teeth. Radiologic
studies are negative for facial fractures. What is the recommended
treatment? - CORRECT-ANSWERSRefer the child to the dentist immediately
for further evaluation
A child who was treated with amoxicillin and then amoxicillin-clavulanate for
acute otitis media is seen for follow-up. The primary care nurse practitioner
notes dull-gray tympanic membranes with a visible air-fluid level. The child is
afebrile and without pain. What is the next course of action? - CORRECT-
ANSWERSMonitoring ear fluid levels for 3 months
An adolescent has localized bleeding of the gums when brushing the teeth.
An exam of the mouth reveals the presence of plaque and calculus on the
teeth which are not loose. What will the primary care nurse practitioner
recommend? - CORRECT-ANSWERSConsistently brushing and flossing the
teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use? - CORRECT-
ANSWERScarbamide peroxide
A parent asks about ways to promote dental health in school-aged children
while on family vacation that are convenient while camping and picnicking.
What will the primary care nurse practitioner recommend? - CORRECT-
ANSWERSOffering gum containing xylitol after meals
A patient reports several episodes of acute vertigo, some lasting up to an
hour with associated nausea and vomiting. What is part of the initial
diagnostic workup for this patient? - CORRECT-ANSWERSAudiogram and MRI
A teen with a history of otitis externa asks about ways to prevent this
condition. What will the primary care nurse practitioner recommend? -
CORRECT-ANSWERSDrying the ear canal with a hair dryer
, A 7-month-old infant has had two prior acute ear infections and is currently
on the 10th day of therapy with amoxicillin-clavulanate after a failed course
of amoxicillin. The primary care nurse practitioner notes marker middle ear
effusion and erythema of the TM. The child is irritable and has a temperature
of 99.8. What is the next step in management of this child's infection? -
CORRECT-ANSWERSRefer the child to an otolaryngologist
A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What is
the likely cause of these symptoms? - CORRECT-ANSWERSSialolithiasis
A child complains of itching in both ears and is having trouble hearing. The
primary care nurse practitioner notes periauricular edema and marked
swelling of the external auditory canal and elicits severe pain when
manipulating the external ear structures. Which is an appropriate
intervention? - CORRECT-ANSWERSOrder ototopical antibiotic/corticosteroid
drops
During a well child assessment of an African American infant, the primary
care nurse practitioner notes a dark red-brown light reflex in the left eye and
a slightly brighter, red-orange light reflex in the right eye. The nurse
practitioner will... - CORRECT-ANSWERSrefer the infant to an ophthalmologist
Which are risk factors for development of cataracts? - CORRECT-
ANSWERSSmoking
Advancing age
UV light
A preschool age child who attend daycare has a 2 day history of matted
eyelids in the morning and burning and itching of the eyes. The primary care
NP notes yellow-green purulent discharge from both eyes, conjunctival
erythema and mild URI symptoms. Which action is correct? - CORRECT-
ANSWERSPrescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during
the night with right ear pain. The primary care NP notes an axillary
temperature of 100.5 and an erythematous, bulging TM. A tympanogram
reveals a peak of +15-mm H2O. What is the recommended treatment for this
child? - CORRECT-ANSWERSAn analgesic medication and watchful waiting
A patient complains of otalgia and difficulty hearing from one ear. The
provider performs an otoscopic exam and notes a dark brown mass in the
lower portion of the external canal blocking the patient's TM. What is the
initial action? - CORRECT-ANSWERSask the patient about previous problems
with the ear
CORRECT ANSWERS
A 5-year-old child is hit in the face with a baseball bat and is brought to the
clinic by a parent. An exam reveals three avulsed front teeth. Radiologic
studies are negative for facial fractures. What is the recommended
treatment? - CORRECT-ANSWERSRefer the child to the dentist immediately
for further evaluation
A child who was treated with amoxicillin and then amoxicillin-clavulanate for
acute otitis media is seen for follow-up. The primary care nurse practitioner
notes dull-gray tympanic membranes with a visible air-fluid level. The child is
afebrile and without pain. What is the next course of action? - CORRECT-
ANSWERSMonitoring ear fluid levels for 3 months
An adolescent has localized bleeding of the gums when brushing the teeth.
An exam of the mouth reveals the presence of plaque and calculus on the
teeth which are not loose. What will the primary care nurse practitioner
recommend? - CORRECT-ANSWERSConsistently brushing and flossing the
teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use? - CORRECT-
ANSWERScarbamide peroxide
A parent asks about ways to promote dental health in school-aged children
while on family vacation that are convenient while camping and picnicking.
What will the primary care nurse practitioner recommend? - CORRECT-
ANSWERSOffering gum containing xylitol after meals
A patient reports several episodes of acute vertigo, some lasting up to an
hour with associated nausea and vomiting. What is part of the initial
diagnostic workup for this patient? - CORRECT-ANSWERSAudiogram and MRI
A teen with a history of otitis externa asks about ways to prevent this
condition. What will the primary care nurse practitioner recommend? -
CORRECT-ANSWERSDrying the ear canal with a hair dryer
, A 7-month-old infant has had two prior acute ear infections and is currently
on the 10th day of therapy with amoxicillin-clavulanate after a failed course
of amoxicillin. The primary care nurse practitioner notes marker middle ear
effusion and erythema of the TM. The child is irritable and has a temperature
of 99.8. What is the next step in management of this child's infection? -
CORRECT-ANSWERSRefer the child to an otolaryngologist
A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What is
the likely cause of these symptoms? - CORRECT-ANSWERSSialolithiasis
A child complains of itching in both ears and is having trouble hearing. The
primary care nurse practitioner notes periauricular edema and marked
swelling of the external auditory canal and elicits severe pain when
manipulating the external ear structures. Which is an appropriate
intervention? - CORRECT-ANSWERSOrder ototopical antibiotic/corticosteroid
drops
During a well child assessment of an African American infant, the primary
care nurse practitioner notes a dark red-brown light reflex in the left eye and
a slightly brighter, red-orange light reflex in the right eye. The nurse
practitioner will... - CORRECT-ANSWERSrefer the infant to an ophthalmologist
Which are risk factors for development of cataracts? - CORRECT-
ANSWERSSmoking
Advancing age
UV light
A preschool age child who attend daycare has a 2 day history of matted
eyelids in the morning and burning and itching of the eyes. The primary care
NP notes yellow-green purulent discharge from both eyes, conjunctival
erythema and mild URI symptoms. Which action is correct? - CORRECT-
ANSWERSPrescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during
the night with right ear pain. The primary care NP notes an axillary
temperature of 100.5 and an erythematous, bulging TM. A tympanogram
reveals a peak of +15-mm H2O. What is the recommended treatment for this
child? - CORRECT-ANSWERSAn analgesic medication and watchful waiting
A patient complains of otalgia and difficulty hearing from one ear. The
provider performs an otoscopic exam and notes a dark brown mass in the
lower portion of the external canal blocking the patient's TM. What is the
initial action? - CORRECT-ANSWERSask the patient about previous problems
with the ear
