NUR 431- DIAGNOSTIC REASONING
EXAM QUESTIONS WITH COMPLETE
ANSWERS
Acute glaucoma - Answer-Emergent referral! Severe pain, blurred vision, N/V
Dilated pupil with minimal to no response
Diffuse injection without discharge
IOP elevated; halos around lights
Retinal vessels - Answer-Branch to all 4 quadrants
Arteries brighter, slightly < veins
Small AV diameter= DM
A-V nicking
A-V nicking - Answer-vein compressed where arteries cross over
HTN and heart disease
Conjunctivitis - Answer-sac is red with exudate
Foreign body - Answer-evert eyelid with cotton swab
Ectropion - Answer-lower lid falls outward
Entropion - Answer-lower lid falls inward
Blepharospasm - Answer-eye fatigue; eye "twitching"
Chalazion - Answer-inflamed/ infected hair follicle that points inward
Hordeolum - Answer-(stye); infected/ inflamed hair follicle that points outward
Blepharitis - Answer-scaly, flaky eyelids caused by staph or seborrheic dermatitis
Tx: baby shampoo
Normal TM - Answer-pearly gray & flat with landmarks
Otitis media with effusion - Answer-ear feels clogged: ET blocked from URI, allergies
TM: yellow, **air bubbles**, retracted or bulging
Tx: decongestant or nasal corticosteroids
Acute otitis media - Answer-"Middle ear infection"
Painful with hearing loss, usually after URI
TM: erythematous, bulging, loss of landmarks
, Perforations: dark, oval
Scarring: dense white
Otitis Externa - Answer-"Swimmer's Ear"
Pain with movement of pinna and hearing loss
Canal swollen shut with debris and drainage
Infectious Rhinitis - Answer-associated with URI
Yellow, green discharge; mucosa erythematous
Allergic rhinitis - Answer-sneezing, itching, eye symptoms
Hallmark sign is itching
Cardinal signs: clear drainage, boggy and pale mucosa
Rhinitis medicamentosa - Answer-swelling without erythema or discharge; nose of
people who use decongestants/ have rebound congestion
Acute sinusitis - Answer-follows URI >1 week
Purulent discharge; mucosa red
Frontal and maxillary sinus tenderness
Fever, malaise, frontal and Baker's HA
Viral pharyngitis - Answer-Fever, malaise, HA, cough, fatigue
Pharynx erythematous w/o exudate
Strep pharyngitis - Answer-10% of ST in adults, 30% kids
Fever, malaise, HA, severe ST
Pharynx erythema with exudate
Anterior cervical lymphadenopathy; + strep test
Mono - Answer-low grade fever, mild ST, fatigue, malaise
Pharynx red with exudates
Post cervical lymphadenopathy, splenomegaly; + test
Apthous stomatitis - Answer-Canker sores: discrete ulcers last 1-2 weeks
Coherence - Answer-do physiology, predisposing factors & complications make sense?
Adequacy - Answer-Does your diagnosis explain all of the symptoms?
Parsimony - Answer-Is this the simplest explanation for the symptoms?
What part of your documentation do you put in your own words? - Answer-HPI and CC
Review of Systems (ROS) - Answer-reveals subjective symptoms that patient hasn't yet
mentioned
EXAM QUESTIONS WITH COMPLETE
ANSWERS
Acute glaucoma - Answer-Emergent referral! Severe pain, blurred vision, N/V
Dilated pupil with minimal to no response
Diffuse injection without discharge
IOP elevated; halos around lights
Retinal vessels - Answer-Branch to all 4 quadrants
Arteries brighter, slightly < veins
Small AV diameter= DM
A-V nicking
A-V nicking - Answer-vein compressed where arteries cross over
HTN and heart disease
Conjunctivitis - Answer-sac is red with exudate
Foreign body - Answer-evert eyelid with cotton swab
Ectropion - Answer-lower lid falls outward
Entropion - Answer-lower lid falls inward
Blepharospasm - Answer-eye fatigue; eye "twitching"
Chalazion - Answer-inflamed/ infected hair follicle that points inward
Hordeolum - Answer-(stye); infected/ inflamed hair follicle that points outward
Blepharitis - Answer-scaly, flaky eyelids caused by staph or seborrheic dermatitis
Tx: baby shampoo
Normal TM - Answer-pearly gray & flat with landmarks
Otitis media with effusion - Answer-ear feels clogged: ET blocked from URI, allergies
TM: yellow, **air bubbles**, retracted or bulging
Tx: decongestant or nasal corticosteroids
Acute otitis media - Answer-"Middle ear infection"
Painful with hearing loss, usually after URI
TM: erythematous, bulging, loss of landmarks
, Perforations: dark, oval
Scarring: dense white
Otitis Externa - Answer-"Swimmer's Ear"
Pain with movement of pinna and hearing loss
Canal swollen shut with debris and drainage
Infectious Rhinitis - Answer-associated with URI
Yellow, green discharge; mucosa erythematous
Allergic rhinitis - Answer-sneezing, itching, eye symptoms
Hallmark sign is itching
Cardinal signs: clear drainage, boggy and pale mucosa
Rhinitis medicamentosa - Answer-swelling without erythema or discharge; nose of
people who use decongestants/ have rebound congestion
Acute sinusitis - Answer-follows URI >1 week
Purulent discharge; mucosa red
Frontal and maxillary sinus tenderness
Fever, malaise, frontal and Baker's HA
Viral pharyngitis - Answer-Fever, malaise, HA, cough, fatigue
Pharynx erythematous w/o exudate
Strep pharyngitis - Answer-10% of ST in adults, 30% kids
Fever, malaise, HA, severe ST
Pharynx erythema with exudate
Anterior cervical lymphadenopathy; + strep test
Mono - Answer-low grade fever, mild ST, fatigue, malaise
Pharynx red with exudates
Post cervical lymphadenopathy, splenomegaly; + test
Apthous stomatitis - Answer-Canker sores: discrete ulcers last 1-2 weeks
Coherence - Answer-do physiology, predisposing factors & complications make sense?
Adequacy - Answer-Does your diagnosis explain all of the symptoms?
Parsimony - Answer-Is this the simplest explanation for the symptoms?
What part of your documentation do you put in your own words? - Answer-HPI and CC
Review of Systems (ROS) - Answer-reveals subjective symptoms that patient hasn't yet
mentioned
