age 1 of 39
WOMEN’S HEALTH NR 602 FINAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) ALREADY GRADED
A+
Step 1 Asthma approach-Intermittent ......ANSWER........symptoms
2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent
......ANSWER........Symptoms >2 x a week, less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
,age 2 of 39
Step 3 Asthma Approach-Moderate Persistant
......ANSWER........daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent
......ANSWER........continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma ......ANSWER........Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
,age 3 of 39
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach ......ANSWER........
Bulbar/palpebral conjunctival infection ......ANSWER........May be
unilateral or bilateral
Leukocoria ......ANSWER........abnormal appearance of a white
film in the pupil; immediate referral to pediatric ophthalmologist
warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn
retinoblastoma
Visual screening in children ......ANSWER........At least once
between ages 3-5 y/o according to USPSTF
AOM ......ANSWER........RF: genetics, males, Native American,
siblings, low economic status, ages 6mo-3y, winter, supine bottle
feeding, daycare, tobacco smoke
S/S of AOM ......ANSWER........erythema, otalgia, bulging TM,
absent cone of light
Dx of AOM ......ANSWER........Audiometry, tympanometry,
possible lateral neck xray to r/o mass
, age 4 of 39
TX of AOM ......ANSWER........uncomplicated: supportive with
tylenol/ibuprofen; watchful waiting 48-72 in 6m-2y/o; <5
benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis ......ANSWER........Preceded by URI-
typically worsens after 5-7 days- not resolved in 2 weeks
Sx of bacterial rhinosinusitis ......ANSWER........Purulant nasal
congestion, drainage, facial pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis ......ANSWER........Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis ......ANSWER........Increased work of
breathing, prolonged expiration, grunting, retractions, nasal
flaring
Croup sx ......ANSWER........Low grade fever, URI symptoms,
barking cough, inspiratory stridor can occur
WOMEN’S HEALTH NR 602 FINAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) ALREADY GRADED
A+
Step 1 Asthma approach-Intermittent ......ANSWER........symptoms
2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent
......ANSWER........Symptoms >2 x a week, less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
,age 2 of 39
Step 3 Asthma Approach-Moderate Persistant
......ANSWER........daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent
......ANSWER........continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma ......ANSWER........Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
,age 3 of 39
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach ......ANSWER........
Bulbar/palpebral conjunctival infection ......ANSWER........May be
unilateral or bilateral
Leukocoria ......ANSWER........abnormal appearance of a white
film in the pupil; immediate referral to pediatric ophthalmologist
warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn
retinoblastoma
Visual screening in children ......ANSWER........At least once
between ages 3-5 y/o according to USPSTF
AOM ......ANSWER........RF: genetics, males, Native American,
siblings, low economic status, ages 6mo-3y, winter, supine bottle
feeding, daycare, tobacco smoke
S/S of AOM ......ANSWER........erythema, otalgia, bulging TM,
absent cone of light
Dx of AOM ......ANSWER........Audiometry, tympanometry,
possible lateral neck xray to r/o mass
, age 4 of 39
TX of AOM ......ANSWER........uncomplicated: supportive with
tylenol/ibuprofen; watchful waiting 48-72 in 6m-2y/o; <5
benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis ......ANSWER........Preceded by URI-
typically worsens after 5-7 days- not resolved in 2 weeks
Sx of bacterial rhinosinusitis ......ANSWER........Purulant nasal
congestion, drainage, facial pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis ......ANSWER........Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis ......ANSWER........Increased work of
breathing, prolonged expiration, grunting, retractions, nasal
flaring
Croup sx ......ANSWER........Low grade fever, URI symptoms,
barking cough, inspiratory stridor can occur
