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NUR 676 Final Exam Latest 2024/
Complete Question And Answer (graded
A)
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 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 A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A PE reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend? daily intranasal steroids What are potential complications of chronic or recurrent sinusitis? Meningitis, orbital infection, and osteomyleitis.
A patient has fever, nausea, anorexia, and RUQ pain. An US is negative for gallstones, which action is necessary? Hospitalization for emergent treatment. What is the most common cause of pancreatitis in the US? Gallstones A patient reports a sudden onset of constant, sharp abd pain to the back. The examiner notes both direct and rebound tenderness with palpation of the abd. What is the significance of this finding? severe acute pancreatitis with peritonitis. The provider suspects that a patient has chronic pancreatitis. Which dx test will be most helpful to confirm this dx? blood glucose and fecal fat A patient has intermittent Left sided abd pain and fever associated with bloating and constipation alternating with diarrhea. The provider suspects acute diverticulitis. Which tests should be ordered? CT scan of abd and pelvis, stool for occult blood.
A patient has a hx of of diverticular disease and asks what can be done to minimize acute symptoms. what will the practitioner recommend? consuming a diet high in fiber A patient who has a hx of diverticular disease has left sided pain and reports seeing blood in the stool. What is an important interventions for these symptoms? referring patient for lower EGD. A patient has a recent episode of vomiting and describes the vomitus as containing mostlymgastric juice. what does this symptom suggest? peptic ulcer A patient has persistent epigastric pain occurring 2-3 hours after a meal. Which test is definitive for diagnosis peptic ulcer in this patient? Endoscopy with biopsy of gastric mucosas. What is the best treatment for H. pylori related PUD? PPI, clarithromycin, for 14 days A patient who has been taking an NSAID for osteoarthritis pain has PUD. What is the initial step in treating this patient?
A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers in the ED? remove the offending chemical and garments A 50 year old previously healthy patient has developed chronic gastritis. What is most likely cause of the condition? H. pylori infection A recovering alcoholic reports nausea, vomiting diarrhea, and abd discomfort. a PE is negative for jaundice or scrites. What will the provider do initially? Order a CBC and liver function tests An adult patient who had pertussis immunization is exposed to pertussis and develops a runny nose, low grade fever, and URI illness with paroxysmal cough. What is recommendation? Azithromycin daily for 5 days
A patient develops a dry, non-productive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms? Antitussive medication A patient develops acute bronchitis and is diagnosed with having influenza. Which medication will help reduce the duration of symptoms in this patient? Oseltamivir Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesis, alond with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS does this patient have? MFS A patient has a cough and fever, the provider ausculates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to onset of cough. A CT shows patchy, nonhomogeneous infiltrates. Based on these findings what organism likely caused this? Mycoplasma A young adult, previously healthy clinic patient has symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient?
A patient who has asthma calls the provider to report having a peak flow measure of 75%, shortness of breath, wheezing, and cough. tells the provider that the symptoms have not improved significantly after a dose of albuterol. the patient uses an inhaled corticosteroid medication twice daily. What will provider reccomend? administering two more doses of albuterol . An adult develops chronic cough with episodes of wheezing and shortness of breath. the provider performs chest radiography and other tests and rules out infection, upper respiratory, and GERD. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms? Spirometry a patient is seen in a clinic for an asthma exacerbation. the provider administers three nebulizer treatments with little improvement, noting a pulse ox reading of 90% with 2L of oxygen. A peak flow assessment is 70%. what is the next step in treating this patient? admit to the hospital with specialist consultation A patient with a purulent skin and soft tissue infection. A hx reveals a previous MRSA infection in a family member. THe clinician performs an incision and drainage of the lesion and send a sample to the lab for culture. what is the next step in treating this patient? prescribe oral clindamycin
a previously healthy patient has an area of inflammation on one leg which has well demarcated borders and the presence of lymphangitis streaking. Based on the symptoms what is initial treatment? Amox-clav A child has vesicuopustular lesions around the nose and mouth with areas of honey colored crusts. The provider notes a few similar lesions on the child's hands and legs. Which treatment is appropriate for this child? amox-clav A patient has eyelid swelling with erythema and warmth and reports pain with eye movement. Which dx test will be performed to confirm diagnosis of orbital cellulitis? CBC, CT scan of orbits Which is the most common cause of orbital cellulitis in all age groups? local spread from the ethmoid sinus A child has unilateral eyelid edema, warmth and erythema and does not exhibit pain with ocular movement. Which is most likely true about this child's infection? The eye is typically spared without conjunctivitis
A 60 year old patient with a previous history of shingles asks about the herpes zoster vaccine. What will the provider recommend? a single dose of herpes zoster vaccine a patient who has recurrent frequent genital herpes outbreaks asks about therapy to minimizw the episodes, what will the provider reccomend as first-line treatment? acyclovir A patient who has never had an outbreak of oral lesions reports a burning sensation on the oral mucosa and then develops multiple painful rounds vesicles at the site. A tzanck culture confirms HSV-1 infection. What will the provider tell the patient about this condition? the initial episode is usually the most severe An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella, What will the provider tell her? contagion is possible until all of her lesions are crusted.
A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order? PCR analysis which medication will the provider prescribe as first-line therapy to treat tinea capitis? Oral griseofulvin when collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape which portion of the lesion? the active, leading border When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a wood lam and is unable to elicit fluoroesence. how is this significant? the patient may have tinea capitis. What is true about electrical injuries> alternating current causes skeletal muscle contraction, electrical injury may cause more necrosis, lightening is less lethal because duration of shock is short.
A patient has a gradually enlarging nodule on one upper eyelid and reports that the lesion is painful. On exam, the lesion appears warm and erythematous. the provider knows that this is likely what? Hordeolum A patient reports he has been using artificial tears for comfort because of burning and itching in both eyes, but reports worsening symptoms. the provider notes redness and discharge along the eyelid margins. what is recommended treatment? Compresses, lid scrubs, and antibiotic ointment A patient who has a cold develops conjunctivitis. The provider notes erythema of one eye with profuse, watery discharge and enlarged anterior cervical lymph nodes, along with a fever. Which treatment is inidcated. artificial tears and cool compresses A patient reports bilateral reports burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. Which type of conjunctivitis is most likely? Allergic conjunctivitis . A patient with allergic conjunctivitis who has been using topical antihistamine- vasosonstrictor medication reports worsening symptoms. What is the providers;s next step managing the patient's symptoms?
determine duration of treatment with medication
