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NURS 631 ADVANCED HEALTH ASSESSMENT EXAM 1 2024/2025 QUESTIONS AND CORRECT ANSWERS GRADED A+ D’YOUVILLE UNIVERSITY LATEST Which eye condition has an increased cup to disc ratio? Glaucoma What are some examples of sensorineural hearing loss? - Presbycusis - Medications - Meniere's disease - Loud noises - Acoustic Neuroma on CN 8 Which medications cause reversible toxicity to the ear? NSAIDS
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Which eye condition has an increased cup to disc ratio?
Glaucoma
What are some examples of sensorineural hearing loss?
Which medications cause reversible toxicity to the ear?
NSAIDS
Which medications cause IRREVERSIBLE toxicity to the ear?
Gentamycin, tobramycin, vancomycin, glycopyrolates
What are some medications that can be used to treat an otitis externa?
Ciprodex and Ofloxacin
What are some examples of conductive hearing loss?
Upon doing the Webber test, the patient states that the sound is being heard louder in the UNAFFECTED EAR. What type of hearing loss is this considered?
Sensory Hearing loss
Upon doing the Webber test, the patient states that the sound is being heard louder in the AFFECTED EAR. What type of hearing loss is this considered?
Conductive Hearing loss
Gradual, painless, progressive loss of vision with glare that occurs when driving at night
Cataracts
An ______________ cataract does NOT obscure the red reflex.
Immature
An ________________ catract obscures the red reflex because it produces a gray pupillary reflex known as leukoria.
Mature
This diagnosis is associated with PERIPHERAL vision loss
Glaucoma
This diagnosis is associated with loss of CENTRAL vision loss
Macular Degeneration
This diagnosis is associated with seeing FLOATERS and flashing lights
Retinal detachment
Near sightedness
Myopia
Far sightedness
Hyperopia
Presbyiopia
Old age loss of near vision
How can the pinhole test be used as a diagnostic test for cataracts?
If it improves without corrective lenses, then it's a refractory error. If it does not improve, then it is an organic cause (cataracts)
Cataracts with visual acuity better than 20/
Type 1
Cataracts with visual acuity of 20/40 or WORSE
Type 2
What are some of the medication treatments that can be used for an ACUTE attack of Meniere's disease?
What is the first line of treatment for Meniere's Disease?
Low salt diet with mild thiazide diuretic (supplement Potassium)
When should you refer a patient with tinnitus?
If the hearing loss is PROGRESSIVE and if the patient has persistent vomiting, seizures or fever.
What is the diagnostic term for hoarseness?
Dysphonia
What should you suspect in a patient that is 50-70 year old man with hoarseness?
Laryngeal cancer
What are the steps for diagnostic reasoning for hoarseness?
Which medications should someone with hoarseness avoid?
Antihistamines
When should you refer a patient with hoarseness?
If symptoms last longer than 2 weeks
What is the most common location for epistaxis to occur?
What is the third line of treatment for epistaxis?
Cauterize with silver nitrate
These patients have clicking, popping or crepitus with movement of the jaw
Temporomandibular Disorders
What is the treatment for TMD?
What is the most common cause of hyperthyroidism?
Grave's Disease (autoimmune)
What is the most common cause of hypothyroidism in the US?
Hashimoto's Thyroiditis
What does an elevated TSH with a normal T4 indicate?
Subclinical hypothyroidism
Which medications can cause hypothyroidism?
-Interferon a
Explain the process of TSH and T3/T4 secretion
Hypothalamus secretes TRH
TRH tells anterior pituitary to release TSH
TSH tells thyroid gland to release T3 and T
This type of hypothyroidism is autoimmune disorder of the thyroid gland itself
What are the normal lab levels for free T4?
0.7- 2.
What are the normal lab levels for cortisol?
6- 23
What are subjective signs of hypothyroidism?
What are some of the cardiovascular, GI and neuro objective symptoms for hypothyroidism?
Which thyroid level is more specific for Hypothyroidism?
free T
Which lab values are associated with hypothyroidsim?
What dose of levothyroxine should be started in a patient who has coronary artery disease?
One HALF of the expected dose 20-50 mcg/day gradually increasing the dose by 25 mcg every 4-6 weeks
Calcitonin would be elevated in ______________
Hyperplasia in the thyroid
Thyroglobulin would be elevated in _________________
Thyroiditis, thyroid cancer
Which diagnostic test would you order for Hashimoto's?
Anti-TPO
What does an elevated T3 and low TSH indicate?
Hyperthyroidism
What education would you provide to a patient starting on levothyroxine?
Take it in the morning on an empty stomach.
DO NOT increase the dose yourself
DO NOT allow pharmacy to change the generic or brand names
Which drugs can interfere with the absorption of levothyroxine?
Iron
Cipro
Calcium carbonate
Aluminum hydroxide
Sucralfate
Tube feedings
Bile acids sequestrants
C. Voice Changes
D. Fatigue
Which thyroid level is more specific to hyperthyroidism?
T
What are the symptoms of hyperthyroidism?
-Anxiety
What are the common lab values that present for Hyperthyroidism?
DECREASED TSH
What are symptoms of a thyroid storm?
High fever, tachycardia, hypertension, sweating, and restlessness
