NSG6420 QUIZ 2

1. Question : An 86-year-old patient who wears a hearing aid complains
of poor hearing in the affected ear. In addition to possible hearing aid
malfunction, this condition is often due to:

Acoustic neuroma

Cerumen impaction

Otitis media

Ménière’s disease

Question 2. In
examination of the nose, the clinician observes gray, pale mucous membranes
with clear, serous discharge. This is most likely indicative of:

Bacterial sinusitis

Allergic rhinitis

Drug abuse

Skull fracture

Question 3. A
45 year old patient presents with ‘sore throat’ and fever for one week. After a
quick strep screen you determine the patient has Strep throat. You know that
streptococcal pharyngitis should be treated with antibiotics to prevent
complications and to shorten the course of disease. Which of the following
antibiotics should be considered when a patient is allergic to Penicillin?

Amoxicillin

EES (erythromycin)

Bicillin L-A

Dicloxacillin

Question 4. Presbycusis
is the hearing impairment that is associated with:

Physiologic aging

Ménière’s disease

Cerumen impaction

Herpes zoster

Question 5. Epistaxis
can be a symptom of:

Over-anticoagulation

Hematologic malignancy

Cocaine abuse

All of the above

Question 6. Your
patient has been using chewing tobacco for 10 years. On physical examination,
you observe a white ulceration surrounded by erythematous base on the side of
his tongue. The clinician should recognize that very often this is:

Malignant melanoma

Squamous cell carcinoma

Aphthous ulceration

Behcet’s syndrome

Question 7. A 26 year old patient presents
with cough and general malaise for 3 days. They note that their eyes have been
watering clear fluid and a ‘runny nose’ since yesterday. They note they ‘feel
miserable’ and demand something to make them feel better. What would be the
best first plan of treatment?

Saline nasal spray for congestion and
acetaminophen as needed for pain.

Z-pack (azithromycin) for infection and
Cromolyn nasal for congestion

Hydrococone/acetaminophen as needed for pain
and Guaifensin for congestion

Cephalexin for infection and Cromolyn
ophthalmic for congestion

Question 8. Which of the following findings
should trigger an urgent referral to a cardiologist or neurologist?

History of bright flash of light followed by
significantly blurred vision

History of transient and painless monocular
loss of vision

History of monocular severe eye pain, blurred
vision, and ciliary flush

All of the above

Question 9. Dizziness that is described as
“lightheaded” or, “like I’m going to faint,” is usually
caused by inadequate cerebral perfusion and is classified as?

Presyncope

Disequilibrium

Vertigo

Syncope

Question 10. It is
important to not dilate the eye if ____ is suspected.

Cataract

Macular degeneration

Acute closed-angle glaucoma

Chronic open-angle glaucoma

Question 11. Mr. GC presents to the clinic
with nausea and vomiting for 2 days, prior to that time he reports occasional
‘dizziness’ that got better with change in position. He denies a recent history
of URI or any history of headaches or migraines. What would the most likely
diagnosis be?

Vestibular neruitis

Benign paroxysmal positional vertigo

Vestibular migraine

Benign hypertensive central vertigo

Question 12. Which
of the following patients with vertigo would require neurologic imaging?

A 68-year-old woman with a history of
hypertension and sudden acute onset constant vertigo. She has right nystagmus
that changes direction with gaze and that does not disappear when she focuses.

A 45-year-old man with recurrent episodes of
brief intense vertigo every time he turns his head rapidly. He has no other
neurologic signs or symptoms. He has a positive Dix-Hallpike maneuver.

A 66-year-old man with recurrent episodes of
vertigo associated with tinnitus and hearing loss. His head thrust test is
positive.

A 28-year-old otherwise well woman with new
onset constant vertigo with no other neurologic symptoms. On physical exam, she
has unidirectional nystagmus that disappears when her gaze is fixed.

Question 13. A patient presents with eye
redness, scant discharge, and a gritty sensation. Your examination reveals the
palpable preauricular nodes, which are most likely with:

Bacterial conjunctivitis

Allergic conjunctivitis

Chemical conjunctivitis

Viral conjunctivitis

Question 14. In assessing the eyes, which of
the following is considered a “red flag” finding when associated with eye
redness?

History of prior red-eye episodes

Grossly visible corneal defect

Exophthalmos

Photophobia

Question 15. A 64-year-old male presents with
erythema of the sclera, tearing, and bilateral pruritus of the eyes. The
symptoms occur intermittently throughout the year and he has associated clear
nasal discharge. Which of the following is most likely because of the
inflammation?

Bacterium

Allergen

Virus

Fungi

Question 16. Patients
that have atopic disorders are mediated by the production of Immunoglobulin E
(IgE) will have histamine stimulated as an immediate phase response. This
release of histamine results in which of the following?

Sinus pain, increased vascular permeability,
and bronchodilation

Bronchospasm, vascular permeability, and
vasodilatation

Contraction of smooth muscle, decreased
vascular permeability, and vasoconstriction

Vasodilatation, bronchodilation, and
increased vascular permeability

Question 17. You have a patient complaining
of vertigo and want to know what could be the cause. Knowing there are many
causes for vertigo, you question the length of time the sensation lasts. She
tells you several hours to days and is accompanied by tinnitus and hearing
loss. You suspect which of the following conditions?

Ménière’s disease

Benign paroxysmal positional vertigo

Transient ischemic attack (TIA)

Migraine

Question 18. In examining the mouth of an
older adult with a history of smoking, the nurse practitioner finds a
suspicious oral lesion. The patient has been referred for a biopsy to be sent
for pathology. Which is the most common oral precancerous lesion?

Fictional keratosis

Keratoacanthoma

Lichen planus

Leukoplakia

Question 19. Rheumatic heart disease is a complication that
can arise from which type of infection?

Student Answer: Epstein-Barr virus

Diphtheria

Group A beta hemolytic streptococcus

Streptococcus pneumoniae

Question 20. Question
: A patient complains of fever,
fatigue, and pharyngitis. On physical examination there is pronounced cervical
lymphadenopathy. Which of the following diagnostic tests should be considered?

Mono spot

Strep test

Throat culture

All of the above