Final Exam: NR569/ NR 569 (Latest 2023/ 2024 Update) Differential Diagnosis in Acute Care Practicum Exam Review| Week 5-8| Questions and Verified Answers| 100% Correct| Grade A- Chamberlain
Final Exam: NR569/ NR 569 (Latest 2023/
2024 Update) Differential Diagnosis in Acute
Care Practicum Exam Review| Week 5-8|
Questions and Verified Answers| 100%
Correct| Grade A- Chamberlain
Q: ROS: EAR
Have you noticed any drainage or blood coming from the ear?
Answer:
Purulent drainage is a commonly reported finding with AOE and cholesteatoma but may not be
present.
Drainage is not associated with AOM and OME unless the TM has ruptured.
Q: Otitis media with effusion (OME)
Answer:
Otitis media with effusion (OME) is fluid in the middle ear, without the presence of infection.
Causes: URI, barotrauma, allergies, or a recent AOM infection. Mild pain, conductive hearing
loss may be present.
Air bubbles are seen behind the TM.
Q: Ear pain/infection: Management
Answer:
ear pain may be treated with OTC analgesics avoid scratching, tugging, or inserting anything in
the ear, including cotton-tipped swabs
reinforce water precautions with TM ruptured
avoid getting water in the ear during bathing/shower avoid submerging ear under water
Q: Acute Mastoiditis
Answer:
*Bacterial infection of the mastoid process*
presents clinically with the same signs and symptoms as acute otitis medial with the addition of
*inflammation and palpatory tenderness over the mastoid*,
hearing loss is commonly associated with it,
tympanic membrane is red, bulging, and immobile bc associated otitis media, should be
suspected when discharge from middle ear is continuous for >10 days
Q: TMJ Dysfunction
Answer:
referred ear pain
acute: pain with opening mouth extremely wide
chronic: malocclusion (from enlarged masseter muscles)/arthritis of TMJ
clicking
palpable crepitus
Q: impacted cerumen
Answer:
rarely bilateral recurrent problem
normal otologic findings
Q: Some clients who present with throat pain may be at risk for airway compromise. The
following signs/symptoms indicate the need for immediate intervention?
Answer:
respiratory distress
drooling
upper airway obstruction stridor
Q: Mono treatment
Answer:
Serum diagnostics: Lymphocytosis
Possible thrombocytopenia,
mild relative and absolute neutropenia
Elevated aminotransferases.
Consider rapid strep test as symptoms mirror Group A Beta Hemolytic Streptococ- cus
Monospot test will not become positive until symptoms present about 10 days. Heterophile
antibody tests or EBV specific antibodies.
There is no specific antiviral therapy used to treat the disease.
Confirmatory testing is utilized to acknowledge disease and explain symptoms. Risks of splenic
rupture are concerning.
Educate patient and family on when to seek healthcare. Avoid contact sports.
If EBV testing is negative, further evaluation is warranted to rule out HIV, cy- tomegalovirus,
and toxoplasmosis.
Q: Antibiotic resistance is rising to dangerously high levels in all parts of the world, including
the United States. Which of the following diagnoses does NOT require antibiotics?
Answer:
peritonsillar abscess
strep throat epiglottitis Ludwig's angina Wrong answer. mononucleosis
Rationale: Mononucleosis is a viral illness, for which antibiotics are unnecessary. Peritonsillar
abscess, Ludwig's angina, and epiglottitis may be bacterial or viral. Strep throat (GABHS) is
bacterial, and antibiotics are appropriate.
Q: Claudette is a 79-year-old who presents to urgent care with red, itchy eyes, itchy palate, and
runny nose. She states she has had these symptoms at times in the past, but they have gotten
"very bad" since moving to the Midwest to live with her daughter this fall. She has a past
medical history of hypertension and is currently on Lisinopril 10 mg PO daily. Select all of the
pharmacologic interventions you would recommend for Claudette
Answer:
The following medications should be recommended to patients with allergic rhinitis :
Loratadine 10 mg PO once daily
Antihistamine nasal spray
Fluticasone nasal spray
Cromolyn nasal spray .
Q: Viral Pharyngitis
Answer:
Sore throat and the presence of a low-grade fever, myalgia, conjunctivitis, coryza, malaise,
diarrhea, or fatigue
Q: Diagnostic algorithm for the patient with a sore throat. RPA, Retro
geal abscess.
Answer:
Q: Candidiasis
Answer:
Most prevalent in diabetic patients and in patients taking broad-spectrum antibiotics.
Inhaled and nasal steroids predispose an individual to Candida pharyngitis.
Q: Aphthous stomatitis
Answer:
Associated with Behçet's disease, Crohn's disease, ul- cerative colitis, malabsorption syndrome,
gluten-sensitive enteropathy, PFAPA syn- drome, and human immunodeficiency virus (HIV)
infection.
Q: streptococcal pharyngitis.
Answer:
Marked erythema and swelling of the throat (often associated with exudative pharyngitis or
tonsillitis)
Tender anterior cervical adenopathy
Fever
Occurrence between September and April
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