NR-511 Differential Diagnosis & Primary Care Practicum

NR511 Midterm Exam Q & A

When you are assessing the internal structure of the eye of your 59-year-old patient, the

absence of a red reflex may indicate:

- A cataract or hemorrhage into the vitreous humor.

What significant finding(s) in a 3-year-old child with otitis media with effusion would prompt

more

- There is a change in the child's hearing threshold to greater than 25 dB.

Max, age 35, states that he thinks he has an ear infection because he just flew back from a

business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next

action?

- Prescribe nasal steroids and oral decongestants.

Susan is a 19-year-old college student and avid swimmer. She frequently gets swimmer's ear

and asks if there is anything, she can do to help prevent it other than wearing earplugs, which

do not really work for her. What do you suggest?

- Start using a cotton-tipped applicator to dry the ears after swimming.

Use ear drops made of a solution of equal parts alcohol and vinegar in each ear after

swimming.

Mary, age 82, presents with several eye problems. She states that her eyes are always dry and

look "sunken in." What do you suspect?

- Normal age-related changes.

Nystatin (Mycostatin) is ordered for Michael, a 56-year-old banker who has an oral fungal

infection. What instructions for taking the medication do you give Michael?

- "Swish and swallow the medication."

The most common cause of a white pupil (leukokoria or leukocoria) in a newborn is:

- A congenital cataract.

You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergency

room. Which of the following symptoms would indicate that an airway obstruction is

imminent?

- Stridor.

A 27-year-old female comes in to your primary care office complaining of a perioral rash. The

patient noticed burning around her lips a couple days ago that quickly went away. She awoke

from sleep yesterday and noticed a group of vesicles with erythematous bases where the

burning had been before. There is no burning today. She is afebrile and has no difficulty eating

or swallowing. What test would confirm her diagnosis?

- Tzanck smear.

Which condition is not included in the atopic triad?

- Aspirin sensitivity.

The ABCDEs of melanoma identification include which of the following?

- Asymmetry: one half does not match the other half.

Your 24-year-old client whose varicella rash just erupted yesterday asks you when she can go

back to work. What do you tell her?

- "Once all the vesicles are crusted over."