nr 511 week 2 quiz 2 versions 1 nr 511 differential diagnosis and primary care practicum
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NR 511 Week 2: Quiz 2
Question 1
pts
A 67-year old female on multiple medications for chronic conditions was just diagnosed with gastroesophageal
reflux disease (GERD). In teaching the patient about the disease, what medication should the clinician
recommend that the patient refrain from using?
Correct Answer
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Oral contraceptives.
Antibiotics.
Antifungals.
Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already irritated gastric
mucosa.
Question 2
pts
When the Weber test is performed with a tuning fork to assess hearing and there is no lateralization, the
clinician should document this finding as:
Correct!
A normal finding.
Perceptive deafness.
Nerve damage.
Conductive deafness.
A Weber test assesses hearing by bone conduction. With normal hearing, sound is heard equally well in both
ears, meaning there is no lateralization.
Question 3
pts
A 26-year-old male recently returned from a camping trip with symptoms of acute gastroenteritis. He reports
that he only ate vegetables from his garden that he canned prior to his outing. Which of the following
pathogens might be causing his symptoms?
Staphylococcus.
Campylobacter jejuni.
Clostridium perfringens.orrect!
Clostridium botulinum.
C botulinum is an anaerobic, gram-positive bacillus that produces toxins. It is widely distributed in the soil and
vegetation. Improperly processed home-canned low-acid vegetables and contaminated meats are the usual
cause of food-borne botulism.
, Question 4
pts
A 29-year-old female just returned from Central America with traveler’s diarrhea and presents to the clinic for
evaluation. Which of the following is the best treatment?
Metronidazole (Flagyl).
Gastric lavage.orrect!
Supportive care.
Penicillin antibiotics.
Enterotoxigenic Escherichia coli (ETEC) is the most common cause of traveler’s diarrhea, which occurs after
ingesting contaminated food or water. It is usually self-limiting, requiring no treatment other than supportive
care. It is common in developing countries. Traveler’s diarrhea caused by E coli used to be frequently treated
with a 3- to 5-day course of a quinolone antibiotic, such as ciprofloxacin (Cipro).
Question 5
pts
A 75-year-old female presents to your office complaining of dizziness and ringing in both ears for 1 day. She
describes the dizziness as feeling like "the room is spinning". On physical exam, the Rinne test reveals that air
conduction is greater than bone conduction bilaterally. The Weber test reveals lateralization to the left. She is
unable to hear the examiner's whisper on the right side but can hear the whisper on the left side. What is the
next step in helping this patient’s symptoms?
Refer the patient to the Emergency Room.
Start her on high-dose Augmentinect!
Start the patient on a low-salt diet, prescribe meclizine for vertigo and refer her to an ENT specialist.
Order a computed tomography (CT) scan to rule out acoustic neuroma.
Meniere's disease is characterized by vertigo, tinnitus and hearing loss. The patient self-reports vertigo and
tinnitus while the results of the Weber, Rinne, and whisper test indicate sensorineural hearing loss on the right.
Meniere disease is diagnosed based on history and the exclusion of other conditions as well. Referral to ENT
is warranted to rule out other etiologies. The treatment for symptoms of Meniere disease is both dietary and
pharmacological. Antibiotics are not indicated, nor is it necessary to send the patient to the Emergency Room.
A CT scan would not help to relieve the patient's symptoms.
UnansweredQuestion 6
pts
In a young child, unilateral purulent rhinitis is most often caused by:
A foreign body.
An allergic reaction.
A bacterial infection.
A viral infection.
In a young child, unilateral purulent rhinitis is most often caused by a foreign body. The key word here is
unilateral.
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