ExamI1:INURSI620/INURS620I(LatestI2024
/I2025IUpdate)IAdult/GerontologyIHealth
ICareIIIGuideI|IQsI&IAs|I100%ICorrect|I
GradeIAI(VerifiedIAnswers)-IMaryville
Q:ISignsIandISymptomsIofIOtitisIExterna
Answer:
"Swimmer'sIEar"
oIInflammationIofItheImembranesIliningIofItheIauditoryIcanalaIand/orIcontiguousIstructuresIof
ItheIouterIear
oICommonlyIcausedIbyImicrobialIinfectionI(p.306)
oISubjective:Iacute,IsevereIotalgiaIwithIsuddenIorIgradualIonset
oIPainImayIbeIworseIatInight,IchewingImayIelicitIoticIpain
oIPruritic
oIPurulentIdischarge
oITendernessIonItractionIofItheIpinna
oIAuditoryIcanalIusuallyIisIedematousIandIerythematous,IpreventingIfullIvisualizationIofItheIe
xternalIcanalIandItympanicImembrane
oIMayIcultureItheIfluidIinItheIearIforIantibioticIsensitivity
Q:ITreatmentIofIOtitisIExterna
Answer:
-IHeat,INSAIDSIorIacetaminophen,IkeepIearIdry,InoIswimmingI4-6Iweeks
-ICiprofloxacinIHC:I3IgttsIBIDIxI7days
-INeomycin/PolymyxinBIHCI(Cortisporin)I3gttsITIDIx7days
-ICortaneIBIAQ:I4-5gttITIDIx7days
-ISystemicICiproI(ifIneeded):I500mgIBIDIx7days
,Q:IOtitisIMedia
Answer:
oIInflammationIofItheIstructuresIofItheImiddleIear
oIChronicIotitisImediaIisIusuallyImoreIthanI3ImonthsIandIrelatedItoItympanicImembraneIperfo
ration
oIMostIsignificantIprecipitatingIevenIisIaIrecentIorIconcurrentIURII(p.311)
oIAllergies,Isinusitis,IrhinitisIandIpharyngitisIcanIallIcauseIswellingIofItheImembranesIliningIt
heIeustachianItubeIandIcauseIOM
Q:ISubjectiveISignsIofIOtitisIMedia
Answer:
-IStuffiness,Ifullness,IandIaIlossIofIauditoryIacuityIinItheIaffectedIearIonly
-
IOME:IPainIisIrare;ImayIdescribeIpopping,Icrackling,IorIgurglingIsoundsIwhenIchewing,Iyawn
ing,IorIblowingItheInose
-
IAOM:I"deep"IearIpainIandIfever,IunilateralIhearingIloss,IoticIdischarge,IsomeImayIhaveIverti
goIorIdizziness.IPainIusuallyIsubsidesIifItheItympanicImembraneIrupturesIbecauseIitIrelievesIp
ressure
-IRareIvertigo
Q:IObjectiveISignsIofIOtitisIMedia
Answer:
-IMucousImembranesIofInasalIandIoralIcavitiesImayIbeIinjectedIorIedematous
-
ITheIeardrumImayIbeIdullIbutIusuallyIisInotIbulging,IandIeardrumImobilityItypicallyIdecrease
sIonIpneumaticIotoscopy
Q:IWhatIisItheIdifferenceIbetweenIOtitisIMediaIandIOtitisIExterna?
,Answer:
InflammationIofItheIauditoryIcanalIand/orIeternalIear,IincludingItheIpinnaIandItragus,IoccurIinI
OtitisIExterna.ITheseIstructuresIareIusuallyInotIaffectedIinIotitisImedia,IandIotitisIexternaItypic
allyIdoesInotIinvolveItheItympanicImembrane"I(p.315,IlastIparagraph).
Q:ISignsIandISymptomsIofIGroupIAIB-HemolyticIStrepI(GABHS)
Answer:
AcuteIonsetIofIfever,IsoreIthroat,Iheadache,Ipain,IcervicalIlymphadenopathyI(anteriorIpartIofIt
heIneck),ItonsilllopharyngealIexudates
Q:IWhatIisItheIfirstIlineIofItreatmentIforIGABHS?
Answer:
•PenIVI500mgIBIDIxI10Idays
•BenzathineIPenIGIIMI1.2ImillionIunits
•AmoxicillinI500ImgIBIDIxI10Idays
•IfIpenIallergy:Ierythromycin,Icephalexin,Icefadroxil,IandIazithromycinIareIalternatives
Q:IWhatIisIClosedIAngleIGlaucoma?
Answer:
SuddenIonsetIsevereIeyeIpain,Ivomiting,IimpairedIvisionIandIheadache.IRainbowIaroundIlights
IatInightIandIblurredIvision
***MEDICALIEMERGENCY-referItoIophthalmologistIASAP
Q:ISymptomsIofIClosedIAngleIGlaucoma
, Answer:
MayIreportIseeingIrainbowIhalosIaroundIlights.IWillIhaveIcornealIcloudinessIwithIdiffuseIconj
unctivalIhyperemia.IPupilImayIbeImoderatelyIdilatedIandIcompletelyIunresponsiveItoIlight.IRe
ferItoIophthalmologistIimmediately.I(p.275)
Q:IFirstILineITreatmentIforIAcuteIBacterialIRhinosinusitisI(ARBS)
Answer:
•Analgesics
•IntranasalIsteroids
•Decongestant
•Second-generationIantihistaminesI(allergyIcomponent)
•NasalIsalineIirrigation
•LocalIheat,IgoodIhydration
•NotIenoughIdataItoIsupportItheIuseIofIguaifenesin
**StartIabxIifIsymptomsIworsenIafterI7Idays,InoIimprovementIafterI10Idays,Ihigh-
gradeIfeverI+IsevereIpain
Q:IWhatIisIsecondIlineItreatmentIofIARBSIafterIfirstIlineItreatmentIfails?
Answer:
-AugmentinI875mg/125mgIBIDITreatIforI10Idays
-
IfItreatmentIfailureIorIriskIfactorsIforIresistance:IHDIAugmentinI2000mg/125mgIBIDIforI10Id
ays
-
IfIPCNIallergy:IDoxycyclineI100mgIBIDIforI10Idays,IorIClindamycinI150mgIQIDI+Icefixime
I400mgIdailyIforI10Idays
-LevofloxacinI500mgIdailyIforI10IdaysI(notIinIelderlyIandIlastIoption)
Q:IMacularIDegeneration