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Sarah Michelle Live Review Study Guide Exam Questions and Complete Solutions Graded A+
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  A new graduate nurse practitioner has a patient presents with a hearing complaint. The patient states that they have had decreased hearing on the right side for the last month that is continuing to get worse. The NP completes both the Rinne and Weber tests. If the patient has Ménière's disea...

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  • August 11, 2024
  • 75
  • 2024/2025
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Sarah Michelle Live
Review Study Guide
Exam Questions and
Complete Solutions
Graded A+
Denning [Date] [Course title]

,A new graduate nurse practitioner has a patient presents with a hearing complaint. The patient states
that they have had decreased hearing on the right side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?



1. AC is 2 times longer than BC

2. BC is 2 times longer than AC

3. The tuning fork lateralizes to the right ear

4. The tuning fork lateralizes to the left ear - Answer: 4. The tuning fork lateralizes to the left ear



What are common signs and symptoms of Meniere's Disease? - Answer: Vertigo, tinnitus, ear pressure,
nystagmus



What is our biggest worry for a Meniere's Disease patient? - Answer: There is a possibility for a
potential, permanent hearing loss.



What is rhinitis meidcamentosa? - Answer: Drug-induced rebound nasal congestion, this can happen
after use of nasal decongestants like Afrin. These nasal decongestants should ideally not be used for
greater than 3-5 days because of this risk.



What is herpes keratitis? - Answer: This is an infection of the cornea due to herpes simplex virus



How is herpes keratitis diagnosed? - Answer: By examining the eye under a black lamp and visualized
the cornea, in herpes keratitis, fern like lines will be seen on the cornea



A child that has a history of mononucleosis is at increased risk for development for what cancer later in
life? And why? - Answer: Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the exposure of
the Epstein-Barr virus



What types of patients will be at a higher risk of pneumonia? - Answer: Patient with chronic lung
diseases: asthma, COPD, cystic fibrosis.

,Why are cough suppressants not helpful in pneumonia patients? - Answer: Because we WANT them to
get that gunk out, we do not want them to hold it in their lungs, an expectorant would be a better
option for these patients.



When should a follow up chest X-Ray be completed after treatment of pneumonia? - Answer: Around 8
week mark



What is COPD? - Answer: Chronic Obstructive Pulmonary Disease. This is a chronic condition that is
made up of chronic bronchitis and emphysema. It is a progressive inflammatory lung disease that makes
it hard for the patients to breathe, because the chronic bronchitis leads to mucous build up and the
emphysema portion destroys areas of the lungs.



What signs and symptoms are common in COPD patients? - Answer: Chronic cough

Sputum production

Dyspnea- difficulty breathing



What signs and symptoms are specific to B12 deficiency anemia? - Answer: Neurological symptoms,
paresthesia (numbness and tingling in hands and feet), unsteady gait, memory issues

Beefy red tongue



What diet can result in B12 deficiency? - Answer: Vegan- oral supplements can be used for treatment



What surgery can result in B12 deficiency? - Answer: Gastric surgery- patient will lose intrinsic factor
that is required to absorb B12- these patients will require life long IM B12 injections



What patient population is lupus commonly seen? - Answer: Women of childbearing age- ages 15-45,
African Americans are going to be at higher risk



What is the diagnostic criteria for Lupus? - Answer: Must have 4/11 diagnostic criteria:



Malar rash

Discoid rash

, Photosensitivity

Oral/nasal ulcers

Non-erosive arthritis

Cardio-pulmonary complaints

Renal complaints

Neurological concerns

Immunological disorders

+ ANA test

Hematologic disorders



What is Sjogren's Syndrome and what is the treatment? - Answer: Dry eyes and dry mouth- treatment
revolves around symptom management- artificial tears, hard candies, etc.

Common in lupus patients



What is a major concern for lupus patients? How do we monitor this? - Answer: Impact on the kidneys-
Lupus nephritis

Be on the look out for glomerularnephritis as well as proteinuria

These patients will require routine UA for assessment of their kidneys and protect them



What is the function of the thyroid? - Answer: Viral hormone gland

Metabolism regulation- impacts every SINGLE cell within the body

Proper growth and development across the entire lifespan



What produces TSH? - Answer: Pituitary gland



What is the function of TSH? - Answer: Tells your thyroid when to produce and release those critical
thyroid hormones- T3 and T4.



What disorders include hypothyroidism? - Answer: Iodine deficiency, Hashimoto's, or thyroiditis

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