6531 Final Deck 2
1. Sharon, age 29, is pregnant for the first time. She complains of nasal
stuffiness and occasional epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and
hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist: C. You do nothing
except for client teaching
- Can occur with pregnancy because of increased vascularization in the upper
respiratory tract
2. David, age 32, 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? A. Prescribe nasal
steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist: A. Prescribe nasal
steroids and oral decongestants
3. A sexual history of oral-genital contact in a client presenting with
pharyngitis is significant when which of the following organisms is
suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae: C. Neisseria gonorrhoeae
- Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
4. The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis: D. Presbycusis
5. How do you describe the cervical lymphadenopathy associated with
asymptomatic HIV infection?
A. Movable, discrete, soft, and nontender lymph nodes
B. Enlarged, warm, tender, firm, but freely movable lymph nodes
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C. Hard, unilateral, nontender, and fixed lymph nodes
D. Firm but not hard, nontender, and mobile lymph nodes: D. Firm but not
hard, nontender, and mobile lymph nodes
6. You diagnose acute epiglottitis in Sally, age 5, and immediately send her
to the local emergeny room. Which of the following symptoms would
indicate that an airway obstruction is imminent?
A. Reddened face
B. Screaming
C. Grabbing her throat
D. Stridor: D. Stridor
7. Purulent matter in the anterior chamber of the eye is called
A. Hyphema
B. Hypopyon
C. Anisocoria
D. Pterygium: B. Hypopyon
8. A 42 year old stockbroker comes to your office for evaluation of a
pulsating headache over the left temporal region and he rates the pain as an
8 on a scale of 1-10. The pain has been constant for the past several hours
and is accompanied by nausea and sensitivity to light. He has had frequent
headaches for many years but not as severe and they are usually relieved by
over the counter medicines. He is unclear as to a precipitating event but
notes that he has had visual disturbances before each headache and has
been under a lot of stress in his job. Based on this description, what is the
most likely diagnosis of this type of headaache?
A. Tension
B. Migraine
C. Cluster
D. Temporal arteritis: B. Migraine
9. The trachea deviates toward the affected side in all of the following except
A. Aortic aneurysm
B. Unilateral thyroid lobe enlargement
C. Large atelectasis
D. Pneumothorax: C. Large atelectasis
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10. Matthew, age 52, has allergic rhinitis and would like some medicine to
relieve his symptoms. He is taking cimetidine (Tagamet) for
gastroesophageal reflux disease. Which medication would you not order?
A. A first-generation antihistamine
B. A second-generation antihistamine
C. A decongestant
D. A topical nasal corticosteroid: B. A second-generation antihistamine
11. Jessica, an 8 year old third grader is broght to the office by her
grandmother, who is the child's babysitter. She has complained of fever and
sore throat for the past 2 days. Five other children in her class have been
sick with sore throats. She denies difficulty swallowing and has been
drinking fluids but has no appetite. ROS reveals that she has clear nasal
drainage, hoarseness, and nonproductive cough. She denies vomiting but
has had mild diarrhea. On examination she has a temperature of 101.5 F, 3+
erythematous tonsils, and palpable, tender cervical lymph nodes. Based on
these findings, what is the most likely diagnosis?
A. Mono
B. Sinusitis
C. Strep pharyingitis
D. Viral pharyngitis: D. Viral pharyngitis
12. Marcia, age 4, is brought into the office by her mother. She has a sore
throat, difficulty swallowing, copious oral secretions, respiratory difficulty,
stridor, and a temperature of 102 F but no pharyngeal erythema or cough.
What do you suspect?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal infection pharyngitis C.
Tonsillitis
D. Diphtheria: A. Epiglottitis
13. You note a completely split uvula in Noi, a 42 year old Asian. What is
your next course of action?
A. Do nothing
B. Refer Noi to a specialist
C. Perform a throat culture
D. Order a CBC: A. Do nothing
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14. Claude, age 78, is being treated with timolol maleate (Timoptic) drops for
his chronic open-angle glaucoma. While performing a new client history and
physical, you note that he is taking other medications. Which medication
would you be most concerned about?
A. Apsirin therapy as prophylaxis for heart attack
B. Ranitidine (Zantac) for gastroesophageal reflux disease
C. Alprazolam (Xanax), an anxiolytic for anxiety
D. Atenolol (Tenormin), a beta blocker for high blood pressure: D. Atenolol
(Tenormin), a beta blocker for high blood pressure
15. Harry, age 69, has had Meniere's disease for several years. He has some
hearing loss but now has persistent vertigo. What treatment might be
instituted to relieve the vertigo? A. A labyrinthectomy
B. Pharmacological therapy
C. A vestibular neurectomy
D. Wearing an earplug in the ear with the most hearing loss: C. A vestibular
neurectomy
16. A 65 year old man presents complaining of left sided deep, throbbing
headache along with mild fatigue. On examination the client has a tender,
tortuous temporal artery. You suspect temporal arteritis. How do you
confirm your diagnosis? A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
D. Otoscopy: B. Erythrocyte sedimentation rate (ESR)
17. Marty has a hordeolum in his right eye. You suspect that the offending
organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli: B. Staphylococcus
18. The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity: A. Pollens of grasses, trees, and weeds
