NR 602 FINAL EXAM 2024/2025 Questions and
Answers (Verified Answers)
1. A mother presents with her 3 month old child and complains of goopy eye
that is sometimes matted shut after naps. Upon exam the conjunctiva is
clear with some mild crusting to eye lashes. What is the diagnosis and
patient teaching?
Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the
duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, erythemic bump to
eyelid. What is the diagnosis and patient education?
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
3. What is blepharitis?
, inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
4. What is the treatment for blepharitis?
Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult
teeth, can cause discoloration. Pediatrics can have Bactrim.
5. A 9 year old patient presents with acute swelling and erythema to eyelid
with flaky, scaly debris to eyelid margins. Patient reports gritty, burning
feeling to eyes. She has already attempted warm compresses and washing
eyelids with baby soap with minimal relief. What is the diagnosis and
treatment?
Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for
kids <8
6. What organism is likely to cause viral conjunctivitis?
, -Adenovirus
-HSV
-Herpes
7. What organism is likely to cause bacterial conjunctivitis?
-Staph aureus
-strep pneumoniae
-H. Influenza
8. A 10-year-old patient presents with unilateral conjunctivitis with watery
discharge x 2 days along with itching of the eye. Mother denies any other
associated symptoms. What is the diagnosis and treatment?
Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
9. What is herpes keratitis?
Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge,
photophobia, and eye redness. Upon exam you note fern-like lines under
the woods lamp. What is the diagnosis and tx?
Herpes Keratitis
Tx: Antivirals
, 11. A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye. Upon
inspection you visualize a n erythemic lesion to the eye. When using
woods lamp you note a small superficial laceration. What is the dx and tx?
Corneal abrasion, refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with
complaints of pain to the groin, knee, and right hip. She reports patient has
been walking with a limp for the last couple days but unable to ambulate
today. Mother denies any recent trauma. Upon inspection there is external
rotation of the right foot. What is the dx and tx?
Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
13. Father presents with his four-year-old son and states that patient has been
limping since this morning and was crying all night complaining of left hip
pain. Upon exam you appreciate decreased range of motion of left hip but
no external rotation or signs of trauma. What is the probable diagnostics,
and treatment?
Toxic transient syndrome- most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
Answers (Verified Answers)
1. A mother presents with her 3 month old child and complains of goopy eye
that is sometimes matted shut after naps. Upon exam the conjunctiva is
clear with some mild crusting to eye lashes. What is the diagnosis and
patient teaching?
Probable lacrimal duct obstruction.
-The baby will likely grow out if it somewhere between six and 12 months.
-You can do a daily lacrimal duct massage and warm compresses to help open up the
duct.
-Watch for Periorbital cellulitis or bacterial conjunctivitis.
2. Nine-year-old patient presents with tender, swollen, erythemic bump to
eyelid. What is the diagnosis and patient education?
Hordeolum (stye)
-warm moist compress
- scrub eye lashes with baby shampoo BID
- eye will feel better when stye pops, if doesn't will refer to optho.
3. What is blepharitis?
, inflammation of the eyelid
- caused by blocked oil gland, allergies, or excessive bacteria
4. What is the treatment for blepharitis?
Cleanse with baby shampoo TID
- Warm, moist compress
- resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult
teeth, can cause discoloration. Pediatrics can have Bactrim.
5. A 9 year old patient presents with acute swelling and erythema to eyelid
with flaky, scaly debris to eyelid margins. Patient reports gritty, burning
feeling to eyes. She has already attempted warm compresses and washing
eyelids with baby soap with minimal relief. What is the diagnosis and
treatment?
Patient has anterior blepharitis
Treat with erythromycin ointment, ointment has longer contact with eye.
Can use azithromycin ointment x 4 weeks for long term treatment
Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for
kids <8
6. What organism is likely to cause viral conjunctivitis?
, -Adenovirus
-HSV
-Herpes
7. What organism is likely to cause bacterial conjunctivitis?
-Staph aureus
-strep pneumoniae
-H. Influenza
8. A 10-year-old patient presents with unilateral conjunctivitis with watery
discharge x 2 days along with itching of the eye. Mother denies any other
associated symptoms. What is the diagnosis and treatment?
Viral Conjunctivitis
Patient should apply cold compresses for comfort
*Bacterial conjunctivitis has purulent discharge.
9. What is herpes keratitis?
Herpes viral infection to the eye caused by HSV.
10. A 19-year-old male presents with blurred vision, watery discharge,
photophobia, and eye redness. Upon exam you note fern-like lines under
the woods lamp. What is the diagnosis and tx?
Herpes Keratitis
Tx: Antivirals
, 11. A 16-year-old female presents with complaints of sudden onset of red,
watery, and painful left eye. She reports possible foreign body to eye. Upon
inspection you visualize a n erythemic lesion to the eye. When using
woods lamp you note a small superficial laceration. What is the dx and tx?
Corneal abrasion, refer to optho emergently or send to ER.
12. A mother brings her nine-year-old overweight son to the clinic with
complaints of pain to the groin, knee, and right hip. She reports patient has
been walking with a limp for the last couple days but unable to ambulate
today. Mother denies any recent trauma. Upon inspection there is external
rotation of the right foot. What is the dx and tx?
Slipped capital femoral epiphysis
Refer to ER, will need surgery.
-most common in adolescent, obese males.
13. Father presents with his four-year-old son and states that patient has been
limping since this morning and was crying all night complaining of left hip
pain. Upon exam you appreciate decreased range of motion of left hip but
no external rotation or signs of trauma. What is the probable diagnostics,
and treatment?
Toxic transient syndrome- most common cause of limp in peds.
Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY will be normal.
