NR511 Midterm Exam Latest Updated 2024 Questions
With Detailed Answers Graded A+
Identify at least two disorders that are considered to be disorders related to conductive
hearing loss. - Cerumen accumulation/impaction
FB in ear canal
Otitis externa
Chronic otitis media
Middle ear effusio...
NR511 Midterm Exa m Latest Updated 2024 Questions With Detailed Answers Graded A+ Identify at least two disorders that are considered to be disorders related to conductive hearing loss. - Cerumen accumulation/impaction FB in ear canal Otitis externa Chronic otitis media Middle ear effusion Tosclerosis Vascular anomaly Cholesteatoma What is the most common cause of bacterial pharyngitis? - Group A Beta Hemolytic Streptococcus (GABHS) What are the clinical findings associated with mononucleosis? - Gradual on set of fever Marked malaise Severe sore throat Maybe exudative tonsillitis (50% of cases) Palatal petechiae/rash Anterior/posterior cervical lymphadenopathy Splenic enlargement How is the diagnosis of streptococcal pharyngitis made clinically based on the Centor criteria? - Fever >38C (100.5F) Tender anterior cervical lymphadenopathy No cough Pharyngotonsillar exudate Presence of all 4 strongly suggest GABHS infection. 3 or more present: empirically dx and treat w/out further testing What is one interven tion for a pt with gastroenteritis? - Fluid repletion (PO if possible, pedialyte; IVF for more severe dehydration) Nutrition When are stool studies warranted? - In pts with severe or prolonged diarrhea, fever >38.5C, bloody stools, stools +leukocytes/occu lt blood What is an appropriate treatment for prophylaxis or treatment of traveler's diarrhea? - Trimethoprim -sulfamethoxazole (Bactrim DS) 1 tab BID x3days Cipro 500mg Norfloxacin (Noroxin) 400mg Ofloxacin (Floxin) 300mg Describe the component of the H& P that should be done for a pt with abd pain. - OLDCARTS Upper abd pain: ask about chronic/recurring and related symptoms (bloating, fullness, heartburn, n/v) Lower abd pain: if acute, is pain sharp, intermittent continuous? If chronic, is there a change in bowel habits (alternating diarrhea/constipation)? Radiation? What is at least one effective treatment for IBS? - Diet (avoid lactose, caffeine, legumes, artificial sweeteners; eat low -fat diet with increased protein, high fiber, bulk -producing agents, 6 4oz water daily) Lifestyle modification Exercise Stress reduction Pharm (for moderate -severe symptoms only): antidiarrheals (imodium, lomotil), laxatives (lactulose, mag hydroxide), antispasmodics (dicyclomine, hyoscyamine), tricyclic antidepressants; avoi d anticholinergics with glaucoma and BPH pts. Define diagnostic reasoning - Reflective thinking because the process involves questioning one's thinking to determine if all possible avenues have been explored and if the conclusions that are being drawn are based on evidence. Seen as a kind of critical thinking. What is subjective data? - Anything the patient tells you or complains of regarding their symptoms Chief complaint HPI ROS What is objective data? - Anything YOU can see, touch, feel, hear, or sm ell as part of your exam Includes lab data, diagnostic test results, etc. Identify components of HPI - Specifically related to the chief complaint only Detailed breakdown of CC OLDCARTS Describe the differences between medical billing and medical codi ng. - Medical billing: process of submitting and following up on claims made to a payer in order to receive payment for medical services rendered by a healthcare provider Medical coding: the use of codes to communicate with payers about which procedures w ere performed and why. Compare and contrast the two coding classification systems that are currently used in the US healthcare system. - ICD: International classification of disease codes are used to provide payer info on necessity of visit or procedure p erformed. Shorthand for pt's dx. CPT: common procedural terminology codes offer the official procedural coding rules and guidelines required when reporting medical services and procedures performed by physician and non -physician providers. Must have corr esponding ICD. How do specificity, sensitivity, and predictive value contribute to the usefulness of diagnostic data? - Specificity: ability of a test to correctly detect a specific condition. If a pt has a condition but test is negative, it is a false ne gative. If pt does NOT have condition but test is positive, it is false positive. Sensitivity: test that has few false negatives. Ability of a test to correctly identify a specific condition when it is present. The higher the sensitivity, the lesser the l ikelihood of a false negative. Predictive value: The likelihood that the pt actually has the condition and is, in part, dependent upon the prevalence of the condition in the population. If a condition is highly likely, the positive result would be more ac curate. Diagnostic tests can be used to confirm or rule out hypotheses. Diagnostic tests may be used to screen for conditions. Diagnostic tests may be used to monitor the progress in managing a chronic condition. Discuss the elements that need to be co nsidered when developing a plan. - Pt's preferences and actions Research evidence Clinical state/circumstances Clinical expertise Describe the components of medical decision making in E&M coding. - Risk, data, diagnosis The more time and consideration in volved in dealing with a pt, the higher the reimbursement from the payer.
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