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NURS 518 FINAL EXAM 2025 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS | NEW UPDATE
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NURS 518 FINAL EXAM 2025 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS | NEW UPDATE
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NURS 518 FINAL EXAM 2025 QUESTIONSAND ANSWERS WITH COMPLETE
SOLUTIONS | NEW UPDATE
Allergic Rhinitis Medication - ANSWER -diphenhydramine: sedating
-cetirizine (zyrtec)
-fexofenadine (allegra): most targeted, least SEs
-nasal steroids: for prevention, daily use, takes 1wk+ for full effect
-eye drops
Uncomplicated URI treatment - ANSWER -increased fluids
-saline spray
-nose frida
-honey - not in children under 1 yo
-NO vapor rub, cough suppressants, or cough medicine
-educate on s/sx of respiratory distress
ABRS vs URI - ANSWER -ABRS lasts for 10+ days w/ nasal discharge and/or
daytime cough
-ABRS initially improves but then gets much worse
ABRS treatment - ANSWER -amox or augmentin 10-28 days
-wait for clinical response then add 7 days
-failure to respond to augmentin - consult ENT
-nasal steroids
,-saline irrigation
-possible decongestants, mucolytics, antihistamines
severe ABRS - ANSWER fever >39 + 3 days purulent discharge (referral to ENT)
croup characteristics - ANSWER -viral: parainfluenza 1 and 3, influenza A, and
RSV most common
-inflammation of larynx/trachea
-most common boys 6 mo-6 yo
-begins as mild URI, progresses to sore throat, barky cough worse at night, +/-
fever
-s/sx peak in 3-5 days
-moderate obstruction: stridor, retractions, tachycardia, nasal flaring
-severe obstruction: cyanosis, worried, lethargic, decreased LOC
moderate croup treatment - ANSWER -calm, distracted, position of comfort,
hydration
-first-line: dexamethasone, then budesonide or prednisone
-cool mist/ cool air
-only xray if suspect FB or congenital problems
croup red flags - ANSWER -stridor at rest: send to ER for racemic epinephrine
neb (potential for rebound)
-toxic looking: send to ER for O2 and IV fluids
,bacterial pneumonia - ANSWER -age: 2+
- high fever, tachypnea, cough
-high WBC + left shift (low WBC is ominous sign)
-x-ray may look normal in early illness
-tx: <5 - amox, augmentin
>5 - macrolide
-f/u in 2-3 weeks or 1-2 days if no improvement from abx
mycoplasma pneumonia - ANSWER -age: >5 years
-slow onset, fever, malaise, cough progressing to productive
-tx: azithromycin or cipro for 7-10 days
chlamydia pneumonia - ANSWER -age: newborn
-50% w/ vaginally infected mothers get it
-afebrile, staccato cough, tachypnea, crackles
-tx: erythromycin
stages of pertussis - ANSWER -catarrhal: most contagious time, mild URI, 7-10
days
-paroxysmal: cough spasms, post-tussive vomiting 1-4 weeks
-convalescent: less paroxysms, wks - months
pertussis diagnosis - ANSWER -nasopharyngeal swab (gold standard) - best 0-2
days after cough onset
-PCR assays - better sensitivity, good when high suspicion
, -serologic testing - rarely used clinically
pertussis treatment - ANSWER -azithromycin (best taken during catarrhal
stage)
-isolate for 5 days after start of abx
bronchiolitis characteristics - ANSWER -cause: often RSV (can get annually)
-serious risk if <3 mo old
-URI prodrome 1-3 days
-days 3-6: worsening cough, tachypnea, crackles, hypoxia, increased WOB,
secretions
bronchiolitis treatment - ANSWER -increase hydration
-suctioning
-O2 PRN
-educate on s/sx of respiratory distress
-hospitalize depending on age, WOB, and SaO2 (<92%)
asthma treatment in office - ANSWER -albuterol q20 min x 3 doses
-oral CS: prednisone or dexamethasone
-if albuterol doesn't help, sent to ED
mild persistant asthma treatment - ANSWER -SABA
-low dose ICS
-alternative: cromolyn or montelukast
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