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NUR 652 - Final Exam Study Guide With Complete Solution
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NUR 652 - Final Exam Study Guide WithComplete Solution
A 5-year-old child is hit in the face with a baseball bat and is brought to the
clinic by a parent. An exam reveals three avulsed front teeth. Radiologic
studies are negative for facial fractures. What is the recommended
treatment? - ANSWER Refer the child to the dentist immediately for further
evaluation
A child who was treated with amoxicillin and then amoxicillin-clavulanate for
acute otitis media is seen for follow-up. The primary care nurse practitioner
notes dull-gray tympanic membranes with a visible air-fluid level. The child is
afebrile and without pain. What is the next course of action? - ANSWER
Monitoring ear fluid levels for 3 months
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube.
What will the primary care nurse practitioner recommend to promote dental
health in this child? - ANSWER Daily chlorhexidine gluconate
A primary care provider may suspect cataract formation in a patient with
which finding? - ANSWER Asymmetric red reflex
A patient has chronically dry eyes, sometimes with a foreign body sensation,
burning, and itching. A Schirmer test is abnormal. What is the suspected
cause of this patient's symptoms? - ANSWER Aqueous Deficiency
A teen who has otitis externa has severe swelling of the external auditory
canal that persists after 2 days of therapy with ototopical
antibiotic/corticosteroid drops. What is the next step in treatment for this
,child? - ANSWER Insert a wick into the external auditory canal
A patient reports tooth pain in a lower molar and the provider notes a mobile
tooth with erythema and edema of the surrounding tissues without
discharge. Which is the initial course of action by the provider? - ANSWER
Prescribe amoxicillin and refer to a dentist in 2-3 days
An elderly patient has a permanent loss of the sense of smell and diminished
taste. What will be included in teaching this patient about managing these
symptoms? - ANSWER 1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen.
The primary nurse practitioner will refer to a pediatric ophthalmologist to
initiate which treatment? - ANSWER Patching of the unaffected eye for 2
hours each day
An adolescent has localized bleeding of the gums when brushing the teeth.
An exam of the mouth reveals the presence of plaque and calculus on the
teeth which are not loose. What will the primary care nurse practitioner
recommend? - ANSWER Consistently brushing and flossing the teeth twice
daily
A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use? - ANSWER Carbamide
peroxide
A parent asks about ways to promote dental health in school-aged children
,while on family vacation that are convenient while camping and picnicking.
What will the primary care nurse practitioner recommend? - ANSWER
Offering gum containing xylitol after meals
A patient reports several episodes of acute vertigo, some lasting up to an
hour with associated nausea and vomiting. What is part of the initial
diagnostic workup for this patient? - ANSWER Audiogram and MRI
A teen with a history of otitis externa asks about ways to prevent this
condition. What will the primary care nurse practitioner recommend? -
ANSWER Drying the ear canal with a hair dryer
A 7-month-old infant has had two prior acute ear infections and is currently
on the 10th day of therapy with amoxicillin-clavulanate after a failed course
of amoxicillin. The primary care nurse practitioner notes marker middle ear
effusion and erythema of the TM. The child is irritable and has a temperature
of 99.8. What is the next step in management of this child's infection? -
ANSWER Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What is
the likely cause of these symptoms? - ANSWER Sialolithiasis
A child complains of itching in both ears and is having trouble hearing. The
primary care nurse practitioner notes periauricular edema and marked
swelling of the external auditory canal and elicits severe pain when
manipulating the external ear structures. Which is an appropriate
intervention? - ANSWER Order ototopical antibiotic/corticosteroid drops
During a well child assessment of an African American infant, the primary
care nurse practitioner notes a dark red-brown light reflex in the left eye and
, a slightly brighter, red-orange light reflex in the right eye. The nurse
practitioner will... - ANSWER Refer the infant to an opthalmologist
Which are risk factors for development of cataracts? - ANSWER 1. Smoking
2. Advancing Age
3. UV Light
A preschool age child who attend daycare has a 2 day history of matted
eyelids in the morning and burning and itching of the eyes. The primary care
NP notes yellow-green purulent discharge from both eyes, conjunctival
erythema and mild URI symptoms. Which action is correct? - ANSWER
Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during
the night with right ear pain. The primary care NP notes an axillary
temperature of 100.5 and an erythematous, bulging TM. A tympanogram
reveals a peak of +15-mm H2O. What is the recommended treatment for this
child? - ANSWER An analgesic medication and watchful waiting
A patient complains of otalgia and difficulty hearing from one ear. The
provider performs an otoscopic exam and notes a dark brown mass in the
lower portion of the external canal blocking the patient's TM. What is the
initial action? - ANSWER Ask the patient about previous problems with the
ear
The primary care NP is treating an infant with lacrimal duct obstruction who
has developed bacterial conjunctivitis. After 2 weeks of treatment with
topical antibiotics along with massage and frequent cleaning of secretions,
the infant's symptoms have not improved. Which action is correct? -
ANSWER Refer to an ophthalmologist
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