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PNP 6680 MIDTERMEXAM QUESTIONS &
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PNP 6680
Evatee 9/2/24 PNP 6680
,PNP 6680 MIDTERM EXAM QUESTIONS &
ANSWERS ALREADY GRADED A+
A 7-year-old is found to have a white mass behind the tympanic membrane on
the right side during routine physical exam. Audiogram confirms a conductive
hearing loss in the right ear. He has no history of previous ear surgery.
Examination reveals a deep retraction pocket. What is your diagnosis?
Group of answer choices
A. Primary acquired cholesteatoma
B. Secondary acquired cholesteatoma
C. Glomus tympanicum
D. Congenital cholesteatoma Answer - A. Primary acquired cholesteatoma
Rationale:
Primary acquired cholesteatoma develops because of negative middle ear
pressure which causes a retraction of the tympanic membrane, most
frequently in the pars flaccida.
There is an outbreak of shigella infection is the community. You suspect that
your three -year-old patient has a severe shigella infection. Because this
organism is particularly drug-resistant, which of the following antibiotics is
MOST appropriate to treat this infection?
A. Ceftriaxone (Rocephin)
B. Amoxicillin (Amoxil, Moxatag)
C. TMP-SMX (Bactrim, Sulfatrim)
D. Ampicillin (Omnipen, Principen Answer - A. Ceftriaxone (Rocephin)
,Rationale:
Treatment of Shigella with antibiotics shortens the duration of bacterial
shedding and clinical symptoms. Antibiotics are indicated if the disease is
severe, or if the patient is immunocompromised. Resistant to antibiotics has
been reported world-wide; in the absence of susceptibility testing, the use of
IM ceftriaxone for 2-5 days for organism resistance is mot appropriate in this
situation
The Ishihara test is used to detect
A. Streptococcal colonization
B. the red reflex
C. bone conduction of sound
D. Color blindness Answer - D. Color blindness
Rationale:
Visual testing for color sensitivity should occur at 4 year of age or before school
entry. Difficulty or confusion when identifying colors may be related to
cognitive learning differences and should alert parents and teachers. Color
blindness is more prevalent in males. Testing should be completed with the
Hardy-Rand-Rittler (HRR) test. The HRR test uses a series of symbols rather
than numbers, which allows reliable testing to be don on young children. The
Ishihara test, which uses a series of figures and letters composed of spots of
certain colors, can be used on the older child. The child with a color vision
deficit fails to see letter or figures of a certain color.
Any child with hemihypertrophy and any child with aniridia should also be
routinely screened for what condition
A. Neurofibroamatosis
B. Turner's Syndrome
, C. Tuberous Sclerosis
D. Wilm's tumor Answer - D. Wilm's tumor
Rationale:
An important feature of Wilms tumor is the occurrence of associated
congenital anomalies including renal abnormalities, such as cryptorchidism,
hypospadias, duplication of the collecting system, ambiguous genitalia,
hemihypertrophy, aniridia, cardiac abnormalities, and Beckwith-Wiedemann,
Denys-Drash, and Perlman syndromes. Wilms tumor occurs with equal
frequency in both sexes although males are diagnosed younger. There is a
higher frequency in African Americans and a lower frequency in Asians.
Please choose the correct definition for the condition sundowning:
A. Downward deviation of the eyes associated with hydrocephalus, intracranial
hemorrhage, other pathologic brain conditions, or early sign of cerebral palsy.
B. Acute inflammation of palpebral and bulbar surfaces of the eye
C. An acute or chronic irritation of the eyelid
D. A cyst in the eyelid caused by inflation of the meibomian gland Answer - A.
Downward deviation of the eyes associated with hydrocephalus, intracranial
hemorrhage, other pathologic brain conditions, or early sign of cerebral palsy.
Rationale:
Sundowning - Downward deviation of the eyes associated with hydrocephalus,
intracranial hemorrhage, other pathologic brain conditions, or early sign of
cerebral palsy; a sign of increased intracranial pressure when symptoms of
lethargy, poor feeding, vomiting, bulging fontanel, or rapidly increasing head
circumference are noted.
A 5-year-old child is brought to the clinic with bilateral purulent discharge from
both eyes. Physical findings include conjunctival redness, bilateral nasal
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