What are the 2 most common etiologic agents in ABRS (Acute Bacterial Rhino Sinusitis)?
1. S. pneumoniae and M. pneumoniae
2. S. pneumoniae and H.
... [Show More] influenzae
3. S. aureus and S. pneumoniae
4. S. aureus and H. influenzae - ✔✔ 2. S. pneumoniae and H. influenzae
What assessment finding is most characteristic of ABRS (Acute Bacterial Rhino Sinusitis)?
1. Fever, sore throat, and purulent nasal discharge
2. URI symptoms lasting > 9 days or worsening after 5 days
3. Discolored nasal discharge and nasal congestion
4. Clear nasal discharge and frontal headache - ✔✔ 2. URI symptoms lasting > 9 days or worsening after 5 days
In a patient with ABRS (Acute Bacterial Rhino Sinusitis), the goal is to:
1. avoid environmental irritants
2. dry up the excessive mucus production with antihistamines
3. irrigation of sinuses to wash out bacteria and thickened secretions
4. promote drainage with decongestants or nasal irrigation - ✔✔ 4. promote drainage with decongestants or nasal irrigation
What is considered first line therapy for a patient with acute sinusitis who is rarely ill?
1. amoxicillin
2. gatifloxacin
3. doxycycline
4. azithromycin - ✔✔ 1. amoxicillin
A patient who was p;laced on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis) has no improvement after 3 days. What should the NP consider?
1. The patient obviously has a beta lactamase producing organism.
2. The dose of amoxicillin should now be increased.
3. A steroid injection should now be considered.
4. The patient may not have a bacterial infection. - ✔✔ 4. The patient may not have a bacterial infection.
A patient who was placed on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis) has no improvement after 3 days. If an antibiotic is considered for the above patient, what would be a good choice?
1. Trimethoprim-sulfamethoxazole
2. Doxycycline
3. Amoxicillin/clavulanate
4. Clarithromycin - ✔✔ 3. Amoxicillin/clavulantate
A patient is taking amoxicillin for acute sinusitis and has developed a pruritic full body rash. What actions by the NP are appropriate?
1. Stop amoxicillin
2. Prescribe clarithromycin
3. Administer 1cc IM steroid
4. Prescribe Omnicef
A. 1, 2, 3
B. 1, 3, 4
C. 1, 3
D. 3, 4 - ✔✔ ? not 100% sure if this answer is correct...
A. 1, 2, and 3 (Stop amoxicillin, prescribeclarithromycin and administer 1cc IM steroid)
A patient with ABRS has had azithromycin in the past 4 weeks for treatment of sore throat. He is PCN allergic. What antibiotic should be initiated?
1. Amoxicillin
2. Azithromycin
3. Doxycycline
4. Levofloxacin - ✔✔ 4. Levofloxacin
In addition to an antibiotic, a patient with ABRS (Acute Bacterial Rhino Sinusitis) should receive a/an:
1. antihistamine
2. a topical nasal steroid
3. a decongestant
4. a mucolytic - ✔✔ 3. a decongestant
Which organism(s) can produce tonsillar exudate and or pustules?
1. Group A beta-hemolytic strep
2. Strep pyogenes
3. Viral pharyngitis
4. Neisseria gonorrhea
1. 1 only
2. 1 & 2
3. 1 & 3
4. All of the above - ✔✔ 4. All of the above
What are the 4 most important indicators of Strep throat? - ✔✔ 1. Tonsillar exudate
2. Anterior cervical adenopathy
3. Presense of a fever >102F
4. Absence of a cough
What is the drug of choice for a patient with Strep throat?
1. Doxycycline
2. Penicillin
3. Azithromycin
4. Trimethoprim-sulfamethoxazole - ✔✔ 2. Penicillin
Which choice below is absolutely contraindicated in a patient who has epiglottitis?
1. Oral meds
2. Thorough oral exam
3. Acidic fluids
4. Narcotic administration - ✔✔ 2. Thorough oral exam
A patient, who presents with abrupt onset of high fever, sore throat, and the "sniffing posture", may have:
1. mononucleosis
2. epicglottitis
3. strep throat
4. ABRS - ✔✔ 2. epiglottitis (they can breathe better with a hyperextended neck)
A patient is diagnosed with epiglottitis. The most appropriate action for the NP is:
1. refer patient to MD
2. initiate antibiotic with beta-lactamase coverage
3. encourage fluids/antipyretics
4. refer to nearest ER facility - ✔✔ 4. refer to nearest ER facility
A college freshman is diagnosed with mononucleosis. What findings on assessment are seen most often?
1. Pharyngitis, fever, and splenomegaly
2. Pharyngitis, adenopathy, and headache
3. Fever, adenopathy, and splenomegaly
4. Fever, fatigue, pharyngitis, lymphadenopathy - ✔✔ 4. Fever, fatigue, pharyngitis, lymphadenopathy
(3F's/1L)
A patient has suspected mononucleosis. Which drug(s) should be avoided in her?
1. Aspirin and penicillin
2. Acetaminophen and doxycycline
3. Dilantin and azithromycin
4. Oral contraceptives - ✔✔ 1. Aspirin and penicillin
PCN avoided b/c ampicillin rash, Reye's syndrome (avoid ASA)
A patient presents with pale, boggy turbinates. What else would the NP expect to find?
1. Thick, green nasal discharge
2. Clear, thin, watery nasal secretions
3. Headache and fever
4. Periorbital swelling - ✔✔ 2. Clear, thin, watery nasal secretions (Allergic Rhinitis)
A rescue agent used to treat patients with allergic rhinitis is:
1. Singulair
2. Nasonex
3. Allegra
4. NasalCrom - ✔✔ 3. Allegra
Decongestants should be avoided in patients with:
1. allergic rhinitis
2. ABRS
3. hypertension
4. epistaxis - ✔✔ 3. hypertension
A patient presents with chief complaint of ear pain and otic discharge. What assessment finding is characteristic of otitis externa?
1. Tragal pain
2. Hearing loss
3. Displaced pinna
4. Increasing ear pain - ✔✔ 1. Tragal pain
A patient with otitis externa can be treated with Cortisporin otic suspension and
1. an analgesic
2. oral antibiotic
3. a decongestant
4. an ear candle - ✔✔ 1. an analgesic
A conductive hearing loss can occur as a result of:
1. impacted cerumen
2. otitis externa
3. otitis media with effusion
4. all of the above - ✔✔ 4. all of the above
Age related hearing deficit associated with loss of high frequency sounds is termed:
1. conductive hearing loss
2. sensor hormonal hearing loss
3. presbycusis
4. hard of hearing - ✔✔ 3. presbycusis [Show Less]