NR 661 Ears, Eyes, Nose, and Throat (EENT) Exam

NR 661 Ears, Eyes, Nose, and Throat Exam/Problems:

1. A 30 year old male has been …. with non-allergic rhinitis. What finding is more likely in non-allergic rhinitis than allergic rhinitis?
2. The throat swab done to identify Streptococcal infection was negative in a 12 year-old female with tonsillar exudate, fever, and sore throat. What statement is true regarding this?
3. What is the usual age for vision screening in young children?
4. Epstein-Barr virus is responsible for:
5. A patient with environmental allergies presents to your clinic. She takes an oral antihistamine every 24 hours. What is the most effective single maintenance medication for allergic rhinitis?
6. Conjunctivitis:
7. At what age would it … unusual to see thrush?
8. A patient presents with severe toothache. She reports sensitivity to heat and cold. There is visible pus around the painful area. What is this termed?
9. How long should a 6 year old with acute otitis media … treated with an antibiotic?
10. A patient is ….. with otitis externa. He complains of tragal pain, otic discharge, otic itching, and fever. What is the cardinal symptom of otitis externa?
11. A patient presents to a nurse practitioner clinic with paroxysmal sneezing, clear rhinorrhea, nasal congestion, facial pain. Which symptom below is NOT …. with allergic rhinitis?
12. An NP examines a screaming 2 year-old. A common finding is:
13. A patient …. with Strept throat received a prescription for azithromycin. She has not improved in 48 hours. What course of action is acceptable?
14. A 93 year-old demented adult … recently treated for an upper respiratory infection (URI) but drainage from the right nostril persists. What should the NP suspect?
15. A 32 year-old patient is a newly …. diabetic. She has developed a sinus infection. Her symptoms have persisted for 10 days. Six weeks ago she was treated with amoxicillin for an upper respiratory infection. It cleared without incident. What should … recommended today?
16. AV nicking may … identified in a patient with what disease?
17. When examining the vessels of the eye:
18. The nurse practitioner performs a fundoscopic exam on a patient who has recently been …. with hypertension. What is the significance of AV nicking?
19. A patient presents to clinic with a complaint of a red eye. Which assessment below rules out the most worrisome diagnoses?
20. Acute otitis media can …… by identifying which otic characteristic(s)?
21. A teenager with fever and pharyngitis has a negative rapid strept test. After 24 hours, the throat culture reveals “normal flora”. Which conclusion can … made?
22. A 61 year-old male presents with a 12-hour history of an extremely painful left red eye. The patient complains of blurred vision, haloes around lights, and vomiting. It began yesterday evening. On examination, the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most likely diagnosis in this patient is:
23. Which antihistamine is preferred for treating allergic rhinitis in an older adult?
24. In a patient who is …. with mastoiditis, which of the following is most likely?
25. A patient who presents with a complaint of sudden decreased visual acuity has a pupil that is about 4 mm, fixed. The affected eye is red. What might … the etiology?
26. Which of the following is most likely observed in a patient with allergic rhinitis?
27. A patient reports a penicillin allergy. What question regarding the allergy should the nurse practitioner ask to determine whether a cephalosporin can … safely prescribed?
28. A patient has been …. with mononucleosis. Which statement is correct?
29. At what age should screening for oral health begin?
30. A 70 year-old male has a yellowish, triangular nodule on the side of the iris. This is probably:
31. When does a child’s vision approximate 20/20?
32. The hearing loss associated with aging involves:
33. A patient has a penicillin allergy. He describes an anaphylactic reaction. Which medication class should … specifically avoided in him?
34. A 6 day-old has a mucopurulent eye discharge bilaterally. What historical finding explains the etiology of the discharge?
35. A patient describes a sensation that “there is a lump in his throat”. He denies throat pain. On exam of the throat and neck, there are no abnormalities identified. What is the most likely reason this occurs?
36. The most common cause of acute pharyngitis in children is:
37. Which of the following symptoms is more indicative of a bacterial sinusitis than viral?
38. A 2 month-old is …. with thrush. An exam of this patient’s saliva demonstrates all except:
39. A patient who is 52 years old presents to your clinic for an exam. You notice a yellowish plaque on her upper eyelid. It is painless. What should the NP assess?
40. An 80 year-old is having difficulty hearing. When the nurse practitioner examines him, she is unable to visualize the tympanic membrane because of cerumen impaction. This produces what kind of hearing loss?
41. The most common complication of influenza is:
42. The single most effective maintenance therapy for allergic rhinitis is:
43. In a patient with mononucleosis, which laboratory abnormality is most common?
44. An older adult has a cold. She calls your office to ask for advice for an agent to help her runny nose and congestion. She has hypertension, COPD, and glaucoma. What agent is safe to use?
45. A patient with diarrhea has a positive enzyme immunoassay for C. difficile. He is on clindamycin for a tooth abscess. How should he … managed?
46. A 3 year-old has been recently treated for an upper respiratory infection (URI) but drainage from the right nostril persists. What should the NP suspect?
47. What symptom triad is most commonly … with infectious mononucleosis?
48. Which of the following will decrease the risk of acute otitis media in a 6 month old?
49. A patient has nasal septal erosion with minor, continuous bleeding. There is macerated tissue. What is a likely etiology?
50. On routine exam, a 15 year-old patient’s tympanic membrane (TM) reveals a tiny white oblong mark just inferior to the umbo on the surface of the TM. The patient has no complaints of ear pain and gross hearing is intact. What is this?
51. A 70 year-old female states that she sees objects better by looking at them with her peripheral vision. She is examined and found to have a loss of central vision, normal peripheral vision, and a normal lens. This best characterizes:
52. A patient is …. with thrush. What might … found on microscopic exam?
53. A patient presents with tragal pain. What is the most likely diagnosis?
54. A 3 year-old has fluid in the middle ear that does not appear infected. The eardrum appears normal. This is referred to as:
55. A patient who is otherwise healthy states that he woke up this morning and has been unable to hear out of his left ear. The Weber and Rinne tests were performed. What is the primary reason for doing this?
56. A patient presents to a nurse practitioner clinic with paroxysmal sneezing, clear rhinorrhea, nasal congestion, facial pain. Which symptom below is NOT … with allergic rhinitis?
57. A patient with environmental allergies presents to your clinic. She takes an oral antihistamine every 24 hours. What is the most effective single maintenance medication for allergic rhinitis?
58. A patient stated that his ears felt stopped up. He pinched his nose and blew through it forcefully. The nurse practitioner …. a ruptured left tympanic membrane. What would indicate this?
59. Which long-acting antihistamine listed below is sedating?
60. A patient presents to your clinic with a painless red eye. Her vision is normal, but her sclera has a blood red area. What is this termed?
61. What clinical finding necessitates an urgent referral of the patient to an emergency department?
62. A 4 year-old was … and treated for left acute otitis media 4 weeks ago. She is here today for a well-child visit. There is an effusion in the left ear. She denies complaints. How should this … managed?
63. A 32 year-old patient is a newly …. diabetic. She has developed a sinus infection. Her symptoms have persisted for 10 days. Six weeks ago she was treated with amoxicillin for an upper respiratory infection. It cleared without incident. What should … recommended today?
64. A 3 year-old has been … with acute otitis media. She is penicillin allergic (Type 1 hypersensitivity reaction). How should she … managed?
65. A patient with mononucleosis has pharyngitis, fever, and ymphadenopathy. His symptoms started 3 days ago.
66. Swimmer’s ear is …. in a patient with tragal tenderness. What other symptom might he have?
67. A teenager with fever and pharyngitis has a negative rapid strept test. After 24 hours, the throat culture reveals “normal flora”. Which conclusion can … made?
68. A 4 month-old infant has thrush. The mother is breastfeeding. She reports that her nipples have become red, irritated, and sensitive. What should the nurse practitioner advise the mother of this baby to treat thrush?
69. A 2 year-old has a sudden onset of high fever while at daycare. The daycare attendant describes a seizure in the child. The child is brought to the clinic; neurologically he appears normal. His body temperature is 99.9 degrees F after receiving ibuprofen. He is …. with otitis media. How should the nurse practitioner manage this?
70. Most commonly, epistaxis occurs:
71. A patient with a bacterial sinusitis cannot spread this to others via:
72. A patient with allergic rhinitis developed a sinus infection 10 days ago. He takes fexofenadine daily. What should … done with the fexofenadine?
73. A tympanic membrane (TM) is erythematous. Which factor …. is NOT the cause of an erythematous TM?
74. A nurse practitioner performs a fundoscopic exam. He identifies small areas of dull, yellowish-white coloration in the retina. What might these …?
75. A 4 year-old child with otitis media with effusion:
76. A 39 year-old has a sudden onset of a right red eye. He reports sensitivity to light and the sensation of a foreign body, though his history for a foreign body is negative. He does not wear contact lenses. How should the NP manage this?
77. Which medication …. ototoxic?
78. A 6 month-old infant has a disconjugate gaze. The nurse practitioner observes that the 6 month old tilts his head when looking at objects in the room. Which statement is true?
79. What are the most common signs and symptoms … with mononucleosis?
80. A patient who is 65 years old states that she has “hayfever” and has had this since childhood. What agent could … safely used to help with rhinitis, sneezing, pruritis, and congestion?
81. Papilledema is noted in a patient with a headache. What is the importance of papilledema in this patient?
82. 70 year-old patient in good health is found to have a large, white plaque on the oral mucosa of the inner cheek. There is no pain … with this. What is a likely diagnosis?
83. What medication should always … avoided in patients with mononucleosis?
84. A common complaint in older patients who have cataracts is:
85. Arcus senilis is described as:
86. Acute otitis media can …… by identifying which otic characteristic(s)?
87. An infant is brought to the nurse practitioner because his gaze is asymmetrical. Which finding indicates a need for referral to ophthalmology?
88. A patient …. given amoxicillin for 8 days for sore throat. Today, the patient has developed a pruritic full body rash and …. with penicillin allergy. What describes the skin manifestations of penicillin allergy?
89. How should the class effect of the nasal steroids … described?
90. A 70 year-old presents urgently to the nurse practitioner clinic with angioedema. This began less than an hour ago. He is breathing without difficulty. What medication may have caused this?
91. Group A Strept pharyngitis:
92. A 45 year-old patient describes a spinning sensation that has occurred intermittently for the past 24 hours. It is …… by position changes like rolling over in bed. During these episodes, he complains of intense nausea. Which symptom is most characteristic of vertigo with a peripheral etiology?
93. A contact lens wearer presents with an erythematous conjunctiva. He denies blurred vision. There is scant drainage and crusting around the eye. He reports that there was crusting when he woke up this morning. How should the exam begin?
94. A patient has been …. with acute rhinosinusitis. Symptoms began 3 days ago. Based on the most likely etiology, how should this patient … managed?
95. Which statement about serous otitis media is correct?
96. A patient has 2 palpable, tender, left pre-auricular nodes that are about 0.5 cm in diameter. What might also …. found in this patient?
97. A 70 year-old patient has begun to have hearing loss. She relates that her elderly parents had difficulty hearing. Which complaint below is typical of presbycusis?