Nr511 Midterm and Final test bank - 2018

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TOTAL CHAPTERS 21 STARTING FROM 3 TO 24 .

CHECK ATTACHMENT FOR ALL QUESTIONS

 

Chapter 3. Health Promotion

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosterone deficiency?

a.

Calcium supplementation

b.

Testicular self-examination

c.

Bone density test

d.

Digital rectal examination

____ 2. Which of the following is an example of secondary prevention in a 50-year-old woman?

a.

Yearly mammogram

b.

Low animal fat diet

c.

Use of seat belt

d.

Daily application of sunscreen

____ 3. Which of the following is an example of tertiary prevention in a patient with chronic renal failure?

a.

Fluid restriction

b.

Hemodialysis 4 days a week

c.

High-protein diet

d.

Maintenance of blood pressure at 120/80

____ 4. Immunizations are an example of which type of prevention?

a.

Primary

b.

Secondary

c.

Tertiary

True/False

Indicate whether the statement is true or false.

____ 1. Prevalence is the number of new cases of a particular disease.

____ 2. The number of cases of a particular disease for the past 5 years is an example of the incidence rate.

____ 3. “There are 1,185,000 cases of HIV/AIDS in the United States” is an example of the morbidity rate.

____ 4. Endemic is the term used when the presence of an event is constant.

____ 5. The “bird” flu of 2005 to 2006 is considered a sporadic outbreak.

____ 6. A pandemic affects many communities in a short period of time.

 

Chapter 5. Evidence-Based Care

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which of the following are parts of evidence-based practice?

a.

Clinician

b.

Patient

c.

Evidence

d.

All of the above

____ 2. Which is the most important question to ask in nursing research?

a.

What findings constitute evidence?

b.

How will the findings be used?

c.

Is this a randomized controlled trial?

d.

What theory is being utilized?

____ 3. Nursing research should be utilized by:

a.

Nurses at the bedside

b.

Advanced practice nurses

c.

Nurse researchers

d.

Nurses at all levels of practice

____ 4. Applying evidence at the point of care requires:

a.

Readily available evidence-based resources

b.

Ability to review research literature

c.

Single articles in journals

d.

Current textbooks

____ 5. Practice guidelines are designed to:

a.

Be inflexible

b.

Be utilized in every circumstance

c.

Provide a reference point for decision making

d.

Be created by a professional organization to guide the practice of a profession

____ 6. Which of the following is a crucial element of developing a guideline?

a.

Creating a physician expert panel

b.

Reviewing the literature with ratings of available evidence

c.

Conducting an external review of a guideline

d.

Developing evidence-based tables

____ 7. Which of the following would be considered the research design for Level I evidence?

a.

Single, well-designed randomized clinical trial

b.

Systematic review of randomized clinical trial studies

c.

Well-designed controlled trials without randomization

d.

Systematic reviews of descriptive or qualitative studies

____ 8. Which of the following would be considered the research design for Level II evidence?

a.

Single descriptive or qualitative study

b.

Well-designed case control or cohort studies

c.

Single, well-designed, randomized clinical trial

d.

Systematic review of randomized clinical trial studies

____ 9. Which of the following would be considered the research design for Level III evidence?

a.

Well-designed controlled trials without randomization

b.

Systematic reviews of descriptive or qualitative studies

c.

Systematic review of randomized clinical trial studies

d.

Opinion of authorities and expert committees

____ 10. Which of the following would be considered the research design for Level IV evidence?

a.

Single descriptive or qualitative study

b.

Opinion of authorities and expert committees

c.

Systematic review of randomized clinical trial studies

d.

Well-designed controlled trials without randomization

____ 11. Which of the following would be considered the research design for Level V evidence?

a.

Systematic review of randomized clinical trial studies

b.

Well-designed controlled trials without randomization

c.

Systematic reviews of descriptive or qualitative studies

d.

Single descriptive or qualitative study

____ 12. Which of the following would be considered the research design for Level VI evidence?

a.

Systematic reviews of descriptive or qualitative studies

b.

Opinion of authorities and expert committees

c.

Well-designed case control or cohort studies

d.

Single descriptive or qualitative study

____ 13. Which of the following would be considered the research design for Level VII evidence?

a.

Well-designed controlled trials without randomization

b.

Opinion of authorities and expert committees

c.

Well-designed case control or cohort studies

d.

Single descriptive or qualitative study

Chapter 6. Neurological Problems

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which statement about confusion is true?

a.

Confusion is a disease process.

b.

Confusion is always temporary.

c.

Age is a reliable predictor of confusion.

d.

Polypharmacy is a major contributor to confusion in older adults.

____ 2. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

a.

Meclizine

b.

Diphenhydramine

c.

Diamox

d.

Promethazine

____ 3. The hallmark of an absence seizure is:

a.

No activity at all

b.

A blank stare

c.

Urine is usually voided involuntarily

d.

The attack usually lasts several minutes

____ 4. How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

a.

Every 3 months

b.

Every 6 months

c.

Annually

d.

Whenever there is a problem

____ 5. Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

a.

A teenage male

b.

A 65-year-old male

c.

A 25-year-old female

d.

A 60-year-old female

____ 6. Which of the following is a specific test to MS?

a.

Magnetic resonance imaging (MRI)

b.

Computed tomography (CT) scan

c.

A lumbar puncture

d.

There is no specific test.

____ 7. Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a.

Cholinesterase inhibitors

b.

Anxiolytics

c.

Antidepressants

d.

Atypical antipsychotics

____ 8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

a.

Epidural hematoma

b.

Subdural hematoma

c.

Subarachnoid hematoma

d.

Intraparenchymal hemorrhage

____ 9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

a.

CN V

b.

CN VII

c.

CN IX

d.

CN X

____ 10. Which statement best describes a carotid bruit?

a.

It is felt with the middle three fingers over the carotid artery.

b.

A bruit becomes audible when the lumen is narrowed to 1 mm or less.

c.

A low-pitched bruit is a medical emergency.

d.

The higher the pitch of the bruit, the higher the degree of stenosis.

____ 11. Which patient is more likely to have a cluster headache?

a.

A female in her reproductive years

b.

A 40-year-old African American male

c.

A 55-year-old female who drinks 10 cups of coffee daily

d.

A 45-year-old male awakened at night

____ 12. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

a.

Dementia

b.

Alzheimer’s disease

c.

Parkinson’s disease

d.

Delirium

____ 13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

a.

Purulent meningitis

b.

Chronic meningitis

c.

Aseptic meningitis

d.

Herpes meningitis

____ 14. Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

a.

MRI

b.

CT

c.

Electroencephalogram (EEG)

d.

An initial lumbar puncture

____ 15. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

a.

A stabbing pain on one small area of the body

b.

A vesicular skin lesion on one side of the body

c.

A pain that is worse upon awakening

d.

A lesion on the exterior ear canal

____ 16. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

a.

“Most patients have complete recovery in 3 to 6 months.”

b.

“Unfortunately, you’ll probably have a small amount of residual damage.”

c.

“Don’t worry, I’ll take care of everything.”

d.

“You may have a few more episodes over the course of your lifetime but no permanent damage.”

____ 17. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

a.

“L-dopa is neuroprotective.”

b.

“The primary goal of therapy is to replace depleted stores of dopamine.”

c.

“This is the only drug that can provide symptomatic benefit.”

d.

“This is the initial monotherapy drug.”

____ 18. Which of the following signs is seen in a patient with more advanced PD?

a.

Resting tremor

b.

Bradykinesia

c.

Rigidity

d.

Postural instability

____ 19. Which of the following is the most commonly experienced symptom of migraine?

a.

Light sensitivity

b.

Pulsatile pain

c.

Sound sensitivity

d.

Experiencing an aura

____ 20. Which of the following characteristics differentiates peripheral vertigo from central vertigo?

a.

The duration of central vertigo is shorter than that of peripheral vertigo.

b.

There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.

c.

Central vertigo is positional, and peripheral vertigo is not.

d.

The onset of central vertigo is more sudden than that of peripheral vertigo.

____ 21. Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

a.

Greater than 25%

b.

Greater than 50%

c.

Greater than 75%

d.

Only for 100% occlusion

____ 22. What antiplatelet agent is most widely used for secondary prevention of stroke?

a.

Aspirin

b.

Ticlopidine

c.

Clopidogrel

d.

Aspirin and clopidogrel

____ 23. Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

a.

MRI

b.

CT

c.

Cerebrospinal fluid analysis

d.

EEG

____ 24. Which herbal preparation may cause delirium and should be avoided in an elderly patient?

a.

Sam-e

b.

Saint John’s Wort

c.

Melatonin

d.

Saw Palmetto

____ 25. Which of the following activities is part of the functional activities questionnaire?

a.

Asking the patient to unravel a Rubik’s cube

b.

Determining if the patient can drive on the highway

c.

Asking the patient about a news event from the current week

d.

Seeing if the patient can keep his or her home clean

____ 26. About 90% of all headaches are?

a.

Tension

b.

Migraine

c.

Cluster

d.

Without pathological cause

____ 27. Which statement is true regarding driving and patients with a seizure disorder?

a.

Once diagnosed with a seizure disorder, patients must never drive again.

b.

After being seizure free for 6 months, patients may drive.

c.

Each state has different laws governing driving for individuals with a seizure disorder.

d.

These persons may drive but never alone.

____ 28. Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

a.

Glatiramer acetate

b.

Natalizumab

c.

Fingolimod

d.

Glucocorticoids

____ 29. The ‘freezing phenomenon’ is a cardinal feature of?

a.

Parkinson’s disease

b.

Alzheimer’s disease

c.

A CVA

d.

Bell’s palsy

____ 30. A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

a.

Spinothalamic dysfunction

b.

Ratcheting

c.

Cogwheeling

d.

Hand tremors

____ 31. Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

a.

Guillain-Barré syndrome

b.

Parkinson’s disease

c.

Alzheimer’s disease

d.

Huntington’s disease

____ 32. Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

a.

Guillain-Barré syndrome

b.

Parkinson’s disease

c.

Alzheimer’s disease

d.

Delirium

____ 33. A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

a.

SLUMS

b.

MoCA

c.

FAST

d.

MMSE

____ 34. Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

a.

1 hour

b.

3 hours

c.

6 hours

d.

12 hours

____ 35. When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

a.

Tension

b.

Migraine

c.

Cluster

d.

Stress

Chapter 7. Skin Problems

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

a.

“You must be under a lot of stress lately.”

b.

“It is hereditary. Did your father experience this also?”

c.

“The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d.

“We’ll have to do some tests.”

____ 2. Which of the following is “a linear crack extending from the epidermis to the dermis?”

a.

An ulcer

b.

A fissure

c.

Lichenification

d.

An excoriation

____ 3. A bulla is:

a.

A vesicle larger than 1 cm in diameter

b.

An elevated solid mass with a hard texture; the shape and borders can be regular or irregular

c.

A superficial elevated lesion filled with purulent fluid

d.

Thinning of the skin (epidermis and dermis) that appears white or translucent

____ 4. An example of ecchymosis is:

a.

A hematoma

b.

A keloid

c.

A bruise

d.

A patch

____ 5. When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a.

Spores

b.

Leukocytes

c.

Pseudohyphae

d.

Epithelial cells

____ 6. Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

a.

Vagistat vaginal cream

b.

Monistat combination pack

c.

Terazol vaginal cream

d.

Diflucan, 150 mg

____ 7. Tinea unguium is also known as:

a.

Onychomycosis

b.

Tinea versicolor

c.

Tinea manuum

d.

Tinea corporis

____ 8. Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus.The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

a.

Bullous impetigo

b.

Staphylococcal scalded skin syndrome (SSSS)

c.

Nonbullous impetigo

d.

Ecthyma

____ 9. Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

a.

Staphylococcal aureus

b.

Clostridium perfringens

c.

S. pyrogenes

d.

Streptococcus

____ 10. When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?

a.

A piece of hair or a thread

b.

Hyphae

c.

Leukocytes

d.

Spores

____ 11. Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?

a.

It is an old wives’ tale.

b.

It is used as a last resort.

c.

Salicylic acid is more effective.

d.

It is a simple treatment that should be tried first.

____ 12. Which is the most potent and irritating dose of tretinoin?

a.

0.05% liquid formulation

b.

0.1% cream

c.

1% foam

d.

0.02% cream

____ 13. Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?

a.

Necrotizing fasciitis

b.

Periorbital cellulitis

c.

Erysipelas

d.

“Flesh-eating” cellulitis

____ 14. Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

a.

Filiform/digitate wart

b.

Dysplastic cervical lesion

c.

Condyloma acuminata

d.

Koilocytosis

____ 15. Jeffrey has atopic dermatitis. You are prescribing a low-dose topical corticosteroid for him. Which would be a good choice?

a.

Betamethasone dipropionate 0.05%

b.

Hydrocortisone base 2.5%

c.

Halcinonide 0.1%

d.

Desonide 0.05%

____ 16. Harvey has a rubbery, smooth, round mass on his chest that is compressible and has a soft-to-very-firm texture. What do you diagnose this as?

a.

A lipoma

b.

A nevi

c.

A skin tag

d.

A possible adenoma

____ 17. Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?

a.

Do not use lidocaine as it may potentiate bleeding.

b.

Pinch the skin taut together.

c.

Use gel foam to control bleeding.

d.

This should be performed by a dermatologist only.

____ 18. The “B” in the ABCDEs of assessing skin cancer represents:

a.

Biopsy

b.

Best practice

c.

Boundary

d.

Border irregularity

____ 19. The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

a.

IgA

b.

IgE

c.

IgG

d.

IgM

____ 20. Eighty percent of men have noticeable hair loss by what age?

a.

35

b.

50

c.

70

d.

85

____ 21. Prevalence of psoriasis is highest in which group?

a.

Scandinavians

b.

African Americans

c.

Asians

d.

Native Americans

____ 22. The most common precancerous skin lesion found in Caucasians is:

a.

A skin tag

b.

Actinic keratosis

c.

A melanoma

d.

A basal cell lesion

____ 23. Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation. There is some edema involved. You suspect:

a.

Necrotizing fasciitis

b.

Kaposi’s sarcoma

c.

Cellulitis

d.

A diabetic ulcer

____ 24. Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

a.

There are round, hypopigmented macules on his back.

b.

Josh has red papules on his face.

c.

There are crusted plaques in Josh’s groin area.

d.

There are white streaks on his neck.

____ 25. Tori is on systemic antifungals for a bad tinea infection. You are aware that the antifungals may cause:

a.

Renal failure

b.

Skin discoloration

c.

Breathing difficulties

d.

Hepatotoxicity

____ 26. Which scalp problem can be caused by a fever and certain drugs?

a.

Telogen effluvium (TE)

b.

Trichotillomania

c.

Psoriasis

d.

Alopecia areata

____ 27. Why do people of African descent have a lower incidence of non-melanoma skin cancer?

a.

They have an increased number of melanocytes.

b.

Their darker skin protects from ultraviolet radiation.

c.

Their skin is thicker.

d.

Their immune system is stronger.

____ 28. Which statement is true regarding chloasma, the ‘mask of pregnancy’?

a.

It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy.

b.

This condition only occurs on the face.

c.

Exposure to sunlight will even out the discoloration.

d.

It is caused by increased levels of estrogen and progesterone.

____ 29. When instructing your elderly client about treating her xerosis, what do you tell her?

a.

A daily hot bath may help the associated pruritus.

b.

Rub the skin briskly to make sure it is completely dry after bathing.

c.

Only take short tepid showers.

d.

Use a gel that is alcohol-based after bathing to soften the skin.

____ 30. Which medication used for scabies is safe for children 2 months and older?

a.

Permethrin cream

b.

Lindane

c.

Crotamiton lotion and cream

d.

Ivermectin

____ 31. Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

a.

Keratosis pilaris

b.

Dennie’s sign

c.

Keratoconus

d.

Pityriasis alba

____ 32. Which of the following statements about performing cryosurgery for actinic keratosis is true?

a.

It is better to slightly overfreeze the area, so you only have to do it once.

b.

Using liquid nitrogen, freeze each lesion for at least 30 seconds.

c.

Every lesion should be biopsied after using liquid nitrogen.

d.

The ‘freeze balls’ should be approximately one-and-a-half times as wide as they are deep.

____ 33. An example of a primary skin lesion is a/an:

a.

Bulla

b.

Scale

c.

Excoriation

d.

Fissure

____ 34. Which statement regarding necrotizing fasciitis is true?

a.

The hallmark of this infection is its slow and steady progression.

b.

Once the border of the infection is “established,” it does not spread.

c.

Loss of life or limb is a potential complication.

d.

The lesion is most dangerous, because it is painless.

____ 35. When staging a malignant melanoma using Clark’s levels, which level extends into the papillary dermis?

a.

Level I

b.

Level II

c.

Level III

d.

Level IV

Chapter 8. Eyes, Ears, Nose, and Throat

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. An acutely presenting, erythematous, tender lump within the eyelid is called:

a.

Blepharitis

b.

Hordeolum

c.

Chalazion

d.

Iritis

____ 2. The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

a.

Viral conjunctivitis

b.

Keratoconjunctivitis

c.

Bacterial conjunctivitis

d.

Allergic conjunctivitis

____ 3. Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?

a.

Nuclear cataracts

b.

Cortical cataracts

c.

Posterior cataracts

d.

Immature cataracts

____ 4. Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?

a.

The body converts bilberry to vitamin A, which helps to maintain a healthy lens.

b.

Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.

c.

Bilberry boosts oxygen and blood delivery to the eye.

d.

Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

____ 5. A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a.

The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.

b.

The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.

c.

Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

d.

Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

____ 6. Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure?

a.

0 to 7 mm Hg

b.

8 to 21 mm Hg

c.

22 to 40 mm Hg

d.

40 to 80 mm Hg

____ 7. As diabetic retinopathy progresses, the presence of ‘cotton wool’ spots can be detected. Cotton wool spots refer to:

a.

Nerve fiber layer infarctions

b.

Blood vessel proliferation

c.

Venous beading

d.

Retinal hemorrhage

____ 8. Which of the following is an example of sensorineural hearing loss?

a.

Perforation of the tympanic membrane

b.

Otosclerosis

c.

Cholesteatoma

d.

Presbycusis

____ 9. The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient’s mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?

a.

Weber test

b.

Schwabach test

c.

Rinne test

d.

Auditory brainstem response (ABR) test

____ 10. A patient presents to the clinician complaining of ear pain. On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition?

a.

Otitis media

b.

Meniere’s disease

c.

Tinnitus

d.

Otitis externa

____ 11. Otitis media is considered chronic when:

a.

Inflammation persists more than 3 months with intermittent or persistent otic discharge.

b.

There are more than six occurrences of otitis media in a 1-year period.

c.

Otitis media does not resolve after two courses of antibiotics.

d.

All of the above

____ 12. The most significant precipitating event leading to otitis media with effusion is:

a.

Pharyngitis

b.

Allergies

c.

Viral upper respiratory infection (URI)

d.

Perforation of the eardrum

____ 13. Patients with acute otitis media should be referred to a specialist in which of the following situations?

a.

Concurrent vertigo or ataxia

b.

Failed closure of a ruptured tympanic membrane

c.

If symptoms worsen after 3 or 4 days of treatment

d.

All of the above

____ 14. Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?

a.

IgA

b.

IgE

c.

IgG

d.

IgM

____ 15. Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?

a.

Vasomotor rhinitis

b.

Rhinitis medicamentosum

c.

Atrophic rhinitis

d.

Viral rhinitis

____ 16. Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:

a.

4 weeks

b.

8 weeks

c.

12 weeks

d.

16 weeks

____ 17. Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected?

a.

Penicillin V

b.

Amoxicillin

c.

Levofloxacin

d.

Clindamycin

____ 18. In which of the following situations would referral to a specialist be needed for sinusitis?

a.

Recurrent sinusitis

b.

Allergic sinusitis

c.

Sinusitis that is refractory to antibiotic therapy

d.

All of the above

____ 19. Which type of stomatitis results in necrotic ulceration of the oral mucous membranes?

a.

Vincent’s stomatitis

b.

Allergic stomatitis

c.

Apthous stomatitis

d.

Herpetic stomatitis

____ 20. The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?

a.

HSV type 2

b.

HIV

c.

Pneumonia

d.

Syphilis

____ 21. Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?

a.

Coxsackievirus

b.

Cytomegalovirus

c.

Francisella tularensis

d.

Group A streptococcus

____ 22. A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?

a.

Gonorrhea

b.

Mononucleosis

c.

Influenza

d.

Herpes zoster

____ 23. A patient presents to the clinician with a sore throat, fever of 100.7°F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

a.

The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

b.

Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.

c.

A throat culture should be performed to confirm the results of the rapid strep test.

d.

The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

____ 24. Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?

a.

Pilocarpine

b.

Timolol

c.

Brinzolamide

d.

Acetazolamide

____ 25. You have a patient who is a positive for Strep on rapid antigen testing (rapid strep test). You order amoxacillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5 F in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide:

a.

to refer the patient.

b.

that he is having an allergic response and needs to be changed to a macrolide antibiotic.

c.

that his antibiotic dosage is not sufficient and should be changed.

d.

that he possibly has mononucleosis concurrent with his strep infection.

____ 26. You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

a.

instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.

b.

stabilize the foreign object and accompany the mother and child to the local ER.

c.

find a water fountain, hold the child to the water, and flush the eye.

d.

call 911.

True/False

Indicate whether the statement is true or false.

____ 1. Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.

 

Chapter 9. Respiratory Problems

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____ 1. A chronic cough lasts longer than:

a.

3 weeks

b.

1 month

c.

6 months

d.

1 year

 

 

____ 2. You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

a.

Baker phenomenon

b.

Arnold reflex

c.

Cough reflex

d.

Tragus reflex

 

 

____ 3. Julie has a postnasal drip along with her cough. You assess her for:

a.

Asthma

b.

Sinusitis

c.

Allergic or vasomotor rhinitis

d.

Influenza

 

 

____ 4. A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from:

a.

Metoprolol

b.

Clopidogrel

c.

Tadalafil

d.

Captopril

Nr511 Midterm and Final test bank - 2018
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