nr 511 differential diagnosis and primary care practicum
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NR 511 Week 2 Quiz 2
NR 511 Differential Diagnosis and Primary
Care Practicum
, Question 1
pts
A 75-year-old female presents to your office complaining of dizziness and ringing in both ears for 1 day.
She describes the dizziness as feeling like "the room is spinning". On physical exam, the Rinne test
reveals that air conduction is greater than bone conduction bilaterally. The Weber test reveals
lateralization to the left. She is unable to hear the examiner's whisper on the right side but can hear the
whisper on the left side. What is the next step in helping this patient’s symptoms?
Start her on high-dose Augmentin.
Correct!
Start the patient on a low-salt diet, prescribe meclizine for vertigo and refer her to an ENT specialist.
Order a computed tomography (CT) scan to rule out acoustic neuroma.
Refer the patient to the Emergency Room.
Meniere's disease is characterized by vertigo, tinnitus and hearing loss. The patient self-reports vertigo
and tinnitus while the results of the Weber, Rinne, and whisper test indicate sensorineural hearing loss
on the right. Meniere disease is diagnosed based on history and the exclusion of other conditions as
well. Referral to ENT is warranted to rule out other etiologies. The treatment for symptoms of Meniere
disease is both dietary and pharmacological. Antibiotics are not indicated, nor is it necessary to send the
patient to the Emergency Room. A CT scan would not help to relieve the patient's symptoms.
Question 2
pts
A 72-year-old male patient presents to the clinic for his annual physical. He states that he is worried
because he only has a bowel movement every three days. How should the clinician respond?
Correct!
“There is no such thing as a ‘normal’ pattern of defecation.”
“You should defecate once a day.”
“You should have at least three stools per week.”
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