Nurs 629 Exam 3 (Maryville) Questions with Complete Solutions
Otitis media pathogens CORRECT ANS Caused by: S. Pneumoniae (most common); H. Influenzae, M. Catarrhils
Otitis media Symptoms: CORRECT ANS Fever, Pain, discharge from ear, tugging at ear, irritability, crying, lethargy, decreased appetite, decreased sleep, Recent URI
Objective findings in otitis media CORRECT ANS Red, bulging OM; Retracted with pus; no movement of TM, Inability to see landmarks; occasional hole in TM
Treatment for AOM + Conjunctivitis d/t : H. Influenzae CORRECT ANS Amoxicillin-clavulanate 80-90 mg/kg/day BID x 10 days
Treatment for AOM d/t S. Pneumoniae (most common): CORRECT ANS Amoxicillin 80-90 mg/kg/day BID x 10 days (high dose)
Treatment for AOM with PCN Allergy: Non-Type 1: CORRECT ANS Cefdinir, Cefuroxime
Treatment for AOM with PCN Allergy: Type 1: CORRECT ANS Azithromycin, clarithromycin OR Ceftriaxone 1-3 days Predisposing factors of otitis externa: CORRECT ANS Frequent moisture, local trauma, aggressive cleaning, Allergies/skin conditions
Causative organisms for otitis externa: CORRECT ANS Psuedomonas aeruginosa (20-60%); Staphylococcus Aureus (10-70%); 10% fungal infection
Symptoms of otitis externa: CORRECT ANS Discharge from ear, recent
history of swimming or placing something in the ear, low-grade fever, pain with movement of tragus, decreased hearing, redness around ear
Objective findings of otitis externa: CORRECT ANS Otalgia ( inner or outer ear pain), discharge, fullness, itching, pain with movement of tragus, redness around ear, decreased hearing.
Treatment of pain and therapeutic management of otitis externa: CORRECT ANS Warm compresses, Auralgan, prednisone, Tylenol/ibuprofen, Wick (abx applied to wick )
When to wick with otitis externa: CORRECT ANS If lumen is reduced to >50%, wicks can help ensure delivery of topical abx to medial canal.
Treatment of otitis externa: CORRECT ANS Topical fluroquinolones (Ciprofloxacin, Ofloxacin), ibuprofen and apap for pain, neomycin/polymixin b/hydrocortison otic (antibiotic/steroid) Hallmark sign of otitis externa: CORRECT ANS Traction of pinna elicits pain
When do we begin hearing tests in clinic for children CORRECT ANS 4
years old
What is a normal audiology test result and how are results read CORRECT ANS Normal -10 to +15 The higher the number, the greater the loss, Severe loss 71-90 (learning disability, limited vocabulary), Profound loss 90
Risk factors related to elevated cholesterol CORRECT ANS Obesity, Diabetes, Hypertension, Family history: Coronary heart disease prior to age 55, Hyperlipidemia, Diabetes
Clinical findings for tetralogy of Fallot: CORRECT ANS Cyanosis: caused by blood low in oxygen, Shortness of breath and rapid breathing, especially during feeding or exercise, Loss of consciousness, Clubbing of fingers and toes, Poor weight gain, delayed growth, Polycythemia, metabolic acidosis, Systolic murmur at 2nd left ICS & holosystolic murmur at LLSB
What criteria would you have to consider inpatient admission in a patient with pneumonia CORRECT ANS Infants less than 4 months old,
Infant with poor feeding, grunting, O2 saturation <92%, respiratory rate >70 , Older child with grunting, inability to tolerate oral intake, oxygen saturation ≤ 92 percent, respiratory rate > 50 breaths per minute, Any age: Comorbidities (e.g., chronic lung disease, asthma, unrepaired or incompletely repaired congenital heart disease, diabetes mellitus, neuromuscular disease)
Visual acuity of a 2-month-old CORRECT ANS • Vision is 20/400 • Fix
and follow objects
Viral conjunctivitis etiology (causative agent): CORRECT ANS Adenovirus is the most common cause. Other causes: HSV, herpes zoster, and varicella
Viral conjunctivitis symptoms: CORRECT ANS o Watery discharge (profuse and clear), foreign body sensation, redness o URI symptoms are
common including sore throat and fever o Itchy conjunctiva and swollen
eye lids o Often bilateral
Viral conjunctivitis Clinical findings CORRECT ANS o Normal visual acuity, PERRLA, EOMI, Fundus normal o Mucoid-profuse watery discharge o Mild, diffuse injection and itching o *Preauricular lymphadenopathy
Viral conjunctivitis Treatment: CORRECT ANS Symptomatic Only - Warm or cool compresses, Strict hand hygiene
Pharyngitis CORRECT ANS Typically viral
Causative organism for bacterial pharyngitis CORRECT ANS Group A Beta Hemolytic strep
