1. A 5-year-old child is hit in the face with a baseball bat and is brought to
the clinic by a parent. An exam reveals three avulsed front teeth. Radiologic
studies are negative for facial fractures. What is the recommended
treatment?
: Refer the child to the dentist immediately for further evaluation
2. A child who was treated with amoxicillin and then amoxicillin-
clavulanate for acute otitis media is seen for follow-up. The primary care
nurse practitioner notes dull-gray tympanic membranes with a visible air-
fluid level. The child is afebrile and without pain. What is the next course of
action: Monitoring ear fluid levels for 3 months
3. A 13-year-old with cerebral palsy receives all nutrition via gastrostomy
tube. What will the primary care nurse practitioner recommend to promote
dental health in this child?: Daily chlorhexidine gluconate
4. A primary care provider may suspect cataract formation in a patient
with which finding?: Asymmetric red reflex
5. A patient has chronically dry eyes, sometimes with a foreign body
sensation, burning, and itching. A Schirmer test is abnormal. What is the
suspected cause of this patient's symptoms?: Aqueous Deficiency
,6. A teen who has otitis externa has severe swelling of the external
auditory canal that persists after 2 days of therapy with ototopical
antibiotic/corticosteroid drops. What is the next step in treatment for this
child?: Insert a wick into the external auditory canal
7. A patient reports tooth pain in a lower molar and the provider notes a
mobile tooth with erythema and edema of the surrounding tissues without
discharge. Which is the initial course of action by the provider?: Prescribe
amoxicillin and refer to a dentist in 2-3 days
8. An elderly patient has a permanent loss of the sense of smell and
diminished taste. What will be included in teaching this patient about
managing these symptoms?:
1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
9. A toddler exhibits exotropia of the right eye during a cover-uncover
screen. The primary nurse practitioner will refer to a pediatric
ophthalmologist to initiate which treatment?: Patching of the unaffected eye
for 2 hours each day
10. An adolescent has localized bleeding of the gums when brushing the
teeth. An exam of the mouth reveals the presence of plaque and calculus on
the teeth which are not loose. What will the primary care nurse practitioner
recommend?: Consistently brushing and flossing the teeth twice daily
11 A provider is recommending a cerumenolytic for a patient who has
chronic cerumen buildup. The provider notes that the patient has dry skin in
the ear canal. Which preparation is FDA approved for this use?: Carbamide
peroxide
, 12. A parent asks about ways to promote dental health in school-aged
children while on family vacation that are convenient while camping and
picnicking. What will the primary care nurse practitioner recommend?:
Offering gum containing xylitol after meals
13. A patient reports several episodes of acute vertigo, some lasting up to
an hour with associated nausea and vomiting. What is part of the initial
diagnostic workup for this patient?: Audiogram and MRI
14. A teen with a history of otitis externa asks about ways to prevent this
condition. What will the primary care nurse practitioner recommend?:
Drying the ear canal with a hair dryer
15. A 7-month-old infant has had two prior acute ear infections and is
currently on the 10th day of therapy with amoxicillin-clavulanate after a
failed course of amoxicillin. The primary care nurse practitioner notes
marker middle ear effusion and erythema of the TM. The child is irritable
and has a temperature of 99.8. What is the next step in management of
this child's infection?: Refer the child to an otolayngologist
16. A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What
is the likely cause of these symptoms?: Sialolithiasis
17. A child complains of itching in both ears and is having trouble hearing.
The primary care nurse practitioner notes periauricular edema and
marked swelling of the external auditory canal and elicits severe pain
when manipulating the external ear structures. Which is an appropriate
intervention?: Order ototopical antibiotic/corticosteroid drops
18. During a well child assessment of an African American infant, the
primary care nurse practitioner notes a dark red-brown light reflex in the
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