1 | P a g e NURS 676 FINAL EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS |LATEST UPDATE A patient who has asthma calls the provider to report having a peak flow measure of 75%, shortness of breath, wheezing, and cough. tells the provider that the symptoms have not improved significantly after a dose of albuterol. the patient uses an inhaled c orticosteroid medication twice daily. What will provider reccomend? administering two more doses of albuterol An adult develops chronic cough with episodes of wheezing and shortness of breath. the provider performs chest radiography and other tests and rul es out infection, upper respiratory, and GERD. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms? Spirometry a patient is seen in a clinic for an asthma exacerbation. the provider administers three nebulizer treatments with little improvement, noting a pulse ox reading of 90% with 2L of oxygen. A peak flow assessment is 70%. what is the next step in treating this patient? admit to the hospital with specialist consultation A patient with a purulent skin and soft tissue infection. A hx reveals a previous MRSA infection in a family member. THe clinician performs an incision and drainage of the lesion and send a sampl e to the lab for culture. what is the next step in treating this patient? prescribe oral clindamycin a previously healthy patient has an area of inflammation on one leg which has well demarcated borders and the presence of lymphangitis streaking. Based on the symptoms what is initial treatment? Amox -clav A child has vesicuopustular lesions around the nose and mouth with areas of honey colored crusts. The provider notes a few similar lesions on the child's hands and legs. Which treatment is appropriate for this child? amox -clav 2 | P a g e A patient has eyelid swelling with erythema and warmth and reports pain with eye movement. Which dx test will be performed to confirm diagnosis of orbital cellulitis? CBC, CT scan of orbits Which is the most common cause of orbital cel lulitis in all age groups? local spread from the ethmoid sinus A child has unilateral eyelid edema, warmth and erythema and does not exhibit pain with ocular movement. Which is most likely true about this child's infection? The eye is typically spared with out conjunctivitis A patient who has an inflamed pterygia lesion has been using loteprednol topical steroid, the patient shows no improvement in symptoms. What is next course of action? consult with ophthalmologist A patient seen in the ED after experienci ng department after a spider bite. the spider is in a jar and is less than one inch in size, yellow -brown, and has a violin shaped marking on its back. depending on patient's symptoms, which treatments and dx evaluations may be ordered? CBC, BUN, electroly tes, and creatinine, coaogulation studies, tetanus prophylaxis A child experiences a snake bite while camping and is seen in the ED. The child's parents are not able to identify the type of snake. An inspection of the site revelas two puncture wounds on th e child's arm with no swelling or erythema at the site. The child has normal vital signs. Which treatment is indicated? cleaning the wound, giving tetanus prophylaxis, and observing for 12 hours which type of bite is generally closed by delayed primary clo sure? bites to the hand, deep puncture wounds, wounds 8 hours old A patient has been bitten by a dog and has sustained several punture wounds near the thumbof one hand. The patient is able to move all fingers and the bleeding has stopped. What is correct t reatment for this patient? obtain a physician consult for eval and treat A 60 year old patient with a previous history of shingles asks about the herpes zoster vaccine. What will the provider recommend? a single dose of herpes zoster vaccine a patient who has recurrent frequent genital herpes outbreaks asks about therapy to minimizw the episodes, what will the provider reccomend as first -line treatment? acyclovir 3 | P a g e A patient who has never had an outbreak of oral lesions reports a burning sensation on the oral mucosa and then develops multiple painful rounds vesicles at the site. A tzanck culture confirms HSV -1 infection. What will the provider tell the patient about this condition? the initial episode is usually the most severe An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella, What will the provider tell her? contagion is possible until all of her lesions are crusted. A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order? PCR analysis which medication will the provider prescribe as first -line therapy to treat tinea capitis? Oral griseofulvin when collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape wh ich portion of the lesion? the active, leading border When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a wood lam and is unable to elicit fluoroesence. how is this significant? the patient may have tinea capit is. What is true about electrical injuries> alternating current causes skeletal muscle contraction, electrical injury may cause more necrosis, lightening is less lethal because duration of shock is short. An adult patient has epiglottitis secondary to chemical burn. Which medication will be given initially to prevent complications. Define the standard of care This is the obligation of the physician to perform acts that a reasonable or prudent physician in a similar situation would perform Define the patient -provider relationship The relationship is built on trust. The patient trusts the provider with their healthcare and the provider trusts the patient to fulfill duties recommended by the provider. A patient who works in a furniture manufacturing ship reports a sudden onset of severe eye pain while sanding a piece of wood and now has tearing, redness, and light sensativity. What is the next step? application of topical flourescein dye 4 | P a g e A child has localized no dule on one eyelid which is warm, tender, and erythematous. On exam, the provider notes clear conjunctivae and no discharge. what is recommended treatment? warm compresses and massage of the lesion A patient has a gradually enlarging nodule on one upper ey elid and reports that the lesion is painful. On exam, the lesion appears warm and erythematous. the provider knows that this is likely what? Hordeolum A patient reports he has been using artificial tears for comfort because of burning and itching in both eyes, but reports worsening symptoms. the provider notes redness and discharge along the eyelid margins. what is recommended treatment? Compresses, lid scrubs, and antibiotic ointment A patient who has a cold develops conjunctivitis. The provider notes eryt hema of one eye with profuse, watery discharge and enlarged anterior cervical lymph nodes, along with a fever. Which treatment is inidcated. artificial tears and cool compresses A patient reports bilateral reports burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. Which type of conjunctivitis is most likely? Allergic conjunctivitis A patient wit h allergic conjunctivitis who has been using topical antihistamine -vasosonstrictor medication reports worsening symptoms. What is the providers;s next step managing the patient's symptoms? determine duration of treatment with medication A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider administers one NG tablet which does not relieve the pain. What is the next action? Give the patient a beta blocker A patient is brought to an emergency department with symptoms of acute ST segment elevation MI (STEMI). The nearest hospiral that can perform a PCI is three hours away, what is the initial treatment for this patient. Initiate fibrinolytic therapy A patient reports a feeling of fullness and pain in both ears and the practitioner elicits pain when manipulating the ear structures, what is likely the diagnosis? acute otitis externa Which are risk factors for developing otitis externa? having underlying DM, use of ear plugs or hearing aids, vigorous external hygiene
