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FNP-652 Quiz 1 Exam/24 Questions and Answers
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FNP-652 Quiz 1 Exam/24 Questions and Answers
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FNP-652 Quiz 1 Exam/24Questions and Answers
Hearing Loss in the elderly - -Conductive- usually caused by problems in the
external or middle ear that interfere with transmitting sound and its
conversion to mechanical vibrations (IE Cerumen impaction, perforated
membrane)
Sensoineural- involves problems converting mechanical vibrations to
electrical potential in the cochlea and/or in auditory nerve transmission to
the brain. It is usually caused by permanent damage in the organ of Corti.
(Age related hearing loss; noise trauma)
-Hearing Loss in the elderly - -Affects 60-80% of 70 yr +. Start with Whisper
and Rinne tests. Refer patients for Adiometric testing if there is no obvious
occlusion.
Differential Diagnoses: Cerumen impaction, foreign object, tumors.
-Vision Screening in <1 year old - -As part of each well-child visit, eye
health, vision development, and alignment of the eyes should be checked.
Findings that merit watchful waiting: Chemical conjunctivitis in neonates
Referral considering age of patient: Eye alignment, not making eye contact
-Tympanogram results - -Tympanometry measures the capacity of the
middle ear to transfer sound energy.
What do they indicate:
Type A: Normal Tympanogram is shaped like a tent
Type B: Abnormal; needs medical attention (flat)
Type C: Almost normal but not right (may be too peaked);refers to a middle
ear with negative pressure. A child with this type of tympanogram should be
monitored and may need medical attention. Such a tympanogram may be
caused by retraction of the eardrum or blockage of the Eustachian tube.
-Group A hemolytic strep - -Illnesses it can cause: Strep throat, Rheumatic
Fever, Scarlet Fever, Post-Streptococcal Glomerularnephritis. It is spread by
nasal or oral secretions and the incubation period of 2-5 days.
Presentation: often pharyngitis is the very first symptom. Suspect Group A
strep if:
Sudden-onset of sore throat
Odynophagia
Fever
, Evaluation:
Pharyngeal and tonsillar erythema
Tonsillar hypertrophy with or without exudates
Palatal petechiae
Anterior cervical lymphadenopathy
Scarlatiniform rash
Diagnosis:
The diagnosis of group A strep pharyngitis is confirmed by either a rapid
antigen detection test (RADT) or a throat culture.
Treatment:Penicillin or amoxicillin is the antibiotic of choice to treat group A
strep pharyngitis.
-Management of Allergic Rhinitis - -Allergic rhinitis: inflammation of the
nasal membranes in response to known or unknown allergens
Medications (available OTC): Intranasal corticosteroids (Fluticasone); oral
antihistamines for intermittent attacks or milder disease (Cetirizine,
fexofenadine)
Home remedies: Avoid triggers, Nasal irrigation, HEPA filter
-Otitis Externa vs Otitis Media - -Otitis Externa: Swimmers ear. Commonly
caused by infection (bacterial usually) or from water/chemical exposure.
Patient notices discomfort usually unilaterally. External auditory canal is
inflamed and irritated with erythema, drainage is common.
Otitis Media: Acute onset with middle ear effusion, inflammation, pain, or
fever. Caused by Eustachian tube dysfunction r/t viral upper respiratory
infection. Start with Amoxicillin, then go to Augmentin.
-Choleasteatoma - -Presentation: Abnormal non-cancerous skin growth that
can develop in the middle section of the ear. May be caused by repeated
middle ear infections
Evaluation: Visual examination, refer to ENT.
-Lacrimal Duct Obstruction in Infant - -Presentation:Tears are produced in
the lacrimal duct. Look for tear lakes and excess watering of the eye. Should
be negative for corneal and conjunctival irritation and abnormalities.
Treatment: Lacrimal sac massage and topical antibiotics.
-Elderly Vision loss - -Causes of typical changes: age related ,acular
degeneration, glaucoma, cataracts, diabetic retinopathy.
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