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NR576 Week 4 Midterm Exam

Which pathogen is most commonly associated with the development of a peritonsillar abscess?

1. Group A beta-hemolytic streptococcus ✅
2. Mycoplasma pneumoniae
3. Epstein-Barr virus
4. Streptococcus pneumoniae

 

A 62 year-old male is diagnosed with toenail onychomycosis following a positive KOH examination. Which medication is the most appropriate initial treatment?

1. Selenium sulfide
2. Terbinafine ✅
3. Fluconazole
4. Ketoconazole

 

A 20-year-old female is prescribed topical tretinoin for acne vulgaris. During the initial visit, which patient education point is most important to include?

1. Expect complete improvement within the first 2 weeks
2. Apply the medication to irritated or sunburned skin
3. Apply the medication immediately after washing the face
4. Use sunscreen daily because tretinoin increases photosensitivity ✅

 

The triad of symptoms commonly associated with Meniere’s disease includes hearing loss, vertigo and _____?

1. Hoarseness
2. Headache
3. Tinnitus ✅
4. Tinnitus

 

Ralph, a 49-year-old man, presents with complaints of a “red, raised, itchy rash” on his anterior and posterior forearms for the past six (6) months. His skin history is negative except for changing his daily work at the furniture factory. Seven months ago, he began working on the assembly line, in which he prepares furniture after the varnish has been applied. He confirms that he wears protective eyewear and gloves. Usually, he wears a short-sleeved shirt due to the temperature in the factory. What would be the most likely diagnosis of Ralph’s rash?

1. Cellulitis
2. Contact dermatitis ✅
3. Atopic dermatitis
4. Psoriasis

 

A 24-year-old competitive swimmer presents with severe right ear pain that worsens when the pinna is moved. Examination reveals an erythematous, edematous external auditory canal with purulent drainage. Which microorganism most commonly causes this condition?

1. Haemophilus influenzae
2. Moraxella catarrhalis
3. Streptococcus pneumoniae
4. Pseudomonas aeruginosa ✅

 

An AGPCNP provides teaching to a patient diagnosed with acute rhinosinusitis. Which statement by the patient indicates that additional teaching is needed?

1. “I will monitor my symptoms and seek care if they worsen.”
2. “I can use my nasal decongestant spray until my congestion is gone.” ✅
3. “I can take acetaminophen to relieve my discomfort.”
4. “I will drink plenty of fluids to stay hydrated.”

 

The AGPCNP performs a Weber test on a patient who reports decreased hearing in the right ear. The tuning fork sound is heard louder in the right ear. What is the most likely interpretation?

1. Mixed hearing loss
2. Right-sided sensorineural hearing loss
3. The exam is normal
4. Right-sided conductive hearing loss ✅

 

An AGPCNP is considering using a newly published clinical practice guideline to manage hypertension in a primary care clinic. Before applying the guideline to a patient, which factor is most important to evaluate?

1. Whether the guideline was recently revised
2. Whether the guideline is appropriate for this patient ✅
3. Whether the guideline was developed by a multidisciplinary panel
4. Whether the guideline includes recommendations for multiple practice settings

 

A pneumatic otoscopic examination is used to assess:

1. Tympanic membrane mobility ✅
2. Cerumen impaction
3. Inner ear conditions
4. Otitis externa

 

The most common etiologic organism for otitis media is?

1. Methicillin resistant staphylococcus
2. Mycoplasma
3. Streptococcus pneumoniae ✅
4. Beta hemolytic streptococcus

 

An 82-year-old male with a recent colostomy presents with a papular rash and satellite lesions surrounding the stoma. Which condition is most likely?

1. Peristomal candidiasis (Candida albicans) ✅
2. Allergic reaction to the appliance
3. Irritant contact dermatitis
4. Normal healing around the stoma

 

A 66-year-old male reports gradually worsening hearing in his left ear over the past year. The AGPCNP suspects either conductive or sensorineural hearing loss. Which combination of tests would best help differentiate these conditions during a clinic-based evaluation?

1. Pneumatic otoscopy, whisper test, and audiometry
2. Otoscopic examination, audiometry, and tympanometry
3. Whisper test, finger rub, and pneumatic otoscopy
4. Weber test, Rinne test, and Schwabach test ✅

 

A 16-year-old female presents to the clinic complaining of severe left sided sore throat and pain with swallowing for 1 day. Upon examination the patient appears uncomfortable and is febrile (101 degrees F). Oropharynx is beefy red with significant swelling and a pocket of pus above the left tonsil causing deviation of the soft palate and uvula. Cervical adenopathy is present on the left side. She has difficulty fully opening her jaw. What should the AGPCNP’s next step be?

1. Complete Blood Count (CBC)
2. Refer the patient to the Emergency Room ✅
3. Throat culture
4. Supportive care

 

A 23-year-old patient presents with sneezing, clear rhinorrhea, and nasal congestion for 3 days. Which additional symptom would most strongly support a diagnosis of allergic rhinitis rather than viral rhinitis?

1. Sore throat and hoarseness
2. Pruritus of the nose and palate ✅
3. Malaise and headache

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