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2025 NURS 676 ADVANCED PHARMACOLOGY FINAL EXAM
|ACTUAL QUESTIONS AND ANSWERS|ALREADY GRADED
A+|UNIVERSITY OF SOUTHERN MISSISSIPPI
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 A patient has an initial episode of otitis external associated with swimming. the patient's ear canal is mildly inflamed and the TM is not involved. Which medication will be ordered? Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to determine the severity of pain in children with OM? Appetite, Difficulty sleeping, and tugging on ears. Which patient may be given symptomatic treatment with 24 hours follow-up assessment without initial antibiotic therapy? A 36 month old with fever of 38.5, mild otalgia, and red, non-bulging TM A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is unable to visualize the TM in the right ear because of the presence of cerumen. The left TM is dull gray with fluid levels present. What is the correct action? Remove the cerumen and visualize the TM A patient reports ear pain and difficulty hearing. An otoscope examination reveals a small tear in the TM of the affected ear with purulent d/c. What is the initial treatment for this patient? Prescribe antibiotic ear drops A patient reports ear pain after being hit in the head with a baseball. The provider notes a perforated TM. What is recommended treatment? Refer the patient to an Otolaryngologist for eval An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul-smelling breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What should you do?
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy and has negative GAS culture. A cbc shows absolute lymphocytosis, but a heterophil antibody test is negative for EBV. What will the provider tell the patient? The likelihood of EBV is still high A patient reports persistent nasal blockage, discharge and facial pain lasting on the right side for 4 months. There is no hx of sneezing or eye involvement, The patient has a hx of seasonal allergies and takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms? Chronic rhinosinusitis A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is first-line treatment? Intranasal corticosteroids A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and thin, clear nasal secretions. The provider notes puffiness around the eyes. The patient;s vital signs are normal. What is likely diagnosis? Allergic rhinitis A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity to trees and grasses. What is first line treatment for this patient? Intranasal steroids
A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A PE reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend? Daily intranasal steroids What are potential complications of chronic or recurrent sinusitis? Meningitis, orbital infection, and osteomyleitis. A patient has nasal congestion, fever, purulent drainage, HA, and facial pain and begins treatment with augmentin. At a follow up visit 10 days later after treatment, the patient continues to have symptoms. What is next course of action? A second course of augmentin Which symptoms in a patient with abdominal pain are suggestive of appendicitis? Abdominal rigidity along with pain, pain accompanied by low grade fever, pain occurring prior to nausea and vomiting. A patient has sudden onset of RUQ pain and epigastric pain with fever, nausea, vomiting. The ED provider notes yellowing of the sclera. What is probable cause of findings? Common bile duct obstruction.
The provider suspects that a patient has chronic pancreatitis. Which dx test will be most helpful to confirm this dx? blood glucose and fecal fat A patient has intermittent Left sided abd pain and fever associated with bloating and constipation alternating with diarrhea. The provider suspects acute diverticulitis. Which tests should be ordered? CT scan of abd and pelvis, stool for occult blood. A patient has a hx of of diverticular disease and asks what can be done to minimize acute symptoms. what will the practitioner recommend? consuming a diet high in fiber A patient who has a hx of diverticular disease has left sided pain and reports seeing blood in the stool. What is an important interventions for these symptoms? referring patient for lower EGD. A patient has a recent episode of vomiting and describes the vomitus as containing mostlymgastric juice. what does this symptom suggest? peptic ulcer
A patient has persistent epigastric pain occurring 2-3 hours after a meal. Which test is definitive for diagnosis peptic ulcer in this patient? Endoscopy with biopsy of gastric mucosas. What is the best treatment for H. pylori related PUD? PPI, clarithromycin, for 14 days A patient who has been taking an NSAID for osteoarthritis pain has PUD. What is the initial step in treating this patient? Discontinue the NSAID Which form of hepatitis virus is rapidly spread via fecal-oral route? Hepatitis A A patient has irritable bowel syndrome with alternating diarrhea and constipation and asks the provider about dietary changes that may help with symptoms. what will the provider recommend? keeping a food and symptom diary
A recovering alcoholic reports nausea, vomiting diarrhea, and abd discomfort. a PE is negative for jaundice or scrites. What will the provider do initially? Order a CBC and liver function tests An adult patient who had pertussis immunization is exposed to pertussis and develops a runny nose, low grade fever, and URI illness with paroxysmal cough. What is recommendation? Azithromycin daily for 5 days A patient develops a dry, non-productive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms? Antitussive medication A patient develops acute bronchitis and is diagnosed with having influenza. Which medication will help reduce the duration of symptoms in this patient? Oseltamivir
Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesis, alond with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS does this patient have? MFS A patient has a cough and fever, the provider ausculates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to onset of cough. A CT shows patchy, nonhomogeneous infiltrates. Based on these findings what organism likely caused this? Mycoplasma A young adult, previously healthy clinic patient has symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient? Empiric treatment with a macrolide antibiotic A patient who was initially treated as an outpatient for pneumonia and then hospitalized for two weeks after no improvement continues to show no improvement after several antibiotic regimens have been attempted. What is next step? Informing dx bronchoscopy
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 sample 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
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 cellulitis 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 without 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 experiencing 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?
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 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 which 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 capitis. 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
Compresses, lid scrubs, and antibiotic ointment A patient who has a cold develops conjunctivitis. The provider notes erythema 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 with 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
