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Differential Diagnoses and Treatment Approaches in Primary Care, Exams of Nursing

A wide range of topics related to primary care, including differential diagnoses, treatment approaches, and management strategies for various medical conditions. It delves into the diagnosis and management of conditions such as otitis media, allergic rhinitis, conjunctivitis, influenza, bronchitis, asthma, hypertension, irritable bowel syndrome, clostridium difficile infection, pernicious anemia, erectile dysfunction, scabies, and more. Detailed information on the appropriate pharmacological and non-pharmacological interventions, as well as the rationale behind the recommended approaches. It also touches on the importance of patient education, risk factor assessment, and the utilization of diagnostic tests to guide clinical decision-making. This comprehensive resource can be valuable for healthcare professionals, particularly those practicing in primary care settings, to enhance their knowledge and improve patient outcomes.

Typology: Exams

2024/2025

Available from 09/19/2024

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NSG 6420 Final Exam Questions and Answers 2024
1. A patient presents with acute otitis externa with obstruction of the ear canal severe enough
to prevent patient self-administration of pharmacologic treatment. What is the most
effectivemeans to administer topical agent solutions.
A. Oral/systemic
antibiotics
B. Aural toileting or wicking or a combination of both
C. A nebulizer machines
D. Surgical debridement
2.Otitis media, hypothyroid disease, deviated nasal septum, and chronic sinusitis are
differential diagnoses for what condition?
A. Mumps
B. Rhinitis
C. Dental Abscess
D. Viral influenza
3.Which of the following would NOT be included as part of the focused SOAP note for a patient
who suffers from allergic rhinitis?
A. Review of the HEENT physical examination
B. Discussion of health promotion issues
C. Patient Vital signs
D. Referral for additional allergy
testing
4.A patient diagnosed with bacterial conjunctivitis. Which of the following education and
counseling notes would NOT be appropriate for this patient?
A. Contact lenses should be discarded and new lenses should not be worn until symptoms
subside
B. Clean all linens thoroughly
C. Patient may return to work upon completing the initial dose of antibiotics
D. Any eye make up should be replaced
5. Incubation period for Group A beta-hemolytic streptococcus?
A. 24-72 hours
B. 12-24 hours
C. 72-96
D. +96
6.Which of the following demographic groups would NOT be considered at risk for
complications of influenza?
A. young children
B. pregnant women
C. Suffering from heart, kidney, or neurologic disease
D. those who did not get the influenza vaccine
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NSG 6420 Final Exam Questions and Answers 2024

  1. A patient presents with acute otitis externa with obstruction of the ear canal severe enough

to prevent patient self-administration of pharmacologic treatment. What is the most

effectivemeans to administer topical agent solutions.

A. Oral/systemic

B. Aural antibi otoiletingtics or wicking or a combination of both

C. A nebulizer machines

D. Surgical debridement

2.Otitis media, hypothyroid disease, deviated nasal septum, and chronic sinusitis are

differential diagnoses for what condition?

A. Mumps

B. Rhinitis

C. Dental Abscess

D. Viral influenza

3.Which of the following would NOT be included as part of the focused SOAP note for a patient

who suffers from allergic rhinitis?

A. Review of the HEENT physical examination

B. Discussion of health promotion issues

C. Patient Vital signs

D. Referral for additional allergy

testing

4.A patient diagnosed with bacterial conjunctivitis. Which of the following education and

counseling notes would NOT be appropriate for this patient?

A. Contact lenses should be discarded and new lenses should not be worn until symptoms

subside

B. Clean all linens thoroughly

C. Patient may return to work upon completing the initial dose of antibiotics

D. Any eye make up should be replaced

  1. Incubation period for Group A beta-hemolytic streptococcus?

A. 24- 72 hours

B. 1 2-2 4 hours

C. 72-

D. +

6.Which of the following demographic groups would NOT be considered at risk for

complications of influenza?

A. young children

B. pregnant women

C. Suffering from heart, kidney, or neurologic disease

D. those who did not get the influenza vaccine

7.A patient is diagnosed acute bronchitis. What is the most appropriate antibiotic treatment for

this patient?

A. Penicillin

B. Oflaxacin

C. Metronidazol

D. Antibiotics are not recommended

8.According to the National Asthma education and prevention program (NAAEPP), which

treatment would be an example of a Step 1 preferred treatment for an adult with persistent

asthma?

A. Short acting beta 2 antagonist prn (SABA)

B. Medium dose ICS and LABA

C. low dose ICS and LABA

D. high dose ICS and LABA and oral corticosteroid

  1. Which of the following would be appropriate in the plan for a patient diagnosed with COPD?

A. Start HCTZ 12.5 mg daily. Discussed diet and exercise including review of DASH diet.

B. Demonstrate proper use of inhalers. Discuss importance of influenza vaccine. Prescribed

albuterol. 2 puffs every 4 hrs prn for SOB

C. Reviewed consequences of untreated condition. Encourage limited caloric intake to 1.

daily. Prescribe lisinopril 1mg daily.

D. Pt prescribed amoxicillin 500 mg po. Refrain from work or school until symptoms

improve.

  1. Assessment findings include increased AP diameter, hypoxemia, expiratory wheezing,

cyanosis, chest tightness, and pursed lip breathing. Based on the symptoms presented what is

the most likely diagnosis?

A. COPD

B. Pharyngitis

C. Hypertension

D. Alpha thalassemia

  1. A 60 y/o white male has presented with HTN and no evidence of CKD or diabetes.

According to JNC 8 which of the following pharmacological interventions would be more

appropriate?

E. Betablocker such as acebutolol

F.C. NiHydrochlorothiazidetroglycerine Spray PRN

D. High intensity statin

  1. At a 6 week follow up appt, a patient has not reached a goal to treat HTN with

hydrochlorothiazide, diet, and exercise. What would be an appropriate addition to the patient’s

regimen?

A.

ACE or ARB

B. aspirin

C. surgical intervention

D. Advanced age

  1. Which of the following has the highest risk factor for anemia?

A. Recent hospitalization

B. Antibiotic use

C. Age less than 40

D. Chronic disease such as kidney or liver

  1. A pt present with a diagnosis of anemia. Which medications may interfere with absorption,

resulting in a vitamin deficiency?

A. Antibiotics

B. Analgesics

C. Antivirals

D. Anticonvulsants

  1. Which demographic group has a genetic risk for pernicious anemia?

A. Women or men from the Thalassemia belt

B. Women of northern European descent

C. African American men

D. Children

  1. Which pharmacologic intervention would be the most appropriate for a patient with a

diagnosis of pernicious anemia?

A. Iron supplements

B. Daily multi-vitamin

C. Vitamin b

D. Antibiotics

  1. Which of the following tests would be used to diagnose pernicious anemia?

A. Schilling test

B. CAGE questionnaire

C. Gold stage

D. Centor criteria

  1. Which of the following are most likely to cause GI bleeding?

A. Acetylsalicyclic acid

B. Antibiotics

C. Antivirals

D. Hormones

  1. A patient being treated for ED would be considered high risk for treatment if also

suffering from which of the following conditions?

A. Refractory angina

B. Asymptomatic coronary artery disease

C. Successful coronary revascularization

D. Mild vascular disease

  1. A patient with a working diagnosis of prostatitis presents with evidence of inflammation of

the prostate in absence of any symptoms. According to the NIH, which category would this

patient be placed?

A. Category III

B. Category

IVC. Category II

D. Category I

  1. A pt presenting with testicular torsion which is not a result of trauma will most likely require

which intervention?

A. TMP-S or other antibiotics

B. Detorsion

C. Orchiectomy

D. Surgery

  1. Which of the following would be most appropriate for an adult male patient with a diagnos

is of genital herpes?

A. NAAT for chlamydia and gonorrhea. Blod test for HIV and syphilis. Start azithromycin 1 g PO

1x. Partner must be treated to avoid re-infection. Avoid sexual intercourse for 7 days.

B. Start acyclovir 400 mg PO daily. Patient education for etiology of symptoms. Culture of lesions

and blood testing for syphilis and HIV. Follow up in 2 weeks.

C. After patient education, start sildenafil 50 mg PO ½ to 4 hours prior to intercourse.

Continue all prescribed medications.

D. After confirmed diagnosis, begin TMP-S 160 mg PO 2x daily. Instruct patient in medications

and proper hygiene with regard to bathing wiping and post intercourse. Follow up if

symptoms persist or return.

  1. A patient presents with a skin infection, raised red rash and mild itching. What would be

the most appropriate pharmacologic treatment for a patient with a diagnosis of scabies?

A. NSAIDS

B. Permethrin

C. Cyclobenzaprine

D. Methimazole

  1. A pt presents with a red popular rash on her hands arms and feet. A Diagnosis of scabies

is made based on observation. Whats the most effective way to confirm this diagnosis?

A. Blood test

B. Urine analysis

C. CT scan

D. A skin scraping and microscope

  1. Lumbosacral sprain, kidney infections or kidney stones, lumbar facet arthropathy, and

lumbar

A. UTI

  1. A patient presents with lower back pain, stiffness and tightness with no trauma injury.

Which of the following pharmacologic interventions would be the most appropriate for a

patient with these symptoms and NKDA?

A. Azithromycin

B. Levothyroxine

C. Ciprofloxacin

D.

Cyclobezapine

  1. Mcmurry’s test can be used to diagnose which of the following conditions?

A. The presence of a meniscal tear

B. A patient’s alcohol and drug use

C. A patient’s vitamin B12 anemia

D. A patient’s rate and severity of depression

  1. A pt presents with injury to the ACL based on a traumatic physical injury and no additional

underlying conditions. Patient is determined not to require surgery. What would be the most

appropriate pharmacologic intervention for this patient?

A. NSAIDs and pain relievers

B. Cyclobenzapine

C. TMP-S

D. Phenazopyridine

  1. A 53 y/o female presents with carpal tunnel syndrome. Determine which of the following

would be the preferred pharmacologic treatment for this patient?

E. Muscle relaxants

F.NSAIDs

C.

D.

Which of

the

following

would be

considere

d a risk

factor for

positional

vertigo?

A. A pt

suffering

from

B. A pt with non-specific dizziness

C. A pt who suffers from migraine headaches

D. A pt aged 60 or older

  1. A pt indicates that he is likely to have experienced a seizure while at home with family.

Based on the observations of family members who were present during the episode it is

likely

that the patient experienced a tonic-clonic seizure. Which of the following risk factors would

warrant immediate neuroimaging for this patient.

A. A pt experiencing his first seizure

B. Pt has experienced his first seizure over the age of 40

C. Pt has recovered from an initial seizure

D. A seizure is likely cause by a stimulant drug

  1. In a patient with a diagnosis of Parkinson’s disease, which of the following pharmacologic

treatments would be most appropriate?

E. Cyclobenzapine

F. Levothyroxine

C. Levodopa or carbidopa

D. Atorvastatin

  1. DEXA imaging would be best used to diagnose which?

A. Doppler ultrasound

B. PET scan

C. Osteoporosis

D. DaTscan

  1. A mini mental status exam Is used to assess which?

A. Range of motion impairment

B. Vision impairment

C. Cognitive impairment

D. Auditory

  1. A 60 y/o patient presents with anemia. Signs and symptom include fatigue and pallor.

Labwork RBC 4.2, Hgb 9.1, Hct 31, WBC 6.8, and folate levels and serum iron 26 and

serum ferritin levels 38 were low. Which of the anemic diagnoses is most likely?

A. Anemia of chronic disease

B. Aplastic anemia

C. Iron def anemia

D. Pernicious anemia

  1. Which of the following statements are true when differentiating thalassemia from other

types of deficiency anemias?

A. Thalassemia anemias are associated with low iron levels

B. Thalassemia anemias are hereditary anemias

C. Thalassemia anemias are associated with chronic disease

D. Thalassemia anemias are associated with low vitamin levels

  1. The destruction of insulin producing beta cells take place in which organ of the body

of patients suffering from diabetes mellitus?

A. Kidneys

C. COPD

D. Anemia of b12 deficiency

  1. Anxiety, rapid heart rate, insomnia, and tachy cardia are all symptoms of which of

the following disorders?

A. Hyperthyroidism

B. Hypothyroidism

C. DM 1

D. GERD

  1. Which of the following factors would NOT be considered a risk factor for Graves disease?

E. Gender

F. Family history of autoimmune disorder

C. A patient over 40 years of age

D. pregnancy

  1. Which of the following patients is most likely to suffer from metabolic syndrome?

A. A patient with a family history of metabolic syndrome

B. A 40 y/o pt

C. Caucasian men

D. A pt who is obese and sedentary

  1. Which of the following would be most appropriate in the treatment plan for a pt with a

diagnosis of metabolic syndrome?

A. ECG demonstrates sinus tachy. Discussed need for radioactive iodine ablations. Prescribed

hydrocortisone cream for lower extremity dermopathy.

B. Discussed critical importance of weight and lifestyle management. Glucophage 850 mg PO 2x

daily and atorvastatin 20 mg po 2x daily

C. Reviewed consequences of untreated condition. Encourage limited caloric intake to 1800

daily. Prescribe lisinopril 1- mg daily

D. Pt prescribed amoxicillin 500 mg po. Refrain from work or school until symptoms

improve.

  1. Patients meeting three of the following criteria are considered to be suffering from what

condition? Elevated blood sugar (greater than 100 fasting), elevated bp (greater than 135/

untreated), abdominal obesity (greater than 35 in for women and 40 for men)

NSG 6420

Final Exam

Questions and

Answers 2024