NR 511 Midterm Exams 2024 | Differential Diagnosis & Primary Care Practicum | Different Versions | Chamberlain College of Nursing

1. Kathleen, age 54, has persistent pruritus of the external auditory canal. External otitis and dermatological
conditions, such as seborrheic dermatitis and psoriasis, have been ruled out. What can you advise her to do?
 Use a cotton-tipped applicator daily to remove all moisture and potential bacteria.
 Wash daily with soap and water.
 Apply mineral oil to counteract dryness (Pruritus of the external ear canal is a common problem. In most
cases, the pruritus is self-induced from overenthusiastic cleaning or excoriation. The protective cerumen
covering must be allowed to regenerate and may be helped to do so by application of a small amount of
mineral oil, which helps counteract dryness and reject moisture. Often, the use of isopropyl alcohol may
relieve ear canal pruritus as well)
 Avoid topical corticosteroids.
2. The most common cause of a white pupil (leukokoria or leukocoria) in a newborn is:
 A congenital cataract (The most common cause of a white pupil (leukokoria or leukocoria) in a newborn is
a congenital cataract. The incidence may be as high as 1 in every 500 to 1000 live births, and there is
usually a family history. Some infants require no treatment; however, in other cases surgery may be
performed during the first few weeks of life)
 Retinoblastoma ( Retinoblastoma, a common intraocular malignancy, is detected within the first few weeks
of life and is the second most common cause of a white pupil.)
 Persistent hyperplastic primary vitreous (
Persistent hyperplastic primary vitreous is the third most common cause of a white pupil and is a congenital
developmental abnormality.)
 Retinal detachment (Retinal detachment may occur as a result of trauma or disease and only rarely occurs
in infancy.)
3. Ellen, a 56-year-old social worker, is seen by the nurse practitioner for complaints of fever; left-sided facial pain;
moderate amounts of purulent, malodorous nasal discharge; and pain and headache when bending forward. The
symptoms have been occurring for approximately 6 days. On physical assessment, there is marked redness and
swelling of the nasal passages and tenderness/pain on palpation over the cheekbones. The nurse practitioner should
suspect:
 Dental abscess.
 Acute rhinosinusitis (The client is exhibiting classic characteristics of acute rhinosinusitis)
 Chronic rhinosinusitis.
 Nasal tumor
4. Which of the following statements about macular degeneration is not true?
 Macular degeneration is characterized by gradual loss of peripheral vision (This is how open-angle
glaucoma is characterized. Macular degeneration is gradual loss of central vision)
 Macular degeneration is the leading cause of blindness in people younger than 60.
 Tobacco use is a risk factor for macular degeneration.
 There are 2 different types of macular degeneration: wet and dry.
5. What is the most common bacterial pathogen associated with acute otitis media?
 Streptococcus pneumonia (This causes 40% to 50% of cases)
 Haemophilus influenza (This causes 10% to 30% of cases)
 Streptococcus pyogenes (this is an uncommon cause)
 Moraxella (Branhamella) catarrhalis (This is an uncommon cause)
6. Mallory brings her 4-week-old infant to the office because she noticed small, yellow-white, glistening bumps on
her infant’s gums. She says they look like teeth, but she is worried that they may be cancer. You diagnose these
bumps as:
 Bednar aphthae (Bednar aphthae are traumatic areas or ulcers that appear on the posterior hard palate on
either side of the midline. They result from abrasions while sucking)
 Epstein pearls (Bednar aphthae are traumatic areas or ulcers that appear on the posterior hard palate on
either side of the midline. They result from abrasions while sucking)
 Buccal tumors (A buccal tumor is a tumor on the inside of the cheek)
 Exostosis (Exostosis (torus palatinus) is found in the midline of the posterior two-thirds of the hard palate
and is benign. It is a smooth, symmetrical bony structure)