Question 1

A 64-year-old male presents with erythema of the sclera,tearing,and bilateral pruritus of the eyes.The symptoms occur intermittently throughout the year and he has associated clear nasal discharge.Which of the following is most likely because of the inflammation?

A) Bacterium
B) Allergen
C) Virus
D) Fungi

Allergen

Accepted Answer

The symptoms of erythema of the sclera, tearing, bilateral pruritus of the eyes, and clear nasal discharge suggest allergic conjunctivitis, which is caused by an allergen. Bacteria, viruses, and fungi typically cause infective conjunctivitis and would present with different symptoms such as purulent discharge or eye pain.

Question 2

The nurse practitioner knows that antihistamines work primarily through which of the following mechanisms?&#10;A) Vasodilatation&#10;B) Blocking leukotriene effects&#10;C) Inhibiting histamine receptor sites&#10;D) Vasoconstriction

Accepted Answer

Antihistamines work by inhibiting histamine receptor sites. They block the action of histamine, which is responsible for triggering symptoms of allergic reactions such as itching, sneezing, and runny nose. Antihistamines do not affect vasodilatation, vasoconstriction, or leukotriene effects.

Question 3

A slightly elevated elastic tissue deposit in the conjunctiva that may extend to the cornea but does not cover it is known as a:&#10;A) Pterygium&#10;B) Pinguecula&#10;C) Xanthelsma&#10;D) Limbal nodule

Accepted Answer

A pinguecula is a benign growth of elastic tissue on the conjunctiva that can extend slightly onto the cornea, but does not cover it. Pterygium is a more advanced growth that can cover the cornea and affect vision. Xanthelsma is a yellowish deposit of cholesterol under the skin, often seen on the eyelids. Limbal nodule is a growth on the cornea near the limbus (border between the cornea and sclera).

Question 4

One of the first-line treatments in patients with allergic rhinitis is the use of nasal corticosteroid sprays.What is the anticipated onset of symptom relief with the use of these medications?&#10;A) Two weeks or more&#10;B) Immediate&#10;C) 1 to 2 days&#10;D) A minimum of one week

Accepted Answer

Nasal corticosteroid sprays typically provide significant relief from symptoms within 1 to 2 days of starting therapy. However, it may take up to 2 weeks to achieve maximum benefit.

Question 5

You have a patient complaining of vertigo and want to know what could be the cause.Knowing there are many causes for vertigo,you question the length of time the sensation lasts.She tells you several hours to days and is accompanied by tinnitus and hearing loss.You suspect which of the following conditions?

A) Ménière's disease
B) Benign paroxysmal positional vertigo
C) TIA
D) Migraine

Accepted Answer

The presence of vertigo lasting several hours to days and accompanied by tinnitus and hearing loss are classic symptoms of Ménière's disease, a disorder of the inner ear. Benign paroxysmal positional vertigo usually lasts seconds to minutes and is not typically associated with hearing loss or tinnitus. TIA (transient ischemic attack) is a brief episode of neurological dysfunction caused by a disruption in blood flow to the brain and can present with vertigo, but it typically resolves within minutes to hours and is not associated with tinnitus or hearing loss. Migraines can cause vertigo, but are usually associated with headache, and the duration of the vertigo is usually shorter than several hours to days.

Question 6

Cromolyn sodium may also be used in the treatment of allergic rhinitis.What is the mechanism of action of this medication?&#10;A) Mast cell stabilization&#10;B) Blocking the effects of IgE&#10;C) Leukotriene inhibition&#10;D) Histamine blockade

Accepted Answer

Cromolyn sodium works by stabilizing mast cells, preventing them from releasing histamine and other inflammatory mediators in response to an allergen. This helps to decrease the symptoms of allergic rhinitis, such as runny nose, itching, and sneezing.

Question 7

Which of the following conditions is the leading cause of blindness in the United States?&#10;A) Macular degeneration&#10;B) Diabetic retinopathy&#10;C) Glaucoma&#10;D) Cataracts

Accepted Answer

Diabetic retinopathy is the leading cause of blindness in the United States. It is a condition that affects the blood vessels in the retina, the light-sensitive tissue at the back of the eye. Diabetic retinopathy can cause bleeding, swelling, and scarring of the retina, which can lead to vision loss and blindness.

Question 8

A gross screening for hearing is the whisper tests.Which cranial nerve is being tested when the nurse practitioner conducts this test?&#10;A) Cranial nerve V&#10;B) Cranial nerve VII&#10;C) Cranial nerve VIII&#10;D) Cranial nerve IV

Accepted Answer

The whisper test assesses hearing and the ability to perceive spoken words at a low volume. This test primarily screens for abnormalities related to cranial nerve VIII, the vestibulocochlear nerve, which is responsible for hearing and balance.

Question 9

In examining the mouth of an older adult with a history of smoking,the nurse practitioner finds a suspicious oral lesion.The patient has been referred for a biopsy to be sent for pathology.Which is the most common oral precancerous lesion?

A) Fictional keratosis
B) Keratoacanthoma
C) Lichen planus
D) Leukoplakia

Accepted Answer

Leukoplakia is the most common precancerous lesion of the oral cavity, particularly in individuals with a history of tobacco use. It is characterized by white, thickened patches on the oral mucosa that cannot be scraped off. It has the potential to develop into squamous cell carcinoma if left untreated. Fictional keratosis, keratoacanthoma, and lichen planus are not precancerous lesions, but they may mimic the appearance of leukoplakia and must be ruled out by biopsy.

Question 10

Patients that have atopic disorders are mediated by the production of IGE will have histamine stimulated as an immediate phase response.This release of histamine results in which of the following?&#10;A) Sinus pain,increased vascular permeability,and bronchodilation&#10;B) Bronchospasm,vascular permeability,and vasodilatation&#10;C) Contraction of smooth muscle,decreased vascular permeability,and vasoconstriction&#10;D) Vasodilatation,bronchodilation,and increased vascular permeability

Accepted Answer

Patients with atopic disorders have an immediate-phase response mediated by the production of IgE, which results in the release of histamine. This histamine release causes bronchospasm, vascular permeability, and vasodilation, which can lead to symptoms such as difficulty breathing, coughing, and hives. Therefore, option B - bronchospasm, vascular permeability, and vasodilation - is the best choice.

Question 11

Which of the following maneuvers is used to induce symptoms of benign paroxysmal positional vertigo?&#10;A) The Fukuda stepping test&#10;B) The Dix-Hallpike maneuver&#10;C) Forced hyperventilation&#10;D) The head thrust test

Accepted Answer

The answer of Which of the following maneuvers is used...

Question 12

A nonmodifiable risk factor for the development of cataracts is:&#10;A) Long-term exposure to ultraviolet B radiation&#10;B) High alcohol intake&#10;C) Strong family history&#10;D) Diabetes mellitus

Accepted Answer

The answer of A nonmodifiable risk factor for the development...

Question 13

Sensory impairment (vision and hearing)in the elderly is associated with:&#10;A) Impaired quality of life&#10;B) Decreased function&#10;C) Increased mortality&#10;D) All of the above

Accepted Answer

The answer of Sensory impairment (vision and hearing)in the elderly...

Question 14

Causes of sensorineural hearing loss include:&#10;A) Ototoxicity&#10;B) M&#233;ni&#232;re's disease&#10;C) Otosclerosis&#10;D) Inner ear fistula

Accepted Answer

The answer of Causes of sensorineural hearing loss include:&#10;A) Ototoxicity&#10;B)...

Question 15

Clinical findings in patients with nonproliferation retinopathy include:&#10;A) Cotton wool spots&#10;B) Microaneursyms&#10;C) Deep hemorrhages&#10;D) Neovascularization

Accepted Answer

The answer of Clinical findings in patients with nonproliferation retinopathy...

Deck 7: Head, neck, and Face Disorders