COURSE
NR511 Differential Diagnosis and Primary Care Practicum
- Question: A 20-year-old male presents to your primary care clinic. This patient is a college student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose and throat exam shows mild erythema of the nasal mucosa and edematous, enlarged tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar He has inflamed posterior cervical lymph nodes. He has a mild nonproductive cough and clear lung exam. What is his most likely diagnosis?
- Question: Which of the following is not a complication of untreated group A streptococcal pharyngitis?
- Question: Jonathan, age 19, has just been given a diagnosis of mononucleosis. Which of the following statements is true?
- Question: Mario, a 17-year-old high school student, came to the office for evaluation. He is complaining of persistent sore throat, fever, and malaise not relieved by the penicillin therapy prescribed recently at the urgent care center. As the nurse practitioner, what would you order next?
- Question: Marcia, age 4, is brought in to the office by her mother. She has a sore throat, difficulty swallowing, copious oral secretions, respiratory difficulty, stridor, and a temperature of 102°F but no pharyngeal erythema or cough. What do you suspect?
- Question: You diagnose acute epiglottitis in Sally, age 5, and immediately send her to the local emergency room. Which of the following symptoms would indicate that an airway obstruction is imminent?
- Question: A patient asks how to avoid contracting pharyngitis and Which piece of advice is not appropriate for this patient?
- Question: Which of the following is not recommended for hoarseness (Dysphonia)?
- Samantha, age 12, presents with ear When you begin to assess her ear, you tug on her normal- appearing auricle, eliciting severe pain. This leads you to suspect:
- Question: Kathleen, age 54, has persistent pruritus of the external auditory External otitis and dermatological conditions, such as seborrheic dermatitis and psoriasis, have been ruled out. What can you advise her to do?
- Question: Jill, a 34-year-old bank teller, presents with symptoms of hay fever. She complains of nasal congestion, runny nose with clear mucus, and itchy nose and eyes. On physical assessment, you observe that she has pale nasal turbinates. What is your diagnosis?
- Question: A 75-year-old African American male presents to your family practice office complaining of visual He has worn corrective lenses for many years but has noticed that his vision has gotten progressively worse the past 6 months. He denies pain. He states his vision is worse in both eyes in the peripheral aspects of his visual field. He also notes trouble driving at night and halos around street lights at night. You test his intraocular pressure, and it is 23 mm Hg. What is his most likely diagnosis?
- Question: What significant finding(s) in a 3-year-old child with otitis media with effusion would prompt more aggressive treatment and referral?
- Question: In a young child, unilateral purulent rhinitis is most often caused by:
- Question: Marjorie, age 37, has asthma and has been told she has nasal What do you tell her about them?
- Question: Kevin, age 26, has AIDS and presents to the clinic with complaints of a painful tongue covered with what look like creamy white, curdlike patches overlying erythematous mucosa. You are able to scrape off these “curds” with a tongue depressor, which assists you in making which of the following diagnoses?
- Question: You diagnose 46-year-old Mabel with viral Your treatment should include: Antibiotics should not be used in clients with viral conjunctivitis)
- Question: The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is:
- Question: An 80-year-old woman comes in to the office with complaints of a rash on the left side of her face that is blistered and painful and accompanied by left-sided eye The rash broke out 2 days ago, and she remembers being very tired and feeling feverish for a week before the rash appeared. On examination, the rash follows the trigeminal nerve on the left, and she has some scleral injection and tearing. You suspect herpes zoster ophthalmicus. Based on what you know to be complications of this disease, you explain to her that she needs:
- Question: A 70-year-old client with herpes zoster has a vesicle on the tip of the nose. This may indicate:
- Question: Dan, age 57, has just been given a diagnosis of herpes He asks you about exposure to others. You tell him:
- Question: Swanson, age 67, presents to the clinic for his annual health exam. He asks you if there is anything he can do to prevent the painful, blistering sores that develop on his lip in the summertime when he plays golf. You explain to Mr. Swanson that the way to prevent the development of these lesions is to:
- Question: Elizabeth, age 83, presents with a 2-day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules at that What do you suspect?
- Question: Which condition is not included in the atopic triad?
- Question: A 16-year-old male presents to your office. He was sent by an orthopedist. He has recently had surgical fixation of a humerus The patient has been going to physical therapy and has been developing a rash on his arm after therapy that disappears shortly after returning home. He does not have the rash prior to therapy. The patient denies fevers and chills, and his incision is well healed, with no signs of infection. Of note, the patient has been experiencing more hand edema than the average patient and has had edema wraps used at the end of therapy to help with his swelling. The wraps are made of a synthetic plastic material. The rash the patient gets is erythematous and blotchy, not raised; it is on the operative upper extremity. What is the most likely diagnosis?
- Question: Which of the following statements about malignant melanomas is true?
- Question: Lee brings her 13-year-old son to your clinic. He has been complaining of a rash on the buttocks, anterior thighs, and posterolateral aspects of his upper arms. He tells you it is mildly pruritic and looks like “gooseflesh.” On examination, the rash appears as small, pinpoint, follicular papules on a mildly erythematous base. You explain to Lee that the benign condition is likely to resolve by the time her son reaches adulthood, and it is known as:
- Question: Jim, age 59, presents with recurrent, sharply circumscribed red papules and plaques with powdery white scale on the extensor aspects of his elbows and What do you suspect?
- Question: Which of the following statements about psoriasis is not true?
- Question: Which presentation is most concerning for skin cancer
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