MN 522 Advanced Health Assessment Midterm

MN 522 Advanced Health Assessment Midterm Review Latest Update - Actual Exam 110 Questions and 100% Verified Correct Answers Verified by Professor

______is an allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen, dust or animal dander is inhaled by an individual with a sensitized immune system. In such individuals; the allergen triggers the production of the antibody immunoglobulin E (IgE), which binds to mast cells and basophils containing histamine.

allergic rhinitis

decompensation

deficiency

degeneration - CORRECT ANSWER: allergic rhinitis

A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the most likely diagnosis?

Xanthelasma

Hordeolum

Dacryocystitis

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Chalazion - CORRECT ANSWER: Hordeolum

A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and fussiness. The ear examination is as follows: external ear, normal appearance and no tenderness with manipulation; canal, normal diameter without evidence of inflammation; tympanic membrane, bulging, erythematous, and opaque. Insufflation is deferred due to pain.What is your diagnosis?

Otitis externa

Cholesteatoma

Ruptured tympanic membrane

Otitis media - CORRECT ANSWER: Otitis media

There is no inflammation of the outer ear, including the canal, thus excluding otitis externa. Cholesteatoma is a painless white lesion behind the TM. There is no drainage from the TM; thus, rupture is unlikely. This is a classic description of otitis media. Many examiners will forego insufflation if the diagnosis is clear, because this can cause discomfort in an already uncomfortable ear.

A 15-year-old high school sophomore and her mother come to your clinic because the mother is concerned about her daughter's weight. You measure her daughter's height and weight and obtain a BMI of 19.5 kg/m2. Based on this information, which of the following is appropriate?

Refer the patient to a nutritionist and a psychologist because the patient is anorexic.

Reassure the mother that this is a normal body weight.

Give the patient information about exercise because the patient is obese. 2 / 4

Give the patient information concerning reduction of fat and cholesterol in her diet

because she is obese. - CORRECT ANSWER: Reassure the mother that this is a

normal body weight.

The patient has a normal BMI; the range for a normal BMI is 18.5 to 24.9 kg/m2. You may be able to give the patient and her mother the lower limit of normal in pounds for her daughter's height, or instruct her in how to use a BMI table.

A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough. Which is the most likely pathologic process?

Infection

Inflammation

Allergic

Vascular - CORRECT ANSWER: Allergic

This description is most consistent with allergic rhinitis.

A 17-year-old high school student is brought in to your emergency room in a comatose state. His friends have accompanied him and tell you that they have been shooting up heroin tonight and they think their friend may have had too much. The patient is unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and he is breathing through the ventilator. He is not posturing and he does not respond to a sternal rub. Preparing to finish the neurologic examination, you get a penlight.What size pupils do you expect to see in this comatose patient?

Asymmetric pupils 3 / 4

Irregularly shaped pupils

Pinpoint pupils

Large pupils - CORRECT ANSWER: Pinpoint pupils

A 19-year old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been.Which of the following physical examination descriptions is most consistent with meningitis?

Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full range of motion

Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous muscle spasm and limited range of motion to the right

Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to perform range of motion

Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple with full range of motion - CORRECT ANSWER: Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to perform range of motion

Blurred disc margins are consistent with papilledema, and neck tenderness and lack of range of motion are consistent with neck stiffness, which in this scenario is likely to be caused by meningeal inflammation. Later, you will learn about Kernig's and Brudzinski's signs, which are helpful in testing for meningeal irritation on examination.

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