APEA Exam – Ears, Eye, Nose and Throat

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APEA Exam – EARS, EYES, NOSE AND THROAT

  1. A 57-year-old man with a history of diabetes complains of difficulty hearing on the telephone and muffled sounds while watching television at a low volume. He should be further evaluated for:
  2. Raised or flat, deep purple colored lesions noted in the mouth may be suggestive of:
  3. Which of the following findings in a preschooler would indicate the need for further evaluation?
  4. Responds to facial expressions and gestures rather than to verbal explanations
  5. A patient is able to recognize distant objects but has difficulty reading a books’ small print. This describes:
  6. Fordyce spots or granules are considered: normal sebaceous glands of the buccal mucosa
  7. When examining the eyes, both pupils appear small and have an irregular shape. They are noted to accommodate but do not appear to react to light. This could be indicative of:
  8. An inward turning of the lower lid margin is called:
  9. Sudden bilateral and painful visual loss is rare but can be associated with:
  10. Which of the following screening tests for hearing loss can detect both sensorineural and conductive hearing loss?
  11. A granulomatous eyelid cyst or nodule that is painless and erythematous is termed:
  12. A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus toward the nose. Tearing is present and when pressure is applied to the lacrimal sac, purulent discharge from the puncta is noted. This is suggestive of:
  13. A 4-year-old child presents with bilateral watery discharge from the eyes. Examination reveals subconjunctival hemorrhage and eyelid ecchymosis. These findings are consistent with:
  14. On ophthalmoscopic examination, glaucomatous cupping appears:
  15. Miosis is a term used to describe:
  16. A patient presents with complaints of earache, blood-tinged discharge from the ear, and hearing loss. Findings reveal painful hemorrhagic vesicles on the tympanic membrane and the ear canal. These findings and symptoms are suggestive of:
  17. A six-year-old complains that something is in her left eye. There is a red raised area of the left lid. There is redness and tenderness of the eye and tearing. These findings are consistent with:
  18. When examining the conjunctiva and sclera, have the patient look upward and then:
  19. Findings following assessment of a person’s eye gaze including both eyes moving in the same direction simultaneously. This condition is most consistent with:
  20. The curved outer ridge of the auricle of the ear is known as the:
  21. Ophthalmoscopic examination of the fundus reveals small, rounded, slightly irregular red spots embedded in the retina. These findings are consistent with:
  22. On the outer ear, anterior and parallel to the helix, is a curved prominence known as the:
  23. A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of:
  24. A deviated trachea could be caused by all of the following except:
  25. In order to examine the tongue, ask the patient to stick out his tongue and with the examiner’s right hand:
  26. A cyclist sustained an avulsion of the upper central incisor. If he is unable to position the tooth in the socket until he is able to be seen by a dentist, he should:
  27. Surgical perforation of the tympanic membrane to allow drainage of the middle ear secretions is termed:
  28. With transillumination of the frontal sinuses, a dim red glow is observed on the forehead. This dim red glow would be indicative of:
  29. A fine rhythmic oscillation of the eyes is termed:
  30. All of the following diseases may be associated with the appearance of a strawberry tongue except:
  31. A person who has been blind since birth presents for a physical exam. Expected findings of the pupillary reaction when light is shown would be:
  32. The sphenoidal sinuses:
  33. When examining pupillary equality, the left pupil is slightly greater than the right pupil. This condition is termed:
  34. Ectropion is defined as:
  35. The middle ear consists of:
  36. Ophthalmoscopic examination of the retina reveals AV banking. This appears as if the:
  37. The function of the auditory ossicles is to:
  38. Ophthalmoscopic examination of 30-year-old with a history of an eye injury 3 years ago, reveals a superficial grayish-white opacity in the right cornea. This may be indicative of a:
  39. The whispered voice test allows the examiner to screen for:
  40. When a person shift gaze from a near object to a far object, the pupils:
  41. A man with a history of long-term use of chewing tobacco presents with a mouth lesion that is suspicious for malignancy. Oral assessment findings describe:
  42. A deviated uvula without swelling may be suggestive of a:
  43. Where in the mouth would reddened areas, nodules, or ulceration that are suspicious of malignancy be present?
  44. On physical exam, an abnormal Rinne test might indicate:
  45. A forty-five-year-old female complains of frequent attacks of dizziness accompanied by a sense of fullness in the right ear, headache, nausea, reduced hearing in the right ear. This patient may need further workup for:
  46. Otosclerosis is an example of a(n):
  47. Examples of sudden, painful, unilateral visual loss include all of the following except:
  48. A term used describe drainage from the nose is:
  49. On ophthalmoscopic examination of a 70-year-old, a thin grayish white arc is noted on the lower end of the cornea. This appearance is referred to as a:
  50. The conductive and sensorineural phases are necessary for hearing to take place. The conductive phase of hearing involves the:
  51. A deposit of uric acid crystals appearing as hard nodules on the helix or antihelix is termed:
  52. What connects the middle ear to the nasopharynx?
  53. A child presents with a complaint of a left earache that worsens with head movement. Findings on examination include temperature of 102F, cellulitis behind the left ear. These findings are consistent with:
  54. A condition that involves optic nerve damage and visual field changes is termed
  55. The gradual loss of vision with a change in color and size of the optic disc is referred to as:
  56. A 30-year-old patient presents with a moderate “aching” in his right eye. Findings reveal a small and irregular shaped right pupil. The cornea appears cloudy with a slight erythematous area around the corneal limbus. There is no ocular discharge noted. These findings are consistent with:
  57. The majority of people who are present with non-24 hours sleep-wake disorder are:
  58. During the newborn’s physical assessment of the mouth, the soft and hard palates are palpated to detect:
  59. A 50-year-old patient presents with complaints of seeing double bilaterally. Examination reveals a vertical diplopia. This may be suggestive of a:
  60. A toddler with suspected hearing loss would:
  61. Examination of the nasolacrimal duct reveals a mucopurulent discharge from the puncta. This finding is suggestive of:
  62. On ophthalmoscopic examination, optic atrophy appears:
  63. That portion of the ear that consists of the auricle and ear canal is the:
  64. A condition of the sclera that appears as localized ocular inflammation of the episcleral vessels is most likely:
  65. Upon examination of the right tympanic membrane, a cone of light was visible at the four o’clock mark. This would be interpreted as:
  66. When examining the eyes, the right pupil reacts briskly to light, near effort, and is much smaller than the left pupil. This condition is mostly likely:
  67. On ophthalmoscopic exam of the older adult, there is an increase cup-to-disc ratio. This finding is suggestive of:
  68. One of the main differences between a migraine headache and tension headache is that:
  69. To visualize the ear canal and the tympanic membrane of an adult, use the otoscope with:
  70. The fleshly projection of the earlobe is known as the:
  71. When comparing veins and arteries in the eyes of older adults, the arteries appear:
  72. On examination of the pupils, both are round, but the right pupil appears larger than the left and reacts much slower to light. This condition may be indicative of:
  73. The patient complains of seeing floating spots. This is consistent with:
  74. Ptosis is defined as:
  75. Which of the paranasal sinuses are accessible to clinical examination?
  76. If a patient has a history of heat intolerance with a preference to light clothing, this behavior could be consistent with:
  77. A sixty-year-old complains of a progressive bilateral hearing loss over the past few months. He has difficulty understanding spoken words and has become sensitive to loud noises. These symptoms are consistent with:
  78. When examining the pupils, the left pupil is noted to be fixed and dilated to light and near accommodation. This condition may be suggestive of:
  79. On otoscopic examination, the cone of light can be visualized:
  80. If a patient complains of seeing flashing lights across the field of vision, this could be:
  81. A reduction in vision in one or both eyes casing loss of binocular vision is termed:
  82. Janeway lesions of the palms and soles appear as:
  83. The ethmoidal sinuses:
  84. The maxillary sinuses:
  85. A condition in which the eyes are not properly aligned with each other is termed:
  86. If there is an abnormal protrusion, what condition should be suspected if there is an abnormal protrusion of the eyes?
  87. A 50-year-old patient complains of being unable to read the hymnal at church. This describes:
  88. Eversion of the upper eyelid can be performed by placing the cotton applicator on the upper lid above the level of the internal tarsal plates and then:
  89. Ophthalmoscopic examination of the fundus reveals blood anterior to the retina and obscuring retinal vessels. These findings are consistent with:
  90. A swollen deviated uvula may be associated with a:
  91. Leukoplakia was noted during an exam of the mouth. This symptom may be:
  92. When assessing extraocular movements:
  93. An eight-year-old complains of itching in the right ear and an increase in pain when the pinna is pulled, or the tragus is palpated. Examination reveals slight redness in the ear canal with a clear odorless fluid. This could be suggestive of:
  94. An example of a cause of conductive hearing loss in children would be:

the presence of a peanut in the ear for three weeks

  1. A nodular protuberance that points backward over the entrance to the ear canal is called the:
  2. One of the refractive errors of vision that presents with symptoms of blurriness and improved with corrective lens, is known as:
  3. A patient is able to read a magazine without difficulty but cannot distinguish distant object. This describes:
  4. Current indications for tympanostomy tube placement include all of the following except which one?
  5. Actinic cheilitis is a condition of the lower lip most commonly seen in:
  6. A localized Staphylococcal infection of the hair follicles at the lid margin is suggestive of:
  7. A patient complains of seeing specks that obscure his line of vision when he looks in a certain direction. This impairment could be caused by:
  8. Fordyce spots or granules are considered:
  9. A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with:
  10. All of the following are examples of causes of sensorineural hearing loss in children except:
  11. Redness, bleeding, pain and swelling of the gums is most likely:
  12. What part of the ear consists mainly of cartilage covered by skin and has a firm yet somewhat elastic feature?
  13. The most common disorder of visual acuity in children is:
  14. A 40-year-old patient presents with complaints of seeing double bilaterally. Examination reveals a horizontal diplopia. This may be suggestive of a:
  15. A 60-year-old patient presents with severe, deep left eye pain. Findings reveal dilated and fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These findings are most likely consistent with:
  16. The acronym for pupils that are equal, round, and react to light and accommodate is:
  17. When examining the conjunctiva and sclera, have the patient look upward and then:
  18. Symptoms of bacterial conjunctivitis in an infant include:
  19. Which of the following findings in a preschooler would indicate the need for further evaluation?
  20. Causes of sensorineural hearing loss include all of the following except:
  21. The mouth of a ten-month-old infant has white patches on the mucosa that cannot be removed. These patches are consistent with:
  22. In other to visualize the opening of Stensen’s duct, examine the:
  23. A buildup of excess fluid around the periphery of the eye orbits is known as:
  24. The function of the labyrinth in the inner ear is to:
  25. A patient presents with complaints of a bump on the eyelid. Findings reveal nontender, firm nodule with freely movable skin overlying the nodule. This could be consistent with:
  26. Children who pick their noses are at a higher risk for development of:
  27. All of the following diseases may be associated with the appearance of a strawberry tongues except:
  28. When the corneal reflex is stimulated by shining the light in the right eye, the right eye blinks. The left eye:
  29. All of the following symptoms in a 10-month-old would be indicative of acute otitis media (OM) except:
  30. When administering ear drops to a 6-year-old, the pinna should be pulled: upward and back
  31. On examination of the tympanic membrane, a red bulging ear drum is detected. This is consistent with:
  32. In patients who have allergic rhinitis, the nasal mucosa appears:
  33. What visual acuity constitutes legal blindness?
  34. Assessment of a 4-year-olds visual acuity resulted in 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means:
  35. On ophthalmoscopic examination, glaucomatous cupping appears:
  36. A patient presents with complaints of burning, itching, tearing, and some pain in the eye. Findings reveal red, scaly, greasy flakes and thickened, crusted lid margins. This would be suggestive of:
  37. The most common cause of bacterial pharyngeal infections in children is:
  38. An infant with a suspected hearing loss:
  39. Round or oval shaped lesions surrounded by erythematous mucosa and noted on an area of the oral mucosa may be:
  40. When a 512 Hz tuning fork is placed over the mastoid bone and then held next to the ear canal with recordings of how long sound was heard in each ear, this is known as the:
  41. Ophthalmoscopic examination reveals dark specks between the fundus and the lens. These specks are most likely:
  42. The usual position of the trachea is located:
  43. A patient was diagnosed as being farsighted. This term for this condition is:
  44. A patient complains of a sore tongue. Findings reveal a smooth and erythematous tongue. This condition is termed:
  45. Examination of the nose and paranasal sinuses reveal local tenderness, pain, fever, and rhinorrhea. These symptoms are suggestive of:
  46. Drooping of the upper eyelid is termed:
  47. When examining the eyes, both pupils appear small and have an irregular shape. They are noted to accommodate but do not appear to react to light. This could be indicative of:
  48. A patient was diagnosed as nearsighted. The term for this condition is
  49. Gingival hyperplasia could be seen in all of the following conditions except:
  50. In the normal ear, all of the following landmarks can be visualized when using the otoscope, except the:
  51. Sudden visual loss suggests:
  52. Findings following assessment of a person’s gaze include the inability of the left eye to look down when turned inward. This condition is most consistent with:
  53. A 40-year-old male was umpiring a little league baseball game when he was hit in the face with flying debris. He presents with decreased vision and severe pain in the left eye. Findings reveal watery, left ocular discharge. The pupils are normal in appearance and the cornea is slightly cloudy with areas of corneal erythema. These findings are most consistent with:
  54. The lacrimal puncta are located:
  55. Findings following assessment of a person’s left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with:
  56. Performance of the Weber and Rinne tests to assess for hearing loss is best performed using tuning fork with a frequency of:
  57. Which disorder of the eye can be detected with the cover-uncover and the Hirschberg test?
  58. Most of the paranasal sinuses drain into the:
  59. With transillumination of the maxillary sinuses, a reddish glow is observed on the hard palate. This red glow would be indicative of:
  60. The ossicles are located in the:
  61. Assessment of a patient’s visual acuity resulted in 20/200 using the Snellen eye chart. This means that:
  62. Raised or flat, deep purple colored lesions noted in the mouth may be suggestive of:
  63. One cause of nasal septum perforation may be:
  64. A teenager complains of itching and burning of his eye. Examination reveals an erythematous eyelid margin with crusting and a clear mucus discharge. These findings are consistent with:
  65. To palpate for frontal sinus tenderness, press up on the frontal sinuses from under the bony brows, then:
  66. When a light beam shines into one pupil causing pupillary constriction in that eye, the term used is:
  67. Sudden bilateral and painless vision loss is rare but can be associated with all of the following except:
  68. When inspecting the neck for the thyroid gland, slightly tilt the patient’s head back, and using tangential lighting directed downward from the tip of the patient’s chin, inspect the:
  69. Findings following assessment of a person’s eye gaze include both eyes moving in the same direction simultaneously. This condition is most consistent with:
  70. Ophthalmoscopic examination of the retina reveals a normal arteriovenous crossing. This appears as if the:
  71. A 30-year-old patient presents with complaints of seeing double in the right eye. Examination reveals diplopia in the right eye when the left eye is closed. This may be suggestive of a:
  72. A softening of the skin at the angles of the mouth which may be due to nutritional deficiency is commonly referred to as:
  73. Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the:
  74. Ophthalmoscopic examination of a 30-year-old with a history of an eye injury 3 years ago, reveals a superficial grayish-white opacity in the right cornea. This may be indicative of a:
  75. Examination of the eye reveals a painful, erythematous, and tender area around the nose and lower eyelid. This condition is most likely:
  76. A six-year-old child presents with sore throat, difficulty swallowing, and a temperature of 102F. findings reveal lymphadenopathy and pharyngeal erythema. This is probably:
  77. The nasolacrimal duct drains into the:
  78. The Rinne hearing test allows the examiner to screen for:
  79. Ophthalmoscopic examination of the fundus reveals tiny, round, red spots in and around the macular are. These findings are consistent with:
  80. Eyelid retraction with exophthalmos presents as:
  81. Mydriasis is a term used to describe:
  82. A patient diagnosed with strep throat received for azithromycin. She has not improved in 48 hours. What course of action is acceptable?
  83. Group a strept pharyngitis:
  84. Which antihistamine is preferred for treating allergic rhinitis in an adolescent or adult?
  85. A 20-year-old patient presented with complaints of a sore throat and cough that began this morning. His oral temperature is 101.2F. He has the following laboratory results. What is his most likely diagnosis?
  86. What are the most common signs and symptoms associated with mononucleosis?
  87. A 61-year-old presents with a 12-hour history of an extremely painful left red eye. The pain complains of blurred vision, haloes around lights, and vomiting. It began yesterday evening. On examination, the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most likely diagnosis in this patient is:
  88. In a patient who is diagnosed with mastoiditis, which of the following is most likely?
  89. A patient presents to a nurse practitioner with paroxysmal sneezing, clear rhinorrhea, nasal congestion, and facial pain. Which symptom below is NOT associated with allergic rhinitis?
  90. A 45-year-old patient describes a spinning sensation that has occurred intermittently for the past 24 hours. It is precipitated by position changes like rolling over in bed. During these episodes, he complains of intense nausea. Which choice best describes benign paroxysmal positional vertigo?
  91. A 93-year-old demented adult has been recently treated for an upper respiratory infection (URI) but drainage from the right nostril persists. What should the NP suspect?
  92. On routine exam, a 15-year-old patient’s tympanic membrane (TM) reveals a tiny white oblong mark just inferior to the umbo on the surface of the TM. The patient has no complaints of ear pain and gross hearing is intact. What is this?
  93. Mr. O has been diagnosed with hearing loss secondary exposure to an ototoxic medication. Which one may be associated with ototoxicity?
  94. A 58-year-old farmer presents with a wedge-shaped, pinkish, clear growth on the nasal side of his eye. He states that it has been present for a while, but only recently began to feel as if a foreign body was in his eye. This is probably a
  95. An elderly patient who has a red eye with tearing diagnosed with conjunctivitis. What characteristics below most closely indicate viral conjunctivitis?
  96. A patient has been diagnosed with mononucleosis. Which statement is correct?
  97. A patient presents to your clinic with a painless red eye. Her vision is normal, but her ocular surface has a blood red area. What is this termed? Subconjunctival hemorrhage
  98. The nurse practitioner performs a fundoscopic exam on a patient who has recently been diagnosed with hypertension. What is the significance of AV nicking?
  99. In a patient with mononucleosis, which laboratory abnormality is most common?
  100. A 30-year-old male has been diagnosed with nonallergic rhinitis. Which finding is more likely in nonallergic rhinitis than allergic rhinitis?
  101. The single most effective maintenance therapy for allergic rhinitis is:
  102. A patient has been taking amoxicillin for 8 days for sore throat. Today, the patient has developed a pruritic full body rash and is diagnosed with penicillin allergy. What described the skin manifestations of penicillin allergy?
  103. Acute otitis media can be diagnosed by identifying which otic characteristic(s)?
  104. The hearing loss associated with aging involves:
  105. A patient presents with tragal pain. What is the most likely diagnosis?
  106. A patient has two palpable, tender, left preauricular nodes that are about 0.5 cm in diameter. What condition might this be associated with?
  107. A patient who is 65 years old states that she has “hay fever” and has had this since childhood. What agent could be safely used to help with rhinitis, sneezing, pruritis, and congestion?
  108. Which statement about serous otitis media is correct?
  109. On examination of the tympanic membrane, a cloudy, red, bulging ear drum with impaired mobility is detected. This is consistent with:
  110. A patient describes a sensation that “there is a lump in his throat.” He denies throat pain. On exam of the throat and neck, there are no abnormalities identified what is the most likely reason this occurs?
  111. A patient with allergic rhinitis developed a sinus infection 10 days ago. He takes fexofenadine daily. What should be done with the fexofenadine?
  112. A common complaint in older patients who have cataracts is:
  113. Arcus senilis is described as:
  114. A patient is diagnosed with thrush. What might be found on microscopic exam?
  115. A 17-year-old has a complaint of ear pain. If he has otitis externa, which complaint is most likely?
  116. A patient who is otherwise healthy states that he woke up this morning and has been unable to hear out of his left ear. The Weber and Rinne tests were performed. What it the primary reason for doing this?
  117. A 32-year-old patient is newly diagnosed diabetic. She has developed a sinus infection. Her symptoms have persisted for 10 days. Six weeks ago, she was treated with amoxicillin for an upper respiratory infection. It cleared without incident. What should be recommended today?
  118. A contact lens wearer presents with an erythematous right conjunctiva. He denies blurred vision. There is scant drainage and crusting around the right eyelashes. He reports that crusting was present when he woke this morning. How should the exam begin?
  119. Swimmer’s ear is diagnosed in a patient who has right-sided tragal tenderness. What other symptoms might he have?
  120. A patient who is 52 years old presents to your clinic for an exam. You notice a yellowish plaque on her upper eyelid. It is painless. What should the NP assess?
  121. A 70-year-old female states that she sees objects better by looking at them with her peripheral vision. She is examined and found to have a loss of central vision, normal peripheral vision, and a normal lens. This best characterizes:
  122. A 70-year-old patient in good health has a large, white plaque on the oral mucosa of the inner cheek. There is no pain associated with this. What is a likely diagnosis?
  123. A patient reports a penicillin allergy. What question regarding the allergy should the nurse practitioner ask to determine whether a cephalosporin can be safely prescribed?
  124. A nurse practitioner performs a fundoscopic exam. He identifies small areas of dull, yellowish-white coloration in the retina. What might this be? Cotton wool spots
  125. Which of the following is most likely observed in a patient with allergic rhinitis?
  126. A patient with environmental allergies presents to your clinic. She takes an oral antihistamine every 24 hours. What is the most effective single maintenance medicine for allergic rhinitis?
  127. A patient has nasal septal with minor, continuous bleeding. That is macerated tissue. What is likely etiology?
  128. An 80-year-old is having difficulty hearing. When the nurse practitioner examines him, she is unable to visualize the tympanic membrane because of cerumen impaction. This produces what kind of hearing loss?
  129. A 70-year-old male has a yellowish-triangular nodule near the iris. This is probably:
  130. A patient is diagnosed with otitis externa. He complains of tragal pain, otic discharge, otic itching, and fever. What is the cardinal symptoms of otitis externa?
  131. An older adult has a common cold. She calls your office to ask for advice for an agent to help her runny nose and congestion. What agent is safe to use?
  132. A patient has been diagnosed with acute rhinosinusitis. Symptoms began 3 days ago. Based on the most likely etiology, how should this patient be managed?
  133. AV nicking may be identified in a patient who has what disease?
  134. Papilledema is noted in a patient with a headache. What is the importance of papilledema in this patient?
  135. Most commonly, epistaxis occurs:
  136. How should the class effect of the nasal steroids be described?
  137. A patient stated that his ears felt stopped up. He pinched his nose and blew through it forcefully. The nurse practitioner diagnosed a ruptured left tympanic membrane. That would indicate this?
  138. A teenager with fever and pharyngitis had a negative rapid strep test. After 24 hours, the throat culture reveals “normal flora”. Which conclusion can be made?
  139. An older adult has cerumen impaction in both ears. His hearing is diminished. This type of hearing loss is:
  140. A patient with bacterial sinusitis cannot spread this to others via:
  141. A patient who presents with a complaint of sudden decreased visual acuity has a pupil that is about 4 mm, fixed. The affected eye is red. What might be the etiology?
  142. A patient presents to the clinic with a complaint of a red-eye. Which assessment below rules out the most worrisome diagnoses?
  143. A medication considered the first line for a patient with allergic rhinitis is a:
  144. What symptom tetrad is most commonly associated with infectious mononucleosis?
  145. A 70-year-old presents urgently to the nurse practitioner clinic with angioedema. This began less than an hour ago. He is breathing without difficulty. What medication may have caused this?
  146. A patient presents with severe toothache. She reports sensitivity to heat and cold. There is visible pus around the painful area. What is this termed?
  147. A 14-year-old was diagnosed and treated for left acute otitis media 4 weeks ago. She presents today for follow-up visit. There is an effusion in the left ear. She denies complaints. How should this be managed?
  148. A patient with mononucleosis has pharyngitis, fever, and lymphadenopathy. His symptoms started 3 days ago. What is likely finding in this patient?
  149. A 70-year-old patient has begun to have hearing loss. She relates that her elderly parents had difficulty hearing. Which complaint below is typical of prescbycusis?
  150. A patient with diarrhea has a positive enzyme immunoassay for C.difficile. he is on clindamycin for a tooth abscess. How should he be managed?
  151. What medication should always be avoided in patients with mononucleosis?
  152. The most common complication of influenza is:
  153. What clinical finding necessitates an urgent referral of the patient to an emergency department?
  154. Which of the following symptoms is more indicative of bacterial sinusitis than viral?
  155. The most common cause of acute pharyngitis in children is:
  156. A rapid strep test was negative in a 12-year-old female with tonsillar exudate, fever, and sore throat. Which statement is true regarding this?