TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 73: Rhinitis Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and thin,
clear nasal secretions. The provider notes puffiness around the eyes. The patient’s vital signs are normal. What is the most likely diagnosis for this patient? a. Acute sinusitis b. Allergic rhinitis c. Chronic sinusitis d. Viral rhinitis ANS: B
Patients with symptoms described above typically have allergic rhinitis. Sinusitis causes facial pain, fever, and purulent discharge. Viral rhinitis will also cause purulent discharge and other symptoms of URI. 2. A patient has seasonal rhinitis symptoms and allergy testing reveals sensitivity to various trees
and grasses. What is the first-line treatment for this patient? a. Antihistamine spray b. Intranasal cromolyn c. Intranasal steroids d. Oral antihistamines ANS: C
NURof SItreatment NGTB.Cand OMare the most effective medication for Intranasal steroids are the mainstay preventing symptoms. Antihistamine sprays are helpful but are not first-line treatments. Intranasal cromolyn can be effective but must be used four times daily. Oral antihistamines are used in conjunction with intranasal steroids but are less effective than the steroids. 3. A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after
getting out of bed in the morning. The patient denies itching and sneezing. A physical examination reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend for this patient? a. Consultation for immunotherapy b. Daily intranasal steroids c. Oral antihistamines each morning d. Oral decongestants as needed ANS: B
This patient has symptoms of vasomotor or idiopathic rhinitis. Intranasal steroids are an effective treatment. Immunotherapy is not effective. This type of rhinitis typically does not respond to antihistamines. Oral decongestants are effective, but are best used around the clock, not just prn.
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