Podcast
Questions and Answers
What percentage of physician fees are reimbursed?
What percentage of physician fees are reimbursed?
- 5%
- 8% (correct)
- 15%
- 10%
Which part of Medicare is primarily responsible for inpatient hospital stays?
Which part of Medicare is primarily responsible for inpatient hospital stays?
- Part D
- Part C
- Part B
- Part A (correct)
Which additional benefits does Medicare Advantage typically NOT provide?
Which additional benefits does Medicare Advantage typically NOT provide?
- Emergency room visits (correct)
- Home health aide services
- Vision exams
- Wellness services
What is the typical out-of-pocket coverage arrangement for clients on traditional Medicare?
What is the typical out-of-pocket coverage arrangement for clients on traditional Medicare?
What is the primary purpose of Medicare Advantage Plans?
What is the primary purpose of Medicare Advantage Plans?
What symptoms are indicative of acute angle-closure glaucoma?
What symptoms are indicative of acute angle-closure glaucoma?
Which of the following indicates a likely case of epiglottitis in a pediatric patient?
Which of the following indicates a likely case of epiglottitis in a pediatric patient?
What is a severe consequence of untreated acute angle-closure glaucoma?
What is a severe consequence of untreated acute angle-closure glaucoma?
Which symptom is NOT typically associated with epiglottitis?
Which symptom is NOT typically associated with epiglottitis?
What best characterizes the pupil appearance in acute angle-closure glaucoma?
What best characterizes the pupil appearance in acute angle-closure glaucoma?
In the context of pharyngitis, which symptom is primarily associated with the condition?
In the context of pharyngitis, which symptom is primarily associated with the condition?
Which of the following is NOT a symptom of acute angle-closure glaucoma?
Which of the following is NOT a symptom of acute angle-closure glaucoma?
What is a major risk if acute epiglottitis is left untreated?
What is a major risk if acute epiglottitis is left untreated?
What is a common sign indicating the presence of a cavity filled with purulent material in a sinus infection?
What is a common sign indicating the presence of a cavity filled with purulent material in a sinus infection?
Which symptom is specifically linked to ethmoid sinus problems?
Which symptom is specifically linked to ethmoid sinus problems?
What factors are used to confirm a diagnosis of sinusitis in a patient with a URI lasting at least 7 days?
What factors are used to confirm a diagnosis of sinusitis in a patient with a URI lasting at least 7 days?
What is the first-line treatment for group A beta-hemolytic streptococcal pharyngitis in adults without known allergies to penicillin?
What is the first-line treatment for group A beta-hemolytic streptococcal pharyngitis in adults without known allergies to penicillin?
What distinguishes acute sinusitis from chronic sinusitis based on duration?
What distinguishes acute sinusitis from chronic sinusitis based on duration?
Which of the following is a potential complication of a peritonsillar abscess?
Which of the following is a potential complication of a peritonsillar abscess?
Which category of third-party payer does not typically cover medical expenses?
Which category of third-party payer does not typically cover medical expenses?
How much are nurse practitioners reimbursed by CMS compared to physicians?
How much are nurse practitioners reimbursed by CMS compared to physicians?
What is a typical presentation of tonsillitis?
What is a typical presentation of tonsillitis?
What symptom in a patient with pharyngitis may indicate the need to check for infectious mononucleosis?
What symptom in a patient with pharyngitis may indicate the need to check for infectious mononucleosis?
What is the most appropriate treatment option for suspected Group A beta-hemolytic streptococcal pharyngitis in adults who have no known allergy to penicillin?
What is the most appropriate treatment option for suspected Group A beta-hemolytic streptococcal pharyngitis in adults who have no known allergy to penicillin?
Which symptom is most indicative of infectious mononucleosis?
Which symptom is most indicative of infectious mononucleosis?
What should be advised to a patient recovering from infectious mononucleosis regarding physical activities?
What should be advised to a patient recovering from infectious mononucleosis regarding physical activities?
Which of the following is a differential diagnosis for hoarseness?
Which of the following is a differential diagnosis for hoarseness?
What test would you perform to differentiate between conductive and sensorineural hearing loss?
What test would you perform to differentiate between conductive and sensorineural hearing loss?
What finding would suggest conductive hearing loss in a patient undergoing the Rinne test?
What finding would suggest conductive hearing loss in a patient undergoing the Rinne test?
Which symptom is least likely associated with viral pharyngitis?
Which symptom is least likely associated with viral pharyngitis?
Which of the following is NOT a common cause of hoarseness?
Which of the following is NOT a common cause of hoarseness?
Which condition is most likely to lead to sudden sensorineural hearing loss?
Which condition is most likely to lead to sudden sensorineural hearing loss?
What is the major viral cause of infectious mononucleosis?
What is the major viral cause of infectious mononucleosis?
What is the primary characteristic of conductive hearing loss in relation to bone and air conduction?
What is the primary characteristic of conductive hearing loss in relation to bone and air conduction?
Which of the following conditions can lead to conductive hearing loss?
Which of the following conditions can lead to conductive hearing loss?
What is the appropriate action for patients presenting with sudden sensorineural hearing loss?
What is the appropriate action for patients presenting with sudden sensorineural hearing loss?
What is a common cause of tinnitus associated with hearing loss?
What is a common cause of tinnitus associated with hearing loss?
Bilateral, high-pitched tinnitus is typically associated with which condition?
Bilateral, high-pitched tinnitus is typically associated with which condition?
What is a recommended strategy to help minimize symptoms of tinnitus?
What is a recommended strategy to help minimize symptoms of tinnitus?
Which common condition could mimic symptoms of ear pain in patients?
Which common condition could mimic symptoms of ear pain in patients?
In which test is a vibrating tuning fork used to distinguish types of hearing loss?
In which test is a vibrating tuning fork used to distinguish types of hearing loss?
Which is a potential outcome if a client experiences sudden sensorineural hearing loss?
Which is a potential outcome if a client experiences sudden sensorineural hearing loss?
What is a classic sign of acute otitis externa upon examination?
What is a classic sign of acute otitis externa upon examination?
What is a significant dietary recommendation for individuals suffering from tinnitus?
What is a significant dietary recommendation for individuals suffering from tinnitus?
What is a common management strategy for barotrauma of the auditory canal?
What is a common management strategy for barotrauma of the auditory canal?
Which characteristic is associated with sensorineural hearing loss?
Which characteristic is associated with sensorineural hearing loss?
What examination finding typically indicates acute otitis media?
What examination finding typically indicates acute otitis media?
What is the main characteristic of the tympanic membrane in a diagnosis of acute otitis media?
What is the main characteristic of the tympanic membrane in a diagnosis of acute otitis media?
Which symptom is most commonly associated with acute otitis externa?
Which symptom is most commonly associated with acute otitis externa?
What is the typical treatment regimen for a healthy pediatric patient diagnosed with acute otitis media?
What is the typical treatment regimen for a healthy pediatric patient diagnosed with acute otitis media?
What finding is typically observed in a patient with allergic rhinitis during nasal examination?
What finding is typically observed in a patient with allergic rhinitis during nasal examination?
What is a common symptom of Eustachian tube dysfunction?
What is a common symptom of Eustachian tube dysfunction?
Which sign indicates a higher likelihood of bacterial sinusitis following a URI?
Which sign indicates a higher likelihood of bacterial sinusitis following a URI?
What is the primary cause of rebound rhinitis?
What is the primary cause of rebound rhinitis?
What is the recommended management for a perforated tympanic membrane?
What is the recommended management for a perforated tympanic membrane?
During the assessment of sinusitis, what finding would typically suggest a cavity filled with purulent material?
During the assessment of sinusitis, what finding would typically suggest a cavity filled with purulent material?
What is a significant symptom of viral rhinitis?
What is a significant symptom of viral rhinitis?
What is a classic sign of acute otitis externa?
What is a classic sign of acute otitis externa?
What symptom would indicate the need for more aggressive treatment in a patient with acute otitis media?
What symptom would indicate the need for more aggressive treatment in a patient with acute otitis media?
Which condition is characterized by nasal congestion without rhinorrhea after short-term use of topical decongestants?
Which condition is characterized by nasal congestion without rhinorrhea after short-term use of topical decongestants?
Flashcards
Angle-closure glaucoma
Angle-closure glaucoma
A condition that presents with sudden vision loss, severe eye pain, halos around lights, headache, nausea, vomiting, and a non-reactive, partially dilated pupil.
Acute angle-closure glaucoma
Acute angle-closure glaucoma
An emergency condition where untreated, can lead to blindness. Sudden onset of symptoms include severe eye pain, blurred vision, redness, headache, halos around lights, and pressure.
Fundoscopic exam
Fundoscopic exam
An examination of the eye's back using ophthalmoscope to look for signs of glaucoma.
Pharyngitis
Pharyngitis
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Epiglottitis
Epiglottitis
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Epiglottitis symptoms
Epiglottitis symptoms
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Signs of impending airway obstruction in epiglottitis
Signs of impending airway obstruction in epiglottitis
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Blindness due to acute angle-closure glaucoma
Blindness due to acute angle-closure glaucoma
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Infectious mononucleosis
Infectious mononucleosis
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Hoarseness (Dysphonia)
Hoarseness (Dysphonia)
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Barotrauma of the Auditory Canal
Barotrauma of the Auditory Canal
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Streptococcal Pharyngitis
Streptococcal Pharyngitis
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Monospot Test
Monospot Test
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Cervical Lymphadenopathy
Cervical Lymphadenopathy
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Strep Test
Strep Test
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Throat Culture
Throat Culture
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Conductive hearing loss
Conductive hearing loss
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Perforated tympanic membrane
Perforated tympanic membrane
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Ear pain
Ear pain
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Otitis externa
Otitis externa
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Otitis media
Otitis media
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Otitis media with effusion
Otitis media with effusion
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Eustachian tube dysfunction
Eustachian tube dysfunction
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Barotrauma
Barotrauma
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Cerumen impaction
Cerumen impaction
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Dental disease
Dental disease
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Tinnitus
Tinnitus
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Sudden sensorineural hearing loss treatment
Sudden sensorineural hearing loss treatment
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Weber test
Weber test
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Rinne test
Rinne test
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Tinnitus cause - middle ear fluid
Tinnitus cause - middle ear fluid
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Tinnitus and depression
Tinnitus and depression
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What does Medicare Part A cover?
What does Medicare Part A cover?
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What does Medicare Part B cover?
What does Medicare Part B cover?
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What are Medicare Advantage Plans?
What are Medicare Advantage Plans?
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What is Medicare Part C?
What is Medicare Part C?
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What does Medicare Part D cover?
What does Medicare Part D cover?
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Acute Otitis Media
Acute Otitis Media
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Allergic Rhinitis
Allergic Rhinitis
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Rebound Rhinitis
Rebound Rhinitis
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Sinusitis
Sinusitis
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Classic Signs of Otitis Externa
Classic Signs of Otitis Externa
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Indicators for Aggressive Otitis Media Treatment
Indicators for Aggressive Otitis Media Treatment
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Amoxicillin/Clavulanate
Amoxicillin/Clavulanate
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Follow-up for Acute Otitis Media
Follow-up for Acute Otitis Media
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Overuse of Nasal Sprays
Overuse of Nasal Sprays
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Allergic Rhinitis Symptoms
Allergic Rhinitis Symptoms
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Managing Allergic Rhinitis
Managing Allergic Rhinitis
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Sinusitis Complications
Sinusitis Complications
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Tonsillitis
Tonsillitis
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Peritonsillar Abscess
Peritonsillar Abscess
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Third-party Payer
Third-party Payer
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Medicare
Medicare
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Medicaid
Medicaid
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Indemnity Insurance Companies
Indemnity Insurance Companies
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Study Notes
Fundoscopic Exam and Angle-Closure Glaucoma
- Fundoscopic exam may reveal cupping, but evaluation can be challenging without experience.
- Angle-closure glaucoma presents acutely with decreased/blurred vision, severe eye pain.
- Symptoms often include frontal headache, nausea, vomiting, and seeing halos around light.
- Affected pupils are non-reactive to light, partially dilated (4-6 mm).
- Tearing and conjunctival redness can be present.
- Increased intraocular pressure (IOP) is a result, and untreated, can lead to blindness.
- Onset is sudden, with dramatic symptoms including blurred vision, redness, unilateral pain/pressure, headache, seeing halos, photophobia, peripheral, then central vision loss.
- Nurse practitioners must assess vision loss upon presentation.
- Sudden, severe IOP can cause optic nerve damage.
Epiglottitis
- Epiglottitis involves severe throat pain, difficulty swallowing, copious oral secretions, respiratory difficulty, stridor, and fever, but without pharyngeal erythema.
- In children, imminent airway obstruction may be indicated by stridor, restlessness, nasal flaring, and accessory muscle use.
Pharyngitis
- Pharyngitis is inflammation of the pharynx causing discomfort, scratchiness, pain, and difficulty swallowing.
- Symptoms like fatigue, fever, pharyngitis accompanied by cervical lymphadenopathy may be evaluated using a Monospot test, strep test, and throat culture.
- Adults with no known allergies to penicillin, suspected of having Group A beta-hemolytic streptococcal pharyngitis, receive a 10-day course of penicillin V potassium (Pen-Vee K) or benzathine penicillin (Bicillin) as an alternative.
Ear Pain (Barotrauma)
- Ear pain due to barotrauma (pressure changes) is often relieved using nasal steroids and oral decongestants.
Hoarseness (Dysphonia)
- Hoarseness involves changes in voice pitch or quality (weak, scratchy, husky).
- Causes include voice overuse, viruses, growths (cysts, papillomas, polyps, nodules), and GERD.
- Laryngoscopy may be used for diagnosis.
Infectious Mononucleosis
- Infectious mononucleosis is a viral infection, often caused by the Epstein-Barr virus (EBV); other viruses are possible.
- Transmission occurs via shared saliva.
- Common symptoms include extreme fatigue, low-grade fever, sore throat, bilaterally enlarged tonsils with erythema, swollen posterior cervical lymph nodes, swollen liver/spleen, rash, body aches, and mild nasal/throat erythema.
- No specific antiviral therapy exists.
- Antibiotics are usually not necessary unless a concurrent bacterial infection is present.
- Amoxicillin/ampicillin can lead to a rash in clients with co-existing mononucleosis.
- Client teaching: return to normal activities when fever and fatigue subside; avoid contact sports for 3-4 weeks; avoid sharing utensils/items. Mention urgency in seeking medical care for jaundice, abdominal pain, or bleeding
Hearing Loss
- Sensorineural: Caused by loud noises, inner ear infections, familial disorders, aging, Meniere's disease, tumors, medications (e.g., aminoglycosides, aspirin, quinine), trauma, or diseases.
- Sudden sensorineural hearing loss requires referral to an ENT.
- Conductive: Caused by presbycusis, serous otitis media, cerumen impaction.
- In conductive loss, bone conduction is better than air conduction.
- Cerumen impaction is a differential diagnosis for otitis externa.
Weber, Rinne, and Schwabach Tests
- Used to differentiate conductive from sensorineural hearing loss.
- Weber: Tuning fork on head; Equal hearing in both ears (normal); Louder in bad ear (conductive); Louder in good ear (sensorineural).
- Rinne, Schwabach tests: Compare air and bone conduction.
Tinnitus
- Tinnitus is a ringing or buzzing sound in one or both ears.
- Potential causes include middle ear fluid (tympanometry, acoustic reflex/reflectometry).
- Severe hypertension (diastolic over 120 mm Hg) can cause bilateral, high-pitched tinnitus; check orthostatics.
- Minimize symptoms by masking noise with background music, reducing caffeine, alcohol, chocolate, salt, smoking, and ensuring adequate rest.
- Encourage chewing gum/swallowing during airplane descent for eustachian tube opening and middle ear pressure equalization.
- Severe tinnitus warrants screening for psychological disorders.
Barotrauma Relief
- Barotrauma (middle ear pressure) relief can be achieved with nasal steroids and oral decongestants.
Acute Otitis Media/Ear Infection
- Usually viral (e.g., flu, URI).
- Diagnosis: red, bulging tympanic membrane; diminished/absent light reflex; decreased mobility.
- Treatment for healthy children with mild symptoms and no recent antibiotics: amoxicillin (40-50 mg/kg/day PO).
- Follow-up within 48-72 hours; or several days after completion of treatment.
Acute Otitis Externa (AOE)
- Outer ear infection, ("swimmer's ear").
- Characterized by pain on traction of pinna and/or pressure on tragus.
- Erythematous ear canal. Often history of recent swimming.
- Important to dry the ear.
Otitis Media with Effusion
- Fluid in the middle ear without infection.
Eustachian Tube Dysfunction (ETD)
- Fluid buildup in eustachian tube, potentially due to allergies, sinusitis, URIs, enlarged adenoids, pregnancy, air travel, or scuba diving.
- Symptoms: pain, muffled hearing, fullness, tinnitus, popping, vertigo.
Allergic Rhinitis
- IgE-mediated hypersensitivity response to airborne irritants (pollen, dust, mold, animal dander).
- Affects eyes, nose, sinuses, throat, bronchi.
- Seasonal or year-round.
- Symptoms: sneezing, runny nose, red, watery, itchy eyes.
- Diagnosis is clinical; examine nasal mucosa for pallor, pale bluish hue, turbinate edema.
- Clear rhinorrhea and postnasal drip may be observed.
- Avoidance of triggers is key to symptom management.
Viral Rhinitis
- Watery rhinorrhea, nasal congestion, "nasal" speech, and mouth breathing are common.
- Rebound rhinitis: congestion without rhinorrhea, from decongestant overuse; improves within 2-3 weeks after discontinuation.
Sinusitis
- Sinus infection - may lead to invasive complications (mastoiditis, meningitis).
- Ethmoid sinus pain: behind eye, high on nose.
- Maxillary sinus pain: cheek area.
- Inability to transilluminate sinus cavity suggests pus buildup.
- Diagnosis: URI for 7+ days; 2+ signs/symptoms (colored discharge, poor decongestant response, facial/sinus pain, headache).
Hoarseness/Dysphonia
- Voice changes (weak, scratchy, husky).
- Causes: voice misuse, viruses, and growths (cysts, papillomas, polyps, nodules), GERD.
Tonsillitis/Pharyngitis
- Tonsillitis/pharyngitis inflammation of tonsils and pharynx.
- Pharyngitis symptoms with swollen cervical lymph nodes require testing for strep, mono, other conditions.
Peritonsillar Abscess
- Acute pharyngeal infection, usually unilateral.
- Symptoms: severe unilateral sore throat, pain swallowing, fever, ear pain, asymmetric cervical adenopathy, trismus, muffled voice.
- May show a toxic appearance such as poor eye contact, irritability, drooling, severe halitosis, tonsillar erythema, and exudates.
- Requires immediate referral to the emergency department due to potential airway compromise or sepsis.
Third-Party Payers
- Medicare, Medicaid, indemnity insurance companies, managed care organizations, workers' compensation, veterans' administration, auto liability.
- Third-party payers reimburse on behalf of insurance recipients/beneficiaries.
NP Reimbursement by CMS
- NPs are reimbursed at 85% of physician fees.
Medicare Benefits
- Part A: Inpatient, skilled nursing, hospice, and home care.
- Part B: Outpatient, provider visits, surgery, labs, medical equipment, preventive exams.
- Part C (Medicare Advantage): Offers added benefits and lower co-payments; includes traditional Medicare benefits.
- Part D: Prescription drugs.
- Clients will frequently seek secondary insurance to cover 20% co-pays.
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Description
Test your knowledge about Medicare plans, including reimbursement percentages, inpatient coverage, and the typical benefits of Medicare Advantage. This quiz will help you understand the key aspects and arrangements of traditional Medicare and its alternatives.
