UTA NURS 5433 FNP II Midterm Exam Review (2025-2026) | Verified Q&A & Clinical
Guidelines
This comprehensive study guide covers the NURS 5433 FNP II midterm, specifically
focusing on ENT, respiratory, and upper airway management modules. It includes
verified questions and answers alongside the latest clinical diagnostic criteria and
pharmacological management protocols used at the University of Texas at Arlington.
Designed for quick recall, this review helps students master high-yield topics like
pharyngitis complications and pediatric antibiotic guidelines for acute otitis media.
1. A 45-year-old male presents with sudden onset of severe eye pain, blurred
vision, and seeing "halos" around lights. On exam, the pupil is semi-dilated and
non-reactive to light. What is the immediate intervention?
A. Prescribe topical antibiotics
B. Perform an Epley maneuver
C. Emergent referral to Ophthalmology
D. Administer oral antihistamines
Answer: C. Emergent referral to Ophthalmology
Rationale: These are classic signs of Acute Angle-Closure Glaucoma, a medical
emergency that can lead to permanent blindness within hours if intraocular pressure is
not reduced.
2. A patient presents with a thick, white, adherent membrane on the tonsils that
bleeds when an attempt is made to scrape it off. This is a hallmark of:
A. Infectious Mononucleosis
B. Diphtheria
C. Candidiasis
D. Vincent’s Angina
Answer: B. Diphtheria
Rationale: While Candidiasis (Thrush) scrapes off and may bleed slightly, the
"pseudomembrane" of Diphtheria is much tougher, grey-white, and bleeds significantly
when disturbed.
,3. Which physical exam finding is the most sensitive indicator for a diagnosis of
Acute Otitis Media (AOM)?
A. Erythema of the tympanic membrane
B. Bulging of the tympanic membrane
C. Clear fluid behind the membrane
D. Tenderness of the pinna
Answer: B. Bulging of the tympanic membrane
Rationale: Bulging indicates middle ear pressure and infection. Redness (erythema) can
occur just from a child crying or having a high fever.
4. A 22-year-old female presents with a sore throat, fever, and fatigue. The NP
notes posterior cervical lymphadenopathy and splenomegaly. Which medication
should be avoided if a rapid strep test is negative?
A. Acetaminophen
B. Amoxicillin
C. Azithromycin
D. Prednisone
Answer: B. Amoxicillin
Rationale: If the patient has Infectious Mononucleosis, giving Amoxicillin or Ampicillin
often triggers a characteristic non-allergic maculopapular rash.
5. A patient with Allergic Rhinitis has failed treatment with second-generation oral
antihistamines. What is the next most effective step in management?
A. Add a first-generation antihistamine at night
B. Start an intranasal corticosteroid spray
C. Begin a 10-day course of oral prednisone
D. Prescribe oral montelukast
Answer: B. Start an intranasal corticosteroid spray
Rationale: Intranasal corticosteroids (e.g., Flonase) are the single most effective
maintenance therapy for allergic rhinitis, superior to oral antihistamines.
6. Which condition is characterized by "drusen" deposits seen during a
fundoscopic exam?
A. Diabetic Retinopathy
B. Hypertensive Retinopathy
,C. Macular Degeneration
D. Glaucoma
Answer: C. Macular Degeneration
Rationale: Drusen are yellow-white extracellular deposits that accumulate in the retina
and are the hallmark of early "dry" macular degeneration.
7. A 60-year-old smoker presents with a painless, white, leathery patch on the
floor of the mouth that cannot be scraped off. This is known as:
A. Oral Thrush
B. Leukoplakia
C. Lichen Planus
D. Aphthous ulcer
Answer: B. Leukoplakia
Rationale: Leukoplakia is a premalignant lesion common in tobacco users. Lesions
that can be scraped off are typically fungal (thrush).
8. A patient complains of the room spinning whenever they turn their head
quickly. The symptoms last about 30 seconds. Which diagnostic test should the
NP perform?
A. Weber Test
B. Romberg Test
C. Dix-Hallpike Maneuver
D. Rinne Test
Answer: C. Dix-Hallpike Maneuver
Rationale: The Dix-Hallpike maneuver is used to provoke nystagmus and confirm a
diagnosis of Benign Paroxysmal Positional Vertigo (BPPV).
9. What is the gold-standard antibiotic for a patient with Acute Bacterial
Rhinosinusitis (ABRS) who has not responded to supportive care after 10 days?
A. Amoxicillin
B. Amoxicillin-Clavulanate (Augmentin)
C. Azithromycin
D. Cephalexin
Answer: B. Amoxicillin-Clavulanate (Augmentin)
Rationale: Augmentin is the preferred first-line agent because it provides better coverage
against beta-lactamase-producing H. influenzae.
, 10. A patient presents with a painful, red, swollen lump on the eyelid margin that
is tender to the touch. This is a:
A. Chalazion
B. Hordeolum
C. Blepharitis
D. Pterygium
Answer: B. Hordeolum
Rationale: A hordeolum (stye) is an acute infectious process (usually Staph) of the eyelid
glands. A chalazion is usually a chronic, non-tender lump.
11. When assessing hearing with the Weber test, sound lateralizes to the patient's
"affected" (bad) ear. This indicates:
A. Sensorineural hearing loss in that ear
B. Conductive hearing loss in that ear
C. Normal hearing
D. Nerve damage to CN VIII
Answer: B. Conductive hearing loss in that ear
Rationale: In conductive loss (like earwax or fluid), the affected ear hears the bone-
conducted vibrations better because background room noise is blocked.
12. A "steeple sign" on a lateral neck X-ray indicates narrowing of the subglottic
airway, which is diagnostic for:
A. Epiglottitis
B. Laryngotracheobronchitis (Croup)
C. Foreign body aspiration
D. Bacterial Tracheitis
Answer: B. Laryngotracheobronchitis (Croup)
Rationale: The "steeple sign" is the classic radiographic finding for Croup. Epiglottitis
shows a "thumbprint sign."
13. A patient presents with "hot potato voice," drooling, and difficulty opening
their mouth (trismus). The NP notes a displaced uvula. This is a:
A. Peritonsillar Abscess
B. Retropharyngeal Abscess
C. Case of Severe Strep Throat
D. Epiglottitis
Guidelines
This comprehensive study guide covers the NURS 5433 FNP II midterm, specifically
focusing on ENT, respiratory, and upper airway management modules. It includes
verified questions and answers alongside the latest clinical diagnostic criteria and
pharmacological management protocols used at the University of Texas at Arlington.
Designed for quick recall, this review helps students master high-yield topics like
pharyngitis complications and pediatric antibiotic guidelines for acute otitis media.
1. A 45-year-old male presents with sudden onset of severe eye pain, blurred
vision, and seeing "halos" around lights. On exam, the pupil is semi-dilated and
non-reactive to light. What is the immediate intervention?
A. Prescribe topical antibiotics
B. Perform an Epley maneuver
C. Emergent referral to Ophthalmology
D. Administer oral antihistamines
Answer: C. Emergent referral to Ophthalmology
Rationale: These are classic signs of Acute Angle-Closure Glaucoma, a medical
emergency that can lead to permanent blindness within hours if intraocular pressure is
not reduced.
2. A patient presents with a thick, white, adherent membrane on the tonsils that
bleeds when an attempt is made to scrape it off. This is a hallmark of:
A. Infectious Mononucleosis
B. Diphtheria
C. Candidiasis
D. Vincent’s Angina
Answer: B. Diphtheria
Rationale: While Candidiasis (Thrush) scrapes off and may bleed slightly, the
"pseudomembrane" of Diphtheria is much tougher, grey-white, and bleeds significantly
when disturbed.
,3. Which physical exam finding is the most sensitive indicator for a diagnosis of
Acute Otitis Media (AOM)?
A. Erythema of the tympanic membrane
B. Bulging of the tympanic membrane
C. Clear fluid behind the membrane
D. Tenderness of the pinna
Answer: B. Bulging of the tympanic membrane
Rationale: Bulging indicates middle ear pressure and infection. Redness (erythema) can
occur just from a child crying or having a high fever.
4. A 22-year-old female presents with a sore throat, fever, and fatigue. The NP
notes posterior cervical lymphadenopathy and splenomegaly. Which medication
should be avoided if a rapid strep test is negative?
A. Acetaminophen
B. Amoxicillin
C. Azithromycin
D. Prednisone
Answer: B. Amoxicillin
Rationale: If the patient has Infectious Mononucleosis, giving Amoxicillin or Ampicillin
often triggers a characteristic non-allergic maculopapular rash.
5. A patient with Allergic Rhinitis has failed treatment with second-generation oral
antihistamines. What is the next most effective step in management?
A. Add a first-generation antihistamine at night
B. Start an intranasal corticosteroid spray
C. Begin a 10-day course of oral prednisone
D. Prescribe oral montelukast
Answer: B. Start an intranasal corticosteroid spray
Rationale: Intranasal corticosteroids (e.g., Flonase) are the single most effective
maintenance therapy for allergic rhinitis, superior to oral antihistamines.
6. Which condition is characterized by "drusen" deposits seen during a
fundoscopic exam?
A. Diabetic Retinopathy
B. Hypertensive Retinopathy
,C. Macular Degeneration
D. Glaucoma
Answer: C. Macular Degeneration
Rationale: Drusen are yellow-white extracellular deposits that accumulate in the retina
and are the hallmark of early "dry" macular degeneration.
7. A 60-year-old smoker presents with a painless, white, leathery patch on the
floor of the mouth that cannot be scraped off. This is known as:
A. Oral Thrush
B. Leukoplakia
C. Lichen Planus
D. Aphthous ulcer
Answer: B. Leukoplakia
Rationale: Leukoplakia is a premalignant lesion common in tobacco users. Lesions
that can be scraped off are typically fungal (thrush).
8. A patient complains of the room spinning whenever they turn their head
quickly. The symptoms last about 30 seconds. Which diagnostic test should the
NP perform?
A. Weber Test
B. Romberg Test
C. Dix-Hallpike Maneuver
D. Rinne Test
Answer: C. Dix-Hallpike Maneuver
Rationale: The Dix-Hallpike maneuver is used to provoke nystagmus and confirm a
diagnosis of Benign Paroxysmal Positional Vertigo (BPPV).
9. What is the gold-standard antibiotic for a patient with Acute Bacterial
Rhinosinusitis (ABRS) who has not responded to supportive care after 10 days?
A. Amoxicillin
B. Amoxicillin-Clavulanate (Augmentin)
C. Azithromycin
D. Cephalexin
Answer: B. Amoxicillin-Clavulanate (Augmentin)
Rationale: Augmentin is the preferred first-line agent because it provides better coverage
against beta-lactamase-producing H. influenzae.
, 10. A patient presents with a painful, red, swollen lump on the eyelid margin that
is tender to the touch. This is a:
A. Chalazion
B. Hordeolum
C. Blepharitis
D. Pterygium
Answer: B. Hordeolum
Rationale: A hordeolum (stye) is an acute infectious process (usually Staph) of the eyelid
glands. A chalazion is usually a chronic, non-tender lump.
11. When assessing hearing with the Weber test, sound lateralizes to the patient's
"affected" (bad) ear. This indicates:
A. Sensorineural hearing loss in that ear
B. Conductive hearing loss in that ear
C. Normal hearing
D. Nerve damage to CN VIII
Answer: B. Conductive hearing loss in that ear
Rationale: In conductive loss (like earwax or fluid), the affected ear hears the bone-
conducted vibrations better because background room noise is blocked.
12. A "steeple sign" on a lateral neck X-ray indicates narrowing of the subglottic
airway, which is diagnostic for:
A. Epiglottitis
B. Laryngotracheobronchitis (Croup)
C. Foreign body aspiration
D. Bacterial Tracheitis
Answer: B. Laryngotracheobronchitis (Croup)
Rationale: The "steeple sign" is the classic radiographic finding for Croup. Epiglottitis
shows a "thumbprint sign."
13. A patient presents with "hot potato voice," drooling, and difficulty opening
their mouth (trismus). The NP notes a displaced uvula. This is a:
A. Peritonsillar Abscess
B. Retropharyngeal Abscess
C. Case of Severe Strep Throat
D. Epiglottitis
