FNP Board-Style Practice Exam
HEENT – Nose Disorders
Questions 1–75
1
A 24-year-old patient presents with recurrent sneezing, clear rhinorrhea, nasal itching, and watery
eyes every spring. On exam, the nasal turbinates appear pale and edematous.
What is the most appropriate first-line treatment?
A. Oral pseudoephedrine
B. Intranasal corticosteroid
C. Oral antibiotic therapy
D. Intranasal phenylephrine
2
A 35-year-old patient presents with nasal congestion and rhinorrhea for 4 days following exposure
to a coworker with a cold. Nasal mucosa is erythematous with watery discharge.
Which diagnosis is most likely?
A. Allergic rhinitis
B. Acute bacterial sinusitis
C. Viral rhinitis
D. Vasomotor rhinitis
3
A patient with allergic rhinitis asks why their nasal steroid spray is not providing immediate relief.
Which statement is correct?
A. Nasal steroids provide immediate symptom relief
B. Nasal steroids work within 24 hours only
C. Nasal steroids may require 1–2 weeks for full effect
D. Nasal steroids should only be used for acute infections
4
Which of the following is the underlying mechanism of allergic rhinitis?
A. Type II hypersensitivity reaction
B. IgE-mediated mast cell activation
C. Bacterial infection of nasal mucosa
D. Autonomic nerve dysfunction
5
A patient presents with rhinorrhea triggered by exposure to cold air and strong perfumes. Allergy
testing is negative.
Which condition is most likely?
,A. Allergic rhinitis
B. Vasomotor rhinitis
C. Acute bacterial sinusitis
D. Chronic sinusitis
6
Which medication is most effective for reducing inflammation in allergic rhinitis?
A. Pseudoephedrine
B. Loratadine
C. Fluticasone nasal spray
D. Oxymetazoline
7
A patient uses oxymetazoline nasal spray daily for 2 weeks and now reports worsening nasal
congestion.
What is the most likely diagnosis?
A. Allergic rhinitis
B. Rhinitis medicamentosa
C. Vasomotor rhinitis
D. Acute sinusitis
8
Which finding is most characteristic of allergic rhinitis on physical examination?
A. Purulent nasal discharge
B. Pale, boggy nasal turbinates
C. Nasal septal perforation
D. Nasal ulcerations
9
A patient with allergic rhinitis also has asthma and eczema.
These conditions collectively represent which concept?
A. Immune suppression
B. Atopy
C. Autoimmune disease
D. Chronic infection
10
Which medication specifically reduces rhinorrhea by blocking parasympathetic stimulation?
A. Ipratropium nasal spray
B. Fluticasone
, C. Montelukast
D. Loratadine
11
Which of the following organisms most commonly causes acute bacterial sinusitis?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Pseudomonas aeruginosa
D. Klebsiella pneumoniae
12
A patient reports sinus congestion, facial pressure, and purulent nasal discharge for 12 days.
What is the most appropriate diagnosis?
A. Viral rhinitis
B. Allergic rhinitis
C. Acute bacterial sinusitis
D. Vasomotor rhinitis
13
Which sinus is most commonly affected in acute bacterial sinusitis?
A. Frontal
B. Ethmoid
C. Maxillary
D. Sphenoid
14
A patient with suspected sinusitis asks when antibiotics are necessary.
Which duration of symptoms suggests bacterial infection?
A. 3 days
B. 5 days
C. 7 days
D. More than 10 days
15
What is the first-line antibiotic for acute bacterial sinusitis?
A. Azithromycin
B. Amoxicillin-clavulanate
C. Ciprofloxacin
D. Trimethoprim-sulfamethoxazole
16
HEENT – Nose Disorders
Questions 1–75
1
A 24-year-old patient presents with recurrent sneezing, clear rhinorrhea, nasal itching, and watery
eyes every spring. On exam, the nasal turbinates appear pale and edematous.
What is the most appropriate first-line treatment?
A. Oral pseudoephedrine
B. Intranasal corticosteroid
C. Oral antibiotic therapy
D. Intranasal phenylephrine
2
A 35-year-old patient presents with nasal congestion and rhinorrhea for 4 days following exposure
to a coworker with a cold. Nasal mucosa is erythematous with watery discharge.
Which diagnosis is most likely?
A. Allergic rhinitis
B. Acute bacterial sinusitis
C. Viral rhinitis
D. Vasomotor rhinitis
3
A patient with allergic rhinitis asks why their nasal steroid spray is not providing immediate relief.
Which statement is correct?
A. Nasal steroids provide immediate symptom relief
B. Nasal steroids work within 24 hours only
C. Nasal steroids may require 1–2 weeks for full effect
D. Nasal steroids should only be used for acute infections
4
Which of the following is the underlying mechanism of allergic rhinitis?
A. Type II hypersensitivity reaction
B. IgE-mediated mast cell activation
C. Bacterial infection of nasal mucosa
D. Autonomic nerve dysfunction
5
A patient presents with rhinorrhea triggered by exposure to cold air and strong perfumes. Allergy
testing is negative.
Which condition is most likely?
,A. Allergic rhinitis
B. Vasomotor rhinitis
C. Acute bacterial sinusitis
D. Chronic sinusitis
6
Which medication is most effective for reducing inflammation in allergic rhinitis?
A. Pseudoephedrine
B. Loratadine
C. Fluticasone nasal spray
D. Oxymetazoline
7
A patient uses oxymetazoline nasal spray daily for 2 weeks and now reports worsening nasal
congestion.
What is the most likely diagnosis?
A. Allergic rhinitis
B. Rhinitis medicamentosa
C. Vasomotor rhinitis
D. Acute sinusitis
8
Which finding is most characteristic of allergic rhinitis on physical examination?
A. Purulent nasal discharge
B. Pale, boggy nasal turbinates
C. Nasal septal perforation
D. Nasal ulcerations
9
A patient with allergic rhinitis also has asthma and eczema.
These conditions collectively represent which concept?
A. Immune suppression
B. Atopy
C. Autoimmune disease
D. Chronic infection
10
Which medication specifically reduces rhinorrhea by blocking parasympathetic stimulation?
A. Ipratropium nasal spray
B. Fluticasone
, C. Montelukast
D. Loratadine
11
Which of the following organisms most commonly causes acute bacterial sinusitis?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Pseudomonas aeruginosa
D. Klebsiella pneumoniae
12
A patient reports sinus congestion, facial pressure, and purulent nasal discharge for 12 days.
What is the most appropriate diagnosis?
A. Viral rhinitis
B. Allergic rhinitis
C. Acute bacterial sinusitis
D. Vasomotor rhinitis
13
Which sinus is most commonly affected in acute bacterial sinusitis?
A. Frontal
B. Ethmoid
C. Maxillary
D. Sphenoid
14
A patient with suspected sinusitis asks when antibiotics are necessary.
Which duration of symptoms suggests bacterial infection?
A. 3 days
B. 5 days
C. 7 days
D. More than 10 days
15
What is the first-line antibiotic for acute bacterial sinusitis?
A. Azithromycin
B. Amoxicillin-clavulanate
C. Ciprofloxacin
D. Trimethoprim-sulfamethoxazole
16
