Page 1 of 71
HEENT & PRIMARY CARE EXAM LATEST VERSION QUESTIONS
AND ANSWERS 2026 EDITION
HEENT — eye, ear, nose and throat complaints
Preventive/Primary care — screening, health maintenance and lifestyle
HEENT & Primary Care: 250 Practice Questions with Rationales
DOMAIN 1: EYE ASSESSMENT AND DISORDERS (50 Questions)
1. During an eye examination, which structure controls the amount of light entering
the eye?
A) Retina
B) Cornea
C) Iris
D) Lens
Answer: C) Iris
Rationale: The iris contains muscles that constrict or dilate the pupil, regulating the
amount of light entering the eye .
2. Which cranial nerve is primarily responsible for vision?
A) CN I (Olfactory)
B) CN II (Optic)
C) CN III (Oculomotor)
D) CN IV (Trochlear)
Answer: B) CN II (Optic)
Rationale: The optic nerve (CN II) transmits visual information from the retina to the
brain .
, Page 2 of 71
3. The Snellen chart is used to assess which aspect of vision?
A) Color vision
B) Visual acuity
C) Peripheral vision
D) Depth perception
Answer: B) Visual acuity
Rationale: The Snellen chart measures how clearly a patient can see letters at a
standardized distance .
4. A patient presents with redness, itching, and watery discharge in both eyes
during pollen season. What is the most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Keratitis
Answer: C) Allergic conjunctivitis
Rationale: Allergic conjunctivitis commonly presents with bilateral itching, tearing, and
redness associated with allergens .
5. A patient complains of sudden loss of vision in one eye with pain during eye
movement. Which condition is most suspected?
A) Cataract
B) Glaucoma
C) Optic neuritis
D) Conjunctivitis
Answer: C) Optic neuritis
Rationale: Sudden vision loss with pain on eye movement suggests optic neuritis, an
inflammatory condition of the optic nerve .
6. A painless, slowly progressive loss of vision due to lens opacity suggests:
A) Glaucoma
B) Cataract
, Page 3 of 71
C) Conjunctivitis
D) Retinopathy
Answer: B) Cataract
Rationale: Cataracts involve clouding of the lens causing gradual, painless vision loss .
7. Increased intraocular pressure leading to optic nerve damage is characteristic
of:
A) Cataract
B) Glaucoma
C) Conjunctivitis
D) Keratitis
Answer: B) Glaucoma
Rationale: Glaucoma is characterized by increased intraocular pressure leading to optic
nerve damage and progressive vision loss .
8. What is PERRLA?
A) Pupils equal, round, reactive to light and accommodation
B) Pupils equal, regular, responsive to light and acuity
C) Pupils equal, round, responsive to light and amplitude
D) Pupils equal, regular, reactive to light and alignment
Answer: A) Pupils equal, round, reactive to light and accommodation
Rationale: PERRLA is a standard documentation abbreviation meaning Pupils Equal,
Round, Reactive to Light and Accommodation .
9. When should the nurse measure pupil size in relation to shining a light in the
client's eyes?
A) After shining the light
B) Before shining the light
C) During the light exposure
D) It does not matter
Answer: B) Before shining the light
Rationale: Pupil size should be measured before shining the light to avoid artificially
induced constriction .
, Page 4 of 71
10. Define anisocoria and what does it indicate?
A) Equal pupil size, indicates normal finding
B) Condition where one pupil is larger than the other, may indicate neurological damage
C) Constricted pupils, indicates medication effect
D) Dilated pupils, indicates sympathetic stimulation
Answer: B) Condition where one pupil is larger than the other, may indicate
neurological damage
Rationale: Anisocoria is a condition where one pupil is larger than the other and may
indicate neurological damage .
11. If a client presents with anisocoria, what is the first thing the nurse should ask?
A) "Do you have a headache?"
B) "Is this a new issue or is it normal?"
C) "Have you had recent eye trauma?"
D) "Are you taking any eye drops?"
Answer: B) "Is this a new issue or is it normal?"
Rationale: The first step in evaluating anisocoria is to determine if the condition is new
or chronic, as chronic anisocoria may be benign while acute onset suggests pathology .
12. Define ectropion:
A) Eyelid turns inward
B) Eyelid turns outward
C) Droopy eyelid
D) Involuntary eye movement
Answer: B) Eyelid turns outward
Rationale: Ectropion is a condition where the eyelid turns outward, often causing
exposure and irritation .
13. Define entropion:
A) Eyelid turns inward
B) Eyelid turns outward
HEENT & PRIMARY CARE EXAM LATEST VERSION QUESTIONS
AND ANSWERS 2026 EDITION
HEENT — eye, ear, nose and throat complaints
Preventive/Primary care — screening, health maintenance and lifestyle
HEENT & Primary Care: 250 Practice Questions with Rationales
DOMAIN 1: EYE ASSESSMENT AND DISORDERS (50 Questions)
1. During an eye examination, which structure controls the amount of light entering
the eye?
A) Retina
B) Cornea
C) Iris
D) Lens
Answer: C) Iris
Rationale: The iris contains muscles that constrict or dilate the pupil, regulating the
amount of light entering the eye .
2. Which cranial nerve is primarily responsible for vision?
A) CN I (Olfactory)
B) CN II (Optic)
C) CN III (Oculomotor)
D) CN IV (Trochlear)
Answer: B) CN II (Optic)
Rationale: The optic nerve (CN II) transmits visual information from the retina to the
brain .
, Page 2 of 71
3. The Snellen chart is used to assess which aspect of vision?
A) Color vision
B) Visual acuity
C) Peripheral vision
D) Depth perception
Answer: B) Visual acuity
Rationale: The Snellen chart measures how clearly a patient can see letters at a
standardized distance .
4. A patient presents with redness, itching, and watery discharge in both eyes
during pollen season. What is the most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Keratitis
Answer: C) Allergic conjunctivitis
Rationale: Allergic conjunctivitis commonly presents with bilateral itching, tearing, and
redness associated with allergens .
5. A patient complains of sudden loss of vision in one eye with pain during eye
movement. Which condition is most suspected?
A) Cataract
B) Glaucoma
C) Optic neuritis
D) Conjunctivitis
Answer: C) Optic neuritis
Rationale: Sudden vision loss with pain on eye movement suggests optic neuritis, an
inflammatory condition of the optic nerve .
6. A painless, slowly progressive loss of vision due to lens opacity suggests:
A) Glaucoma
B) Cataract
, Page 3 of 71
C) Conjunctivitis
D) Retinopathy
Answer: B) Cataract
Rationale: Cataracts involve clouding of the lens causing gradual, painless vision loss .
7. Increased intraocular pressure leading to optic nerve damage is characteristic
of:
A) Cataract
B) Glaucoma
C) Conjunctivitis
D) Keratitis
Answer: B) Glaucoma
Rationale: Glaucoma is characterized by increased intraocular pressure leading to optic
nerve damage and progressive vision loss .
8. What is PERRLA?
A) Pupils equal, round, reactive to light and accommodation
B) Pupils equal, regular, responsive to light and acuity
C) Pupils equal, round, responsive to light and amplitude
D) Pupils equal, regular, reactive to light and alignment
Answer: A) Pupils equal, round, reactive to light and accommodation
Rationale: PERRLA is a standard documentation abbreviation meaning Pupils Equal,
Round, Reactive to Light and Accommodation .
9. When should the nurse measure pupil size in relation to shining a light in the
client's eyes?
A) After shining the light
B) Before shining the light
C) During the light exposure
D) It does not matter
Answer: B) Before shining the light
Rationale: Pupil size should be measured before shining the light to avoid artificially
induced constriction .
, Page 4 of 71
10. Define anisocoria and what does it indicate?
A) Equal pupil size, indicates normal finding
B) Condition where one pupil is larger than the other, may indicate neurological damage
C) Constricted pupils, indicates medication effect
D) Dilated pupils, indicates sympathetic stimulation
Answer: B) Condition where one pupil is larger than the other, may indicate
neurological damage
Rationale: Anisocoria is a condition where one pupil is larger than the other and may
indicate neurological damage .
11. If a client presents with anisocoria, what is the first thing the nurse should ask?
A) "Do you have a headache?"
B) "Is this a new issue or is it normal?"
C) "Have you had recent eye trauma?"
D) "Are you taking any eye drops?"
Answer: B) "Is this a new issue or is it normal?"
Rationale: The first step in evaluating anisocoria is to determine if the condition is new
or chronic, as chronic anisocoria may be benign while acute onset suggests pathology .
12. Define ectropion:
A) Eyelid turns inward
B) Eyelid turns outward
C) Droopy eyelid
D) Involuntary eye movement
Answer: B) Eyelid turns outward
Rationale: Ectropion is a condition where the eyelid turns outward, often causing
exposure and irritation .
13. Define entropion:
A) Eyelid turns inward
B) Eyelid turns outward
