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NURS 5433 ENT & UPPER AIRWAY DISORDERS EXAM
2026/2027 | SINUS NASAL OTOLOGIC DISORDERS –
CHAMBERLAIN | EXPERT VERIFIED | 75 VERIFIED Q&A
| DETAILED RATIONALES | NGN-ALIGNED | PASS
GUARANTEED - A+ GRADED
SECTION A: MULTIPLE CHOICE (Questions 1-50)
Instructions: Select the single best answer for each question.
1. A 35-year-old female client presents with facial pain, nasal congestion, and purulent nasal
discharge for 10 days. She reports that her symptoms worsened after a viral upper respiratory
infection. Which diagnosis is most likely?
• A) Allergic rhinitis
• B) Acute sinusitis
• C) Chronic sinusitis
• D) Nasal polyps
Answer: B) Acute sinusitis
Rationale: Acute sinusitis is characterized by facial pain, nasal congestion, and purulent nasal
discharge lasting less than 4 weeks. It often follows a viral URI. Allergic rhinitis presents with clear
nasal discharge and itching. Chronic sinusitis lasts > 12 weeks. Nasal polyps are non-tender growths.
Teaching Point: Acute sinusitis is commonly caused by viral infections but can become bacterial.
First-line treatment includes nasal saline irrigation, decongestants, and analgesics. Antibiotics are
indicated for persistent symptoms (> 10 days) or severe symptoms.
2. A 25-year-old male client presents with sudden onset of severe vertigo, nausea, vomiting, and
hearing loss in the right ear. Symptoms began 2 hours ago. Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: C) Labyrinthitis
Rationale: Labyrinthitis presents with sudden onset of severe vertigo, nausea, vomiting, and hearing
loss. Vestibular neuritis presents with vertigo without hearing loss. BPPV presents with brief
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episodes of vertigo with positional changes. Ménière's disease presents with episodic vertigo,
hearing loss, and tinnitus.
Teaching Point: Labyrinthitis is inflammation of the inner ear, often viral. Treatment includes
vestibular suppressants (meclizine, diazepam) and corticosteroids. Bacterial labyrinthitis is a medical
emergency requiring IV antibiotics.
3. A 50-year-old male client presents with hoarseness for 3 weeks. He has a 30-pack-year smoking
history and reports drinking alcohol daily. Which diagnosis must be ruled out?
• A) Laryngitis
• B) Vocal cord nodules
• C) Laryngeal cancer
• D) Gastroesophageal reflux disease (GERD)
Answer: C) Laryngeal cancer
Rationale: Hoarseness lasting > 2 weeks in a smoker with alcohol use requires evaluation for
laryngeal cancer. Laryngitis is usually acute and self-limiting. Vocal cord nodules occur with voice
overuse. GERD can cause hoarseness but is less urgent.
Teaching Point: Laryngeal cancer is associated with smoking and alcohol use. Persistent hoarseness
requires laryngoscopy for evaluation.
4. A 40-year-old female client presents with recurrent episodes of vertigo, tinnitus, and hearing
loss. Symptoms last for several hours and are associated with a feeling of fullness in the ear.
Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: B) Ménière's disease
Rationale: Ménière's disease is characterized by episodic vertigo, tinnitus, hearing loss, and aural
fullness. Symptoms last from 20 minutes to 12 hours. BPPV presents with brief episodes triggered by
position changes. Labyrinthitis and vestibular neuritis are typically acute and not recurrent.
Teaching Point: Ménière's disease is caused by endolymphatic hydrops. Treatment includes low-
sodium diet, diuretics, and vestibular suppressants.
5. A 55-year-old male client presents with a sensation of a lump in the throat (globus sensation)
and hoarseness. He reports that symptoms are worse in the morning. Which diagnosis is most
likely?
, 3
• A) Laryngeal cancer
• B) Gastroesophageal reflux disease (GERD)
• C) Vocal cord nodules
• D) Allergic rhinitis
Answer: B) Gastroesophageal reflux disease (GERD)
Rationale: Globus sensation and hoarseness worse in the morning are classic symptoms of
laryngopharyngeal reflux (LPR), a form of GERD. Laryngeal cancer is a concern but less likely without
risk factors. Vocal cord nodules occur with voice overuse. Allergic rhinitis presents with nasal
symptoms.
Teaching Point: LPR is treated with proton pump inhibitors (PPIs), lifestyle modifications (elevating
head of bed, avoiding late meals), and voice rest.
6. A 30-year-old female client presents with recurrent episodes of vertigo triggered by turning her
head in bed. Episodes last less than 1 minute. Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: A) Benign paroxysmal positional vertigo (BPPV)
Rationale: BPPV presents with brief episodes of vertigo (usually < 1 minute) triggered by positional
changes (turning in bed, looking up). Ménière's disease episodes last hours. Labyrinthitis and
vestibular neuritis cause continuous vertigo.
Teaching Point: BPPV is caused by otoconia in the semicircular canals. Treatment includes the Epley
maneuver (canalith repositioning) and vestibular rehabilitation.
7. A 45-year-old male client presents with sudden onset of hearing loss in the right ear. He reports
no pain or vertigo. Which diagnosis is most likely?
• A) Otitis media
• B) Sudden sensorineural hearing loss (SSNHL)
• C) Cerumen impaction
• D) Otosclerosis
Answer: B) Sudden sensorineural hearing loss (SSNHL)
Rationale: Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of ≥ 30 dB over at
least 3 frequencies occurring within 72 hours. It is a medical emergency. Otitis media presents with
pain. Cerumen impaction is gradual. Otosclerosis is progressive.
NURS 5433 ENT & UPPER AIRWAY DISORDERS EXAM
2026/2027 | SINUS NASAL OTOLOGIC DISORDERS –
CHAMBERLAIN | EXPERT VERIFIED | 75 VERIFIED Q&A
| DETAILED RATIONALES | NGN-ALIGNED | PASS
GUARANTEED - A+ GRADED
SECTION A: MULTIPLE CHOICE (Questions 1-50)
Instructions: Select the single best answer for each question.
1. A 35-year-old female client presents with facial pain, nasal congestion, and purulent nasal
discharge for 10 days. She reports that her symptoms worsened after a viral upper respiratory
infection. Which diagnosis is most likely?
• A) Allergic rhinitis
• B) Acute sinusitis
• C) Chronic sinusitis
• D) Nasal polyps
Answer: B) Acute sinusitis
Rationale: Acute sinusitis is characterized by facial pain, nasal congestion, and purulent nasal
discharge lasting less than 4 weeks. It often follows a viral URI. Allergic rhinitis presents with clear
nasal discharge and itching. Chronic sinusitis lasts > 12 weeks. Nasal polyps are non-tender growths.
Teaching Point: Acute sinusitis is commonly caused by viral infections but can become bacterial.
First-line treatment includes nasal saline irrigation, decongestants, and analgesics. Antibiotics are
indicated for persistent symptoms (> 10 days) or severe symptoms.
2. A 25-year-old male client presents with sudden onset of severe vertigo, nausea, vomiting, and
hearing loss in the right ear. Symptoms began 2 hours ago. Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: C) Labyrinthitis
Rationale: Labyrinthitis presents with sudden onset of severe vertigo, nausea, vomiting, and hearing
loss. Vestibular neuritis presents with vertigo without hearing loss. BPPV presents with brief
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episodes of vertigo with positional changes. Ménière's disease presents with episodic vertigo,
hearing loss, and tinnitus.
Teaching Point: Labyrinthitis is inflammation of the inner ear, often viral. Treatment includes
vestibular suppressants (meclizine, diazepam) and corticosteroids. Bacterial labyrinthitis is a medical
emergency requiring IV antibiotics.
3. A 50-year-old male client presents with hoarseness for 3 weeks. He has a 30-pack-year smoking
history and reports drinking alcohol daily. Which diagnosis must be ruled out?
• A) Laryngitis
• B) Vocal cord nodules
• C) Laryngeal cancer
• D) Gastroesophageal reflux disease (GERD)
Answer: C) Laryngeal cancer
Rationale: Hoarseness lasting > 2 weeks in a smoker with alcohol use requires evaluation for
laryngeal cancer. Laryngitis is usually acute and self-limiting. Vocal cord nodules occur with voice
overuse. GERD can cause hoarseness but is less urgent.
Teaching Point: Laryngeal cancer is associated with smoking and alcohol use. Persistent hoarseness
requires laryngoscopy for evaluation.
4. A 40-year-old female client presents with recurrent episodes of vertigo, tinnitus, and hearing
loss. Symptoms last for several hours and are associated with a feeling of fullness in the ear.
Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: B) Ménière's disease
Rationale: Ménière's disease is characterized by episodic vertigo, tinnitus, hearing loss, and aural
fullness. Symptoms last from 20 minutes to 12 hours. BPPV presents with brief episodes triggered by
position changes. Labyrinthitis and vestibular neuritis are typically acute and not recurrent.
Teaching Point: Ménière's disease is caused by endolymphatic hydrops. Treatment includes low-
sodium diet, diuretics, and vestibular suppressants.
5. A 55-year-old male client presents with a sensation of a lump in the throat (globus sensation)
and hoarseness. He reports that symptoms are worse in the morning. Which diagnosis is most
likely?
, 3
• A) Laryngeal cancer
• B) Gastroesophageal reflux disease (GERD)
• C) Vocal cord nodules
• D) Allergic rhinitis
Answer: B) Gastroesophageal reflux disease (GERD)
Rationale: Globus sensation and hoarseness worse in the morning are classic symptoms of
laryngopharyngeal reflux (LPR), a form of GERD. Laryngeal cancer is a concern but less likely without
risk factors. Vocal cord nodules occur with voice overuse. Allergic rhinitis presents with nasal
symptoms.
Teaching Point: LPR is treated with proton pump inhibitors (PPIs), lifestyle modifications (elevating
head of bed, avoiding late meals), and voice rest.
6. A 30-year-old female client presents with recurrent episodes of vertigo triggered by turning her
head in bed. Episodes last less than 1 minute. Which diagnosis is most likely?
• A) Benign paroxysmal positional vertigo (BPPV)
• B) Ménière's disease
• C) Labyrinthitis
• D) Vestibular neuritis
Answer: A) Benign paroxysmal positional vertigo (BPPV)
Rationale: BPPV presents with brief episodes of vertigo (usually < 1 minute) triggered by positional
changes (turning in bed, looking up). Ménière's disease episodes last hours. Labyrinthitis and
vestibular neuritis cause continuous vertigo.
Teaching Point: BPPV is caused by otoconia in the semicircular canals. Treatment includes the Epley
maneuver (canalith repositioning) and vestibular rehabilitation.
7. A 45-year-old male client presents with sudden onset of hearing loss in the right ear. He reports
no pain or vertigo. Which diagnosis is most likely?
• A) Otitis media
• B) Sudden sensorineural hearing loss (SSNHL)
• C) Cerumen impaction
• D) Otosclerosis
Answer: B) Sudden sensorineural hearing loss (SSNHL)
Rationale: Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of ≥ 30 dB over at
least 3 frequencies occurring within 72 hours. It is a medical emergency. Otitis media presents with
pain. Cerumen impaction is gradual. Otosclerosis is progressive.
