NR667 FNP Exam 1 — Comprehensive Practice
Question Bank (Verified Update)
Format: Question → Answer → Detailed Rationale | Complete
Verified Questions | Graded A+
SECTION 1: HEENT & RESPIRATORY (Questions)
1. A 45-year-old patient presents with sudden onset of vertigo,
hearing loss, and tinnitus in the left ear. What is the most
likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Meniere's disease
C) Labyrinthitis
D) Acoustic neuroma
Correct Answer: B
Rationale: Meniere's disease is characterized by recurrent
episodes of vertigo, fluctuating sensorineural hearing loss,
tinnitus, and aural fullness. BPPV has positional triggers without
hearing loss. Labyrinthitis typically follows viral illness and lacks
fluctuating hearing loss. Acoustic neuroma usually presents with
unilateral gradual hearing loss .
,2. A 6-year-old presents with sore throat, fever, and
"strawberry tongue." On exam, you note cervical
lymphadenopathy and a sandpaper-like rash on the trunk.
What is the most likely diagnosis?
A) Kawasaki disease
B) Scarlet fever
C) Measles
D) Epstein-Barr virus
Correct Answer: B
Rationale: Scarlet fever is caused by Group A Streptococcus and
presents with sore throat, fever, strawberry tongue, and
sandpaper rash. Kawasaki disease lacks sore throat. Measles
has Koplik spots .
3. A patient presents with "double vision" in the right eye that
resolves when either eye is closed. This finding suggests:
A) Monocular diplopia
B) Binocular diplopia
C) Myasthenia gravis
D) Thyroid eye disease
Correct Answer: A
Rationale: Monocular diplopia (present in one eye only,
resolving when that eye is closed) typically indicates an
intraocular problem like corneal or lens issues .
,4. A patient presents with a "red eye" that is painless with no
discharge, visual disturbance, or photophobia. Slit lamp shows
a well-defined, shallow ulcer with a gray base. What is the
diagnosis?
A) Viral conjunctivitis
B) Corneal abrasion
C) Corneal ulcer (sterile)
D) Bacterial keratitis
Correct Answer: C
Rationale: Sterile corneal ulcers (often from contact lens
overwear, dry eye) present as painless red eye with a well-
defined shallow ulcer .
5. Which of the following best characterizes presbycusis in the
older adult?
A) Bilateral low-frequency sensorineural hearing loss
B) Bilateral high-frequency sensorineural hearing loss
C) Unilateral high-frequency sensorineural hearing loss
D) Unilateral low-frequency sensorineural hearing loss
Correct Answer: B
Rationale: Presbycusis is age-related hearing loss that
characteristically affects high frequencies bilaterally .
6. A 35-year-old woman presents with allergic rhinitis,
experiencing significant nasal congestion, sneezing, and itchy
eyes. She has tried OTC antihistamines with limited relief.
, What is the most appropriate next step in management?
A) Oral decongestants
B) Nasal saline irrigation
C) Intranasal corticosteroids
D) Referral to an allergist for immunotherapy
Correct Answer: C
Rationale: Intranasal corticosteroids are the most effective first-
line treatment for moderate-to-severe allergic rhinitis .
7. A 45-year-old male presents with a sore throat, fever, and
tender anterior cervical lymph nodes. He has no cough. Centor
criteria score is 3. What is the most appropriate management?
A) Symptomatic treatment only
B) Rapid strep test
C) Empiric antibiotics
D) Throat culture
Correct Answer: B
Rationale: Centor criteria of 3 warrants rapid strep testing to
guide antibiotic therapy .
8. A 60-year-old smoker presents with hoarseness lasting 6
weeks. What is the most appropriate next step?
A) Reassurance and follow-up in 3 months
B) Referral to ENT for laryngoscopy
C) Trial of PPIs
D) Voice rest
Question Bank (Verified Update)
Format: Question → Answer → Detailed Rationale | Complete
Verified Questions | Graded A+
SECTION 1: HEENT & RESPIRATORY (Questions)
1. A 45-year-old patient presents with sudden onset of vertigo,
hearing loss, and tinnitus in the left ear. What is the most
likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Meniere's disease
C) Labyrinthitis
D) Acoustic neuroma
Correct Answer: B
Rationale: Meniere's disease is characterized by recurrent
episodes of vertigo, fluctuating sensorineural hearing loss,
tinnitus, and aural fullness. BPPV has positional triggers without
hearing loss. Labyrinthitis typically follows viral illness and lacks
fluctuating hearing loss. Acoustic neuroma usually presents with
unilateral gradual hearing loss .
,2. A 6-year-old presents with sore throat, fever, and
"strawberry tongue." On exam, you note cervical
lymphadenopathy and a sandpaper-like rash on the trunk.
What is the most likely diagnosis?
A) Kawasaki disease
B) Scarlet fever
C) Measles
D) Epstein-Barr virus
Correct Answer: B
Rationale: Scarlet fever is caused by Group A Streptococcus and
presents with sore throat, fever, strawberry tongue, and
sandpaper rash. Kawasaki disease lacks sore throat. Measles
has Koplik spots .
3. A patient presents with "double vision" in the right eye that
resolves when either eye is closed. This finding suggests:
A) Monocular diplopia
B) Binocular diplopia
C) Myasthenia gravis
D) Thyroid eye disease
Correct Answer: A
Rationale: Monocular diplopia (present in one eye only,
resolving when that eye is closed) typically indicates an
intraocular problem like corneal or lens issues .
,4. A patient presents with a "red eye" that is painless with no
discharge, visual disturbance, or photophobia. Slit lamp shows
a well-defined, shallow ulcer with a gray base. What is the
diagnosis?
A) Viral conjunctivitis
B) Corneal abrasion
C) Corneal ulcer (sterile)
D) Bacterial keratitis
Correct Answer: C
Rationale: Sterile corneal ulcers (often from contact lens
overwear, dry eye) present as painless red eye with a well-
defined shallow ulcer .
5. Which of the following best characterizes presbycusis in the
older adult?
A) Bilateral low-frequency sensorineural hearing loss
B) Bilateral high-frequency sensorineural hearing loss
C) Unilateral high-frequency sensorineural hearing loss
D) Unilateral low-frequency sensorineural hearing loss
Correct Answer: B
Rationale: Presbycusis is age-related hearing loss that
characteristically affects high frequencies bilaterally .
6. A 35-year-old woman presents with allergic rhinitis,
experiencing significant nasal congestion, sneezing, and itchy
eyes. She has tried OTC antihistamines with limited relief.
, What is the most appropriate next step in management?
A) Oral decongestants
B) Nasal saline irrigation
C) Intranasal corticosteroids
D) Referral to an allergist for immunotherapy
Correct Answer: C
Rationale: Intranasal corticosteroids are the most effective first-
line treatment for moderate-to-severe allergic rhinitis .
7. A 45-year-old male presents with a sore throat, fever, and
tender anterior cervical lymph nodes. He has no cough. Centor
criteria score is 3. What is the most appropriate management?
A) Symptomatic treatment only
B) Rapid strep test
C) Empiric antibiotics
D) Throat culture
Correct Answer: B
Rationale: Centor criteria of 3 warrants rapid strep testing to
guide antibiotic therapy .
8. A 60-year-old smoker presents with hoarseness lasting 6
weeks. What is the most appropriate next step?
A) Reassurance and follow-up in 3 months
B) Referral to ENT for laryngoscopy
C) Trial of PPIs
D) Voice rest
