NRNP 6540 Midterm Exam Guide: 180 Practice Questions & Verified Answers (2025/2026)

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NRNP 6540 MIDTERM EXAM LATEST/NRNP6540 MIDTERM EXAM
PREPARATION/ NRNP 6540 MIDTERM EXAM 180 PRACTICE
QUESTIONS AND ANSWERS 2025/2026 (VERIFIED ANSWERS)
Bell's Palsy: definition, cause, findings, treatment - ......ANSWER........- sudden self-limited
unilateral facial paralysis

- Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes), HTN, DM, Lyme's

- Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic
lesions, taste disturbances

- artificial tears, steroids (to treat CN 7 inflammation), antivirals



Otitis externa: definition, cause, findings, treatment - ......ANSWER........- inflammation of
the outer wear (swimmers' ear)

- water, fungi, bacterial, trauma, viral

- pain with fullness of ear, itching, edema, otorrhea

- suction of debris, ab and steroid solution in ear, oral ab's (based on bold culture)



Otitis media: definition, cause, findings, treatment - ......ANSWER........- inflammation of
middle ear

- congestion in eustachian tube, respiratory bacteria, neoplasm

- pain, hearing loss, vertigo, nausea, pulsatile otorrhea, red and bulging tympanic
membrane, hole in tympanic membrane with rupture

- ab's (Amoxil - 10 days), analgesic for pain, ENT for recurrent



Vertigo: definition, cause, findings, treatment - ......ANSWER........- dizziness

- vestibular neuronitis, Meniere disease, damage to CN 8 (meningitis, trauma), damage to
brain stem nuclei, syphilis, drugs, dm, TIA/ CVA

- dizziness, Tintis, N/V, "full" ear, Romberg sign (sways/ falls with eyes closed)

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- TSH (to rule out hypothyroidism), CT/ MRI, glucose, treat symptoms/ bedrest, vestibular
suppressants (meclizine, diazepam, scopolamine), antiemetics. low salt and diuretic with
Meniere



Epistaxis: definition, cause, findings, treatment - ......ANSWER........- nosebleed

- forceful expiration, winter, trauma, sinusitis, HTN, coagulopathies

- bleeding from nose

- head erect and elevated, cotton ball with Afrin, topical lidocaine, nasal packing



Sinusitis: definition, cause, findings, treatment - ......ANSWER........- inflammation of the
sinuses

- upper respiratory infections, neoplasms

- pain, headache, congestion

- ab's (amoxi, doxycycl), analgesics



Pharyngitis: definition, cause, findings, treatment - ......ANSWER........- inflammation of
pharynx, often with tonsillitis

- viral (influenza A & B, Adeno) (most common), bacterial (streptococcus), fungal

- pain, fever. Viral: ulcers in oral cavity, edema of lymphoid tissue. Bacterial: white/ yellow
exudate, swollen tonsils, bright red mucosa, high fever. Fungal: white spots

- rapid strep test, throat culture, mono spot, chlamydia testing, pain relief. Strep: AB's
(Bicillin, Cephalexin, azithromycin. Candida/ fungal: Nystatin, fluconazole



Epiglottitis (Supraglottitis): definition, cause, findings, treatment - ......ANSWER........-
inflammation of mucous membrane resulting in airway obstruction because of swelling

- bacterial (H. influenza, streptococcus, S. aureus)

- voice change, dyspnea, anxiety, hoarse voice, drooling, don't examine pharynx till x-ray
done

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- xr-neck, CT neck, xr chest, CBC, bld cult, monitor vitals, ER, protect airway (nasotracheal
intubation), ab's (3rd cephalon: ceftriaxone or Vanco, or calinda)



temporomandibular joint (TMJ) disorder: definition, cause, findings, treatment
- ......ANSWER........- pain in joint

- rheumatoid arthritis, trauma, dentures, dental work

- pain, jaw clicking, earache

- NSAIDS, local heat, soft diet



Trigeminal neuralgia (tic douloureux): definition, cause, findings, treatment
- ......ANSWER........- pain and pressure of CN 5 (face sensation and chewing)

- idiopathic

- intense sharp pain (unilateral)

- CT (rule out neoplasm), MRI, carbamazepine, lamotrigine



Labs and tests to perform for violent patient - ......ANSWER........- blood/ urine drug screen

- electrolytes

- BMP

- CT head



Management of violent patients - ......ANSWER........- summon police when weapons
involved

- calm voice

- meds: Lorazepam (2mg), Olanzapine (5mg) Risperdal, Haldol (5mg)

- restraints

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Depression findings - ......ANSWER........- hopelessness, decreased appetite, lack of
energy, suicidal thoughts, diarrhea/ impaction, abd. or chest pain



Depression treatment - ......ANSWER........Labs: TSH, vit B12, folate, glucose, CBC, ECG
(before starting tricyclic antidepressants)

Meds: take 6 - 8 wks. to go into effect

SSRI: citalopram, sertraline, fluoxetine. Lower overdose or side effect potential. May add:
Effexor, Cymbalta, bupropion or mirtazapine

Tricyclic antidepressants and MAOI: overdose potential



bipolar disorder, 3 types - ......ANSWER........type 1: mania

type 2: depressive

type 3: fluctuating between mania and depression



Bipolar treatment - ......ANSWER........Lithium and Depakote. Antidepressants can cause
mania.



Alcohol withdrawal treatment - ......ANSWER........- rehydration

- Thiamine

- Hypoglycemia prevention

- Benzodiazepines: diazepam and lorazepam



Anxiety treatment - ......ANSWER........- rule out physical cause

- meds:

- benzodiazepines: lorazepam

- buspirone (slow onset of action: 2 wks.)