FNP 652 MIDTERM EXAM NEWEST 2026=2027/FNP 652
MIDTERM EXAM NEWEST UPDATES 2026-2027 EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
Hearing Loss in the elderly - ANSWERS-Conductive- usually caused by problems in the external
or middle ear that interfere with transmitting sound and its conversion to mechanical vibrations
(IE Cerumen impaction, perforated membrane)
Sensoineural- involves problems converting mechanical vibrations to electrical potential in the
cochlea and/or in auditory nerve transmission to the brain. It is usually caused by permanent
damage in the organ of Corti. (Age related hearing loss; noise trauma)
Hearing Loss in the elderly - ANSWERS-Affects 60-80% of 70 yr +. Start with Whisper and Rinne
tests. Refer patients for Adiometric testing if there is no obvious occlusion.
Differential Diagnoses: Cerumen impaction, foreign object, tumors.
Vision Screening in <1 year old - ANSWERS-As part of each well-child visit, eye health, vision
development, and alignment of the eyes should be checked.
Findings that merit watchful waiting: Chemical conjunctivitis in neonates
Referral considering age of patient: Eye alignment, not making eye contact
,Tympanogram results - ANSWERS-Tympanometry measures the capacity of the middle ear to
transfer sound energy.
What do they indicate:
Type A: Normal Tympanogram is shaped like a tent
Type B: Abnormal; needs medical attention (flat)
Type C: Almost normal but not right (may be too peaked);refers to a middle ear with negative
pressure. A child with this type of tympanogram should be monitored and may need medical
attention. Such a tympanogram may be caused by retraction of the eardrum or blockage of the
Eustachian tube.
Group A hemolytic strep - ANSWERS-Illnesses it can cause: Strep throat, Rheumatic Fever,
Scarlet Fever, Post-Streptococcal Glomerularnephritis. It is spread by nasal or oral secretions and
the incubation period of 2-5 days.
Presentation: often pharyngitis is the very first symptom. Suspect Group A strep if:
Sudden-onset of sore throat
Odynophagia
Fever
Evaluation:
Pharyngeal and tonsillar erythema
Tonsillar hypertrophy with or without exudates
Palatal petechiae
Anterior cervical lymphadenopathy
Scarlatiniform rash
Diagnosis:
,The diagnosis of group A strep pharyngitis is confirmed by either a rapid antigen detection test
(RADT) or a throat culture.
Treatment:Penicillin or amoxicillin is the antibiotic of choice to treat group A strep pharyngitis.
Management of Allergic Rhinitis - ANSWERS-Allergic rhinitis: inflammation of the nasal
membranes in response to known or unknown allergens
Medications (available OTC): Intranasal corticosteroids (Fluticasone); oral antihistamines for
intermittent attacks or milder disease (Cetirizine, fexofenadine)
Home remedies: Avoid triggers, Nasal irrigation, HEPA filter
Otitis Externa vs Otitis Media - ANSWERS-Otitis Externa: Swimmers ear. Commonly caused by
infection (bacterial usually) or from water/chemical exposure. Patient notices discomfort usually
unilaterally. External auditory canal is inflamed and irritated with erythema, drainage is
common.
Otitis Media: Acute onset with middle ear effusion, inflammation, pain, or fever. Caused by
Eustachian tube dysfunction r/t viral upper respiratory infection. Start with Amoxicillin, then go
to Augmentin.
Choleasteatoma - ANSWERS-Presentation: Abnormal non-cancerous skin growth that can
develop in the middle section of the ear. May be caused by repeated middle ear infections
Evaluation: Visual examination, refer to ENT.
Lacrimal Duct Obstruction in Infant - ANSWERS-Presentation:Tears are produced in the lacrimal
duct. Look for tear lakes and excess watering of the eye. Should be negative for corneal and
conjunctival irritation and abnormalities.
, Treatment: Lacrimal sac massage and topical antibiotics.
Elderly Vision loss - ANSWERS-Causes of typical changes: age related ,acular degeneration,
glaucoma, cataracts, diabetic retinopathy.
Presentation: Slow progression of vision changes, often starts with near sighted changes
(needing reading glasses).
Trigeminal neuralgia Vs Bells palsy - ANSWERS-Trigeminal Neuralgia: Chronic pain, "electric
shock". May start as small short bursts of pain with facial stimulation (IE brushing teeth,
applying makeup). Perform extensive neuro exam and MRI, refer to neurology for
anticonvulsants, antispasmodics and botox.
Bells Palsy: Sudden facial hemi palsy/droop. Swelling and inflammation of the nerve. Headache,
trouble opening eye, tears and saliva taste weird. Often caused by viruses or happens shortly
after pregnancy.
Viral vs Bacterial Conjunctivits - ANSWERS-Viral Conjunctivitis: Clears without treatment in <10
days. Typically starts in just one eye after a viral illness such as a cold.
Bacterial Conjunctivitis: (Pink eye). Both eyes (may initially be just one), thick sticky discharge.
Responds to antibiotics in 24 hours. VERY contagious.
Periorbital cellulitis (aka Preseptal Cellulitis) - ANSWERS-Presentation: Most often secondary to
a sinus infection or head cold.
Evaluation: Swelling and redness of the eyelid. Does not affect the eye.
Treatment: Augmentin and close observation
RED FLAG: Orbital redness and swelling, or swelling to both eyelids. Send to the ED!
MIDTERM EXAM NEWEST UPDATES 2026-2027 EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
Hearing Loss in the elderly - ANSWERS-Conductive- usually caused by problems in the external
or middle ear that interfere with transmitting sound and its conversion to mechanical vibrations
(IE Cerumen impaction, perforated membrane)
Sensoineural- involves problems converting mechanical vibrations to electrical potential in the
cochlea and/or in auditory nerve transmission to the brain. It is usually caused by permanent
damage in the organ of Corti. (Age related hearing loss; noise trauma)
Hearing Loss in the elderly - ANSWERS-Affects 60-80% of 70 yr +. Start with Whisper and Rinne
tests. Refer patients for Adiometric testing if there is no obvious occlusion.
Differential Diagnoses: Cerumen impaction, foreign object, tumors.
Vision Screening in <1 year old - ANSWERS-As part of each well-child visit, eye health, vision
development, and alignment of the eyes should be checked.
Findings that merit watchful waiting: Chemical conjunctivitis in neonates
Referral considering age of patient: Eye alignment, not making eye contact
,Tympanogram results - ANSWERS-Tympanometry measures the capacity of the middle ear to
transfer sound energy.
What do they indicate:
Type A: Normal Tympanogram is shaped like a tent
Type B: Abnormal; needs medical attention (flat)
Type C: Almost normal but not right (may be too peaked);refers to a middle ear with negative
pressure. A child with this type of tympanogram should be monitored and may need medical
attention. Such a tympanogram may be caused by retraction of the eardrum or blockage of the
Eustachian tube.
Group A hemolytic strep - ANSWERS-Illnesses it can cause: Strep throat, Rheumatic Fever,
Scarlet Fever, Post-Streptococcal Glomerularnephritis. It is spread by nasal or oral secretions and
the incubation period of 2-5 days.
Presentation: often pharyngitis is the very first symptom. Suspect Group A strep if:
Sudden-onset of sore throat
Odynophagia
Fever
Evaluation:
Pharyngeal and tonsillar erythema
Tonsillar hypertrophy with or without exudates
Palatal petechiae
Anterior cervical lymphadenopathy
Scarlatiniform rash
Diagnosis:
,The diagnosis of group A strep pharyngitis is confirmed by either a rapid antigen detection test
(RADT) or a throat culture.
Treatment:Penicillin or amoxicillin is the antibiotic of choice to treat group A strep pharyngitis.
Management of Allergic Rhinitis - ANSWERS-Allergic rhinitis: inflammation of the nasal
membranes in response to known or unknown allergens
Medications (available OTC): Intranasal corticosteroids (Fluticasone); oral antihistamines for
intermittent attacks or milder disease (Cetirizine, fexofenadine)
Home remedies: Avoid triggers, Nasal irrigation, HEPA filter
Otitis Externa vs Otitis Media - ANSWERS-Otitis Externa: Swimmers ear. Commonly caused by
infection (bacterial usually) or from water/chemical exposure. Patient notices discomfort usually
unilaterally. External auditory canal is inflamed and irritated with erythema, drainage is
common.
Otitis Media: Acute onset with middle ear effusion, inflammation, pain, or fever. Caused by
Eustachian tube dysfunction r/t viral upper respiratory infection. Start with Amoxicillin, then go
to Augmentin.
Choleasteatoma - ANSWERS-Presentation: Abnormal non-cancerous skin growth that can
develop in the middle section of the ear. May be caused by repeated middle ear infections
Evaluation: Visual examination, refer to ENT.
Lacrimal Duct Obstruction in Infant - ANSWERS-Presentation:Tears are produced in the lacrimal
duct. Look for tear lakes and excess watering of the eye. Should be negative for corneal and
conjunctival irritation and abnormalities.
, Treatment: Lacrimal sac massage and topical antibiotics.
Elderly Vision loss - ANSWERS-Causes of typical changes: age related ,acular degeneration,
glaucoma, cataracts, diabetic retinopathy.
Presentation: Slow progression of vision changes, often starts with near sighted changes
(needing reading glasses).
Trigeminal neuralgia Vs Bells palsy - ANSWERS-Trigeminal Neuralgia: Chronic pain, "electric
shock". May start as small short bursts of pain with facial stimulation (IE brushing teeth,
applying makeup). Perform extensive neuro exam and MRI, refer to neurology for
anticonvulsants, antispasmodics and botox.
Bells Palsy: Sudden facial hemi palsy/droop. Swelling and inflammation of the nerve. Headache,
trouble opening eye, tears and saliva taste weird. Often caused by viruses or happens shortly
after pregnancy.
Viral vs Bacterial Conjunctivits - ANSWERS-Viral Conjunctivitis: Clears without treatment in <10
days. Typically starts in just one eye after a viral illness such as a cold.
Bacterial Conjunctivitis: (Pink eye). Both eyes (may initially be just one), thick sticky discharge.
Responds to antibiotics in 24 hours. VERY contagious.
Periorbital cellulitis (aka Preseptal Cellulitis) - ANSWERS-Presentation: Most often secondary to
a sinus infection or head cold.
Evaluation: Swelling and redness of the eyelid. Does not affect the eye.
Treatment: Augmentin and close observation
RED FLAG: Orbital redness and swelling, or swelling to both eyelids. Send to the ED!
