UTA NURS 5433 FNP II Midterm Exam Review (2025-2026) | Verified Q&A & Clinical
Guidelines
This comprehensive study guide covers the NURS 5433 FNP II midterm, specifically
focusing on ENT, respiratory, and upper airway management modules. It includes
verified questions and answers alongside the latest clinical diagnostic criteria and
pharmacological management protocols used at the University of Texas at Arlington.
Designed for quick recall, this review helps students master high-yield topics like
pharyngitis complications and pediatric antibiotic guidelines for acute otitis media.
1. A 3-year-old child presents with a 2-day history of ear pain, fever of
, and a bulging, opaque tympanic membrane. What is the first-line treatment?
A) Azithromycin 10 mg/kg
B) Amoxicillin 80-90 mg/kg/day
C) Ceftriaxone 50 mg/kg IM
D) Watchful waiting
*Answer: B) Amoxicillin 80-90 mg/kg/day *
Rationale: High-dose Amoxicillin is the gold standard for acute otitis media (AOM) in
children when no risk factors for resistance are present.
2. Which finding is most characteristic of allergic conjunctivitis?
A) Unilateral purulent discharge
B) Pre-auricular lymphadenopathy
C) Bilateral intense itching and watery discharge
D) Crusty eyelid margins
*Answer: C) Bilateral intense itching and watery discharge *
Rationale: Itching is the hallmark of allergic conjunctivitis and is almost always bilateral.
3. A machine operator requires treatment for allergic rhinitis. Which is the best
choice to avoid sedation?
A) Diphenhydramine
B) Loratadine
,C) Hydroxyzine
D) Chlorpheniramine
*Answer: B) Loratadine *
Rationale: Second-generation antihistamines like Loratadine do not cross the blood-
brain barrier significantly, making them non-sedating.
4. A painful 2mm pustule on the lateral eyelid margin is most likely a:
A) Chalazion
B) Blepharitis
C) Hordeolum
D) Dacryocystitis
*Answer: C) Hordeolum *
Rationale: A hordeolum (stye) is an acute infection of the eyelid gland, whereas a
chalazion is a chronic, painless granuloma.
5. Which influenza medication is contraindicated in patients with Asthma or COPD?
A) Oseltamivir
B) Peramivir
C) Baloxavir
D) Zanamivir
*Answer: D) Zanamivir *
Rationale: Zanamivir is inhaled and can trigger bronchospasm in patients with reactive
airway disease.
6. A patient sees "halos" around lights and has a mid-dilated, non-reactive pupil.
What is the likely diagnosis?
A) Cataracts
B) Open-angle glaucoma
C) Acute angle-closure glaucoma
D) Conjunctivitis
*Answer: C) Acute angle-closure glaucoma *
Rationale: This is a medical emergency characterized by sudden IOP increase, halos,
and a fixed, mid-dilated pupil.
,7. A patient with a non-anaphylactic rash-only allergy to Penicillin needs treatment
for Strep pharyngitis. What is appropriate?
A) Amoxicillin
B) Cephalexin
C) Clindamycin
D) Azithromycin
*Answer: B) Cephalexin *
Rationale: First-generation cephalosporins are safe for patients with Type II (non-
anaphylactic) penicillin allergies.
8. A patient has hoarseness for 5 weeks and a history of smoking. What is the next
step?
A) Voice rest
B) Antibiotics
C) Referral to ENT for laryngoscopy
D) PPI trial
*Answer: C) Referral to ENT for laryngoscopy *
Rationale: Hoarseness exceeding 3-4 weeks in a smoker must be evaluated for
laryngeal cancer.
9. What is the gold standard for diagnosing a corneal abrasion?
A) Snellen chart
B) Fluorescein staining
C) Tonometry
D) Red reflex
*Answer: B) Fluorescein staining *
Rationale: Fluorescein dye highlights epithelial defects under a cobalt blue light.
10. IDSA recommended duration for uncomplicated bacterial sinusitis in adults?
A) 3 days
B) 5-7 days
C) 10-14 days
D) 21 days
*Answer: B) 5-7 days *
, Rationale: Recent guidelines suggest shorter courses (5-7 days) are as effective as
longer courses with fewer side effects.
11. Chronic crusting and "gritty" sensation on eyelid margins suggests:
A) Viral conjunctivitis
B) Blepharitis
C) Hordeolum
D) Iritis
*Answer: B) Blepharitis *
Rationale: Blepharitis is chronic inflammation of the lid margins often linked to seborrhea
or rosacea.
12. First-line for resistant Blepharitis after failed hygiene measures?
A) Topical steroids
B) Oral Doxycycline
C) Topical Penicillin
D) Oral Antihistamines
*Answer: B) Oral Doxycycline *
Rationale: Low-dose tetracyclines are used for their anti-inflammatory properties in
chronic blepharitis.
13. "Honey-colored" crusts on a child's face are typical of:
A) Eczema
B) Impetigo
C) Herpes Simplex
D) Acne
*Answer: B) Impetigo *
Rationale: Honey-colored crusts are the classic clinical sign of S. aureus or S. pyogenes
skin infection.
14. Funduscopic exam finding indicating glaucoma:
A) AV nicking
B) Cotton wool spots
Guidelines
This comprehensive study guide covers the NURS 5433 FNP II midterm, specifically
focusing on ENT, respiratory, and upper airway management modules. It includes
verified questions and answers alongside the latest clinical diagnostic criteria and
pharmacological management protocols used at the University of Texas at Arlington.
Designed for quick recall, this review helps students master high-yield topics like
pharyngitis complications and pediatric antibiotic guidelines for acute otitis media.
1. A 3-year-old child presents with a 2-day history of ear pain, fever of
, and a bulging, opaque tympanic membrane. What is the first-line treatment?
A) Azithromycin 10 mg/kg
B) Amoxicillin 80-90 mg/kg/day
C) Ceftriaxone 50 mg/kg IM
D) Watchful waiting
*Answer: B) Amoxicillin 80-90 mg/kg/day *
Rationale: High-dose Amoxicillin is the gold standard for acute otitis media (AOM) in
children when no risk factors for resistance are present.
2. Which finding is most characteristic of allergic conjunctivitis?
A) Unilateral purulent discharge
B) Pre-auricular lymphadenopathy
C) Bilateral intense itching and watery discharge
D) Crusty eyelid margins
*Answer: C) Bilateral intense itching and watery discharge *
Rationale: Itching is the hallmark of allergic conjunctivitis and is almost always bilateral.
3. A machine operator requires treatment for allergic rhinitis. Which is the best
choice to avoid sedation?
A) Diphenhydramine
B) Loratadine
,C) Hydroxyzine
D) Chlorpheniramine
*Answer: B) Loratadine *
Rationale: Second-generation antihistamines like Loratadine do not cross the blood-
brain barrier significantly, making them non-sedating.
4. A painful 2mm pustule on the lateral eyelid margin is most likely a:
A) Chalazion
B) Blepharitis
C) Hordeolum
D) Dacryocystitis
*Answer: C) Hordeolum *
Rationale: A hordeolum (stye) is an acute infection of the eyelid gland, whereas a
chalazion is a chronic, painless granuloma.
5. Which influenza medication is contraindicated in patients with Asthma or COPD?
A) Oseltamivir
B) Peramivir
C) Baloxavir
D) Zanamivir
*Answer: D) Zanamivir *
Rationale: Zanamivir is inhaled and can trigger bronchospasm in patients with reactive
airway disease.
6. A patient sees "halos" around lights and has a mid-dilated, non-reactive pupil.
What is the likely diagnosis?
A) Cataracts
B) Open-angle glaucoma
C) Acute angle-closure glaucoma
D) Conjunctivitis
*Answer: C) Acute angle-closure glaucoma *
Rationale: This is a medical emergency characterized by sudden IOP increase, halos,
and a fixed, mid-dilated pupil.
,7. A patient with a non-anaphylactic rash-only allergy to Penicillin needs treatment
for Strep pharyngitis. What is appropriate?
A) Amoxicillin
B) Cephalexin
C) Clindamycin
D) Azithromycin
*Answer: B) Cephalexin *
Rationale: First-generation cephalosporins are safe for patients with Type II (non-
anaphylactic) penicillin allergies.
8. A patient has hoarseness for 5 weeks and a history of smoking. What is the next
step?
A) Voice rest
B) Antibiotics
C) Referral to ENT for laryngoscopy
D) PPI trial
*Answer: C) Referral to ENT for laryngoscopy *
Rationale: Hoarseness exceeding 3-4 weeks in a smoker must be evaluated for
laryngeal cancer.
9. What is the gold standard for diagnosing a corneal abrasion?
A) Snellen chart
B) Fluorescein staining
C) Tonometry
D) Red reflex
*Answer: B) Fluorescein staining *
Rationale: Fluorescein dye highlights epithelial defects under a cobalt blue light.
10. IDSA recommended duration for uncomplicated bacterial sinusitis in adults?
A) 3 days
B) 5-7 days
C) 10-14 days
D) 21 days
*Answer: B) 5-7 days *
, Rationale: Recent guidelines suggest shorter courses (5-7 days) are as effective as
longer courses with fewer side effects.
11. Chronic crusting and "gritty" sensation on eyelid margins suggests:
A) Viral conjunctivitis
B) Blepharitis
C) Hordeolum
D) Iritis
*Answer: B) Blepharitis *
Rationale: Blepharitis is chronic inflammation of the lid margins often linked to seborrhea
or rosacea.
12. First-line for resistant Blepharitis after failed hygiene measures?
A) Topical steroids
B) Oral Doxycycline
C) Topical Penicillin
D) Oral Antihistamines
*Answer: B) Oral Doxycycline *
Rationale: Low-dose tetracyclines are used for their anti-inflammatory properties in
chronic blepharitis.
13. "Honey-colored" crusts on a child's face are typical of:
A) Eczema
B) Impetigo
C) Herpes Simplex
D) Acne
*Answer: B) Impetigo *
Rationale: Honey-colored crusts are the classic clinical sign of S. aureus or S. pyogenes
skin infection.
14. Funduscopic exam finding indicating glaucoma:
A) AV nicking
B) Cotton wool spots
