UTA NURS 5433 FNP II Midterm Exam Review (2024-2026) | 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 5-year-old presents with a 48-hour history of ear pain and a bulging, red
tympanic membrane. He has a history of a "hives-like" rash with Penicillin. What
is the best antibiotic choice?
A. Amoxicillin
B. Cefdinir
C. Azithromycin
D. Gentamicin
Answer: B. Cefdinir
Rationale: For patients with non-type-1 Penicillin allergies (like a rash), certain
cephalosporins like Cefdinir are recommended for AOM. If the allergy was anaphylaxis,
a macrolide or clindamycin would be used.
2. Which of the following is a classic finding in a patient with Infectious
Mononucleosis?
A. Posterior cervical lymphadenopathy
B. Anterior cervical lymphadenopathy
C. Rapid relief with Amoxicillin
D. Absence of fatigue
Answer: A. Posterior cervical lymphadenopathy
Rationale: While Strep throat typically causes anterior lymphadenopathy, Mono is
famous for posterior cervical involvement and significant malaise/fatigue.
3. A patient presents with sudden, painless loss of vision described as a "curtain"
coming down over the eye. This is most suggestive of:
,A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
C. Macular Degeneration
D. Cataracts
Answer: B. Retinal Detachment
Rationale: Retinal detachment is a painless emergency often described as a curtain or
shadow falling across the field of vision, sometimes preceded by flashes or floaters.
4. A 65-year-old patient reports difficulty hearing in crowded restaurants but can
hear fine in a quiet room. This high-frequency hearing loss is known as:
A. Presbycusis
B. Otosclerosis
C. Cholesteatoma
D. Conductive loss
Answer: A. Presbycusis
Rationale: Presbycusis is the most common cause of sensorineural hearing loss in the
elderly, characterized by the loss of high-frequency sounds and difficulty with speech
discrimination in noise.
5. What is the first-line treatment for a patient with Mild Intermittent Allergic
Rhinitis?
A. Oral Corticosteroids
B. Second-generation Oral Antihistamines
C. Intranasal Oxymetazoline
D. Montelukast
Answer: B. Second-generation Oral Antihistamines
Rationale: For mild/intermittent symptoms, second-generation antihistamines (like
Loratadine) are preferred because they are non-sedating compared to first-generation
drugs like Benadryl.
6. Which cranial nerve is being tested when you ask a patient to stick out their
tongue and move it side to side?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN VII (Facial)
,Answer: C. CN XII (Hypoglossal)
Rationale: The Hypoglossal nerve controls the motor movements of the tongue.
7. A patient presents with "hot potato voice," drooling, and a displaced uvula.
What is the immediate priority?
A. Start oral antibiotics
B. Obtain a throat culture
C. Refer to the ER for airway management and drainage
D. Prescribe a steroid burst
Answer: C. Refer to the ER for airway management and drainage
Rationale: These are signs of a peritonsillar abscess, which can compromise the airway
and requires surgical drainage.
8. Which medication can cause "Rhinitis Medicamentosa" if used for more than 3
consecutive days?
A. Fluticasone (Flonase)
B. Oxymetazoline (Afrin)
C. Azelastine (Astelin)
D. Cromolyn Sodium
Answer: B. Oxymetazoline (Afrin)
Rationale: Decongestant nasal sprays like Afrin cause rebound congestion (rhinitis
medicamentosa) when used long-term.
9. When assessing a patient with the Weber test, sound lateralizes to the "good"
ear (unaffected ear). This indicates:
A. Conductive hearing loss in the good ear
B. Sensorineural hearing loss in the affected ear
C. Normal hearing
D. Conductive hearing loss in the affected ear
Answer: B. Sensorineural hearing loss in the affected ear
Rationale: In sensorineural loss, the sound "fails" in the bad ear and is heard better by
the functional nerve in the good ear.
10. A "steeple sign" on a neck X-ray is classic for which pediatric condition?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
, C. Foreign body aspiration
D. Tonsillitis
Answer: B. Croup (Laryngotracheobronchitis)
Rationale: The steeple sign indicates subglottic narrowing characteristic of Croup.
11. Which finding during a fundoscopic exam is most indicative of chronic
hypertension?
A. AV nicking
B. Papilledema
C. Drusen
D. Optic disc cupping
Answer: A. AV nicking
Rationale: Arteriovenous (AV) nicking occurs when hypertensive arteries compress the
veins; it is a classic sign of hypertensive retinopathy.
12. A patient with a 14-day history of sinus pressure now has worsening pain and
green nasal discharge. What is the gold-standard antibiotic for Acute Bacterial
Rhinosinusitis?
A. Amoxicillin
B. Amoxicillin-Clavulanate (Augmentin)
C. Cephalexin
D. Doxycycline
Answer: B. Amoxicillin-Clavulanate (Augmentin)
Rationale: Augmentin is first-line to cover both S. pneumoniae and H. influenzae
(including beta-lactamase producing strains).
13. A patient has a positive Rinne test (AC > BC). What does this mean?
A. They have conductive hearing loss
B. They have sensorineural hearing loss or normal hearing
C. They have a perforated eardrum
D. They have an ear infection
Answer: B. They have sensorineural hearing loss or normal hearing
Rationale: A "positive" Rinne is the normal finding where air conduction is twice as long
as bone conduction.
14. What is the most common cause of Otitis Externa (Swimmer’s Ear)?
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 5-year-old presents with a 48-hour history of ear pain and a bulging, red
tympanic membrane. He has a history of a "hives-like" rash with Penicillin. What
is the best antibiotic choice?
A. Amoxicillin
B. Cefdinir
C. Azithromycin
D. Gentamicin
Answer: B. Cefdinir
Rationale: For patients with non-type-1 Penicillin allergies (like a rash), certain
cephalosporins like Cefdinir are recommended for AOM. If the allergy was anaphylaxis,
a macrolide or clindamycin would be used.
2. Which of the following is a classic finding in a patient with Infectious
Mononucleosis?
A. Posterior cervical lymphadenopathy
B. Anterior cervical lymphadenopathy
C. Rapid relief with Amoxicillin
D. Absence of fatigue
Answer: A. Posterior cervical lymphadenopathy
Rationale: While Strep throat typically causes anterior lymphadenopathy, Mono is
famous for posterior cervical involvement and significant malaise/fatigue.
3. A patient presents with sudden, painless loss of vision described as a "curtain"
coming down over the eye. This is most suggestive of:
,A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
C. Macular Degeneration
D. Cataracts
Answer: B. Retinal Detachment
Rationale: Retinal detachment is a painless emergency often described as a curtain or
shadow falling across the field of vision, sometimes preceded by flashes or floaters.
4. A 65-year-old patient reports difficulty hearing in crowded restaurants but can
hear fine in a quiet room. This high-frequency hearing loss is known as:
A. Presbycusis
B. Otosclerosis
C. Cholesteatoma
D. Conductive loss
Answer: A. Presbycusis
Rationale: Presbycusis is the most common cause of sensorineural hearing loss in the
elderly, characterized by the loss of high-frequency sounds and difficulty with speech
discrimination in noise.
5. What is the first-line treatment for a patient with Mild Intermittent Allergic
Rhinitis?
A. Oral Corticosteroids
B. Second-generation Oral Antihistamines
C. Intranasal Oxymetazoline
D. Montelukast
Answer: B. Second-generation Oral Antihistamines
Rationale: For mild/intermittent symptoms, second-generation antihistamines (like
Loratadine) are preferred because they are non-sedating compared to first-generation
drugs like Benadryl.
6. Which cranial nerve is being tested when you ask a patient to stick out their
tongue and move it side to side?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XII (Hypoglossal)
D. CN VII (Facial)
,Answer: C. CN XII (Hypoglossal)
Rationale: The Hypoglossal nerve controls the motor movements of the tongue.
7. A patient presents with "hot potato voice," drooling, and a displaced uvula.
What is the immediate priority?
A. Start oral antibiotics
B. Obtain a throat culture
C. Refer to the ER for airway management and drainage
D. Prescribe a steroid burst
Answer: C. Refer to the ER for airway management and drainage
Rationale: These are signs of a peritonsillar abscess, which can compromise the airway
and requires surgical drainage.
8. Which medication can cause "Rhinitis Medicamentosa" if used for more than 3
consecutive days?
A. Fluticasone (Flonase)
B. Oxymetazoline (Afrin)
C. Azelastine (Astelin)
D. Cromolyn Sodium
Answer: B. Oxymetazoline (Afrin)
Rationale: Decongestant nasal sprays like Afrin cause rebound congestion (rhinitis
medicamentosa) when used long-term.
9. When assessing a patient with the Weber test, sound lateralizes to the "good"
ear (unaffected ear). This indicates:
A. Conductive hearing loss in the good ear
B. Sensorineural hearing loss in the affected ear
C. Normal hearing
D. Conductive hearing loss in the affected ear
Answer: B. Sensorineural hearing loss in the affected ear
Rationale: In sensorineural loss, the sound "fails" in the bad ear and is heard better by
the functional nerve in the good ear.
10. A "steeple sign" on a neck X-ray is classic for which pediatric condition?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
, C. Foreign body aspiration
D. Tonsillitis
Answer: B. Croup (Laryngotracheobronchitis)
Rationale: The steeple sign indicates subglottic narrowing characteristic of Croup.
11. Which finding during a fundoscopic exam is most indicative of chronic
hypertension?
A. AV nicking
B. Papilledema
C. Drusen
D. Optic disc cupping
Answer: A. AV nicking
Rationale: Arteriovenous (AV) nicking occurs when hypertensive arteries compress the
veins; it is a classic sign of hypertensive retinopathy.
12. A patient with a 14-day history of sinus pressure now has worsening pain and
green nasal discharge. What is the gold-standard antibiotic for Acute Bacterial
Rhinosinusitis?
A. Amoxicillin
B. Amoxicillin-Clavulanate (Augmentin)
C. Cephalexin
D. Doxycycline
Answer: B. Amoxicillin-Clavulanate (Augmentin)
Rationale: Augmentin is first-line to cover both S. pneumoniae and H. influenzae
(including beta-lactamase producing strains).
13. A patient has a positive Rinne test (AC > BC). What does this mean?
A. They have conductive hearing loss
B. They have sensorineural hearing loss or normal hearing
C. They have a perforated eardrum
D. They have an ear infection
Answer: B. They have sensorineural hearing loss or normal hearing
Rationale: A "positive" Rinne is the normal finding where air conduction is twice as long
as bone conduction.
14. What is the most common cause of Otitis Externa (Swimmer’s Ear)?
