2026/2027
NUR 155 Exam 4 Final Revision
Guide with Case-Based Questions
and Answers for 2026/2027
Academic Year
Question 1
A physician palpates a patient’s sinuses during an examination. Which sinus is most
directly assessed by pressure applied below the cheekbones?
A. Ethmoidal sinus
B. Frontal sinus
C. Maxillary sinus
D. Sphenoidal sinus
Correct Answer: C. Maxillary sinus
Rationale:
The maxillary sinuses are palpated by applying gentle upward pressure below the
cheekbones. This is a standard component of sinus examination. The frontal sinuses
are assessed above the eyebrows, while ethmoidal and sphenoidal sinuses are not
directly accessible by external palpation.
Question 2
Olfactory receptors are primarily located in which anatomical region?
A. Inferior nasal turbinate
B. Nasal vestibule
C. Nasopharynx
D. Upper nasal mucosa
Correct Answer: D. Upper nasal mucosa
Rationale:
Olfactory receptors are located in the upper portion of the nasal cavity within the
mucosal lining. This area is responsible for detecting odor molecules. The vestibule
and nasopharynx are involved in air passage, not smell perception.
,2026/2027
Question 3
Diphenhydramine is classified as:
A. Decongestant
B. Antihistamine
C. Expectorant
D. Analgesic
Correct Answer: B. Antihistamine
Rationale:
Diphenhydramine is an antihistamine used to treat allergic reactions by blocking
histamine receptors. It is not a decongestant, expectorant, or pain reliever.
Question 4
A patient taking beta-blockers develops nasal congestion. The most likely explanation
is:
A. Increased mucus production
B. Medication side effect
C. Allergic reaction
D. Infection
Correct Answer: B. Medication side effect
Rationale:
Beta-blockers can cause nasal congestion as a pharmacologic side effect due to
vascular and autonomic effects. This is not typically caused by infection or allergy in
this context.
Question 5
Pale, boggy nasal turbinates are most commonly associated with:
A. Trauma
B. Infection
C. Allergies
D. Dehydration
Correct Answer: C. Allergies
Rationale:
Allergic rhinitis causes pale, swollen (boggy) turbinates due to histamine-mediated
,2026/2027
inflammation. Infection usually produces redness and purulent discharge rather than
pallor.
Question 6
A patient with allergic symptoms requires a diagnostic test that safely identifies
specific allergens. Which test is most appropriate?
A. TSH test
B. RAST test
C. Chest X-ray
D. Sinus ultrasound
Correct Answer: B. RAST test
Rationale:
The RAST (radioallergosorbent test) identifies specific allergens safely through blood
testing and is useful in patients at risk for anaphylaxis. The other options are unrelated
to allergy identification.
Question 7
Nosebleeds during pregnancy are most commonly caused by:
A. Decreased blood volume
B. Hormonal vasoconstriction
C. Increased vascularity
D. Low blood pressure
Correct Answer: C. Increased vascularity
Rationale:
Pregnancy increases estrogen levels, leading to increased nasal vascularity and
fragility, which predisposes to epistaxis. Blood volume increases, not decreases.
Question 8
The correct anatomical pathway of the pharynx is:
A. Oropharynx → Nasopharynx → Laryngopharynx
B. Nasopharynx → Oropharynx → Laryngopharynx
C. Laryngopharynx → Nasopharynx → Oropharynx
D. Nasopharynx → Laryngopharynx → Oropharynx
Correct Answer: B. Nasopharynx → Oropharynx → Laryngopharynx
, 2026/2027
Rationale:
Air and food pass sequentially through the nasopharynx, oropharynx, and
laryngopharynx. This anatomical order supports respiration and digestion.
Question 9
Bacterial pharyngitis is most accurately characterized by:
A. Slow onset of symptoms
B. Rapid onset of symptoms
C. No diagnostic tools available
D. Always occurring in summer
Correct Answer: B. Rapid onset of symptoms
Rationale:
Bacterial pharyngitis typically presents suddenly with severe symptoms. Rapid onset
helps distinguish it from viral causes.
Question 10
Smoking affects gum health primarily by causing:
A. Vasodilation
B. Vasoconstriction
C. Increased saliva production
D. Tissue regeneration
Correct Answer: B. Vasoconstriction
Rationale:
Nicotine causes vasoconstriction, reducing blood flow to gum tissues and impairing
healing, increasing periodontal disease risk.
Question 11
A common oral finding in geriatric patients is:
A. Increased saliva production
B. Varicose veins under the tongue
C. Bright red mucosa
D. Enlarged tonsils
Correct Answer: B. Varicose veins under the tongue
NUR 155 Exam 4 Final Revision
Guide with Case-Based Questions
and Answers for 2026/2027
Academic Year
Question 1
A physician palpates a patient’s sinuses during an examination. Which sinus is most
directly assessed by pressure applied below the cheekbones?
A. Ethmoidal sinus
B. Frontal sinus
C. Maxillary sinus
D. Sphenoidal sinus
Correct Answer: C. Maxillary sinus
Rationale:
The maxillary sinuses are palpated by applying gentle upward pressure below the
cheekbones. This is a standard component of sinus examination. The frontal sinuses
are assessed above the eyebrows, while ethmoidal and sphenoidal sinuses are not
directly accessible by external palpation.
Question 2
Olfactory receptors are primarily located in which anatomical region?
A. Inferior nasal turbinate
B. Nasal vestibule
C. Nasopharynx
D. Upper nasal mucosa
Correct Answer: D. Upper nasal mucosa
Rationale:
Olfactory receptors are located in the upper portion of the nasal cavity within the
mucosal lining. This area is responsible for detecting odor molecules. The vestibule
and nasopharynx are involved in air passage, not smell perception.
,2026/2027
Question 3
Diphenhydramine is classified as:
A. Decongestant
B. Antihistamine
C. Expectorant
D. Analgesic
Correct Answer: B. Antihistamine
Rationale:
Diphenhydramine is an antihistamine used to treat allergic reactions by blocking
histamine receptors. It is not a decongestant, expectorant, or pain reliever.
Question 4
A patient taking beta-blockers develops nasal congestion. The most likely explanation
is:
A. Increased mucus production
B. Medication side effect
C. Allergic reaction
D. Infection
Correct Answer: B. Medication side effect
Rationale:
Beta-blockers can cause nasal congestion as a pharmacologic side effect due to
vascular and autonomic effects. This is not typically caused by infection or allergy in
this context.
Question 5
Pale, boggy nasal turbinates are most commonly associated with:
A. Trauma
B. Infection
C. Allergies
D. Dehydration
Correct Answer: C. Allergies
Rationale:
Allergic rhinitis causes pale, swollen (boggy) turbinates due to histamine-mediated
,2026/2027
inflammation. Infection usually produces redness and purulent discharge rather than
pallor.
Question 6
A patient with allergic symptoms requires a diagnostic test that safely identifies
specific allergens. Which test is most appropriate?
A. TSH test
B. RAST test
C. Chest X-ray
D. Sinus ultrasound
Correct Answer: B. RAST test
Rationale:
The RAST (radioallergosorbent test) identifies specific allergens safely through blood
testing and is useful in patients at risk for anaphylaxis. The other options are unrelated
to allergy identification.
Question 7
Nosebleeds during pregnancy are most commonly caused by:
A. Decreased blood volume
B. Hormonal vasoconstriction
C. Increased vascularity
D. Low blood pressure
Correct Answer: C. Increased vascularity
Rationale:
Pregnancy increases estrogen levels, leading to increased nasal vascularity and
fragility, which predisposes to epistaxis. Blood volume increases, not decreases.
Question 8
The correct anatomical pathway of the pharynx is:
A. Oropharynx → Nasopharynx → Laryngopharynx
B. Nasopharynx → Oropharynx → Laryngopharynx
C. Laryngopharynx → Nasopharynx → Oropharynx
D. Nasopharynx → Laryngopharynx → Oropharynx
Correct Answer: B. Nasopharynx → Oropharynx → Laryngopharynx
, 2026/2027
Rationale:
Air and food pass sequentially through the nasopharynx, oropharynx, and
laryngopharynx. This anatomical order supports respiration and digestion.
Question 9
Bacterial pharyngitis is most accurately characterized by:
A. Slow onset of symptoms
B. Rapid onset of symptoms
C. No diagnostic tools available
D. Always occurring in summer
Correct Answer: B. Rapid onset of symptoms
Rationale:
Bacterial pharyngitis typically presents suddenly with severe symptoms. Rapid onset
helps distinguish it from viral causes.
Question 10
Smoking affects gum health primarily by causing:
A. Vasodilation
B. Vasoconstriction
C. Increased saliva production
D. Tissue regeneration
Correct Answer: B. Vasoconstriction
Rationale:
Nicotine causes vasoconstriction, reducing blood flow to gum tissues and impairing
healing, increasing periodontal disease risk.
Question 11
A common oral finding in geriatric patients is:
A. Increased saliva production
B. Varicose veins under the tongue
C. Bright red mucosa
D. Enlarged tonsils
Correct Answer: B. Varicose veins under the tongue
