,NR 545 Exam 1 – Pharmacology, Physical Assessment &
Pathophysiology – Q&A (2026) PDF | Chamberlain
1. A 4-year-old child presents with ear pain, fever, and a bulging, erythematous
tympanic membrane on otoscopic exam. The nurse practitioner diagnoses otitis
media. Which of the following best describes this condition?
A) Inflammation of the external auditory canal
B) Infection of the middle ear cavity
C) Allergic reaction of the nasal mucosa
D) Inflammation of the mastoid air cells
Correct Answer: B) Infection of the middle ear cavity
Rationale: Otitis media is an infection or inflammation of the middle ear space,
located behind the tympanic membrane. It often follows an upper respiratory
infection. Otitis externa involves the external canal; allergic rhinitis affects nasal
mucosa; mastoiditis involves the mastoid bone.
2. A patient with otitis externa reports severe pain when the auricle is pulled or
moved. The nurse practitioner explains that this pain is due to inflammation of
the:
A) Tympanic membrane
B) External auditory canal
C) Eustachian tube
D) Mastoid process
Correct Answer: B) External auditory canal
,Rationale: Otitis externa (swimmer's ear) is an infection of the external auditory
canal, causing pain with manipulation of the pinna or tragus. The tympanic
membrane is typically normal. The eustachian tube connects the middle ear to
the nasopharynx.
3. The nurse practitioner is examining a patient with suspected otitis media.
What is the hallmark diagnostic finding on otoscopic examination?
A) Retraction of the tympanic membrane
B) Erythema of the external canal
C) Presence of cerumen impaction
D) Bulging of the tympanic membrane
Correct Answer: D) Bulging of the tympanic membrane
Rationale: A bulging, opaque, and erythematous tympanic membrane with
decreased mobility is the classic sign of acute otitis media. Fluid bubbles may
also be visible. Retraction suggests negative pressure, and erythema alone is
nonspecific.
4. A patient with allergic conjunctivitis presents with bilateral itchy, red eyes
and a rope-like, clear discharge. The nurse practitioner explains that this
condition is mediated by:
A) IgG antibodies
B) IgM antibodies
C) IgE antibodies
D) IgA antibodies
, Correct Answer: C) IgE antibodies
Rationale: Allergic conjunctivitis is an IgE-mediated hypersensitivity reaction to
allergens. Mast cell degranulation releases histamine, causing itching, redness,
and watery discharge. The other immunoglobulins are not primarily involved.
5. A 7-year-old child with bacterial conjunctivitis has purulent, green-yellow
drainage and crusted eyelids. The nurse practitioner prescribes a topical
antibiotic. What instruction is most important?
A) Apply the ointment directly to the cornea
B) Use the medication only until symptoms improve
C) Complete the full course of antibiotics and practice hand hygiene
D) Share the medication with siblings to prevent spread
Correct Answer: C) Complete the full course of antibiotics and practice hand
hygiene
Rationale: Bacterial conjunctivitis requires completion of prescribed antibiotics
to eradicate the infection and prevent resistance. Hand hygiene prevents
transmission. Ointment is applied to the conjunctival sac, not the cornea.
Medication should not be shared.
6. The nurse practitioner is differentiating bacterial from viral conjunctivitis.
Which finding is most characteristic of a viral etiology?
A) Green, purulent discharge
B) Preauricular lymphadenopathy and watery discharge
Pathophysiology – Q&A (2026) PDF | Chamberlain
1. A 4-year-old child presents with ear pain, fever, and a bulging, erythematous
tympanic membrane on otoscopic exam. The nurse practitioner diagnoses otitis
media. Which of the following best describes this condition?
A) Inflammation of the external auditory canal
B) Infection of the middle ear cavity
C) Allergic reaction of the nasal mucosa
D) Inflammation of the mastoid air cells
Correct Answer: B) Infection of the middle ear cavity
Rationale: Otitis media is an infection or inflammation of the middle ear space,
located behind the tympanic membrane. It often follows an upper respiratory
infection. Otitis externa involves the external canal; allergic rhinitis affects nasal
mucosa; mastoiditis involves the mastoid bone.
2. A patient with otitis externa reports severe pain when the auricle is pulled or
moved. The nurse practitioner explains that this pain is due to inflammation of
the:
A) Tympanic membrane
B) External auditory canal
C) Eustachian tube
D) Mastoid process
Correct Answer: B) External auditory canal
,Rationale: Otitis externa (swimmer's ear) is an infection of the external auditory
canal, causing pain with manipulation of the pinna or tragus. The tympanic
membrane is typically normal. The eustachian tube connects the middle ear to
the nasopharynx.
3. The nurse practitioner is examining a patient with suspected otitis media.
What is the hallmark diagnostic finding on otoscopic examination?
A) Retraction of the tympanic membrane
B) Erythema of the external canal
C) Presence of cerumen impaction
D) Bulging of the tympanic membrane
Correct Answer: D) Bulging of the tympanic membrane
Rationale: A bulging, opaque, and erythematous tympanic membrane with
decreased mobility is the classic sign of acute otitis media. Fluid bubbles may
also be visible. Retraction suggests negative pressure, and erythema alone is
nonspecific.
4. A patient with allergic conjunctivitis presents with bilateral itchy, red eyes
and a rope-like, clear discharge. The nurse practitioner explains that this
condition is mediated by:
A) IgG antibodies
B) IgM antibodies
C) IgE antibodies
D) IgA antibodies
, Correct Answer: C) IgE antibodies
Rationale: Allergic conjunctivitis is an IgE-mediated hypersensitivity reaction to
allergens. Mast cell degranulation releases histamine, causing itching, redness,
and watery discharge. The other immunoglobulins are not primarily involved.
5. A 7-year-old child with bacterial conjunctivitis has purulent, green-yellow
drainage and crusted eyelids. The nurse practitioner prescribes a topical
antibiotic. What instruction is most important?
A) Apply the ointment directly to the cornea
B) Use the medication only until symptoms improve
C) Complete the full course of antibiotics and practice hand hygiene
D) Share the medication with siblings to prevent spread
Correct Answer: C) Complete the full course of antibiotics and practice hand
hygiene
Rationale: Bacterial conjunctivitis requires completion of prescribed antibiotics
to eradicate the infection and prevent resistance. Hand hygiene prevents
transmission. Ointment is applied to the conjunctival sac, not the cornea.
Medication should not be shared.
6. The nurse practitioner is differentiating bacterial from viral conjunctivitis.
Which finding is most characteristic of a viral etiology?
A) Green, purulent discharge
B) Preauricular lymphadenopathy and watery discharge
