NR 545 EXAM 1 COMPREHENSIVE
EXAM PREP 2026/2027 | VERIFIED
Q&A | CHAMBERLAIN UNIVERSITY
Question 1
A 4-year-old child presents with sudden ear pain, fever, and
increased nasal congestion following a recent upper respiratory
infection. On otoscopic examination, the tympanic membrane is
bulging and erythematous. Which of the following sets of
pathogens represents the most common bacterial causes of this
condition?
• A. Pseudomonas aeruginosa, Escherichia coli,
Streptococcus pyogenes
• B. Haemophilus influenzae, Streptococcus pneumoniae,
Staphylococcus aureus
• C. Moraxella catarrhalis, Mycoplasma pneumoniae,
Legionella pneumophila
• D. Klebsiella pneumoniae, Bordetella pertussis, Chlamydia
pneumoniae
Correct Answer: B Rationale: Acute otitis media (AOM)
commonly follows viral respiratory infections and is most
frequently caused by bacterial pathogens such as Haemophilus
influenzae, Streptococcus pneumoniae, and Staphylococcus
aureus, as well as various viral agents.
,Question 2
A patient presents with acute onset of right ear pain. When the
clinician gently manipulates the patient's pinna and tragus, the
patient experiences severe pain. What feature best differentiates
this condition from acute otitis media?
• A. Presence of fever and system toxicity
• B. Pain elicited upon movement of the pinna
• C. Presence of conductive hearing loss
• D. History of a preceding upper respiratory infection
Correct Answer: B Rationale: Pain with movement of the
pinna or tragus is a hallmark diagnostic finding of otitis externa
(swimmer's ear), whereas acute otitis media involves
inflammation behind an intact tympanic membrane and typically
does not produce pain upon external ear movement.
Question 3
An adult patient with no known drug allergies is diagnosed with
uncomplicated acute bacterial rhinosinusitis after experiencing
symptoms for 12 days. What is the recommended first-line oral
antibiotic therapy?
• A. Doxycycline
• B. Cephalexin
• C. Amoxicillin
• D. Azithromycin
,Correct Answer: C Rationale: Amoxicillin is the first-line
antibiotic treatment for acute bacterial sinusitis in patients
without a penicillin allergy. Doxycycline is typically reserved as
a second-line option for penicillin-allergic individuals.
Question 4
A patient who has been taking high doses of aspirin for severe
arthritis reports a continuous ringing sound in both ears. What is
the most appropriate initial management step for this drug-
induced ototoxicity?
• A. Prescribe a high-dose oral corticosteroid regimen
• B. Discontinue or adjust the dose of the offending agent
• C. Schedule an immediate stapedectomy
• D. Initiate empiric antibiotic treatment with amoxicillin
Correct Answer: B Rationale: Tinnitus is an early sign of
ototoxicity caused by medications like aspirin, NSAIDs,
aminoglycosides, or loop diuretics. The primary step in
management is addressing or removing the causative agent
while utilizing supportive measures such as noise suppression
therapy.
Question 5
A 6-year-old child is brought to the clinic with suspected acute
otitis media. The child is mildly uncomfortable but has no prior
, history of ear infections. What is the first-line pharmacologic
approach for pain management in this child?
• A. Immediate course of broad-spectrum systemic
corticosteroids
• B. Acetaminophen or ibuprofen for symptom relief
• C. Oral doxycycline twice daily
• D. Routine prescription of oral opioids
Correct Answer: B Rationale: Pain control using analgesics
like acetaminophen or ibuprofen is the cornerstone of managing
acute otitis media symptoms. First-line oral antibiotics (like
amoxicillin) are reserved for confirmed bacterial infections or
recurrent cases.
Question 6
During a cranial nerve examination, the clinician asks the patient
to shrug their shoulders against resistance and turn their head
from side to side. Which cranial nerve is being evaluated?
• A. Cranial Nerve IX (Glossopharyngeal)
• B. Cranial Nerve X (Vagus)
• C. Cranial Nerve XI (Accessory)
• D. Cranial Nerve XII (Hypoglossal)
Correct Answer: C Rationale: Cranial Nerve XI (Accessory)
controls motor function of the sternocleidomastoid and trapezius
muscles, tested via shoulder shrugging and head turning against
resistance.
EXAM PREP 2026/2027 | VERIFIED
Q&A | CHAMBERLAIN UNIVERSITY
Question 1
A 4-year-old child presents with sudden ear pain, fever, and
increased nasal congestion following a recent upper respiratory
infection. On otoscopic examination, the tympanic membrane is
bulging and erythematous. Which of the following sets of
pathogens represents the most common bacterial causes of this
condition?
• A. Pseudomonas aeruginosa, Escherichia coli,
Streptococcus pyogenes
• B. Haemophilus influenzae, Streptococcus pneumoniae,
Staphylococcus aureus
• C. Moraxella catarrhalis, Mycoplasma pneumoniae,
Legionella pneumophila
• D. Klebsiella pneumoniae, Bordetella pertussis, Chlamydia
pneumoniae
Correct Answer: B Rationale: Acute otitis media (AOM)
commonly follows viral respiratory infections and is most
frequently caused by bacterial pathogens such as Haemophilus
influenzae, Streptococcus pneumoniae, and Staphylococcus
aureus, as well as various viral agents.
,Question 2
A patient presents with acute onset of right ear pain. When the
clinician gently manipulates the patient's pinna and tragus, the
patient experiences severe pain. What feature best differentiates
this condition from acute otitis media?
• A. Presence of fever and system toxicity
• B. Pain elicited upon movement of the pinna
• C. Presence of conductive hearing loss
• D. History of a preceding upper respiratory infection
Correct Answer: B Rationale: Pain with movement of the
pinna or tragus is a hallmark diagnostic finding of otitis externa
(swimmer's ear), whereas acute otitis media involves
inflammation behind an intact tympanic membrane and typically
does not produce pain upon external ear movement.
Question 3
An adult patient with no known drug allergies is diagnosed with
uncomplicated acute bacterial rhinosinusitis after experiencing
symptoms for 12 days. What is the recommended first-line oral
antibiotic therapy?
• A. Doxycycline
• B. Cephalexin
• C. Amoxicillin
• D. Azithromycin
,Correct Answer: C Rationale: Amoxicillin is the first-line
antibiotic treatment for acute bacterial sinusitis in patients
without a penicillin allergy. Doxycycline is typically reserved as
a second-line option for penicillin-allergic individuals.
Question 4
A patient who has been taking high doses of aspirin for severe
arthritis reports a continuous ringing sound in both ears. What is
the most appropriate initial management step for this drug-
induced ototoxicity?
• A. Prescribe a high-dose oral corticosteroid regimen
• B. Discontinue or adjust the dose of the offending agent
• C. Schedule an immediate stapedectomy
• D. Initiate empiric antibiotic treatment with amoxicillin
Correct Answer: B Rationale: Tinnitus is an early sign of
ototoxicity caused by medications like aspirin, NSAIDs,
aminoglycosides, or loop diuretics. The primary step in
management is addressing or removing the causative agent
while utilizing supportive measures such as noise suppression
therapy.
Question 5
A 6-year-old child is brought to the clinic with suspected acute
otitis media. The child is mildly uncomfortable but has no prior
, history of ear infections. What is the first-line pharmacologic
approach for pain management in this child?
• A. Immediate course of broad-spectrum systemic
corticosteroids
• B. Acetaminophen or ibuprofen for symptom relief
• C. Oral doxycycline twice daily
• D. Routine prescription of oral opioids
Correct Answer: B Rationale: Pain control using analgesics
like acetaminophen or ibuprofen is the cornerstone of managing
acute otitis media symptoms. First-line oral antibiotics (like
amoxicillin) are reserved for confirmed bacterial infections or
recurrent cases.
Question 6
During a cranial nerve examination, the clinician asks the patient
to shrug their shoulders against resistance and turn their head
from side to side. Which cranial nerve is being evaluated?
• A. Cranial Nerve IX (Glossopharyngeal)
• B. Cranial Nerve X (Vagus)
• C. Cranial Nerve XI (Accessory)
• D. Cranial Nerve XII (Hypoglossal)
Correct Answer: C Rationale: Cranial Nerve XI (Accessory)
controls motor function of the sternocleidomastoid and trapezius
muscles, tested via shoulder shrugging and head turning against
resistance.
