NURS 5433 ADVANCED PATHOPHYSIOLOGY | CHAMBERLAIN
UNIVERSITY | ACADEMIC YEAR 2026/2027 | COMPREHENSIVE FINAL
EXAMINATION |VERIFIED QUESTIONS AND CORRECT ANSWERs
RATIONALES
1. A patient comes in complaining of yellow nasal drainage, facial pressure and tooth
pain. The patient is allergic to penicillin and when he takes penicillin, it causes a rash.
Name the medications that would be good alternatives? (5-6) - ANSWERS-
• Cefpodoxime
• Cefdinir
• Cefuroxime
• Levofloxacin
• Moxfloxacin
• Doxycycline
2. What findings indicates bacterial sinusitis?
A. Symptoms lasting more than 10 days without improvement
B. Water discharge for 5 days
C. Clear nasal drainage
D. Nighttime coughing - ANSWERS-A. Symptoms lasting more than 10 days without
improvement
3. Which is NOT recommended for sinusitis due to resistance?
A. Amoxicillin.
B. Azithromycin.
C. Cefpodoxime.
D. Levofloxacin. - ANSWERS-B. Azithromycin.
4. The most common site for anterior epistaxis?
A. Middle turbinate
B. Kisselbach's plexus
C. Inferior meatus
D. Frontal Sinus - ANSWERS-B. Kisselbach's plexus
5. An eight-year-old patient comes in with a mild fever and white patches on their
tonsils. The patient does not report having a cough. What should be the next steps? -
ANSWERS-Perform a rapid strep test
6. Name all things that gain a point in the Centor Criteria? - ANSWERS-History of fever
Present of tonsillar exudates
Tender anterior cervical lymphadenopathy
< 15 years old
7. Name all things that lose a point in the Centor Criteria? - ANSWERS-> 45 years old
Cough
,8. Centor Criteria: 3-4 points
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-A. Treat empirically
9. Centor Criteria: 2 points
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-C. Perform a rapid strep test
10. Centor Criteria: 1 point
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-B. Unlikely to be strep, no testing
needed
11. What is the first line treatment for Group B strep pharyngitis? (3) - ANSWERS-Penicillin
Pen VK
• Amoxicillin
• Penicillinbenzathine injection
12. What is the initial management of Epistaxis? - ANSWERS-Positioning: tilt the head
forward to prevent blood from pooling in the throat
13. What is the second step for management of Epistaxis? - ANSWERS-Compression:
apply direct pressure by pinching nostrils at the septal area continuously for about 5-
20 minutes
14. Name two vasoconstrictive Agents used for nose bleeds if compression and position
done work? - ANSWERS-Oxymetazoline
Phenylephrine
15. What is used for nose bleeds if compression and vasoconstriction agents don't work?
- ANSWERS-Silver Nitrate
16. A child with drooling tripod posture and strider, likely has:
A. Allergic rhinitis
B. Otitis Externa
C. Pharyngitis
D. Epiglottis - ANSWERS-D. Epiglottis
17. A key sign of peritonsillar abscess is:
A. Bilateral tonsillar swelling
B. Uvular deviation
C. Epistaxis
D. Otalgia - ANSWERS-B. Uvular deviation
,18. Albuterol, levabuterol, terbutaline are considered what category of medication? -
ANSWERS-sabas
Short acting, beta agonist
19. When are sabas used? - ANSWERS--quick relief of acute exacerbations and pre tx for
EIB
-use at lowest dosage and frequency possible
-excessive use indicates poor asthma control
20. Budesonide/Formoterol and
Beclomethasone/ Formoterol
Are considered what category of medication? - ANSWERS-LABA
21. What are labas used for? - ANSWERS-Maintenance therapy bronchodilation
22. Name two samas
Short acting, muscarinic antagonist - ANSWERS-Ipratropium Bromide
Oxitropium Bromide
23. Beclomethasone, Budesonide, Fluticasone propionate, and Mometasone are
considered what category of medication? - ANSWERS-Inhaled Corticosteroids
24. What category of medication is most commonly paired with inhaled cortical steroids?
- ANSWERS-labas
25. Name three leukotriene modifiers - ANSWERS-Montelukast (Singulair)
• Zafirlukast (Accolate)
• Zileuton (Zyflo)
• Pranlukast
26. What is a rare but serious side effect of Montelukast?
A. Weight gain
B. Hyperglycemia
C. Suicidal ideation
D. Rash - ANSWERS-C. Suicidal ideation: behavioral changes and suicidal
thoughts
27. Tiotropium and Umeclidinium are in what category of medication? - ANSWERS-lamas
Long acting muscarinic antagonists
28. Glycopyrronium is a medication that is paired with what medication combo when
asthma is uncontrolled? - ANSWERS-ICS+LABA
29. Which of the following Biologics are indicated for sever eosinophilic asthma or
Eosinophilic Granulomatosis with Polyangiitis (EGPA)? - ANSWERS-Mepolizumab
(Nucala)
, 30. What lab should be checked before staring Zarfirlukast? - ANSWERS-Liver function
tests
31. What biologic is approved for eosinophilic asthma and atopic dermatitis?
A. Reslizumab
B. Benralizumab
C. Dupilumab
D. Fluticasone - ANSWERS-C. Dupilumab
32. What airflow limitation would confirm asthma in an adult (range)? - ANSWERS-
FEV1/FVC < 0.75 - 0.80
33. What airflow limitation would confirm asthma in a child? - ANSWERS-FEV1/FVC <
0.90
34. How is Reversibility confirmed when diagnosing asthma? - ANSWERS-Reversibility is
confirmed if FEV1 improves by > 12%
35. What diagnostic confirmed asthma reversibility?
A. FEV1 increases by 5%
B. FEV1 increases by > 12% and > 200ml after bronchodilator
C. FEV1 drops 10% after exercise
D. PEF increases by 5% - ANSWERS-B. FEV1 increases by > 12% and > 200ml after
bronchodilator
36. What test is most appropriate to confirm asthma when bronchodilator response is
inconclusive? - ANSWERS-Methacholine challenge test
37. A 12 year old is diagnosed with asthma, what is the preferred initial treatment for this
patient?
A. Levalbuterol
B. Fluticasone propionate
C.Ipratropium bromide
E. Formoterol/Tiotropium
F. Monestasone/Formoterol - ANSWERS-E. Monestasone/Formoterol
38. Before prescribing ADDITIONAL asthma therapy, what should be assessed first?
A. Vaccination status
B. Inhaler technique and medication adherence
C. Allergy testing
D. Serum eosinophils - ANSWERS-B. Inhaler technique and medication
adherence
39. When stepping down asthma therapy, how should ICS be adjusted?
A. Stop ICS immediately
B. Reduce by 10% every 6 months
C. Reduce by 20-50% every 2-3 months
UNIVERSITY | ACADEMIC YEAR 2026/2027 | COMPREHENSIVE FINAL
EXAMINATION |VERIFIED QUESTIONS AND CORRECT ANSWERs
RATIONALES
1. A patient comes in complaining of yellow nasal drainage, facial pressure and tooth
pain. The patient is allergic to penicillin and when he takes penicillin, it causes a rash.
Name the medications that would be good alternatives? (5-6) - ANSWERS-
• Cefpodoxime
• Cefdinir
• Cefuroxime
• Levofloxacin
• Moxfloxacin
• Doxycycline
2. What findings indicates bacterial sinusitis?
A. Symptoms lasting more than 10 days without improvement
B. Water discharge for 5 days
C. Clear nasal drainage
D. Nighttime coughing - ANSWERS-A. Symptoms lasting more than 10 days without
improvement
3. Which is NOT recommended for sinusitis due to resistance?
A. Amoxicillin.
B. Azithromycin.
C. Cefpodoxime.
D. Levofloxacin. - ANSWERS-B. Azithromycin.
4. The most common site for anterior epistaxis?
A. Middle turbinate
B. Kisselbach's plexus
C. Inferior meatus
D. Frontal Sinus - ANSWERS-B. Kisselbach's plexus
5. An eight-year-old patient comes in with a mild fever and white patches on their
tonsils. The patient does not report having a cough. What should be the next steps? -
ANSWERS-Perform a rapid strep test
6. Name all things that gain a point in the Centor Criteria? - ANSWERS-History of fever
Present of tonsillar exudates
Tender anterior cervical lymphadenopathy
< 15 years old
7. Name all things that lose a point in the Centor Criteria? - ANSWERS-> 45 years old
Cough
,8. Centor Criteria: 3-4 points
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-A. Treat empirically
9. Centor Criteria: 2 points
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-C. Perform a rapid strep test
10. Centor Criteria: 1 point
A. Treat empirically
B. Unlikely to be strep, no testing needed
C. Perform a rapid strep test - ANSWERS-B. Unlikely to be strep, no testing
needed
11. What is the first line treatment for Group B strep pharyngitis? (3) - ANSWERS-Penicillin
Pen VK
• Amoxicillin
• Penicillinbenzathine injection
12. What is the initial management of Epistaxis? - ANSWERS-Positioning: tilt the head
forward to prevent blood from pooling in the throat
13. What is the second step for management of Epistaxis? - ANSWERS-Compression:
apply direct pressure by pinching nostrils at the septal area continuously for about 5-
20 minutes
14. Name two vasoconstrictive Agents used for nose bleeds if compression and position
done work? - ANSWERS-Oxymetazoline
Phenylephrine
15. What is used for nose bleeds if compression and vasoconstriction agents don't work?
- ANSWERS-Silver Nitrate
16. A child with drooling tripod posture and strider, likely has:
A. Allergic rhinitis
B. Otitis Externa
C. Pharyngitis
D. Epiglottis - ANSWERS-D. Epiglottis
17. A key sign of peritonsillar abscess is:
A. Bilateral tonsillar swelling
B. Uvular deviation
C. Epistaxis
D. Otalgia - ANSWERS-B. Uvular deviation
,18. Albuterol, levabuterol, terbutaline are considered what category of medication? -
ANSWERS-sabas
Short acting, beta agonist
19. When are sabas used? - ANSWERS--quick relief of acute exacerbations and pre tx for
EIB
-use at lowest dosage and frequency possible
-excessive use indicates poor asthma control
20. Budesonide/Formoterol and
Beclomethasone/ Formoterol
Are considered what category of medication? - ANSWERS-LABA
21. What are labas used for? - ANSWERS-Maintenance therapy bronchodilation
22. Name two samas
Short acting, muscarinic antagonist - ANSWERS-Ipratropium Bromide
Oxitropium Bromide
23. Beclomethasone, Budesonide, Fluticasone propionate, and Mometasone are
considered what category of medication? - ANSWERS-Inhaled Corticosteroids
24. What category of medication is most commonly paired with inhaled cortical steroids?
- ANSWERS-labas
25. Name three leukotriene modifiers - ANSWERS-Montelukast (Singulair)
• Zafirlukast (Accolate)
• Zileuton (Zyflo)
• Pranlukast
26. What is a rare but serious side effect of Montelukast?
A. Weight gain
B. Hyperglycemia
C. Suicidal ideation
D. Rash - ANSWERS-C. Suicidal ideation: behavioral changes and suicidal
thoughts
27. Tiotropium and Umeclidinium are in what category of medication? - ANSWERS-lamas
Long acting muscarinic antagonists
28. Glycopyrronium is a medication that is paired with what medication combo when
asthma is uncontrolled? - ANSWERS-ICS+LABA
29. Which of the following Biologics are indicated for sever eosinophilic asthma or
Eosinophilic Granulomatosis with Polyangiitis (EGPA)? - ANSWERS-Mepolizumab
(Nucala)
, 30. What lab should be checked before staring Zarfirlukast? - ANSWERS-Liver function
tests
31. What biologic is approved for eosinophilic asthma and atopic dermatitis?
A. Reslizumab
B. Benralizumab
C. Dupilumab
D. Fluticasone - ANSWERS-C. Dupilumab
32. What airflow limitation would confirm asthma in an adult (range)? - ANSWERS-
FEV1/FVC < 0.75 - 0.80
33. What airflow limitation would confirm asthma in a child? - ANSWERS-FEV1/FVC <
0.90
34. How is Reversibility confirmed when diagnosing asthma? - ANSWERS-Reversibility is
confirmed if FEV1 improves by > 12%
35. What diagnostic confirmed asthma reversibility?
A. FEV1 increases by 5%
B. FEV1 increases by > 12% and > 200ml after bronchodilator
C. FEV1 drops 10% after exercise
D. PEF increases by 5% - ANSWERS-B. FEV1 increases by > 12% and > 200ml after
bronchodilator
36. What test is most appropriate to confirm asthma when bronchodilator response is
inconclusive? - ANSWERS-Methacholine challenge test
37. A 12 year old is diagnosed with asthma, what is the preferred initial treatment for this
patient?
A. Levalbuterol
B. Fluticasone propionate
C.Ipratropium bromide
E. Formoterol/Tiotropium
F. Monestasone/Formoterol - ANSWERS-E. Monestasone/Formoterol
38. Before prescribing ADDITIONAL asthma therapy, what should be assessed first?
A. Vaccination status
B. Inhaler technique and medication adherence
C. Allergy testing
D. Serum eosinophils - ANSWERS-B. Inhaler technique and medication
adherence
39. When stepping down asthma therapy, how should ICS be adjusted?
A. Stop ICS immediately
B. Reduce by 10% every 6 months
C. Reduce by 20-50% every 2-3 months
