NURS 5433 Family 2 FNP FINAL EXAM QUESTION AND
ANSWER FALL 2025/26 -THE UNIVERSITY OF TEXAS AT
ARLINGTON
allergic rhinitis
1st line tx: mild- 2nd gen antihistamine (cetririzine, loratadine) and mod-severe- intranasal
corticosteroid (fluticasone, budenoside)
2nd line: nasal antihistamine (azelastine), leukotreine receptor antagonists (montelukast),
decongestants (pseudophedrine, phenylephrine), cromolyn
non allergic rhinitis
response to environmental triggers but not immune mediated
vasomotor rhinitis
overeactive response of nasal blood vessels to triggers (change in temp, humidity, stress, odors)
sinusitis
inflammation of at least 1 paranasal sinus d/t bacteria, virus, fungus, or allergy
pathogens: strep pneumo, M cat, H flu
predisposing factors:
URIs, allergies, immunodeficiency, smoking, dental infections, anatomical abnormalities
bacterial sinusitis causative agents
strep pneumoniae
h. flu
m catarrhalis
sx >7-10 days or worsening after 5 days OR temp >102 with purulence OR worsening after initial
treatment indicates bacterial
bacterial sinusitis treatment
abx only for persistent sx >10 days or high fever >102, purulent discharge
1st line: Amoxicillin 500mg tid OR Augmentin 875mg/125mg bid x5-7 days
,PCN allergy: doxycycline or levofloxacin
AVOID macrolides and bactrim d/t bacterial resistance
vertigo
peripheral - 90% of cases, otogenic, toxic, meniere's, BPPV
central - migraine, TIA, postural hypotension
neurologic - MS, temporal lobe szs, cervical disorders, cerebellar lesions, acoustic tumor
other causes: Labrynthitis or neuronitis (viral causes), menieres disease
vertigo tx
antihistamines, vestibular suppressants (meclizine), anticholinergics (scopolamine), antivirals,
anxiolytics, corticosteroids, antiemetics, promethazine, benzos
BPPV tx: epley's maneuver
Meniere's: salt restriction, thiazide diuretics
Labryinthitis: meclizine, steroids, antiemetics
dx with dix hallpike maneuver (BPPV)
Benign Paroxysmal Positional Vertigo
caused by sediment such as calcium carbonate that are in inner ear, last 60 seconds with position
changes as sediment settles
epiglotitis
caused by h. influenzae
medical emergency
cardinal signs: stridor, tripoding, drooling
lateral soft tissue side view xray will show "thumb sign"
apthous ulcers
Canker sores
painful, shallow lesions of MM, immune system dysregulation
tx: topical corticosteroids, topical anesthetic, oral steroids, antimicrobial mouthwash, aloe vera, honey,
salt rinses
risk factors: stress hormone changes, family hx, foods (spicy, acidic), nutritional deficits
dental abscess tx
,amoxicillin or clindamycin
drainage
salt rinses
analgesic
herpes labialis
cold sores
risk factors: hsv, stress, immunocompromise
tx: antivirals, PO or cream
analgesics
balms
cheilosis
inflammatory condition that effects the corners of the mouth, cracks and fissures
risk factors: dentures, poor hygiene, excessive salivation, immunocompromise
dx: swab fo culture, bacteria or yeast
tx: antifungals topical, tobical abx, hydrocortisone
thrush
oral candida
tx: antifungals for systemic, topical antifungals, decrease sugar intake, salt rinses
leukoplakia
white patchy lesions in the mouth that cannot be scraped off, linked to tobacco use, etoh, chronic
irritants, precancerous
diagnose with clinical exam or biopsy
oral cancer
squamous cell carcinoma
tongue, lips, floor of mouth, palate
risk factors: smoking, older age, hpv, heavy etoh
diagnostics of pyelonephritis
WBC casts
fever > 101.3
rigors
flank pain
increased WBCs on CBC and urine culture
, dipstick analysis - protein
indicates kidney damage
dipstick analysis - glucose
may suggest diabetes
dipstick analysis - blood
UTI, trauma, stones
dipstick analysis - leukocyte esterase
UTI
dipstick analysis - nitrites
UTI
dipstick analysis - pH
urine acidity, hydration status
dipstick analysis - specific gravity
kidney ability to concentrate urine
dipstick analysis - ketones
DKA or starvation
dipstick analysis - bilirubin
liver disease or hemolysis
UTI in pregnancy
always treat
Amoxicillin, cephalosporin, fosfomycin
AVOID nitrofuratoin and bactrim
chronic UTI tx
macrobid 100mg daily to prevent
UTI causative agents
proteus
e. coli
klebsiella
enterobactor or staph saprophyctiicus also possible
ANSWER FALL 2025/26 -THE UNIVERSITY OF TEXAS AT
ARLINGTON
allergic rhinitis
1st line tx: mild- 2nd gen antihistamine (cetririzine, loratadine) and mod-severe- intranasal
corticosteroid (fluticasone, budenoside)
2nd line: nasal antihistamine (azelastine), leukotreine receptor antagonists (montelukast),
decongestants (pseudophedrine, phenylephrine), cromolyn
non allergic rhinitis
response to environmental triggers but not immune mediated
vasomotor rhinitis
overeactive response of nasal blood vessels to triggers (change in temp, humidity, stress, odors)
sinusitis
inflammation of at least 1 paranasal sinus d/t bacteria, virus, fungus, or allergy
pathogens: strep pneumo, M cat, H flu
predisposing factors:
URIs, allergies, immunodeficiency, smoking, dental infections, anatomical abnormalities
bacterial sinusitis causative agents
strep pneumoniae
h. flu
m catarrhalis
sx >7-10 days or worsening after 5 days OR temp >102 with purulence OR worsening after initial
treatment indicates bacterial
bacterial sinusitis treatment
abx only for persistent sx >10 days or high fever >102, purulent discharge
1st line: Amoxicillin 500mg tid OR Augmentin 875mg/125mg bid x5-7 days
,PCN allergy: doxycycline or levofloxacin
AVOID macrolides and bactrim d/t bacterial resistance
vertigo
peripheral - 90% of cases, otogenic, toxic, meniere's, BPPV
central - migraine, TIA, postural hypotension
neurologic - MS, temporal lobe szs, cervical disorders, cerebellar lesions, acoustic tumor
other causes: Labrynthitis or neuronitis (viral causes), menieres disease
vertigo tx
antihistamines, vestibular suppressants (meclizine), anticholinergics (scopolamine), antivirals,
anxiolytics, corticosteroids, antiemetics, promethazine, benzos
BPPV tx: epley's maneuver
Meniere's: salt restriction, thiazide diuretics
Labryinthitis: meclizine, steroids, antiemetics
dx with dix hallpike maneuver (BPPV)
Benign Paroxysmal Positional Vertigo
caused by sediment such as calcium carbonate that are in inner ear, last 60 seconds with position
changes as sediment settles
epiglotitis
caused by h. influenzae
medical emergency
cardinal signs: stridor, tripoding, drooling
lateral soft tissue side view xray will show "thumb sign"
apthous ulcers
Canker sores
painful, shallow lesions of MM, immune system dysregulation
tx: topical corticosteroids, topical anesthetic, oral steroids, antimicrobial mouthwash, aloe vera, honey,
salt rinses
risk factors: stress hormone changes, family hx, foods (spicy, acidic), nutritional deficits
dental abscess tx
,amoxicillin or clindamycin
drainage
salt rinses
analgesic
herpes labialis
cold sores
risk factors: hsv, stress, immunocompromise
tx: antivirals, PO or cream
analgesics
balms
cheilosis
inflammatory condition that effects the corners of the mouth, cracks and fissures
risk factors: dentures, poor hygiene, excessive salivation, immunocompromise
dx: swab fo culture, bacteria or yeast
tx: antifungals topical, tobical abx, hydrocortisone
thrush
oral candida
tx: antifungals for systemic, topical antifungals, decrease sugar intake, salt rinses
leukoplakia
white patchy lesions in the mouth that cannot be scraped off, linked to tobacco use, etoh, chronic
irritants, precancerous
diagnose with clinical exam or biopsy
oral cancer
squamous cell carcinoma
tongue, lips, floor of mouth, palate
risk factors: smoking, older age, hpv, heavy etoh
diagnostics of pyelonephritis
WBC casts
fever > 101.3
rigors
flank pain
increased WBCs on CBC and urine culture
, dipstick analysis - protein
indicates kidney damage
dipstick analysis - glucose
may suggest diabetes
dipstick analysis - blood
UTI, trauma, stones
dipstick analysis - leukocyte esterase
UTI
dipstick analysis - nitrites
UTI
dipstick analysis - pH
urine acidity, hydration status
dipstick analysis - specific gravity
kidney ability to concentrate urine
dipstick analysis - ketones
DKA or starvation
dipstick analysis - bilirubin
liver disease or hemolysis
UTI in pregnancy
always treat
Amoxicillin, cephalosporin, fosfomycin
AVOID nitrofuratoin and bactrim
chronic UTI tx
macrobid 100mg daily to prevent
UTI causative agents
proteus
e. coli
klebsiella
enterobactor or staph saprophyctiicus also possible
