NURS 5335 EENT EXAM 2026/2027 | 100% Correct Answers
with Complete Solutions | Graduate Nursing Eyes, Ears,
Nose, Throat Assessment | Pass Guaranteed - A+ Graded
Domain 1: Eye Disorders (15 Questions)
Q1: A 28-year-old teacher presents with bilateral red, itchy eyes and watery discharge for
3 days. She reports similar symptoms during spring pollen season. Visual acuity is
20/20 bilaterally. Examination reveals bilateral conjunctival injection with papillae and
mild chemosis. There is no corneal involvement or preauricular lymphadenopathy. What
is the most appropriate initial treatment?
A. Topical antibiotic drops (erythromycin) four times daily
B. Topical antihistamine/mast cell stabilizer (olopatadine) twice daily [CORRECT]
C. Topical corticosteroid drops (prednisolone) every 2 hours
D. Oral antibiotics (amoxicillin-clavulanate) for 7 days
Correct Answer: B
Rationale: This patient presents with classic allergic conjunctivitis: bilateral involvement,
intense itching, watery discharge, seasonal pattern, and papillary reaction. According to
the AAO Conjunctivitis Preferred Practice Pattern 2023 , first-line treatment for allergic
conjunctivitis includes topical antihistamines or dual-action antihistamine/mast cell
stabilizers like olopatadine. Topical antibiotics (A) are inappropriate as this is not
bacterial conjunctivitis (which typically has purulent discharge and mattering). Topical
,corticosteroids (C) are reserved for severe cases due to risks of elevated intraocular
pressure and cataract formation. Oral antibiotics (D) are unnecessary and inappropriate
for allergic conditions.
Q2: A 45-year-old construction worker presents with sudden onset severe left eye pain,
blurred vision, and halos around lights after working in a dark warehouse. He reports
headache and nausea. Examination reveals injected conjunctiva, cloudy cornea, fixed
mid-dilated pupil, and intraocular pressure (IOP) of 52 mmHg. What is the immediate
management priority?
A. Topical antibiotic drops and patching
B. Urgent ophthalmology referral for laser peripheral iridotomy
C. Immediate IOP reduction with topical and systemic medications [CORRECT]
D. Dilating drops to break posterior synechiae
Correct Answer: C
Rationale: This patient presents with acute angle-closure glaucoma (AACG), an
ophthalmologic emergency. The classic triad includes severe eye pain, blurred vision
with halos, and nausea/vomiting. The fixed mid-dilated pupil and markedly elevated IOP
(normal <21 mmHg) confirm the diagnosis. According to AAO guidelines , immediate
management must focus on rapid IOP reduction using topical beta-blockers (timolol),
alpha-agonists (apraclonidine), and systemic carbonic anhydrase inhibitors
(acetazolamide) or osmotic agents (mannitol). Once IOP is controlled (<40 mmHg),
miotics (pilocarpine) can be used, followed by definitive laser peripheral iridotomy (B).
Antibiotics (A) are irrelevant, and dilating drops (D) would worsen the angle closure.
,Q3: A 6-year-old child is brought in with a 2-day history of right eye redness and
discharge. The mother reports that the child has had a cold and now has thick yellow
discharge causing the eyelids to stick together, especially in the morning. Examination
reveals injected conjunctiva with mucopurulent discharge and mild eyelid edema. Visual
acuity is normal. What is the most appropriate management?
A. Immediate referral to ophthalmology
B. Topical antibiotic drops (trimethoprim-polymyxin B) with hygiene instructions
[CORRECT]
C. Topical corticosteroid-antibiotic combination drops
D. Observation only; no treatment needed
Correct Answer: B
Rationale: This child presents with acute bacterial conjunctivitis, characterized by
mucopurulent discharge, mattering of eyelids, and unilateral onset often associated
with upper respiratory infection. According to AAO guidelines , mild bacterial
conjunctivitis is often self-limiting, but topical antibiotics (trimethoprim-polymyxin B,
erythromycin, or fluoroquinolones) shorten symptom duration and reduce transmission.
Hygiene instructions (hand washing, avoiding shared towels) are essential. Immediate
referral (A) is unnecessary for uncomplicated cases. Corticosteroids (C) are
contraindicated in infectious conjunctivitis. Observation only (D) is inappropriate given
the significant discharge and symptoms.
, Q4: A 32-year-old contact lens wearer presents with severe left eye pain, photophobia,
and blurred vision for 24 hours. She reports sleeping in her contact lenses. Examination
reveals a corneal epithelial defect with a surrounding white infiltrate and an anterior
chamber reaction. What is the most likely diagnosis and appropriate management?
A. Corneal abrasion; topical antibiotic and patching
B. Bacterial keratitis; urgent ophthalmology referral and topical fluoroquinolone
[CORRECT]
C. Viral keratitis; topical antiviral therapy
D. Allergic keratoconjunctivitis; topical antihistamine
Correct Answer: B
Rationale: This patient presents with contact lens-related bacterial keratitis, a
vision-threatening emergency. Risk factors include contact lens wear (especially
overnight use), acute onset of pain, photophobia, blurred vision, and the presence of a
corneal infiltrate with anterior chamber reaction. According to AAO guidelines, this
requires urgent ophthalmology referral and immediate treatment with topical
broad-spectrum antibiotics (fluoroquinolones or fortified antibiotics). Corneal abrasion
(A) would not present with a white infiltrate. Viral keratitis (C) typically presents with
dendritic lesions and less acute onset. Allergic conditions (D) do not cause corneal
infiltrates or significant pain.
Q5: A 58-year-old patient with type 2 diabetes presents for routine eye examination.
Visual acuity is 20/40 in the right eye and 20/25 in the left. Fundoscopic examination
with Complete Solutions | Graduate Nursing Eyes, Ears,
Nose, Throat Assessment | Pass Guaranteed - A+ Graded
Domain 1: Eye Disorders (15 Questions)
Q1: A 28-year-old teacher presents with bilateral red, itchy eyes and watery discharge for
3 days. She reports similar symptoms during spring pollen season. Visual acuity is
20/20 bilaterally. Examination reveals bilateral conjunctival injection with papillae and
mild chemosis. There is no corneal involvement or preauricular lymphadenopathy. What
is the most appropriate initial treatment?
A. Topical antibiotic drops (erythromycin) four times daily
B. Topical antihistamine/mast cell stabilizer (olopatadine) twice daily [CORRECT]
C. Topical corticosteroid drops (prednisolone) every 2 hours
D. Oral antibiotics (amoxicillin-clavulanate) for 7 days
Correct Answer: B
Rationale: This patient presents with classic allergic conjunctivitis: bilateral involvement,
intense itching, watery discharge, seasonal pattern, and papillary reaction. According to
the AAO Conjunctivitis Preferred Practice Pattern 2023 , first-line treatment for allergic
conjunctivitis includes topical antihistamines or dual-action antihistamine/mast cell
stabilizers like olopatadine. Topical antibiotics (A) are inappropriate as this is not
bacterial conjunctivitis (which typically has purulent discharge and mattering). Topical
,corticosteroids (C) are reserved for severe cases due to risks of elevated intraocular
pressure and cataract formation. Oral antibiotics (D) are unnecessary and inappropriate
for allergic conditions.
Q2: A 45-year-old construction worker presents with sudden onset severe left eye pain,
blurred vision, and halos around lights after working in a dark warehouse. He reports
headache and nausea. Examination reveals injected conjunctiva, cloudy cornea, fixed
mid-dilated pupil, and intraocular pressure (IOP) of 52 mmHg. What is the immediate
management priority?
A. Topical antibiotic drops and patching
B. Urgent ophthalmology referral for laser peripheral iridotomy
C. Immediate IOP reduction with topical and systemic medications [CORRECT]
D. Dilating drops to break posterior synechiae
Correct Answer: C
Rationale: This patient presents with acute angle-closure glaucoma (AACG), an
ophthalmologic emergency. The classic triad includes severe eye pain, blurred vision
with halos, and nausea/vomiting. The fixed mid-dilated pupil and markedly elevated IOP
(normal <21 mmHg) confirm the diagnosis. According to AAO guidelines , immediate
management must focus on rapid IOP reduction using topical beta-blockers (timolol),
alpha-agonists (apraclonidine), and systemic carbonic anhydrase inhibitors
(acetazolamide) or osmotic agents (mannitol). Once IOP is controlled (<40 mmHg),
miotics (pilocarpine) can be used, followed by definitive laser peripheral iridotomy (B).
Antibiotics (A) are irrelevant, and dilating drops (D) would worsen the angle closure.
,Q3: A 6-year-old child is brought in with a 2-day history of right eye redness and
discharge. The mother reports that the child has had a cold and now has thick yellow
discharge causing the eyelids to stick together, especially in the morning. Examination
reveals injected conjunctiva with mucopurulent discharge and mild eyelid edema. Visual
acuity is normal. What is the most appropriate management?
A. Immediate referral to ophthalmology
B. Topical antibiotic drops (trimethoprim-polymyxin B) with hygiene instructions
[CORRECT]
C. Topical corticosteroid-antibiotic combination drops
D. Observation only; no treatment needed
Correct Answer: B
Rationale: This child presents with acute bacterial conjunctivitis, characterized by
mucopurulent discharge, mattering of eyelids, and unilateral onset often associated
with upper respiratory infection. According to AAO guidelines , mild bacterial
conjunctivitis is often self-limiting, but topical antibiotics (trimethoprim-polymyxin B,
erythromycin, or fluoroquinolones) shorten symptom duration and reduce transmission.
Hygiene instructions (hand washing, avoiding shared towels) are essential. Immediate
referral (A) is unnecessary for uncomplicated cases. Corticosteroids (C) are
contraindicated in infectious conjunctivitis. Observation only (D) is inappropriate given
the significant discharge and symptoms.
, Q4: A 32-year-old contact lens wearer presents with severe left eye pain, photophobia,
and blurred vision for 24 hours. She reports sleeping in her contact lenses. Examination
reveals a corneal epithelial defect with a surrounding white infiltrate and an anterior
chamber reaction. What is the most likely diagnosis and appropriate management?
A. Corneal abrasion; topical antibiotic and patching
B. Bacterial keratitis; urgent ophthalmology referral and topical fluoroquinolone
[CORRECT]
C. Viral keratitis; topical antiviral therapy
D. Allergic keratoconjunctivitis; topical antihistamine
Correct Answer: B
Rationale: This patient presents with contact lens-related bacterial keratitis, a
vision-threatening emergency. Risk factors include contact lens wear (especially
overnight use), acute onset of pain, photophobia, blurred vision, and the presence of a
corneal infiltrate with anterior chamber reaction. According to AAO guidelines, this
requires urgent ophthalmology referral and immediate treatment with topical
broad-spectrum antibiotics (fluoroquinolones or fortified antibiotics). Corneal abrasion
(A) would not present with a white infiltrate. Viral keratitis (C) typically presents with
dendritic lesions and less acute onset. Allergic conditions (D) do not cause corneal
infiltrates or significant pain.
Q5: A 58-year-old patient with type 2 diabetes presents for routine eye examination.
Visual acuity is 20/40 in the right eye and 20/25 in the left. Fundoscopic examination
