Page 1 of 43
NR 545 EXAM 1 WITH VERIFIED ANSWERS DETAILED
RATIONALES GRADED A+
Section 1: EENT Disorders (Questions 1-75)
1. A patient presents with bilateral itchy, red eyes with rope-like discharge and
clear nasal discharge. What is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Rationale: Allergic conjunctivitis presents with bilateral itching, redness, and rope-like
discharge. It is an IgE-mediated response to allergens such as dust, mites, or animal
dander.
2. A patient reports waking up with their eyelids "stuck together." On exam, you
note purulent drainage and injected conjunctiva. Which type of conjunctivitis is
most likely?
A. Allergic conjunctivitis
B. Bacterial conjunctivitis
1|Page
,Page 2 of 43
C. Viral conjunctivitis
D. Chemical conjunctivitis
Rationale: Bacterial conjunctivitis commonly presents with unilateral red and irritated
eyes, eyelids "stuck together" upon awakening, and purulent drainage.
3. Viral conjunctivitis is most commonly caused by which organism?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Adenovirus
D. Chlamydia trachomatis
Rationale: Viral conjunctivitis is most commonly caused by adenovirus. It typically
resolves in 2-3 weeks without antibacterial therapy.
4. A patient presents with ear pain that worsens with movement of the pinna. This
finding is most consistent with:
A. Acute otitis media
B. Otitis externa
C. Mastoiditis
D. Serous otitis media
Rationale: Otitis externa (swimmer's ear) can be differentiated from otitis media
because pain is increased with movement of the pinna.
2|Page
,Page 3 of 43
5. The most common causative agent for otitis externa is:
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Pseudomonas aeruginosa
D. Moraxella catarrhalis
Rationale: Otitis externa is usually bacterial but occasionally fungal. The most common
causative agent is Pseudomonas aeruginosa.
6. A 6-year-old child presents with a 3-day history of ear pain, fever, and
irritability. On otoscopic examination, the tympanic membrane is erythematous,
bulging, and has decreased mobility. Which of the following is the most
appropriate first-line treatment?
A. Observation without antibiotics for 48-72 hours
B. Amoxicillin 80-90 mg/kg/day divided BID
C. Amoxicillin-clavulanate 80-90 mg/kg/day divided BID
D. Azithromycin 10 mg/kg/day for 3 days
Rationale: Acute otitis media in children is typically treated with high-dose amoxicillin
(80-90 mg/kg/day) as first-line therapy. Observation is appropriate for select cases.
3|Page
, Page 4 of 43
7. A patient with allergic rhinitis presents with sneezing, nasal congestion, and
clear rhinorrhea. Which of the following is the most appropriate first-line
pharmacological treatment?
A. Oral antihistamines
B. Intranasal corticosteroids
C. Intranasal antihistamines
D. Oral decongestants
Rationale: Intranasal corticosteroids are the most effective first-line treatment for
allergic rhinitis. They reduce inflammation and all symptoms including nasal congestion.
8. What is otitis media?
A. Inflammation of the external auditory canal
B. Infection of the middle ear
C. Infection of the inner ear
D. Inflammation of the mastoid bone
Rationale: Otitis media is an infection of the middle ear, often presenting after an upper
respiratory infection from increased nasal drainage.
9. What is otitis externa?
A. Infection of the middle ear
B. Inflammation of external auditory canal
4|Page
NR 545 EXAM 1 WITH VERIFIED ANSWERS DETAILED
RATIONALES GRADED A+
Section 1: EENT Disorders (Questions 1-75)
1. A patient presents with bilateral itchy, red eyes with rope-like discharge and
clear nasal discharge. What is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Rationale: Allergic conjunctivitis presents with bilateral itching, redness, and rope-like
discharge. It is an IgE-mediated response to allergens such as dust, mites, or animal
dander.
2. A patient reports waking up with their eyelids "stuck together." On exam, you
note purulent drainage and injected conjunctiva. Which type of conjunctivitis is
most likely?
A. Allergic conjunctivitis
B. Bacterial conjunctivitis
1|Page
,Page 2 of 43
C. Viral conjunctivitis
D. Chemical conjunctivitis
Rationale: Bacterial conjunctivitis commonly presents with unilateral red and irritated
eyes, eyelids "stuck together" upon awakening, and purulent drainage.
3. Viral conjunctivitis is most commonly caused by which organism?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Adenovirus
D. Chlamydia trachomatis
Rationale: Viral conjunctivitis is most commonly caused by adenovirus. It typically
resolves in 2-3 weeks without antibacterial therapy.
4. A patient presents with ear pain that worsens with movement of the pinna. This
finding is most consistent with:
A. Acute otitis media
B. Otitis externa
C. Mastoiditis
D. Serous otitis media
Rationale: Otitis externa (swimmer's ear) can be differentiated from otitis media
because pain is increased with movement of the pinna.
2|Page
,Page 3 of 43
5. The most common causative agent for otitis externa is:
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Pseudomonas aeruginosa
D. Moraxella catarrhalis
Rationale: Otitis externa is usually bacterial but occasionally fungal. The most common
causative agent is Pseudomonas aeruginosa.
6. A 6-year-old child presents with a 3-day history of ear pain, fever, and
irritability. On otoscopic examination, the tympanic membrane is erythematous,
bulging, and has decreased mobility. Which of the following is the most
appropriate first-line treatment?
A. Observation without antibiotics for 48-72 hours
B. Amoxicillin 80-90 mg/kg/day divided BID
C. Amoxicillin-clavulanate 80-90 mg/kg/day divided BID
D. Azithromycin 10 mg/kg/day for 3 days
Rationale: Acute otitis media in children is typically treated with high-dose amoxicillin
(80-90 mg/kg/day) as first-line therapy. Observation is appropriate for select cases.
3|Page
, Page 4 of 43
7. A patient with allergic rhinitis presents with sneezing, nasal congestion, and
clear rhinorrhea. Which of the following is the most appropriate first-line
pharmacological treatment?
A. Oral antihistamines
B. Intranasal corticosteroids
C. Intranasal antihistamines
D. Oral decongestants
Rationale: Intranasal corticosteroids are the most effective first-line treatment for
allergic rhinitis. They reduce inflammation and all symptoms including nasal congestion.
8. What is otitis media?
A. Inflammation of the external auditory canal
B. Infection of the middle ear
C. Infection of the inner ear
D. Inflammation of the mastoid bone
Rationale: Otitis media is an infection of the middle ear, often presenting after an upper
respiratory infection from increased nasal drainage.
9. What is otitis externa?
A. Infection of the middle ear
B. Inflammation of external auditory canal
4|Page
