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NR602 Exam Questions With Verified
Answers
α Thalassemias - Answers✔are composed of several variant Hgbs that are responsible for the
various presentations. Current nomenclature often refers to the subtypes by including an
indication of the number of gene deletions of α globin; the severity of symptoms increases with
more deletions. Three gene deletions result in severe, even fatal, manifestations of disease. Two
gene deletions present with hypochromia; the absence of gene deletions causes mild anemia and
often erythrocytosis. A single globin gene deletion is clinically insignificant
Tinea corporis (ringworm) - Answers✔Physical Examination
• Classical appearance of lesions: Annular, oval, or circinate with one or more flat, scaling,
mildly erythematous circular patches or plaques with red, scaly borders
• Lesions spread peripherally and clear centrally or may be inflammatory throughout with
superficial pustules
• Often prominent over hair follicles
• Multiple secondary lesions may merge into a large area several centimeters in diameter
Myopia (nearsightedness) - Answers✔or nearsightedness, exists when the axial length of the eye
is increased in relation to the eye's optical power. As a result, light from a distant object is
focused in front of the retina rather than directly on it. A child sees close objects clearly but
distant objects are blurry.
Hyperopia (farsightedness) - Answers✔or farsightedness, exists when the visual image is
focused behind the retina. As a result, distant objects are seen clearly but close objects are blurry.
astigmatism - Answers✔exists when the curvature of the cornea or the lens is uneven; thus the
retina cannot appropriately focus light from an object regardless of the distance, which makes
vision blurry close up and far away.
Anisometropia - Answers✔is a different refractive error in each eye. It may consist of any
combination of refractive errors discussed earlier, or it may occur with aphakia.
amblyopia - Answers✔It is usually a unilateral deficit in which there is defective development of
the visual pathways needed to attain central vision. Clear focused images fail to reach the brain,
resulting in reduced or permanent loss of vision. The condition is labeled (or typed) according to
, ©THESTAR EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
the structural or refractive problem that is causing the poor visual image to reach the brain:
deprivational, or obstruction of vision (e.g., caused by ptosis, cataract, nystagmus), strabismic
(caused by strabismus or lazy eye), or refractive (myopia, hyperopia, astigmatism,
anisometropia).
strabismus - Answers✔is a defect in ocular alignment, or the position of the eyes in relation to
each other; it is commonly called lazy eye. In this condition the visual axes are not parallel
because the muscles of the eyes are not coordinated; when one eye is directed straight ahead, the
other deviates. As a result, one or both eyes appear crossed. In children, strabismus may appear
as a phoria or tropia
Phoria - Answers✔is an intermittent deviation in ocular alignment that is held latent by sensory
fusion. The child can maintain alignment on an object. Deviation occurs when binocular fusion is
disrupted, most often during the cover/uncover test.
Tropias - Answers✔is a consistent or intermittent deviation in ocular alignment. A child with this
condition is unable to maintain alignment on an object of fixation. Intermittent may occur when a
child is tired.
blepharoptosis, ptosis - Answers✔drooping of the upper eyelids affecting one or both eyes. It can
be congenital or acquired, secondary to trauma or inflammation.
nystagmus - Answers✔is the presence of involuntary, rhythmic movements that may be pendular
oscillations or jerky drifts of one or both eyes. Movement is horizontal, vertical, rotary, or mixed,
and is classified as congenital or acquired.
cataract - Answers✔a partial or complete opacity of the lens affecting one or both eyes, is the
most common cause of an abnormal pupillary reflex.
Glaucoma - Answers✔is a disturbance in the circulation of aqueous fluid that results in an
increase in IOP and subsequent damage to the optic nerve. It can be classified according to age at
the time of its appearance and type of structural abnormality or other associated conditions.
Primary congenital is present at birth; infantile develops in the first 1 to 2 years of life; juvenile
occurs after age 3. Most glaucoma has no identifiable cause and is considered primary.
Signs and symptoms of glaucoma - Answers✔Clinicians should look for
• The classic triad—tearing, photophobia, and excessive blinking/blepharospasm
• Whether their infant tends to turn away from light
• Hazy corneas, corneal edema
management of glaucoma - Answers✔Primary treatment is surgery as early as possible (often
multiple surgeries are required). Medications may be used as part of the medical management.
Systemic (azetazolamide or methazolamide) or topical (dorzolamide or brinzolamide drops)
carbonic anhydrase inhibitors will reduce IOP. Beta blocker (timolol) or combined beta
blocker/carbonic anhydrase inhibitor drops may be used
, ©THESTAR EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
Retinoblastoma - Answers✔is an intraocular tumor that develops in the retina. Although it is
rare, this malignant retinal tumor is the most common tumor in childhood (some 4% of cancers
in children younger than 15 years of age)
Retinoblastoma - Answers✔Clinical Findings
• Strabismus is the most common finding.
• There is decreased visual acuity.
• Uni- or bilateral white pupil (leukocoria), described often as an intermittent "glow, glint, gleam,
or glare" by parents, is usually seen in low-light settings or noted in photographs taken with a
flash (e.g., cat's eye reflex).
• Other symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital cellulitis and
photophobia (causes pain), hyphema, hypopyon (pus in anterior chamber of eye); signs of global
rupture are also possible.
Management for retinoblastoma - Answers✔Depending on the diagnosis, treatment may involve
cryotherapy, laser photocoagulation, episcleral plaque brachytherapy, systemic chemotherapy, or
enucleation (Kaufman, Kim, and Berry, 2017). Early detection and advances in treatment have
led to less enucleation and the preservation of sight.
Inclusion conjunctivitis (chlamydia) - Answers✔is usually caused by one of eight known strains
of C. trachomatis and is most often seen in a neonate or sexually active adolescent. Neonates
usually demonstrate symptoms within the first 5 to 14 days of life (to 6 weeks),
Bacterial conjunctivitis - Answers✔is a contagious and easily spread disease. H. influenzae is the
most common organism isolated in children who are below 7 years of age. is most common in
the winter and in toddlers and preschoolers
Bacterial conjunctivitis - Answers✔Clinical Findings
• Erythema of one or both eyes, usually starting unilaterally and becoming bilateral (key finding)
• Yellow-green purulent discharge (key finding)
• Encrusted and matted eyelids on awakening (key finding)
• Burning, stinging, or itching of the eyes and a feeling of a foreign body
• Photophobia
• Petechiae on bulbar conjunctiva
• Symptoms of upper respiratory infection, otitis media, or acute pharyngitis
• Vision screen should be normal and documented in the patient's record
Management of bacterial conjunctivitis - Answers✔For uncomplicated bacterial conjunctivitis,
treatment includes (Jacobs, 2017a; Lopez Montero, 2018) the following:
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• Sodium sulfacetamide 10% ophthalmic solution or ointment; not effective against H.
influenzae; stings; can cause allergic reactions (including Stevens-Johnson syndrome)
• Trimethoprim sulfate plus polymyxin B sulfate ophthalmic solution
• Erythromycin 0.5% ophthalmic ointment for patients with sulfa allergy and infants
Azithromycin drops for children older than 12 months
• Fluoroquinolone ophthalmic drops including besifloxacin, ciprofloxacin, gatifloxacin,
levofloxacin, moxifloxacin, or ofloxacin for children older than 12 months
The aminoglycosides (neomycin, tobramycin, and gentamicin) are to be avoided because of
possible hypersensitization, severe allergic reactions, and increasing resistance.
Viral conjunctivitis - Answers✔is usually caused by an adenovirus but can also be caused by
herpes simplex, herpes zoster, enterovirus, molluscum contagiosum, or varicella virus. It is more
common in children older than 6 years of age and in the spring and fall (see ).
Signs and symptoms of viral conjunctivitis - Answers✔Clinical Findings
• Tearing and profuse clear, watery discharge (key findings)
• Fever, headache, anorexia, malaise, upper respiratory symptoms (pharyngitis-conjunctivitis-
fever triad with adenovirus [key findings])
• Pharyngitis with enlarged preauricular nodes (key findings)
• Itchy, red, and swollen conjunctiva
• Hyperemia and swollen eyelids
• Photophobia with measles or varicella rashes
• Herpetic vesicles on the eyelid margins and eyelashes (marginal blepharitis) or on the
conjunctiva and cornea (keratoconjunctivitis)
Management of viral conjunctivitis - Answers✔self-limited and should resolve in 7 to 14 days.
Conjunctivitis is often difficult to distinguish from keratitis. If there is any question about
diagnosis, refer for ophthalmologic assessment.
• Warm or cold compresses and artificial tears can be used.
• Prophylaxis with antibiotics is not recommended.
• Antihistamine or vasoconstrictive ophthalmic solutions may be used for symptomatic relief.
• If HSV infection is suspected, immediate referral to an ophthalmologist is indicated. Topical
corticosteroids should be avoided because they may worsen the course.
ALL RIGHTS RESERVED.
NR602 Exam Questions With Verified
Answers
α Thalassemias - Answers✔are composed of several variant Hgbs that are responsible for the
various presentations. Current nomenclature often refers to the subtypes by including an
indication of the number of gene deletions of α globin; the severity of symptoms increases with
more deletions. Three gene deletions result in severe, even fatal, manifestations of disease. Two
gene deletions present with hypochromia; the absence of gene deletions causes mild anemia and
often erythrocytosis. A single globin gene deletion is clinically insignificant
Tinea corporis (ringworm) - Answers✔Physical Examination
• Classical appearance of lesions: Annular, oval, or circinate with one or more flat, scaling,
mildly erythematous circular patches or plaques with red, scaly borders
• Lesions spread peripherally and clear centrally or may be inflammatory throughout with
superficial pustules
• Often prominent over hair follicles
• Multiple secondary lesions may merge into a large area several centimeters in diameter
Myopia (nearsightedness) - Answers✔or nearsightedness, exists when the axial length of the eye
is increased in relation to the eye's optical power. As a result, light from a distant object is
focused in front of the retina rather than directly on it. A child sees close objects clearly but
distant objects are blurry.
Hyperopia (farsightedness) - Answers✔or farsightedness, exists when the visual image is
focused behind the retina. As a result, distant objects are seen clearly but close objects are blurry.
astigmatism - Answers✔exists when the curvature of the cornea or the lens is uneven; thus the
retina cannot appropriately focus light from an object regardless of the distance, which makes
vision blurry close up and far away.
Anisometropia - Answers✔is a different refractive error in each eye. It may consist of any
combination of refractive errors discussed earlier, or it may occur with aphakia.
amblyopia - Answers✔It is usually a unilateral deficit in which there is defective development of
the visual pathways needed to attain central vision. Clear focused images fail to reach the brain,
resulting in reduced or permanent loss of vision. The condition is labeled (or typed) according to
, ©THESTAR EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
the structural or refractive problem that is causing the poor visual image to reach the brain:
deprivational, or obstruction of vision (e.g., caused by ptosis, cataract, nystagmus), strabismic
(caused by strabismus or lazy eye), or refractive (myopia, hyperopia, astigmatism,
anisometropia).
strabismus - Answers✔is a defect in ocular alignment, or the position of the eyes in relation to
each other; it is commonly called lazy eye. In this condition the visual axes are not parallel
because the muscles of the eyes are not coordinated; when one eye is directed straight ahead, the
other deviates. As a result, one or both eyes appear crossed. In children, strabismus may appear
as a phoria or tropia
Phoria - Answers✔is an intermittent deviation in ocular alignment that is held latent by sensory
fusion. The child can maintain alignment on an object. Deviation occurs when binocular fusion is
disrupted, most often during the cover/uncover test.
Tropias - Answers✔is a consistent or intermittent deviation in ocular alignment. A child with this
condition is unable to maintain alignment on an object of fixation. Intermittent may occur when a
child is tired.
blepharoptosis, ptosis - Answers✔drooping of the upper eyelids affecting one or both eyes. It can
be congenital or acquired, secondary to trauma or inflammation.
nystagmus - Answers✔is the presence of involuntary, rhythmic movements that may be pendular
oscillations or jerky drifts of one or both eyes. Movement is horizontal, vertical, rotary, or mixed,
and is classified as congenital or acquired.
cataract - Answers✔a partial or complete opacity of the lens affecting one or both eyes, is the
most common cause of an abnormal pupillary reflex.
Glaucoma - Answers✔is a disturbance in the circulation of aqueous fluid that results in an
increase in IOP and subsequent damage to the optic nerve. It can be classified according to age at
the time of its appearance and type of structural abnormality or other associated conditions.
Primary congenital is present at birth; infantile develops in the first 1 to 2 years of life; juvenile
occurs after age 3. Most glaucoma has no identifiable cause and is considered primary.
Signs and symptoms of glaucoma - Answers✔Clinicians should look for
• The classic triad—tearing, photophobia, and excessive blinking/blepharospasm
• Whether their infant tends to turn away from light
• Hazy corneas, corneal edema
management of glaucoma - Answers✔Primary treatment is surgery as early as possible (often
multiple surgeries are required). Medications may be used as part of the medical management.
Systemic (azetazolamide or methazolamide) or topical (dorzolamide or brinzolamide drops)
carbonic anhydrase inhibitors will reduce IOP. Beta blocker (timolol) or combined beta
blocker/carbonic anhydrase inhibitor drops may be used
, ©THESTAR EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
Retinoblastoma - Answers✔is an intraocular tumor that develops in the retina. Although it is
rare, this malignant retinal tumor is the most common tumor in childhood (some 4% of cancers
in children younger than 15 years of age)
Retinoblastoma - Answers✔Clinical Findings
• Strabismus is the most common finding.
• There is decreased visual acuity.
• Uni- or bilateral white pupil (leukocoria), described often as an intermittent "glow, glint, gleam,
or glare" by parents, is usually seen in low-light settings or noted in photographs taken with a
flash (e.g., cat's eye reflex).
• Other symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital cellulitis and
photophobia (causes pain), hyphema, hypopyon (pus in anterior chamber of eye); signs of global
rupture are also possible.
Management for retinoblastoma - Answers✔Depending on the diagnosis, treatment may involve
cryotherapy, laser photocoagulation, episcleral plaque brachytherapy, systemic chemotherapy, or
enucleation (Kaufman, Kim, and Berry, 2017). Early detection and advances in treatment have
led to less enucleation and the preservation of sight.
Inclusion conjunctivitis (chlamydia) - Answers✔is usually caused by one of eight known strains
of C. trachomatis and is most often seen in a neonate or sexually active adolescent. Neonates
usually demonstrate symptoms within the first 5 to 14 days of life (to 6 weeks),
Bacterial conjunctivitis - Answers✔is a contagious and easily spread disease. H. influenzae is the
most common organism isolated in children who are below 7 years of age. is most common in
the winter and in toddlers and preschoolers
Bacterial conjunctivitis - Answers✔Clinical Findings
• Erythema of one or both eyes, usually starting unilaterally and becoming bilateral (key finding)
• Yellow-green purulent discharge (key finding)
• Encrusted and matted eyelids on awakening (key finding)
• Burning, stinging, or itching of the eyes and a feeling of a foreign body
• Photophobia
• Petechiae on bulbar conjunctiva
• Symptoms of upper respiratory infection, otitis media, or acute pharyngitis
• Vision screen should be normal and documented in the patient's record
Management of bacterial conjunctivitis - Answers✔For uncomplicated bacterial conjunctivitis,
treatment includes (Jacobs, 2017a; Lopez Montero, 2018) the following:
, ©THESTAR EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
• Sodium sulfacetamide 10% ophthalmic solution or ointment; not effective against H.
influenzae; stings; can cause allergic reactions (including Stevens-Johnson syndrome)
• Trimethoprim sulfate plus polymyxin B sulfate ophthalmic solution
• Erythromycin 0.5% ophthalmic ointment for patients with sulfa allergy and infants
Azithromycin drops for children older than 12 months
• Fluoroquinolone ophthalmic drops including besifloxacin, ciprofloxacin, gatifloxacin,
levofloxacin, moxifloxacin, or ofloxacin for children older than 12 months
The aminoglycosides (neomycin, tobramycin, and gentamicin) are to be avoided because of
possible hypersensitization, severe allergic reactions, and increasing resistance.
Viral conjunctivitis - Answers✔is usually caused by an adenovirus but can also be caused by
herpes simplex, herpes zoster, enterovirus, molluscum contagiosum, or varicella virus. It is more
common in children older than 6 years of age and in the spring and fall (see ).
Signs and symptoms of viral conjunctivitis - Answers✔Clinical Findings
• Tearing and profuse clear, watery discharge (key findings)
• Fever, headache, anorexia, malaise, upper respiratory symptoms (pharyngitis-conjunctivitis-
fever triad with adenovirus [key findings])
• Pharyngitis with enlarged preauricular nodes (key findings)
• Itchy, red, and swollen conjunctiva
• Hyperemia and swollen eyelids
• Photophobia with measles or varicella rashes
• Herpetic vesicles on the eyelid margins and eyelashes (marginal blepharitis) or on the
conjunctiva and cornea (keratoconjunctivitis)
Management of viral conjunctivitis - Answers✔self-limited and should resolve in 7 to 14 days.
Conjunctivitis is often difficult to distinguish from keratitis. If there is any question about
diagnosis, refer for ophthalmologic assessment.
• Warm or cold compresses and artificial tears can be used.
• Prophylaxis with antibiotics is not recommended.
• Antihistamine or vasoconstrictive ophthalmic solutions may be used for symptomatic relief.
• If HSV infection is suspected, immediate referral to an ophthalmologist is indicated. Topical
corticosteroids should be avoided because they may worsen the course.
