ESTUDYR
NURS 5433 MIDTERM EXAM UPDATED EXAM WITH MOST
TESTED QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
Which of the following best describes common symptoms of blepharitis?
A. Sudden severe eye pain, photophobia
B. Crusty/irritated lid margin, debris at lash roots, dry eye symptoms ✅
C. Painless lump inside eyelid only
D. Central vision loss
Rationale: Blepharitis causes chronic eyelid margin inflammation with crusting and symptoms
of ocular surface irritation.
For resistant or persistent blepharitis infections, which oral antibiotic is commonly used?
(Select two)
A. Azithromycin
B. Doxycycline 100 mg PO BID ✅
C. Tetracycline 250 mg QID ✅
D. Ciprofloxacin
Rationale: Tetracyclines (doxycycline or tetracycline) are used for chronic posterior
blepharitis/meibomian gland dysfunction.
A 40-year-old woman presents with scaling, crusting, and photophobia on sunny days. What
would you recommend first?
A. Doxycycline 100 mg PO BID
B. Tetracycline 250 mg QID
C. Warm compresses only
D. Lid scrubs with baby shampoo ✅
Rationale: Initial conservative management for anterior blepharitis includes lid hygiene and
scrubs.
Posterior blepharitis is most often associated with which systemic condition?
A. Seborrhea
B. Rosacea ✅
C. Astigmatism
D. Conjunctivitis
Rationale: Rosacea commonly involves meibomian glands leading to posterior blepharitis.
A painful, red swelling at the eyelid margin most likely represents:
A. Hordeolum (stye) ✅
B. Chalazion
,ESTUDYR
C. Conjunctivitis
D. Cataract
Rationale: Hordeolum is an acute painful eyelid margin abscess.
Preferred first-line management for a hordeolum is:
A. Topical steroids
B. Warm compresses ✅
C. Oral antivirals
D. Eye patch
Rationale: Warm compresses and lid hygiene are primary treatment to promote drainage.
What is the main difference between a hordeolum and a chalazion?
A. Location only
B. Hordeolum is painful (lid margin); chalazion is usually painless and points inward ✅
C. One is infectious and one is allergic only
D. No difference
Rationale: Hordeolum is acute and painful; chalazion is granulomatous and usually painless.
A 7-year-old with red eyes, purulent discharge, and lids matted shut in the morning — most
likely cause?
A. Allergic conjunctivitis
B. Viral conjunctivitis
C. Bacterial conjunctivitis ✅
D. Herpetic conjunctivitis
Rationale: Purulent discharge and matted lids are characteristic of bacterial conjunctivitis.
Which symptom is most characteristic of allergic conjunctivitis?
A. Preauricular lymphadenopathy
B. Bilateral itching with watery discharge ✅
C. Thick yellow discharge
D. Unilateral crusting
Rationale: Itching and watery, bilateral symptoms suggest allergy.
Watery discharge, preauricular lymphadenopathy, and gritty sensation typically indicate:
A. Allergic conjunctivitis
B. Viral conjunctivitis ✅
C. Bacterial conjunctivitis
D. Fungal conjunctivitis
Rationale: Viral conjunctivitis commonly causes watery discharge and tender preauricular
nodes.
,ESTUDYR
Herpetic viral conjunctivitis is distinguished by which diagnostic finding?
A. Pseudomembrane formation
B. Dendritic lesions on fluorescein stain ✅
C. Subconjunctival hemorrhage
D. Mucopurulent discharge only
Rationale: Herpes simplex causes dendritic corneal ulcers visible with fluorescein.
Which exam checks optic nerve function and assesses anterior chamber inflammation?
A. External inspection only
B. Dilated pupil exam (fundoscopy) / slit lamp ✅
C. Visual acuity only
D. Intraocular pressure only
Rationale: Dilated fundus exam and slit lamp allow optic nerve and anterior chamber
evaluation.
Which two antibiotics are commonly used systemically for chlamydia and gonococcal
conjunctivitis?
A. Ceftriaxone ✅
B. Doxycycline ✅
C. Vancomycin
D. Tobramycin
Rationale: Ceftriaxone for gonorrhea + doxycycline or azithromycin for chlamydia.
Which antibiotic is not recommended for orbital/periorbital cellulitis?
A. Cephalosporin
B. Ampicillin-clavulanate
C. Penicillin (narrow spectrum) ✅
D. Levofloxacin
E. Ciprofloxacin
Rationale: Narrow penicillins lack adequate coverage for the polymicrobial infections; broader
agents are used.
Rimexolone and loteprednol ophthalmic preparations are used for:
A. Antibacterial therapy
B. Antiviral therapy
C. Topical steroid therapy for inflammatory ocular surface disorders ✅
D. Mydriatic effects
Rationale: These are topical corticosteroids used for inflammatory conjunctival conditions.
, ESTUDYR
The primary difference between a pingueculum and a pterygium is:
A. Visual loss only
B. Laterality only
C. Pingueculum does not cross cornea; pterygium extends onto cornea ✅
D. Color difference only
Rationale: Pterygium invades corneal surface; pingueculum is localized conjunctival thickening.
When is surgical removal indicated for pingueculum or pterygium?
A. Cosmetic reasons only
B. When vision is impaired or progressive encroachment occurs ✅
C. Always on detection
D. Never
Rationale: Surgery is reserved for visual compromise or recurrent irritation.
A yellowish raised lesion on the nasal conjunctiva that does not affect vision is most likely:
A. Pingueculum ✅
B. Pterygium
C. Cataract
D. Conjunctival hemorrhage
Rationale: Pingueculum is a benign conjunctival lesion often nasal.
First-line topical therapy for uncomplicated bacterial conjunctivitis in adults often includes:
A. Oral doxycycline
B. Topical corticosteroids
C. Erythromycin ophthalmic ointment (or topical antibiotic drops) ✅
D. Systemic antivirals
Rationale: Topical antibiotics (drops/ointments) are standard for bacterial conjunctivitis.
A fluorescein stain is most useful to diagnose:
A. Corneal abrasion/ulcer ✅
B. Blepharitis
C. Cataracts
D. Macular degeneration
Rationale: Fluorescein highlights corneal epithelial defects.
A patient with chronic dry eye fails cyclosporine ophthalmic emulsion. Which next steps are
appropriate? (Select three)
A. Topical corticosteroids
B. Systemic anti-inflammatories
C. Surgery
NURS 5433 MIDTERM EXAM UPDATED EXAM WITH MOST
TESTED QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
Which of the following best describes common symptoms of blepharitis?
A. Sudden severe eye pain, photophobia
B. Crusty/irritated lid margin, debris at lash roots, dry eye symptoms ✅
C. Painless lump inside eyelid only
D. Central vision loss
Rationale: Blepharitis causes chronic eyelid margin inflammation with crusting and symptoms
of ocular surface irritation.
For resistant or persistent blepharitis infections, which oral antibiotic is commonly used?
(Select two)
A. Azithromycin
B. Doxycycline 100 mg PO BID ✅
C. Tetracycline 250 mg QID ✅
D. Ciprofloxacin
Rationale: Tetracyclines (doxycycline or tetracycline) are used for chronic posterior
blepharitis/meibomian gland dysfunction.
A 40-year-old woman presents with scaling, crusting, and photophobia on sunny days. What
would you recommend first?
A. Doxycycline 100 mg PO BID
B. Tetracycline 250 mg QID
C. Warm compresses only
D. Lid scrubs with baby shampoo ✅
Rationale: Initial conservative management for anterior blepharitis includes lid hygiene and
scrubs.
Posterior blepharitis is most often associated with which systemic condition?
A. Seborrhea
B. Rosacea ✅
C. Astigmatism
D. Conjunctivitis
Rationale: Rosacea commonly involves meibomian glands leading to posterior blepharitis.
A painful, red swelling at the eyelid margin most likely represents:
A. Hordeolum (stye) ✅
B. Chalazion
,ESTUDYR
C. Conjunctivitis
D. Cataract
Rationale: Hordeolum is an acute painful eyelid margin abscess.
Preferred first-line management for a hordeolum is:
A. Topical steroids
B. Warm compresses ✅
C. Oral antivirals
D. Eye patch
Rationale: Warm compresses and lid hygiene are primary treatment to promote drainage.
What is the main difference between a hordeolum and a chalazion?
A. Location only
B. Hordeolum is painful (lid margin); chalazion is usually painless and points inward ✅
C. One is infectious and one is allergic only
D. No difference
Rationale: Hordeolum is acute and painful; chalazion is granulomatous and usually painless.
A 7-year-old with red eyes, purulent discharge, and lids matted shut in the morning — most
likely cause?
A. Allergic conjunctivitis
B. Viral conjunctivitis
C. Bacterial conjunctivitis ✅
D. Herpetic conjunctivitis
Rationale: Purulent discharge and matted lids are characteristic of bacterial conjunctivitis.
Which symptom is most characteristic of allergic conjunctivitis?
A. Preauricular lymphadenopathy
B. Bilateral itching with watery discharge ✅
C. Thick yellow discharge
D. Unilateral crusting
Rationale: Itching and watery, bilateral symptoms suggest allergy.
Watery discharge, preauricular lymphadenopathy, and gritty sensation typically indicate:
A. Allergic conjunctivitis
B. Viral conjunctivitis ✅
C. Bacterial conjunctivitis
D. Fungal conjunctivitis
Rationale: Viral conjunctivitis commonly causes watery discharge and tender preauricular
nodes.
,ESTUDYR
Herpetic viral conjunctivitis is distinguished by which diagnostic finding?
A. Pseudomembrane formation
B. Dendritic lesions on fluorescein stain ✅
C. Subconjunctival hemorrhage
D. Mucopurulent discharge only
Rationale: Herpes simplex causes dendritic corneal ulcers visible with fluorescein.
Which exam checks optic nerve function and assesses anterior chamber inflammation?
A. External inspection only
B. Dilated pupil exam (fundoscopy) / slit lamp ✅
C. Visual acuity only
D. Intraocular pressure only
Rationale: Dilated fundus exam and slit lamp allow optic nerve and anterior chamber
evaluation.
Which two antibiotics are commonly used systemically for chlamydia and gonococcal
conjunctivitis?
A. Ceftriaxone ✅
B. Doxycycline ✅
C. Vancomycin
D. Tobramycin
Rationale: Ceftriaxone for gonorrhea + doxycycline or azithromycin for chlamydia.
Which antibiotic is not recommended for orbital/periorbital cellulitis?
A. Cephalosporin
B. Ampicillin-clavulanate
C. Penicillin (narrow spectrum) ✅
D. Levofloxacin
E. Ciprofloxacin
Rationale: Narrow penicillins lack adequate coverage for the polymicrobial infections; broader
agents are used.
Rimexolone and loteprednol ophthalmic preparations are used for:
A. Antibacterial therapy
B. Antiviral therapy
C. Topical steroid therapy for inflammatory ocular surface disorders ✅
D. Mydriatic effects
Rationale: These are topical corticosteroids used for inflammatory conjunctival conditions.
, ESTUDYR
The primary difference between a pingueculum and a pterygium is:
A. Visual loss only
B. Laterality only
C. Pingueculum does not cross cornea; pterygium extends onto cornea ✅
D. Color difference only
Rationale: Pterygium invades corneal surface; pingueculum is localized conjunctival thickening.
When is surgical removal indicated for pingueculum or pterygium?
A. Cosmetic reasons only
B. When vision is impaired or progressive encroachment occurs ✅
C. Always on detection
D. Never
Rationale: Surgery is reserved for visual compromise or recurrent irritation.
A yellowish raised lesion on the nasal conjunctiva that does not affect vision is most likely:
A. Pingueculum ✅
B. Pterygium
C. Cataract
D. Conjunctival hemorrhage
Rationale: Pingueculum is a benign conjunctival lesion often nasal.
First-line topical therapy for uncomplicated bacterial conjunctivitis in adults often includes:
A. Oral doxycycline
B. Topical corticosteroids
C. Erythromycin ophthalmic ointment (or topical antibiotic drops) ✅
D. Systemic antivirals
Rationale: Topical antibiotics (drops/ointments) are standard for bacterial conjunctivitis.
A fluorescein stain is most useful to diagnose:
A. Corneal abrasion/ulcer ✅
B. Blepharitis
C. Cataracts
D. Macular degeneration
Rationale: Fluorescein highlights corneal epithelial defects.
A patient with chronic dry eye fails cyclosporine ophthalmic emulsion. Which next steps are
appropriate? (Select three)
A. Topical corticosteroids
B. Systemic anti-inflammatories
C. Surgery
