NR 511 MIDTERM EXAM 2026 EXAM Q&A
STUDY GUIDE COMPLETE QUESTIONS WITH
VERIFIED SOLUTIONS
◉ A 25-year-old male presents with "bleeding in my eye" for 1 day.
He awoke this morning with a dark area of redness in his eye. He has
no visual loss or changes. He denies constitutional symptoms,
pruritus, drainage, or recent trauma. The redness presents on
physical exam as a dark red area in the patient's sclera of the right
eye only and takes up less than 50% of the eye. The patient's
remaining sclera is clear and white. He also notes he was drinking
alcohol last night and vomited afterward. What is the best
treatment?
1.Topical steroids and close follow-up with an ophthalmologist.
2.Sending the patient to the emergency department for immediate
ophthalmology consult.
3.Reassurance that this lesion will resolve without any treatment in
2 to 4 weeks.
4.Cold compresses and frequent handwashing Answer: Reassurance
that this lesion will resolve without any treatment in 2 to 4 weeks.
rationale: This is the classic presentation of a subconjunctival
hemorrhage. It will resolve without treatment in 2 to 4 weeks.
Vomiting probably caused his hemorrhage
,◉ Which of the following statements about macular degeneration is
not true?
1.Macular degeneration is characterized by gradual loss of
peripheral vision.
2.Macular degeneration is the leading cause of blindness in people
younger than 60.
3.Tobacco use is a risk factor for macular degeneration.
4.There are 2 different types of macular degeneration: wet and dry
Answer: Macular degeneration is characterized by gradual loss of
peripheral vision
rationale: This is how open-angle glaucoma is characterized.
Macular degeneration is gradual loss of central vision
◉ A 75-year-old female presents to your office complaining of
dizziness and hearing loss. The patient states she awoke yesterday
with dizziness, which she described as feeling the room spinning.
She also notes intermittent ringing in her ears. On physical exam, the
patient has lateralization of her hearing loss to the unaffected ear.
Rinne test shows air conduction lasts longer than bone conduction.
What is the next step in helping this patient's symptoms?
1.Order a computed tomography (CT) scan to rule out acoustic
neuroma.
2.Start her on high-dose Augmentin.
,3.Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
4.Immediate referral to an ear, nose, and throat (ENT) specialist
Answer: Start the patient on a low-salt, low-caffeine diet and give
her meclizine for vertigo attacks
rationale: This is the treatment for symptoms of Meniere disease.
You would also want to consider an ear, nose, and throat consult to
rule out other etiologies of the patient's symptoms. Meniere disease
is diagnosed based on history and the exclusion of other conditions
as well
◉ What is the most common bacterial pathogen associated with
acute otitis media?
1.Streptococcus pneumoniae.
2.Haemophilus influenzae.
3.Streptococcus pyogenes.
4.Moraxella (Branhamella) catarrhalis. Answer: Streptococcus
pneumoniae
rationale: This causes 40% to 50% of cases.
◉ A 20-year-old male presents to your primary care clinic. This
patient is a college student. He complains of fatigue, sore throat, and
low-grade fever for 3 days. On physical exam, he has a temperature
, of 100.7°F. His ear exam is normal. His nose and throat exam shows
mild erythema of the nasal mucosa and edematous, enlarged tonsils
bilaterally, with erythema of the pharyngeal wall and tonsillar
exudates. He has inflamed posterior cervical lymph nodes. He has a
mild nonproductive cough and clear lung exam. What is his most
likely diagnosis?
1.Viral pharyngitis.
2.Mononucleosis.
3.Streptococcal pharyngitis.
4.Upper respiratory infection Answer: Mono
rationale: This presentation could be a viral pharyngitis; however,
with posterior cervical lymphadenitis, you would suspect
mononucleosis.
◉ The antibiotic of choice for recurrent acute otitis media (AOM)
and/or treatment failure in children is:
1.Amoxicillin (Amoxil).
2.Amoxicillin and potassium clavulanate (Augmentin).
3.Azithromycin (Zithromax).
4.Prednisone (Deltasone) Answer: Augmentin
rationale: The antibiotic of choice for recurrent AOM or treatment
failure is amoxicillin and potassium clavulanate (Augmentin)
STUDY GUIDE COMPLETE QUESTIONS WITH
VERIFIED SOLUTIONS
◉ A 25-year-old male presents with "bleeding in my eye" for 1 day.
He awoke this morning with a dark area of redness in his eye. He has
no visual loss or changes. He denies constitutional symptoms,
pruritus, drainage, or recent trauma. The redness presents on
physical exam as a dark red area in the patient's sclera of the right
eye only and takes up less than 50% of the eye. The patient's
remaining sclera is clear and white. He also notes he was drinking
alcohol last night and vomited afterward. What is the best
treatment?
1.Topical steroids and close follow-up with an ophthalmologist.
2.Sending the patient to the emergency department for immediate
ophthalmology consult.
3.Reassurance that this lesion will resolve without any treatment in
2 to 4 weeks.
4.Cold compresses and frequent handwashing Answer: Reassurance
that this lesion will resolve without any treatment in 2 to 4 weeks.
rationale: This is the classic presentation of a subconjunctival
hemorrhage. It will resolve without treatment in 2 to 4 weeks.
Vomiting probably caused his hemorrhage
,◉ Which of the following statements about macular degeneration is
not true?
1.Macular degeneration is characterized by gradual loss of
peripheral vision.
2.Macular degeneration is the leading cause of blindness in people
younger than 60.
3.Tobacco use is a risk factor for macular degeneration.
4.There are 2 different types of macular degeneration: wet and dry
Answer: Macular degeneration is characterized by gradual loss of
peripheral vision
rationale: This is how open-angle glaucoma is characterized.
Macular degeneration is gradual loss of central vision
◉ A 75-year-old female presents to your office complaining of
dizziness and hearing loss. The patient states she awoke yesterday
with dizziness, which she described as feeling the room spinning.
She also notes intermittent ringing in her ears. On physical exam, the
patient has lateralization of her hearing loss to the unaffected ear.
Rinne test shows air conduction lasts longer than bone conduction.
What is the next step in helping this patient's symptoms?
1.Order a computed tomography (CT) scan to rule out acoustic
neuroma.
2.Start her on high-dose Augmentin.
,3.Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
4.Immediate referral to an ear, nose, and throat (ENT) specialist
Answer: Start the patient on a low-salt, low-caffeine diet and give
her meclizine for vertigo attacks
rationale: This is the treatment for symptoms of Meniere disease.
You would also want to consider an ear, nose, and throat consult to
rule out other etiologies of the patient's symptoms. Meniere disease
is diagnosed based on history and the exclusion of other conditions
as well
◉ What is the most common bacterial pathogen associated with
acute otitis media?
1.Streptococcus pneumoniae.
2.Haemophilus influenzae.
3.Streptococcus pyogenes.
4.Moraxella (Branhamella) catarrhalis. Answer: Streptococcus
pneumoniae
rationale: This causes 40% to 50% of cases.
◉ A 20-year-old male presents to your primary care clinic. This
patient is a college student. He complains of fatigue, sore throat, and
low-grade fever for 3 days. On physical exam, he has a temperature
, of 100.7°F. His ear exam is normal. His nose and throat exam shows
mild erythema of the nasal mucosa and edematous, enlarged tonsils
bilaterally, with erythema of the pharyngeal wall and tonsillar
exudates. He has inflamed posterior cervical lymph nodes. He has a
mild nonproductive cough and clear lung exam. What is his most
likely diagnosis?
1.Viral pharyngitis.
2.Mononucleosis.
3.Streptococcal pharyngitis.
4.Upper respiratory infection Answer: Mono
rationale: This presentation could be a viral pharyngitis; however,
with posterior cervical lymphadenitis, you would suspect
mononucleosis.
◉ The antibiotic of choice for recurrent acute otitis media (AOM)
and/or treatment failure in children is:
1.Amoxicillin (Amoxil).
2.Amoxicillin and potassium clavulanate (Augmentin).
3.Azithromycin (Zithromax).
4.Prednisone (Deltasone) Answer: Augmentin
rationale: The antibiotic of choice for recurrent AOM or treatment
failure is amoxicillin and potassium clavulanate (Augmentin)
