PRIMARY CARE I, (LATEST 2026/ 2027
UPDATE) WITH CORRECT/ACCURATE
ANSWERS
Verified Questions, Answers & Rationales
AT (GCU) GRAND CANYON UNIVERSITY
FNP6552 FAMILY PRIMARY CARE I
1. A mother of a 1-month-old infant reports constant tearing of the
right eye and mild crusting of the lashes. What is the most likely
diagnosis, and what should you recommend?
A. Viral conjunctivitis; give warm compresses
B. Bacterial conjunctivitis; start Polytrim
C. Dacryostenosis; massage the nasolacrimal duct twice daily
D. Allergic conjunctivitis; prescribe antihistamine drops
Answer: C. Dacryostenosis; massage the nasolacrimal duct twice daily
Rationale:
Nasolacrimal duct obstruction is common in infants under 6 months and presents with tearing and mild
crusting but no conjunctival erythema. Management is conservative with lacrimal duct massage, as most
cases resolve by 6 months.
2. At what age should an infant with dacryostenosis be referred to
ophthalmology?
A. Immediately at diagnosis
B. At 3 months
C. If severe, before 6 months; otherwise refer at 9–12 months
D. At age 2 years
,Answer: C. If severe, before 6 months; otherwise refer at 9–12 months
Rationale:
Persistent obstruction beyond 9–12 months or severe obstruction with recurrent infections requires referral
for possible probing.
3. Injected conjunctiva, profuse tearing, mucous discharge, burning,
cold symptoms, and preauricular lymph node swelling suggest what
type of conjunctivitis?
A. Bacterial
B. Viral
C. Allergic
D. Chemical
Answer: B. Viral
Rationale:
Viral conjunctivitis is associated with watery discharge, burning, and preauricular adenopathy and often
accompanies a URI.
4. A 2-week-old infant presents with profuse eye discharge and
genitourinary symptoms. What diagnosis is most likely?
A. Gonococcal conjunctivitis
B. Chlamydial conjunctivitis
C. HSV conjunctivitis
D. Bacterial conjunctivitis
Answer: B. Chlamydial conjunctivitis
Rationale:
Chlamydial ophthalmia neonatorum typically appears 5–14 days after birth and may be associated with
pneumonia or GU symptoms.
5. A 2-day-old newborn presents with copious purulent eye
drainage. What is the suspected cause?
,A. Chlamydia
B. Gonorrhea
C. HSV
D. Staph aureus
Answer: B. Gonorrhea
Rationale:
Gonococcal conjunctivitis presents within 24–48 hours of birth and is a medical emergency due to risk of
blindness.
6. What is the first-line medication for bacterial conjunctivitis? How
is it prescribed?
A. Erythromycin ointment daily
B. Polytrim, 2 drops 4× daily
C. Ciprofloxacin ointment 3× daily
D. Oral azithromycin
Answer: B. Polytrim, 2 drops 4× daily
Rationale:
Polymyxin B/trimethoprim (Polytrim) is a safe, broad-spectrum first-line agent for uncomplicated
bacterial conjunctivitis.
7. The painless appearance of a bright red spot on the sclera that
does not affect vision is most consistent with what condition?
A. Hordeolum
B. Subconjunctival hemorrhage
C. Chalazion
D. Uveitis
Answer: B. Subconjunctival hemorrhage
Rationale:
This harmless condition often results from minor trauma, coughing, or Valsalva and requires no treatment.
8. What are the two types of blepharitis?
, A. Viral and bacterial
B. Acute and chronic
C. Ulcerative and seborrheic
D. Internal and external
Answer: C. Ulcerative and seborrheic
Rationale:
Blepharitis is chronic eyelid margin inflammation.
Seborrheic: greasy flakes
Ulcerative: staph-related, crusting, lash loss
9. Benign, chronic eyelid inflammation caused by meibomian gland
blockage is known as:
A. Hordeolum
B. Chalazion
C. Blepharitis
D. Entropion
Answer: B. Chalazion
Rationale:
A chalazion is painless, non-erythematous, and due to chronic meibomian gland obstruction.
10. A painless eyelid lesion that does not involve eyelashes is most
likely a:
A. Hordeolum
B. Stye
C. Chalazion
D. Blepharitis
Answer: C. Chalazion
Rationale:
Painless + not involving lashes = classic chalazion.
11. A painful lump on the eyelid margin most likely represents a: