NRNP 6531 WHOLE SYLLABUS EXAM
QUESTIONS MIDTERM AND FINAL WELL
GUIDED QUESTIONS WITH RATIONALES
EXPERT VERIFIED 2023/2024
A 65 year old man presents complaining of left sided deep, throbbing headache along with mild
fatigue. On examination the client has a tender, tortuous temporal artery. You suspect temporal
arteritis. How do you confirm your diagnosis?
A. MRI fo the head
B. Erythrocyte sedimentation rate (ESR)
C. EEG
D. Otoscopy
B. Erythrocyte sedimentation rate (ESR)
Marty has a hordeolum in his right eye. You suspect that the offending organism is
A. Herpes simplex virus
B. Staphylococcus
C. Candida albicans
D. Escherichia coli
B. Staphylococcus
The most common offending allergens causing allergic rhinitis are
A. Pollens of grasses, trees and weeds
B. Fungi
C. Animal allergens
D. Food sensitivity
A. Pollens of grasses, trees, and weeds
Cydney, age 7, is complaining that she feels as though something is stuck in her ear. What action
is contraindicated?
A. Inspecting the ear canal with an otoscope
B. Using a small suction device to try to remove the object
C. Flushing the ear with water
D. Instilling several drops of mineral oil in the ear
C. Flushing the ear with water
June, age 50, presents with soft, raised, yellow plaques on her eyelids at the inner canthus. She is
concerned that they may be cancerous skin lesions. You tell her they are probably
A. Xanthelasmas
B. Pingueculae
C. The result of arcus senilis
D. Actinic keratoses
A. Xanthelasmas
Mavis is 70 years old and wonders if she can donate her corneas when she dies. How do you
respond?
A. “As long as you don’t have any chronic illness, you corneas may be harvested.”
B. “They will use corneas only from persons younger than age 65.”
C. “What makes you feel like you are dying?”
D. “Don’t think about such terrible things now.”
B. “They will use corneas only from persons younger than age 65.”
Manny, age 16, was hit in the eye with a baseball. He developed pain in the eye, decreased visual
acuity, and injection of the globe. You confirm the diagnosis of hyphema by finding blood in the
anterior chamber. What treatment would you recommend while Manny is waiting to see the
ophthalmologist?
A. Apply bilateral eye patches
B. Have Manny lie flat
C. Refer him to an ophthalmologist within a week
D. Make sure Manny is able to be awakened every 30 minutes
A. Apply bilateral eye patches
Judy, age 67, complains of a sudden onset of impaired vision, severe eye pain, vomiting, and a
headache. You diagnose the following condition and refer for urgent treatment
A. Cataracts
B. Macular degeneration
C. Presbyopia
D. Acute glaucoma
D. Acute glaucoma
Which of the following refractive errors in vision is a result of the natural loss of accomodative
capacity with age?
A. Presbyopia
B. Hyperopia
C. Myopia
D. Astigmatism
A. Presbyopia
The leading cause of blindness in persons age 20-60 in the United States is
A. Macular degeneration
B. Glaucoma
C. Diabetic retinopathy
D. Trauma
C. Diabetic retinopathy
A 62 year old obese woman comes in today complaining of difficulty swallowing for the past 3
weeks. She states that “some foods get stuck” and she has been having “heartburn” at night when
she lies down, especially if she has had a heavy meal. Occasionally she will awake at night
coughing. She denies weight gain and/or weight loss, vomiting, or change in bowel movements.
She does not drink or smoke. There is no pertinent family history or findings on review of
systems (ROS). Physical examination is normal with no abdominal tenderness, and the stool is
OB negative. What is the most likely diagnosis?
A. Esophageal varices
B. Esophageal cancer
C. Gastroesophageal reflux disease (GERD)
D. Peptic ulcer disease
C. Gastroesophageal reflux disease (GERD)
Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming.
What do you suspect?
A. Acute otitis media
B. Chronic otitis media
C. External otitis
D. Temporomandibular joint syndrome
C. External otitis
Barbara, age 72, states that she was told she had atrophic macular degeneration and asks you if
there is any treatment. How do you respond?
A. “No, but 5 years from the time of the first symptoms, the process usually stops.”
B. “Yes, there is a surgical procedure that will cure this.”
C. “If we start medications now, they may prevent any further damage.”
D. “Unfortunately, there is no effective treatment, but I can refer you to a rehabilitation agency
that can help you adjust to the visual loss.”
D. “Unfortunately, there is no effective treatment, but I can refer you to a rehabilitation agency
that can help you adjust to the visual loss.”
Natasha, age 4, has amblyopia. How do you respond when her mother asks about treatment?
A. “We’ll wait until she’s 7 years old before starting treatment.”
B. “Treatment needs to be started now. We’ll cover her ‘bad’ eye.”
C. “Treatment needs to be started now. We’ll cover her ‘good’ eye.”
D. “No treatment is necessary. She’ll outgrow this.”
C. “Treatment needs to be started now. We’ll cover her ‘good’ eye.”
When Judith, age 15, asks you to explain the 20/50 vision in her right eye, you respond
A. “You can see at 20ft with your left eye what the normal person can see at 50ft.”
B. “You can see at 20ft with your right eye what the normal person can see at 50ft.”
C. “You can see at 50ft with your right eye what the normal person can see at 20ft.”
D. “You can see at 50ft with the left eye what the normal person can see at 20ft.”
B. “You can see at 20ft with your right eye what the normal person can see at 50ft.”
- If vision is greater than 20/30, refer the client to an ophthalmologist or optometrist
Sharon, age 29, is pregnant for the first time. She complains of nasal stuffiness and occasional
epistaxis. What do you do?
A. Order lab tests, such as a CBC with differential, hemoglobin and hematocrit
B. Prescribe an antihistamine
C. You do nothing except for client teaching
D. Refer the client to an ear, nose and throat specialist
C. You do nothing except for client teaching - Can occur with pregnancy because of increased vascularization in the upper respiratory tract
David, age 32, states that he thinks he has an ear infection because he just flew back from a
business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next
action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist
A. Prescribe nasal steroids and oral decongestants
A sexual history of oral-genital contact in a client presenting with pharyngitis is significant when
which of the following organisms is suspected?
A. Escherichia coli
B. Haemophilus influenzae
C. Neisseria gonorrhoeae
D. Streptococcus pneumoniae
C. Neisseria gonorrhoeae - Neisseria gonorrhoeae pharyngitis is a common sexually transmitted disease
The most common cause of sensoineural hearing loss is
A. Trauma
B. Tympanic membrane sclerosis and scarring
C. Otosclerosis
D. Presbycusis
D. Presbycusis