, NR 603 WEEK 2 QUIZ | QUESTIONS AND
ANSWERS WITH RATIONALES | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
🧠 SECTION 1: HEENT DISORDERS (Questions 1–
12)
Question 1
A patient presents with decreased hearing on the right side that is
progressively worsening. The NP completes Rinne and Weber tests.
If the patient has Ménière's disease, what would be the expected
finding on the Weber test?
A) Lateralizes to the right ear
B) Lateralizes to the left ear
C) No lateralization
D) Unable to hear the tuning fork
Correct Answer: B) Lateralizes to the left ear
Rationale: Ménière's disease causes sensorineural hearing loss, which is
often unilateral. On the Weber test, sound lateralizes to the unaffected
ear (the ear with better hearing). In sensorineural loss, the affected ear
cannot perceive sound as well, so the patient perceives the sound louder in
the normal ear. In contrast, conductive hearing loss lateralizes to
the affected ear .
Question 2
What are the classic signs and symptoms of Ménière's disease?
,A) Bilateral hearing loss, tinnitus, headache
B) Recurrent spinning vertigo, low-frequency sensorineural hearing loss,
tinnitus, aural fullness
C) Facial droop, ear pain, fever
D) Tinnitus only, no hearing loss
Correct Answer: B) Recurrent spinning vertigo, low-frequency
sensorineural hearing loss, tinnitus, aural fullness
Rationale: The classic triad of Ménière's disease includes:
Episodic vertigo (lasting 20 minutes to several hours)
Fluctuating sensorineural hearing loss (typically low-frequency)
Tinnitus (often roaring quality)
Aural fullness (pressure in the affected ear)
All three symptoms must be present for the diagnosis. The condition is
caused by endolymphatic hydrops (increased fluid pressure in the inner ear).
Treatment includes low-sodium diet, diuretics, and vestibular suppressants
for acute attacks .
Question 3
In Rinne testing, air conduction (AC) should normally be how much
longer than bone conduction (BC)?
A) Equal in duration
B) 2 times longer (positive Rinne)
C) BC longer than AC (negative Rinne)
D) 3 times longer
Correct Answer: B) 2 times longer (positive Rinne)
Rationale: In a normal Rinne test, air conduction is heard twice as long as
bone conduction (positive Rinne). This indicates that the external and middle
ear are functioning properly. In conductive hearing loss, bone conduction is
equal to or longer than air conduction (negative Rinne). In sensorineural
hearing loss, air conduction remains longer than bone conduction, but both
are reduced .
, Question 4
How is herpes keratitis diagnosed?
A) Corneal scraping with culture
B) Examining the eye under a black lamp for fern-like (dendritic) lines
C) Slit lamp examination only
D) Visual acuity testing
Correct Answer: B) Examining the eye under a black lamp for fern-like
(dendritic) lines
Rationale: Herpes simplex keratitis produces characteristic dendritic
ulcerations on the cornea. These are best visualized using fluorescein
stain and examination under a Wood's lamp (black light), which reveals
branching, fern-like lines. This is an ocular emergency requiring prompt
antiviral treatment (e.g., topical trifluridine or oral acyclovir) to prevent
corneal scarring and vision loss .
Question 5
What is the treatment for rhinitis medicamentosa?
A) Continue decongestant and add antihistamine
B) Discontinue topical decongestant; add intranasal corticosteroid
C) Oral antibiotics
D) Surgical turbinate reduction
Correct Answer: B) Discontinue topical decongestant; add intranasal
corticosteroid
Rationale: Rhinitis medicamentosa is rebound nasal congestion caused
by prolonged use of topical decongestants (e.g., oxymetazoline,
phenylephrine) for more than 3–5 days. Treatment requires:
1. Discontinuation of the offending topical decongestant
2. Initiation of intranasal corticosteroid (e.g., fluticasone,
mometasone) to reduce rebound inflammation
Patients should be educated to avoid prolonged use of OTC nasal
sprays .
ANSWERS WITH RATIONALES | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
🧠 SECTION 1: HEENT DISORDERS (Questions 1–
12)
Question 1
A patient presents with decreased hearing on the right side that is
progressively worsening. The NP completes Rinne and Weber tests.
If the patient has Ménière's disease, what would be the expected
finding on the Weber test?
A) Lateralizes to the right ear
B) Lateralizes to the left ear
C) No lateralization
D) Unable to hear the tuning fork
Correct Answer: B) Lateralizes to the left ear
Rationale: Ménière's disease causes sensorineural hearing loss, which is
often unilateral. On the Weber test, sound lateralizes to the unaffected
ear (the ear with better hearing). In sensorineural loss, the affected ear
cannot perceive sound as well, so the patient perceives the sound louder in
the normal ear. In contrast, conductive hearing loss lateralizes to
the affected ear .
Question 2
What are the classic signs and symptoms of Ménière's disease?
,A) Bilateral hearing loss, tinnitus, headache
B) Recurrent spinning vertigo, low-frequency sensorineural hearing loss,
tinnitus, aural fullness
C) Facial droop, ear pain, fever
D) Tinnitus only, no hearing loss
Correct Answer: B) Recurrent spinning vertigo, low-frequency
sensorineural hearing loss, tinnitus, aural fullness
Rationale: The classic triad of Ménière's disease includes:
Episodic vertigo (lasting 20 minutes to several hours)
Fluctuating sensorineural hearing loss (typically low-frequency)
Tinnitus (often roaring quality)
Aural fullness (pressure in the affected ear)
All three symptoms must be present for the diagnosis. The condition is
caused by endolymphatic hydrops (increased fluid pressure in the inner ear).
Treatment includes low-sodium diet, diuretics, and vestibular suppressants
for acute attacks .
Question 3
In Rinne testing, air conduction (AC) should normally be how much
longer than bone conduction (BC)?
A) Equal in duration
B) 2 times longer (positive Rinne)
C) BC longer than AC (negative Rinne)
D) 3 times longer
Correct Answer: B) 2 times longer (positive Rinne)
Rationale: In a normal Rinne test, air conduction is heard twice as long as
bone conduction (positive Rinne). This indicates that the external and middle
ear are functioning properly. In conductive hearing loss, bone conduction is
equal to or longer than air conduction (negative Rinne). In sensorineural
hearing loss, air conduction remains longer than bone conduction, but both
are reduced .
, Question 4
How is herpes keratitis diagnosed?
A) Corneal scraping with culture
B) Examining the eye under a black lamp for fern-like (dendritic) lines
C) Slit lamp examination only
D) Visual acuity testing
Correct Answer: B) Examining the eye under a black lamp for fern-like
(dendritic) lines
Rationale: Herpes simplex keratitis produces characteristic dendritic
ulcerations on the cornea. These are best visualized using fluorescein
stain and examination under a Wood's lamp (black light), which reveals
branching, fern-like lines. This is an ocular emergency requiring prompt
antiviral treatment (e.g., topical trifluridine or oral acyclovir) to prevent
corneal scarring and vision loss .
Question 5
What is the treatment for rhinitis medicamentosa?
A) Continue decongestant and add antihistamine
B) Discontinue topical decongestant; add intranasal corticosteroid
C) Oral antibiotics
D) Surgical turbinate reduction
Correct Answer: B) Discontinue topical decongestant; add intranasal
corticosteroid
Rationale: Rhinitis medicamentosa is rebound nasal congestion caused
by prolonged use of topical decongestants (e.g., oxymetazoline,
phenylephrine) for more than 3–5 days. Treatment requires:
1. Discontinuation of the offending topical decongestant
2. Initiation of intranasal corticosteroid (e.g., fluticasone,
mometasone) to reduce rebound inflammation
Patients should be educated to avoid prolonged use of OTC nasal
sprays .
