MARYVILLE UNIVERSITY NURS 621 HEENT EXAM 1/ ACTUAL
NURS 621 HEENT EXAM 1 LATEST 2026/2027 COMPLETE
ACCURATE EXAM APPROVED QUESTIONS AND CORRCET
VERIFIED ANSWERS WITH DETAILED RATIONALES (A NEW
UPDATED VERSION 2026 EDITION) |GUARANTEED PASS A+
|BRAND NEW! |FULL REVISED NURS621 HEENT EXAM 1
|MARYVILLE UNIVERSITY
1. A 45-year-old patient presents with a 3-day history of severe right-
sided headache, retro-orbital pain, and ipsilateral conjunctival injection.
The patient reports restlessness during episodes. Which of the following
is the most likely diagnosis?
A. Migraine without aura
B. Tension-type headache
C. Cluster headache
D. Temporal arteritis
Correct Answer: C. Cluster headache
Rationale: Cluster headaches are characterized by unilateral, severe,
periorbital/retro-orbital pain with autonomic features (conjunctival
injection, lacrimation, rhinorrhea) and agitation/restlessness. Migraines
typically cause throbbing pain with photophobia and nausea, not
restlessness. Temporal arteritis presents with jaw claudication and
elevated ESR.
2. A 68-year-old female reports a tender, nodular, reddened area on her
right temple, associated with new-onset headache and jaw pain while
,chewing. Which diagnostic test is most appropriate initially?
A. CT head without contrast
B. Lumbar puncture
C. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
D. Temporal artery biopsy
Correct Answer: C. Erythrocyte sedimentation rate (ESR) and C-
reactive protein (CRP)
Rationale: This presentation suggests giant cell arteritis (temporal
arteritis). Elevated ESR/CRP support the diagnosis. Temporal artery
biopsy is definitive but should not delay initial testing; ESR/CRP are
first-line. CT head is not diagnostic for vasculitis. LP is for meningitis.
3. During an otoscope exam of a 6-year-old, you note a translucent,
pearly-gray membrane with a cone of light in the anterior-inferior
quadrant. What is the correct interpretation?
A. Acute otitis media
B. Otitis media with effusion
C. Normal tympanic membrane
D. Cholesteatoma
Correct Answer: C. Normal tympanic membrane
Rationale: A healthy TM is pearly-gray, translucent, with a visible cone
of light (light reflex) usually in the anterior-inferior quadrant. Redness,
bulging, or opacity suggests pathology. Cholesteatoma appears as a
retraction pocket or white mass.
,4. Which cranial nerve is assessed by asking the patient to shrug their
shoulders against resistance and turn their head side to side?
A. CN IX (Glossopharyngeal)
B. CN X (Valgus)
C. CN XI (Spinal accessory)
D. CN XII (Hypoglossal)
Correct Answer: C. CN XI (Spinal accessory)
Rationale: CN XI innervates the sternocleidomastoid (head turning) and
trapezius (shoulder shrug). CN IX/X are for gag/phonation. CN XII is
for tongue movement.
5. A 23-year-old reports recurrent episodes of seeing flashing lights and
zigzag lines, followed by a unilateral throbbing headache with nausea.
What is the most appropriate acute treatment?
A. Oral sumatriptan
B. Acetaminophen 1000 mg
C. Propranolol daily
D. Naproxen 500 mg
Correct Answer: A. Oral sumatriptan
Rationale: This describes migraine with aura. Trip tans (sumatriptan)
are first-line for acute moderate-to-severe migraine. Propranolol is for
prophylaxis, not acute. Naproxen may be used for mild migraines but is
less effective for severe attacks.
, 6. On fundoscopic exam, you note sharp disc margins, an arteriovenous
(AV) ratio of 1:3, and arterial nicking. What condition does this most
likely indicate?
A. Papilledema
B. Hypertensive retinopathy
C. Diabetic retinopathy
D. Optic atrophy
Correct Answer: B. Hypertensive retinopathy
Rationale: Hypertensive retinopathy features AV nicking, silver wiring,
and decreased AV ratio (normal is 2:3). Papilledema shows blurred disc
margins. Diabetic retinopathy shows micro aneurysms and dot-blot
hemorrhages.
7. A 55-year-old diabetic presents with gradual hearing loss, worse in
noisy environments, and a normal otoscope exam. Weber test lateralizes
to the right ear, and Rianne test shows air conduction > bone conduction
bilaterally but reduced on the right. What is the most likely diagnosis?
A. Conductive hearing loss, right ear
B. Sensorineural hearing loss, right ear
C. Mixed hearing loss, right ear
D. Normal hearing
Correct Answer: B. Sensorineural hearing loss, right ear
Rationale: Weber lateralizing to the right indicates right sensorineural
loss (or left conductive). Rianne AC>BC bilaterally rules out conductive
loss. Asymmetric sensorineural loss in a diabetic suggests possible
noise-induced or presbycusis, but lateralization confirms unilateral
sensorineural.
NURS 621 HEENT EXAM 1 LATEST 2026/2027 COMPLETE
ACCURATE EXAM APPROVED QUESTIONS AND CORRCET
VERIFIED ANSWERS WITH DETAILED RATIONALES (A NEW
UPDATED VERSION 2026 EDITION) |GUARANTEED PASS A+
|BRAND NEW! |FULL REVISED NURS621 HEENT EXAM 1
|MARYVILLE UNIVERSITY
1. A 45-year-old patient presents with a 3-day history of severe right-
sided headache, retro-orbital pain, and ipsilateral conjunctival injection.
The patient reports restlessness during episodes. Which of the following
is the most likely diagnosis?
A. Migraine without aura
B. Tension-type headache
C. Cluster headache
D. Temporal arteritis
Correct Answer: C. Cluster headache
Rationale: Cluster headaches are characterized by unilateral, severe,
periorbital/retro-orbital pain with autonomic features (conjunctival
injection, lacrimation, rhinorrhea) and agitation/restlessness. Migraines
typically cause throbbing pain with photophobia and nausea, not
restlessness. Temporal arteritis presents with jaw claudication and
elevated ESR.
2. A 68-year-old female reports a tender, nodular, reddened area on her
right temple, associated with new-onset headache and jaw pain while
,chewing. Which diagnostic test is most appropriate initially?
A. CT head without contrast
B. Lumbar puncture
C. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
D. Temporal artery biopsy
Correct Answer: C. Erythrocyte sedimentation rate (ESR) and C-
reactive protein (CRP)
Rationale: This presentation suggests giant cell arteritis (temporal
arteritis). Elevated ESR/CRP support the diagnosis. Temporal artery
biopsy is definitive but should not delay initial testing; ESR/CRP are
first-line. CT head is not diagnostic for vasculitis. LP is for meningitis.
3. During an otoscope exam of a 6-year-old, you note a translucent,
pearly-gray membrane with a cone of light in the anterior-inferior
quadrant. What is the correct interpretation?
A. Acute otitis media
B. Otitis media with effusion
C. Normal tympanic membrane
D. Cholesteatoma
Correct Answer: C. Normal tympanic membrane
Rationale: A healthy TM is pearly-gray, translucent, with a visible cone
of light (light reflex) usually in the anterior-inferior quadrant. Redness,
bulging, or opacity suggests pathology. Cholesteatoma appears as a
retraction pocket or white mass.
,4. Which cranial nerve is assessed by asking the patient to shrug their
shoulders against resistance and turn their head side to side?
A. CN IX (Glossopharyngeal)
B. CN X (Valgus)
C. CN XI (Spinal accessory)
D. CN XII (Hypoglossal)
Correct Answer: C. CN XI (Spinal accessory)
Rationale: CN XI innervates the sternocleidomastoid (head turning) and
trapezius (shoulder shrug). CN IX/X are for gag/phonation. CN XII is
for tongue movement.
5. A 23-year-old reports recurrent episodes of seeing flashing lights and
zigzag lines, followed by a unilateral throbbing headache with nausea.
What is the most appropriate acute treatment?
A. Oral sumatriptan
B. Acetaminophen 1000 mg
C. Propranolol daily
D. Naproxen 500 mg
Correct Answer: A. Oral sumatriptan
Rationale: This describes migraine with aura. Trip tans (sumatriptan)
are first-line for acute moderate-to-severe migraine. Propranolol is for
prophylaxis, not acute. Naproxen may be used for mild migraines but is
less effective for severe attacks.
, 6. On fundoscopic exam, you note sharp disc margins, an arteriovenous
(AV) ratio of 1:3, and arterial nicking. What condition does this most
likely indicate?
A. Papilledema
B. Hypertensive retinopathy
C. Diabetic retinopathy
D. Optic atrophy
Correct Answer: B. Hypertensive retinopathy
Rationale: Hypertensive retinopathy features AV nicking, silver wiring,
and decreased AV ratio (normal is 2:3). Papilledema shows blurred disc
margins. Diabetic retinopathy shows micro aneurysms and dot-blot
hemorrhages.
7. A 55-year-old diabetic presents with gradual hearing loss, worse in
noisy environments, and a normal otoscope exam. Weber test lateralizes
to the right ear, and Rianne test shows air conduction > bone conduction
bilaterally but reduced on the right. What is the most likely diagnosis?
A. Conductive hearing loss, right ear
B. Sensorineural hearing loss, right ear
C. Mixed hearing loss, right ear
D. Normal hearing
Correct Answer: B. Sensorineural hearing loss, right ear
Rationale: Weber lateralizing to the right indicates right sensorineural
loss (or left conductive). Rianne AC>BC bilaterally rules out conductive
loss. Asymmetric sensorineural loss in a diabetic suggests possible
noise-induced or presbycusis, but lateralization confirms unilateral
sensorineural.
