N675 Practice Exam UPDATED
QUESTIONS AND CORRECT ANSWERS
A patient reports a sudden onset of sore throat, fever, malaise, and cough. The provider notes mild
erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most
likely cause of these symptoms? - CORRECT ANSWER Viral pharyngitis
What are factors associated with acute suppurative parotitis? (Select all that apply.) - CORRECT
ANSWER Anticholinergic medications
Diabetes mellitus
Group A strep pharyngitis: - CORRECT ANSWER Can be accompanied by abdominal pain
A 61 year old male presents with a 12 hour history of extremely painful left red eye. The patient
complains of blurred vision, halos around lights, and vomiting. It began yesterday evening. On exam,
the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most
likely diagnosis in this patient is: - CORRECT ANSWER Acute angle glaucoma
A patient has an initial episode otitis external associated with swimming. The patient's ear canal is
mildly inflamed and the tympanic membrane is not involved. Which medication will be ordered? -
CORRECT ANSWER Cipro HC
Which physical examination finding suggests viral rather than bacterial parotitis? - CORRECT
ANSWER Clear discharge from Stensen's duct
A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus
toward nose. Tearing is present and when pressure is applied to the lacrimal sac, purulent discharge
from the puncta is noted. This is suggestive of: - CORRECT ANSWER Dacryocystitis
Pt has painful oral lesions and the provider notes several white verrucous lesions in clusters
throughout the mouth. What is the recommended treatment for this? - CORRECT
ANSWER Surgical incision.
,A Pt is concerned about frequent nasal stuffiness and congestions that begins shortly after getting out
of bed in the morning. Pt denies itching, sneezing. A physical exam reveals erythematous nasal
mucosa with scant watery discharge. What treatment will the provider recommend? - CORRECT
ANSWER Daily intranasal steroid.
A pediatric Pt has otalgia, fever 38.8C & recent h/o of URI. The examiner is unable to visualize the
tympanic membrane in the Rt ear b/c of cerumen in the ear canal. The Lt ear tympanic is dull gray w/
fluid present. What is correct course of action? - CORRECT ANSWER Remove cerumen &
visualize tympanic membrane.
A 70 yr old male Pt c/o a bright red spot that has been present on his Lt eye for 2 days. He denies eye
pain, or visual changes or HA's. He has new onset of cough from recent UPR & he takes 1 ASA a day.
- CORRECT ANSWER Advise the Pt that the condition is benign and will resolve
spontaneously. This question was on both practice quizzes.
During an eye exam of 50-year-old with HTN, Pt c/o severe HA. The borders of the disc margins on
both eyes are blurred. What is the name of this clinical finding? - CORRECT
ANSWER Papilledema
Child is hit w/ baseball bat during game & sustains injury to nose along w/ transient loss of
consciousness. A healthcare provider at the game notes bleeding from nose & displacement of septum.
What is the most important intervention at this time? - CORRECT ANSWER Immobilize the
child's head and call 911.
A Pt has nasal congestion, fever, purulent nasal d/c, HA, fever & pain and begins treatment with
Amox-Clav. At f/u 10-days later, Pt still has purulent d/c, congestion & pain but no fever. What is next
course of action? - CORRECT ANSWER 2nd course of Amox-Clav.
A Pt has recurrent epistaxis without signs of localized irritation. Which lab tests may be performed at
this time to evaluate his condition? - CORRECT ANSWER PT, PTT, PT/INR, CBC Platelets.
A 32-yr-old is newly dx DM, She has developed a sinus infection. She has had symptoms for 10 days.
6-weeks ago she got amoxicillin for URI. It was cleared up without incident. What's next? -
CORRECT ANSWER Prescribe Amoxicillin-Clavulanate today.
Swimmer's ear question on practice test - CORRECT ANSWER Prescribe Cipro HC
, A Pt reports severe episodes of vertigo with some lasting up to an hour, the episodes are associated
with nausea & vomiting. What is part of the initial diagnostic workup? - CORRECT
ANSWER Audiogram & MRI.
A Pt reports a feeling of fullness & pain in both ears & the practitioner elicits pain when manipulating
the external ear structures. What is likely diagnosis? - CORRECT ANSWER Acute otitis
externa.
During a routine physical exam a provider notes a shiny irregular painless lesion on top of one ear
auricle & suspects skin cancer. What will the the provider tell the patient about this lesion? -
CORRECT ANSWER A biopsy should be performed.
Which symptoms in children are evaluated using a parent-reported scoring system to determine the
severity of pain in children with otitis media? - CORRECT ANSWER Tugging on ears,
difficulty sleeping, and appetite.
A 70 year old male has a yellowish, triangular nodule near the iris this is probably a - CORRECT
ANSWER pinguecula.
A 20 year old make of hispanic descent who reports a history of cold that resolved 2 weeks ago except
for a dry cough and pain over right cheek that worsens when he bends down. The patient denies fever.
The Pt tells you he is very allergic to keflex, and erythromycin. VSS except temp is 99.2 F. -
CORRECT ANSWER Acute sinusitis.
During routine physical exam of an elderly woman, a triangular thickening of the bulbar conjunctiva
on the temporal side is noted to be encroaching on the cornea. She denies any eye pain or visual
changes. Which of the following is most likely? - CORRECT ANSWER Pterygium.
Previous quiz question about 32 diabetic patient w/ sinus infection. - CORRECT
ANSWER Prescribe Amoxicillin-Clavulanate today. Rationale: Amoxicillin is not indicated
when a beta-lactamase producing organism and suspected, this is the case as patient took antibiotics 6
weeks ago. Amoxicillin-clavulanate is a good choice as it covers a beta-lactamase producers. And
bacteria etiology is suspected as symptoms have persisted for 10 days. A decongestant can be added,
however this does not substitute antibiotics in this case
QUESTIONS AND CORRECT ANSWERS
A patient reports a sudden onset of sore throat, fever, malaise, and cough. The provider notes mild
erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most
likely cause of these symptoms? - CORRECT ANSWER Viral pharyngitis
What are factors associated with acute suppurative parotitis? (Select all that apply.) - CORRECT
ANSWER Anticholinergic medications
Diabetes mellitus
Group A strep pharyngitis: - CORRECT ANSWER Can be accompanied by abdominal pain
A 61 year old male presents with a 12 hour history of extremely painful left red eye. The patient
complains of blurred vision, halos around lights, and vomiting. It began yesterday evening. On exam,
the eye is red, tender and inflamed. The cornea is hazy and pupil reacts poorly to light. The most
likely diagnosis in this patient is: - CORRECT ANSWER Acute angle glaucoma
A patient has an initial episode otitis external associated with swimming. The patient's ear canal is
mildly inflamed and the tympanic membrane is not involved. Which medication will be ordered? -
CORRECT ANSWER Cipro HC
Which physical examination finding suggests viral rather than bacterial parotitis? - CORRECT
ANSWER Clear discharge from Stensen's duct
A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus
toward nose. Tearing is present and when pressure is applied to the lacrimal sac, purulent discharge
from the puncta is noted. This is suggestive of: - CORRECT ANSWER Dacryocystitis
Pt has painful oral lesions and the provider notes several white verrucous lesions in clusters
throughout the mouth. What is the recommended treatment for this? - CORRECT
ANSWER Surgical incision.
,A Pt is concerned about frequent nasal stuffiness and congestions that begins shortly after getting out
of bed in the morning. Pt denies itching, sneezing. A physical exam reveals erythematous nasal
mucosa with scant watery discharge. What treatment will the provider recommend? - CORRECT
ANSWER Daily intranasal steroid.
A pediatric Pt has otalgia, fever 38.8C & recent h/o of URI. The examiner is unable to visualize the
tympanic membrane in the Rt ear b/c of cerumen in the ear canal. The Lt ear tympanic is dull gray w/
fluid present. What is correct course of action? - CORRECT ANSWER Remove cerumen &
visualize tympanic membrane.
A 70 yr old male Pt c/o a bright red spot that has been present on his Lt eye for 2 days. He denies eye
pain, or visual changes or HA's. He has new onset of cough from recent UPR & he takes 1 ASA a day.
- CORRECT ANSWER Advise the Pt that the condition is benign and will resolve
spontaneously. This question was on both practice quizzes.
During an eye exam of 50-year-old with HTN, Pt c/o severe HA. The borders of the disc margins on
both eyes are blurred. What is the name of this clinical finding? - CORRECT
ANSWER Papilledema
Child is hit w/ baseball bat during game & sustains injury to nose along w/ transient loss of
consciousness. A healthcare provider at the game notes bleeding from nose & displacement of septum.
What is the most important intervention at this time? - CORRECT ANSWER Immobilize the
child's head and call 911.
A Pt has nasal congestion, fever, purulent nasal d/c, HA, fever & pain and begins treatment with
Amox-Clav. At f/u 10-days later, Pt still has purulent d/c, congestion & pain but no fever. What is next
course of action? - CORRECT ANSWER 2nd course of Amox-Clav.
A Pt has recurrent epistaxis without signs of localized irritation. Which lab tests may be performed at
this time to evaluate his condition? - CORRECT ANSWER PT, PTT, PT/INR, CBC Platelets.
A 32-yr-old is newly dx DM, She has developed a sinus infection. She has had symptoms for 10 days.
6-weeks ago she got amoxicillin for URI. It was cleared up without incident. What's next? -
CORRECT ANSWER Prescribe Amoxicillin-Clavulanate today.
Swimmer's ear question on practice test - CORRECT ANSWER Prescribe Cipro HC
, A Pt reports severe episodes of vertigo with some lasting up to an hour, the episodes are associated
with nausea & vomiting. What is part of the initial diagnostic workup? - CORRECT
ANSWER Audiogram & MRI.
A Pt reports a feeling of fullness & pain in both ears & the practitioner elicits pain when manipulating
the external ear structures. What is likely diagnosis? - CORRECT ANSWER Acute otitis
externa.
During a routine physical exam a provider notes a shiny irregular painless lesion on top of one ear
auricle & suspects skin cancer. What will the the provider tell the patient about this lesion? -
CORRECT ANSWER A biopsy should be performed.
Which symptoms in children are evaluated using a parent-reported scoring system to determine the
severity of pain in children with otitis media? - CORRECT ANSWER Tugging on ears,
difficulty sleeping, and appetite.
A 70 year old male has a yellowish, triangular nodule near the iris this is probably a - CORRECT
ANSWER pinguecula.
A 20 year old make of hispanic descent who reports a history of cold that resolved 2 weeks ago except
for a dry cough and pain over right cheek that worsens when he bends down. The patient denies fever.
The Pt tells you he is very allergic to keflex, and erythromycin. VSS except temp is 99.2 F. -
CORRECT ANSWER Acute sinusitis.
During routine physical exam of an elderly woman, a triangular thickening of the bulbar conjunctiva
on the temporal side is noted to be encroaching on the cornea. She denies any eye pain or visual
changes. Which of the following is most likely? - CORRECT ANSWER Pterygium.
Previous quiz question about 32 diabetic patient w/ sinus infection. - CORRECT
ANSWER Prescribe Amoxicillin-Clavulanate today. Rationale: Amoxicillin is not indicated
when a beta-lactamase producing organism and suspected, this is the case as patient took antibiotics 6
weeks ago. Amoxicillin-clavulanate is a good choice as it covers a beta-lactamase producers. And
bacteria etiology is suspected as symptoms have persisted for 10 days. A decongestant can be added,
however this does not substitute antibiotics in this case
