DNP Review- ENT questions with complete solutions
What are the 2 most common etiologic agents in ABRS (Acute Bacterial Rhino Sinusitis)?
1. S. pneumoniae and M. pneumoniae
2. S. pneumoniae and H. influenzae
3. S. aureus and S. pneumoniae
4. S. aureus and H. influenzae Correct Answer: 2. S. pneumoniae and H. influenzae
What assessment finding is most characteristic of ABRS (Acute Bacterial Rhino Sinusitis)?
1. Fever, sore throat, and purulent nasal discharge
2. URI symptoms lasting > 9 days or worsening after 5 days
3. Discolored nasal discharge and nasal congestion
4. Clear nasal discharge and frontal headache Correct Answer: 2. URI symptoms lasting > 9
days or worsening after 5 days
In a patient with ABRS (Acute Bacterial Rhino Sinusitis), the goal is to:
1. avoid environmental irritants
2. dry up the excessive mucus production with antihistamines
3. irrigation of sinuses to wash out bacteria and thickened secretions
4. promote drainage with decongestants or nasal irrigation Correct Answer: 4. promote drainage
with decongestants or nasal irrigation
What is considered first line therapy for a patient with acute sinusitis who is rarely ill?
1. amoxicillin
2. gatifloxacin
3. doxycycline
4. azithromycin Correct Answer: 1. amoxicillin
A patient who was p;laced on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis)
has no improvement after 3 days. What should the NP consider?
1. The patient obviously has a beta lactamase producing organism.
2. The dose of amoxicillin should now be increased.
3. A steroid injection should now be considered.
4. The patient may not have a bacterial infection. Correct Answer: 4. The patient may not have a
bacterial infection.
A patient who was placed on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis)
has no improvement after 3 days. If an antibiotic is considered for the above patient, what would
be a good choice?
1. Trimethoprim-sulfamethoxazole
2. Doxycycline
3. Amoxicillin/clavulanate
4. Clarithromycin Correct Answer: 3. Amoxicillin/clavulantate
,A patient is taking amoxicillin for acute sinusitis and has developed a pruritic full body rash.
What actions by the NP are appropriate?
1. Stop amoxicillin
2. Prescribe clarithromycin
3. Administer 1cc IM steroid
4. Prescribe Omnicef
A. 1, 2, 3
B. 1, 3, 4
C. 1, 3
D. 3, 4 Correct Answer: ? not 100% sure if this answer is correct...
A. 1, 2, and 3 (Stop amoxicillin, prescribeclarithromycin and administer 1cc IM steroid)
A patient with ABRS has had azithromycin in the past 4 weeks for treatment of sore throat. He is
PCN allergic. What antibiotic should be initiated?
1. Amoxicillin
2. Azithromycin
3. Doxycycline
4. Levofloxacin Correct Answer: 4. Levofloxacin
In addition to an antibiotic, a patient with ABRS (Acute Bacterial Rhino Sinusitis) should
receive a/an:
1. antihistamine
2. a topical nasal steroid
3. a decongestant
4. a mucolytic Correct Answer: 3. a decongestant
Which organism(s) can produce tonsillar exudate and or pustules?
1. Group A beta-hemolytic strep
2. Strep pyogenes
3. Viral pharyngitis
4. Neisseria gonorrhea
1. 1 only
2. 1 & 2
3. 1 & 3
4. All of the above Correct Answer: 4. All of the above
What are the 4 most important indicators of Strep throat? Correct Answer: 1. Tonsillar exudate
2. Anterior cervical adenopathy
3. Presense of a fever >102F
4. Absence of a cough
What is the drug of choice for a patient with Strep throat?
1. Doxycycline
2. Penicillin
, 3. Azithromycin
4. Trimethoprim-sulfamethoxazole Correct Answer: 2. Penicillin
Which choice below is absolutely contraindicated in a patient who has epiglottitis?
1. Oral meds
2. Thorough oral exam
3. Acidic fluids
4. Narcotic administration Correct Answer: 2. Thorough oral exam
A patient, who presents with abrupt onset of high fever, sore throat, and the "sniffing posture",
may have:
1. mononucleosis
2. epicglottitis
3. strep throat
4. ABRS Correct Answer: 2. epiglottitis (they can breathe better with a hyperextended neck)
A patient is diagnosed with epiglottitis. The most appropriate action for the NP is:
1. refer patient to MD
2. initiate antibiotic with beta-lactamase coverage
3. encourage fluids/antipyretics
4. refer to nearest ER facility Correct Answer: 4. refer to nearest ER facility
A college freshman is diagnosed with mononucleosis. What findings on assessment are seen
most often?
1. Pharyngitis, fever, and splenomegaly
2. Pharyngitis, adenopathy, and headache
3. Fever, adenopathy, and splenomegaly
4. Fever, fatigue, pharyngitis, lymphadenopathy Correct Answer: 4. Fever, fatigue, pharyngitis,
lymphadenopathy
(3F's/1L)
A patient has suspected mononucleosis. Which drug(s) should be avoided in her?
1. Aspirin and penicillin
2. Acetaminophen and doxycycline
3. Dilantin and azithromycin
4. Oral contraceptives Correct Answer: 1. Aspirin and penicillin
PCN avoided b/c ampicillin rash, Reye's syndrome (avoid ASA)
A patient presents with pale, boggy turbinates. What else would the NP expect to find?
1. Thick, green nasal discharge
2. Clear, thin, watery nasal secretions
3. Headache and fever
4. Periorbital swelling Correct Answer: 2. Clear, thin, watery nasal secretions (Allergic Rhinitis)
A rescue agent used to treat patients with allergic rhinitis is:
What are the 2 most common etiologic agents in ABRS (Acute Bacterial Rhino Sinusitis)?
1. S. pneumoniae and M. pneumoniae
2. S. pneumoniae and H. influenzae
3. S. aureus and S. pneumoniae
4. S. aureus and H. influenzae Correct Answer: 2. S. pneumoniae and H. influenzae
What assessment finding is most characteristic of ABRS (Acute Bacterial Rhino Sinusitis)?
1. Fever, sore throat, and purulent nasal discharge
2. URI symptoms lasting > 9 days or worsening after 5 days
3. Discolored nasal discharge and nasal congestion
4. Clear nasal discharge and frontal headache Correct Answer: 2. URI symptoms lasting > 9
days or worsening after 5 days
In a patient with ABRS (Acute Bacterial Rhino Sinusitis), the goal is to:
1. avoid environmental irritants
2. dry up the excessive mucus production with antihistamines
3. irrigation of sinuses to wash out bacteria and thickened secretions
4. promote drainage with decongestants or nasal irrigation Correct Answer: 4. promote drainage
with decongestants or nasal irrigation
What is considered first line therapy for a patient with acute sinusitis who is rarely ill?
1. amoxicillin
2. gatifloxacin
3. doxycycline
4. azithromycin Correct Answer: 1. amoxicillin
A patient who was p;laced on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis)
has no improvement after 3 days. What should the NP consider?
1. The patient obviously has a beta lactamase producing organism.
2. The dose of amoxicillin should now be increased.
3. A steroid injection should now be considered.
4. The patient may not have a bacterial infection. Correct Answer: 4. The patient may not have a
bacterial infection.
A patient who was placed on amoxicillin (4g/day) for ABRS (Acute Bacterial Rhino Sinusitis)
has no improvement after 3 days. If an antibiotic is considered for the above patient, what would
be a good choice?
1. Trimethoprim-sulfamethoxazole
2. Doxycycline
3. Amoxicillin/clavulanate
4. Clarithromycin Correct Answer: 3. Amoxicillin/clavulantate
,A patient is taking amoxicillin for acute sinusitis and has developed a pruritic full body rash.
What actions by the NP are appropriate?
1. Stop amoxicillin
2. Prescribe clarithromycin
3. Administer 1cc IM steroid
4. Prescribe Omnicef
A. 1, 2, 3
B. 1, 3, 4
C. 1, 3
D. 3, 4 Correct Answer: ? not 100% sure if this answer is correct...
A. 1, 2, and 3 (Stop amoxicillin, prescribeclarithromycin and administer 1cc IM steroid)
A patient with ABRS has had azithromycin in the past 4 weeks for treatment of sore throat. He is
PCN allergic. What antibiotic should be initiated?
1. Amoxicillin
2. Azithromycin
3. Doxycycline
4. Levofloxacin Correct Answer: 4. Levofloxacin
In addition to an antibiotic, a patient with ABRS (Acute Bacterial Rhino Sinusitis) should
receive a/an:
1. antihistamine
2. a topical nasal steroid
3. a decongestant
4. a mucolytic Correct Answer: 3. a decongestant
Which organism(s) can produce tonsillar exudate and or pustules?
1. Group A beta-hemolytic strep
2. Strep pyogenes
3. Viral pharyngitis
4. Neisseria gonorrhea
1. 1 only
2. 1 & 2
3. 1 & 3
4. All of the above Correct Answer: 4. All of the above
What are the 4 most important indicators of Strep throat? Correct Answer: 1. Tonsillar exudate
2. Anterior cervical adenopathy
3. Presense of a fever >102F
4. Absence of a cough
What is the drug of choice for a patient with Strep throat?
1. Doxycycline
2. Penicillin
, 3. Azithromycin
4. Trimethoprim-sulfamethoxazole Correct Answer: 2. Penicillin
Which choice below is absolutely contraindicated in a patient who has epiglottitis?
1. Oral meds
2. Thorough oral exam
3. Acidic fluids
4. Narcotic administration Correct Answer: 2. Thorough oral exam
A patient, who presents with abrupt onset of high fever, sore throat, and the "sniffing posture",
may have:
1. mononucleosis
2. epicglottitis
3. strep throat
4. ABRS Correct Answer: 2. epiglottitis (they can breathe better with a hyperextended neck)
A patient is diagnosed with epiglottitis. The most appropriate action for the NP is:
1. refer patient to MD
2. initiate antibiotic with beta-lactamase coverage
3. encourage fluids/antipyretics
4. refer to nearest ER facility Correct Answer: 4. refer to nearest ER facility
A college freshman is diagnosed with mononucleosis. What findings on assessment are seen
most often?
1. Pharyngitis, fever, and splenomegaly
2. Pharyngitis, adenopathy, and headache
3. Fever, adenopathy, and splenomegaly
4. Fever, fatigue, pharyngitis, lymphadenopathy Correct Answer: 4. Fever, fatigue, pharyngitis,
lymphadenopathy
(3F's/1L)
A patient has suspected mononucleosis. Which drug(s) should be avoided in her?
1. Aspirin and penicillin
2. Acetaminophen and doxycycline
3. Dilantin and azithromycin
4. Oral contraceptives Correct Answer: 1. Aspirin and penicillin
PCN avoided b/c ampicillin rash, Reye's syndrome (avoid ASA)
A patient presents with pale, boggy turbinates. What else would the NP expect to find?
1. Thick, green nasal discharge
2. Clear, thin, watery nasal secretions
3. Headache and fever
4. Periorbital swelling Correct Answer: 2. Clear, thin, watery nasal secretions (Allergic Rhinitis)
A rescue agent used to treat patients with allergic rhinitis is:
