NR 569 Final Study Guide: (Latest 2026/2027 Update) ENT,
Musculoskeletal, Eye, Differential Diagnosis | Q&A | Grade A | 100%
Correct (Verified Answers)
ADVANCED PRACTICE CLINICAL REVIEW | FINAL STUDY GUIDE
SUBJECT SOURCE
Family Medicine - ENT, Ophthalmology, NR 569 Final Study Guide 2026/2027
Orthopedics, Differential Diagnosis
Q1
What are red flag symptoms in eye differential diagnosis?
A Severe pain, decreased vision, foreign body sensation, photophobia
B Mild itching, watery discharge, occasional redness
C Crusting around eyelids only
D Burning sensation without vision changes
CORRECT ANSWER A. Severe pain, decreased vision, foreign body sensation, photophobia
CLINICAL RATIONALE
Red flags in eye exam: sudden vision loss, severe pain, photophobia, foreign body sensation, and new-
onset flashes/floaters. These require immediate ophthalmology referral to rule out angle-closure
glaucoma, uveitis, keratitis, or retinal detachment.
,Q2
What is the hallmark symptom of allergic conjunctivitis?
A Purulent discharge and crusting
B Itching (most consistent sign; also red eyes, sneezing, allergic history)
C Watery discharge with preauricular lymphadenopathy
D Photophobia and severe pain
CORRECT ANSWER B. Itching (most consistent sign; also red eyes, sneezing, allergic history)
CLINICAL RATIONALE
Allergic conjunctivitis affects up to 40% of the population. Itching is the pathognomonic feature.
Associated with other allergic disease symptoms (rhinitis, asthma, eczema). Treatment: antihistamines,
mast cell stabilizers, artificial tears.
Q3
What is the most common cause of infectious conjunctivitis?
A Bacterial (purulent discharge)
B Viral (watery discharge, most common cause of infectious conjunctivitis)
C Fungal
D Parasitic
CORRECT ANSWER B. Viral (watery discharge, most common cause of infectious
conjunctivitis)
CLINICAL RATIONALE
Viral conjunctivitis (adenovirus most common) presents with watery discharge, preauricular
lymphadenopathy, and is highly contagious. Bacterial conjunctivitis has purulent/mucopurulent
discharge. Antibiotics not indicated for viral cause.
, Q4
What is the hallmark physical exam finding in otitis externa (swimmer's ear)?
A Pain on manipulation of the pinna or tragus
B Bulging tympanic membrane with decreased mobility
C Conductive hearing loss only
D Purulent drainage without ear pain
CORRECT ANSWER A. Pain on manipulation of the pinna or tragus
CLINICAL RATIONALE
Otitis externa (OE) is inflammation of the external auditory canal. Pain with pinna/tragus manipulation is
pathognomonic. Causes: excess moisture (swimmer's ear), trauma, dermatitis. 90% bacterial
(Pseudomonas, S. aureus), 10% fungal.
Q5
When should acute mastoiditis be suspected?
A When discharge from middle ear is continuous for >10 days despite appropriate antibiotics
B When ear pain resolves with OTC analgesics
C With isolated hearing loss without fever
D With allergic rhinitis symptoms only
CORRECT ANSWER A. When discharge from middle ear is continuous for >10 days despite
appropriate antibiotics
CLINICAL RATIONALE
Acute mastoiditis presents with same signs as AOM plus postauricular erythema, swelling, tenderness,
and protrusion of auricle. TM is red, bulging, immobile. Requires IV antibiotics and possible surgical
drainage.
Musculoskeletal, Eye, Differential Diagnosis | Q&A | Grade A | 100%
Correct (Verified Answers)
ADVANCED PRACTICE CLINICAL REVIEW | FINAL STUDY GUIDE
SUBJECT SOURCE
Family Medicine - ENT, Ophthalmology, NR 569 Final Study Guide 2026/2027
Orthopedics, Differential Diagnosis
Q1
What are red flag symptoms in eye differential diagnosis?
A Severe pain, decreased vision, foreign body sensation, photophobia
B Mild itching, watery discharge, occasional redness
C Crusting around eyelids only
D Burning sensation without vision changes
CORRECT ANSWER A. Severe pain, decreased vision, foreign body sensation, photophobia
CLINICAL RATIONALE
Red flags in eye exam: sudden vision loss, severe pain, photophobia, foreign body sensation, and new-
onset flashes/floaters. These require immediate ophthalmology referral to rule out angle-closure
glaucoma, uveitis, keratitis, or retinal detachment.
,Q2
What is the hallmark symptom of allergic conjunctivitis?
A Purulent discharge and crusting
B Itching (most consistent sign; also red eyes, sneezing, allergic history)
C Watery discharge with preauricular lymphadenopathy
D Photophobia and severe pain
CORRECT ANSWER B. Itching (most consistent sign; also red eyes, sneezing, allergic history)
CLINICAL RATIONALE
Allergic conjunctivitis affects up to 40% of the population. Itching is the pathognomonic feature.
Associated with other allergic disease symptoms (rhinitis, asthma, eczema). Treatment: antihistamines,
mast cell stabilizers, artificial tears.
Q3
What is the most common cause of infectious conjunctivitis?
A Bacterial (purulent discharge)
B Viral (watery discharge, most common cause of infectious conjunctivitis)
C Fungal
D Parasitic
CORRECT ANSWER B. Viral (watery discharge, most common cause of infectious
conjunctivitis)
CLINICAL RATIONALE
Viral conjunctivitis (adenovirus most common) presents with watery discharge, preauricular
lymphadenopathy, and is highly contagious. Bacterial conjunctivitis has purulent/mucopurulent
discharge. Antibiotics not indicated for viral cause.
, Q4
What is the hallmark physical exam finding in otitis externa (swimmer's ear)?
A Pain on manipulation of the pinna or tragus
B Bulging tympanic membrane with decreased mobility
C Conductive hearing loss only
D Purulent drainage without ear pain
CORRECT ANSWER A. Pain on manipulation of the pinna or tragus
CLINICAL RATIONALE
Otitis externa (OE) is inflammation of the external auditory canal. Pain with pinna/tragus manipulation is
pathognomonic. Causes: excess moisture (swimmer's ear), trauma, dermatitis. 90% bacterial
(Pseudomonas, S. aureus), 10% fungal.
Q5
When should acute mastoiditis be suspected?
A When discharge from middle ear is continuous for >10 days despite appropriate antibiotics
B When ear pain resolves with OTC analgesics
C With isolated hearing loss without fever
D With allergic rhinitis symptoms only
CORRECT ANSWER A. When discharge from middle ear is continuous for >10 days despite
appropriate antibiotics
CLINICAL RATIONALE
Acute mastoiditis presents with same signs as AOM plus postauricular erythema, swelling, tenderness,
and protrusion of auricle. TM is red, bulging, immobile. Requires IV antibiotics and possible surgical
drainage.
