Question 1

Which of the following best explains why overuse of topical nasal decongestants can worsen symptoms in patients with rhinitis?

Accepted Answer

They cause rebound nasal congestion due to downregulation of alpha-adrenergic receptors.

Question 2

A patient presents with facial pain, purulent nasal discharge, and a fever of 39°C for 12 days. Which of the following is the most likely diagnosis?

Accepted Answer

Acute bacterial rhinosinusitis

Question 3

Which of the following medications is most appropriate for initial symptomatic relief of sneezing and rhinorrhea in allergic rhinitis?

Accepted Answer

Antihistamines

Question 4

A 45-year-old male with obesity and hypertension reports loud snoring, daytime sleepiness, and his partner notes he stops breathing during sleep. What is the most definitive diagnostic test for his suspected condition?

Accepted Answer

Polysomnography (sleep study)

Question 5

Which of the following is a key patient education point to prevent recurrence of epistaxis after an acute episode?

Accepted Answer

Avoid forceful nose blowing and keep nasal passages humidified.

Question 6

A patient with chronic rhinosinusitis is prescribed a 4-week course of antibiotics. Which of the following additional interventions is most likely to improve outcomes?

Accepted Answer

Daily use of saline nasal sprays

Question 7

Which of the following is NOT a recommended self-care measure for patients with viral rhinitis?

Accepted Answer

Use of antibiotics to shorten illness duration

Question 8

A patient with a history of allergic rhinitis presents with persistent nasal congestion and anosmia. Which of the following is the most likely complication?

Accepted Answer

Development of nasal polyps

Question 9

Which of the following is the primary rationale for avoiding antibiotics in the treatment of viral rhinitis?

Accepted Answer

Antibiotics do not affect viruses and contribute to antibiotic resistance.

Question 10

A patient with a total laryngectomy is being discharged. Which of the following instructions is most important to prevent respiratory complications?

Accepted Answer

Use a loose-fitting protective cover over the stoma.

Question 11

Which of the following is a significant risk factor for laryngeal cancer according to the American Cancer Society?

Accepted Answer

Tobacco use (smoked or smokeless)

Question 12

A patient with acute pharyngitis has a rapid antigen detection test (RADT) that is negative. What is the next best step?

Accepted Answer

Confirm the result with a throat culture.

Question 13

Which of the following best describes the pathophysiology of obstructive sleep apnea (OSA)?

Accepted Answer

Repetitive upper airway obstruction during sleep causes hypoxia and hypercapnia.

Question 14

A patient with a history of recurrent acute rhinosinusitis is at increased risk for which of the following complications if left untreated?

Accepted Answer

Brain abscess

Question 15

Which of the following is the most appropriate first-line antibiotic for acute bacterial rhinosinusitis in a patient without a penicillin allergy?

Accepted Answer

Amoxicillin or amoxicillin–clavulanic acid

Question 16

A patient with chronic rhinosinusitis reports persistent cough, mouth breathing, and decreased sense of smell. Which of the following is the most likely underlying mechanism?

Accepted Answer

Mechanical obstruction of sinus ostia preventing drainage

Question 17

Which of the following is a recommended intervention for a patient experiencing an acute episode of epistaxis?

Accepted Answer

Sit upright, tilt the head forward, and apply pressure to the soft outer portion of the nose.

Question 18

A patient with a history of allergic rhinitis is prescribed cromolyn nasal spray. What is the primary mechanism of action of this medication?

Accepted Answer

Inhibits histamine release from mast cells

Question 19

Which of the following is a classic triad for diagnosing obstructive sleep apnea (OSA)?

Accepted Answer

Snoring, sleepiness, significant other report of apnea episodes

Question 20

A patient with laryngeal cancer is scheduled for a total laryngectomy. Which of the following is a key aspect of preoperative patient education?

Accepted Answer

Breathing will occur through a permanent opening in the neck (stoma).

Chapter 18: Management of Patients with Upper Respiratory Tract Disorders

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