Richard’s symptoms are consistent with allergy rhinitis. An allergic reaction is triggered by environmental triggers, such as dust, pollen or pet hair. These symptoms include nasal congestion and sneezing. They may also cause rhinorrhea or postnasal discharge.
Richard touching his bridge of the nose during his exam and complaining of minimal improvements after taking Mucinex indicates that his nasal symptoms bother him and are impacting on his quality of living. This is further supported by the pale nasal mucosa, with thin clear secretions. The enlarged nasal turbinates also support an allergic rhinitis diagnosis.
The lungs of this patient are completely clear. This suggests that his symptoms only affect his upper respiratory tract.
On the basis of this examination, you may want to suggest that Richard undergo further testing and evaluation for allergic rhinitis. This could include allergy tests or nasal corticosteroid treatment. It may also be beneficial to advise him on how to avoid any environmental triggers which could be aggravating his symptoms.