Deck 12: Ears, Nose, and Throat

Question 1

The middle ear contains the:

A) cerumen and sebaceous glands.
B) umbo and malleus.
C) vestibule and cochlea.
D) pars tensa and semicircular canals.

Answer 1

umbo and malleus.

Question 2

During which developmental stage are hoarseness, voice cracking, and a persistent cough common findings in females?

A) Adolescence
B) Infancy
C) Menopause
D) Pregnancy

Answer 2

Pregnancy

Question 3

A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the:

A) sphenoid and frontal sinuses.
B) maxillary and frontal sinuses.
C) maxillary sinuses only.
D) sphenoid sinuses only.

Answer 3

maxillary sinuses only.

Question 4

Hearing tends to decline after 50 years of age because of deterioration of:

A) hair cells of the organ of Corti.
B) the eustachian tube.
C) the helix.
D) cerumen.

Question 5

The middle ear is normally filled with:

A) air.
B) blood.
C) serous fluid.
D) cerebrospinal fluid.

Question 6

Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant's middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:

A) pull the auricle down and back.
B) hold the speculum in the canal.
C) distract the infant.
D) stabilize the chest.

Question 7

Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning?

A) Eustachian tube
B) Inner ear
C) Pars flaccida
D) Triangular fossa

Question 8

Mr. Spencer presents with the complaint of hearing loss. You specifically inquire about current medications. Which medications, if listed, are likely to contribute to his hearing loss?

A) Chlorothiazide
B) Acetaminophen
C) Salicylates
D) Cephalosporins

Question 9

An infant's auditory canal, compared with an adult's, is:

A) short, narrow, and straight.
B) short and curved upward.
C) long, narrow, and curved forward.
D) short and curved downward.

Question 10

Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with health care information, you will explain that she can expect to experience:

A) more nasal stuffiness.
B) a sensitive sense of smell.
C) drooling.
D) enhanced hearing.

Question 11

The organ of Corti is a coiled structure located inside the:

A) cochlea in the inner ear.
B) pars flaccida in the tympanic membrane.
C) eustachian tube.
D) lateral aspect of the pinna.

Question 12

Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which of the following recreational drugs is commonly associated with nasal septum perforation?

A) Heroin
B) Cocaine
C) PCP
D) Ecstasy

Question 13

You are using a pneumatic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to:

A) remove all cerumen from the canal.
B) change to a larger speculum.
C) squeeze the bulb with more force.
D) insert the speculum to a depth of 2 cm.

Question 14

A 6-month-old who can hear well can be expected to:

A) exhibit the Moro reflex.
B) stop breathing in response to sudden noise.
C) turn his or her head toward the source of sound.
D) imitate simple words.

Question 15

To approximate vocal frequencies, which tuning fork should be used to assess hearing?

A) 100 to 300 Hz
B) 200 to 400 Hz
C) 500 to 1000 Hz
D) 1500 to 2000 Hz

Question 16

The eruption of permanent teeth usually begins with:

A) upper central incisors.
B) upper canines.
C) lower central incisors.
D) lower canines.

Question 17

Which risk factor is associated with the highest rate of oral cancers?

A) Women
B) Being younger than 55 years
C) excessive caffeine use
D) Fanconi anemia

Question 18

The hair cells of Corti and membrane of Corti:

A) produce a waxy lubricant.
B) protect the ear from foreign particles.
C) stimulate the eighth cranial nerve.
D) transmit vibrations to the ossicles.

Question 19

You are performing hearing screening tests. Who would be expected to find difficulty in hearing the highest frequencies?

A) A 7-year-old
B) An 18-year-old
C) A 30-year-old
D) A 50-year-old

Question 20

Mr. Williams, age 25 years, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented in which section of his history?

A) Age-specific data
B) Past medical data
C) Past surgical data
D) Social history

Question 21

A newborn whose serum bilirubin level is greater than 20 mg/100 mL has a risk of later:

A) hearing loss.
B) sinusitis.
C) tooth decay.
D) meningitis.

Question 22

Speech with a monotonous tone and erratic volume may indicate:

A) otitis externa.
B) hearing loss.
C) serous otitis media.
D) sinusitis.

Question 23

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:

A) Fordyce spots.
B) aphthous ulcers.
C) Stensen ducts.
D) leukoedema.

Question 24

Severe vertigo, tinnitus, and progressive hearing loss are characteristic of:

A) cholesteatoma.
B) Ménière disease.
C) otosclerosis.
D) cocaine abuse.

Question 25

When hearing is evaluated, which cranial nerve is being tested?

A) III
B) IV
C) VIII
D) XII

Question 26

Which abnormality is common during pregnancy?

A) Eruption of additional molars
B) Hypertrophy of the gums
C) Otitis externa
D) Otitis media

Question 27

A hairy tongue with yellowish brown to black elongated papillae on the dorsum:

A) is indicative of oral cancer.
B) is sometimes seen following antibiotic therapy.
C) usually indicates vitamin deficiency.
D) usually indicates anemia.

Question 28

Which variation may be an expected finding in the ear examination of a newborn?

A) Diffuse light reflex
B) Purulent material in the ear canal
C) Redness and swelling of the mastoid process
D) Small perforations of the tympanic membrane

Question 29

You are interviewing a parent whose child has a fever, is pulling at her right ear, and is irritable. You ask the parent about the child's appetite and find that the child has a decreased appetite. This additional finding is more suggestive of:

A) acute otitis media.
B) otitis externa.
C) serous otitis media.
D) middle ear effusion.

Question 30

For best results, an otoscopic and oral examination in a child should be:

A) conducted at the beginning of the assessment.
B) done after inspection.
C) performed at the end of the examination.
D) performed before palpation.

Question 31

Bulging of an amber tympanic membrane without mobility is usually associated with:

A) middle ear effusion.
B) healed tympanic membrane perforation.
C) impacted cerumen in the canal.
D) repeated and prolonged crying cycles.

Question 32

A smooth red tongue with a slick appearance may indicate:

A) niacin or vitamin B₁₂ deficiency.
B) oral cancer.
C) recent use of antibiotics.
D) fungal infection.

Question 33

Placing the base of a vibrating tuning fork on the midline vertex of the patient's head is a test for:

A) air conduction of sound.
B) bone versus air conduction.
C) lateralization of sound.
D) mallear auditory ability.

Question 34

To inspect the lateral borders of the tongue, you should:

A) ask the patient to extend the tongue outward.
B) insert the tongue blade obliquely against the tongue.
C) lift the tongue upward with gloved fingers.
D) pull the gauze-wrapped tongue to each side.

Question 35

Nasal symptoms that imply an allergic response include:

A) purulent nasal drainage.
B) bluish gray turbinates.
C) small, atrophied nasal membranes.
D) firm consistency of turbinates.

Question 36

An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or:

A) digestive disorders.
B) skeletal anomalies.
C) renal disorders.
D) heart defects.

Question 37

Normal tympanic membrane color is:

A) amber.
B) chalky white.
C) green.
D) pearly gray.

Question 38

You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, air conduction-to-bone conduction ratio is less than 2:1. You interpret these findings as suggestive of:

A) a defect in the inner ear.
B) a defect in the middle ear.
C) otitis externa.
D) impacted cerumen.

Question 39

When conducting an adult otoscopic examination, you should:

A) position the patient's head leaning toward you.
B) grasp the handle of the otoscope as you would a baseball bat.
C) select the largest speculum that will fit in the canal.
D) ask the patient to keep his or her eyes closed.

Question 40

To perform the Rinne test, place the tuning fork on the:

A) top of the head.
B) mastoid bone.
C) forehead.
D) preauricular area.

Question 41

In adults, the length of the external auditory canal is ____ cm.

Question 42

Expected physical changes associated with older adults include:

A) shiny buccal mucosa.
B) shorter teeth.
C) wetter nasal mucosa.
D) bristly hairs in the vestibule.

Question 43

When you ask the patient to identify smells, you are assessing cranial nerve __.

Question 44

The structures that lie along the lateral wall of the nasal cavity near the facial cheek are the __________ sinuses.

Question 45

Intense pain with movement of the pinna is most closely associated with:

A) otitis media with effusion.
B) otitis externa.
C) purulent otitis media.
D) bacterial otitis media.