Deck 13: Ears, Nose, and Throat

Question 1

Which signs and symptoms occur with a sensorineural hearing loss? (Select all that apply.)

A) Air conduction shorter than bone conduction
B) Lateralization to the affected ear
C) Loss of high-frequency sounds
D) Speaks more loudly
E) Disorder of the inner ear
F) Air conduction longer than bone conduction

Answer 1

Loss of high-frequency sounds
Speaks more loudly
Disorder of the inner ear
Air conduction longer than bone conduction

Question 2

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.

Answer 2

bluish gray turbinates.

Question 3

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.

Answer 3

performed at the end of the examination.

Question 4

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 5

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 6

Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which are changes in hearing that occur in older adults? (Select all that apply.)

A) Results from cranial nerve VII
B) Slow progression
C) Loss of high frequency
D) Bone conduction heard longer than air conduction
E) Sounds may be garbled, difficult to localize
F) Unable to hear in a crowded room

Question 7

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 8

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.

Question 9

Speech with a monotonous tone and erratic volume may indicate:

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

Question 10

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 11

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 12

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 13

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 14

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 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

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

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

Question 17

Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with healthcare 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 18

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 19

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 20

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 21

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