Question 1

Which of the following statements is true regarding tympanic membrane temperature?
A)It is taken by placing an infrared probe anterior to the ear.
B)The probe is placed in the external auditory canal to occlude it.
C)Temperatures taken with a tympanic thermometer never vary from those taken by the oral or rectal route.
D)It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus.
E)It is taken by placing an infrared probe posterior to the ear.

Accepted Answer

The tympanic membrane shares its blood supply with the hypothalamus and is therefore an accurate measurement of body temperature. Tympanic thermometer probes are gently placed at the external opening of the ear canal, but not in the canal, and they should not occlude the canal.

Question 2

A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?
A)Strabismoscope
B)Red-free filter
C)Slit lamp
D)Small aperture
E)Grid

Accepted Answer

The red-free filter permits recognition of hemorrhages. The grid estimates the size of lesions, the slit lamp examines the anterior eye and assesses the elevation of lesions, and the small aperture is used with small pupils. The strabismoscope is used for detecting strabismus.

Question 3

A rubber or plastic ring should be around the bell endpiece of a stethoscope to
A)prevent the transmission of static electricity.
B)avoid cold metal from touching the patient.
C)prevent the sharp edge of the stethoscope from damaging the patient's skin.
D)allow firm pressure to be applied without discomfort.
E)ensure secure contact with the body surface.

Accepted Answer

The ring around the bell portion of the stethoscope functions to secure contact with body surfaces when placed lightly on the skin.

Question 4

The Tumbling "E" vision acuity chart would most likely be used for _____ patients.
A)older
B)infant
C)pregnant
D)preschool
E)color-blind adult

Accepted Answer

The E chart is used for children 3 to 5 years of age and others who do not know the alphabet. The examinee is asked which way the "E" points.

Question 5

The stethoscope's diaphragm is most useful in the assessment of _____ sounds.
A)high-pitched
B)dull
C)low-pitched
D)rhythmic
E)tympanic

Accepted Answer

The diaphragm is best for hearing high-pitched sounds, such as breath sounds, bowel sounds, and normal heart tones.

Question 6

Which technique should be used to stabilize the stethoscope during auscultation?
A)The tubing should be held lightly near the endpiece.
B)The tubing should be held firmly near the endpiece.
C)The endpiece should be held between the second and third fingers.
D)The endpiece should be covered with the examiner's flattened hand.
E)The endpiece should be held with all the examiner's fingers.

Accepted Answer

To stabilize the stethoscope at the desired location, the endpiece should be held in place with the second and third fingers.

Question 7

When examining the abdomen, which technique should be used first?
A)Inspection
B)Light palpation
C)Percussion
D)Auscultation
E)Direct palpation

Accepted Answer

Inspection is always used as the first technique in all physical examinations, including the abdomen.

Question 8

A scale used to assess a patient's weight should be calibrated
A)when the patient tells you the weight is not correct.
B)by a qualified technician at regularly scheduled intervals.
C)each time it is used.
D)when necessary, with the patient standing on the scale.
E)only by the manufacturer.

Accepted Answer

Obtaining weight begins with a manual calibration of the scale before the patient stands on the scale. Electronic scales are automatically calibrated before each reading.

Question 9

Auscultation should be carried out last except when examining
A)the neck area.
B)the abdomen.
C)the lungs.
D)the heart.
E)none of the above; auscultation is always carried out last in a proper physical examination.

Accepted Answer

Auscultation is the last examination technique used for all areas except the abdomen. In this case, it is performed after inspection.

Question 10

The pneumatic attachment for the otoscope is used to evaluate
A)ear canal patency.
B)eardrum landmarks.
C)hearing acuity.
D)tympanic membrane movement.
E)tympanic membrane temperature.

Accepted Answer

The pneumatic attachment on the otoscope produces a puff or air to the tympanic membrane, resulting in its movement.

Question 11

The patient tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using a(n)
A)nasal speculum.
B)neurologic hammer.
C)otoscope with pneumatic attachment.
D)tympanometer.
E)tuning fork.

Accepted Answer

This patient is describing eustachian tube dysfunction. The tympanometer measures compliance of the middle ear as air pressures are varied. It is an objective means of assessing the function of the ossicular chain, eustachian tube, and tympanic membrane.

Question 12

Which of the following occurs when firm pressure is used to apply the stethoscope's bell endpiece to the skin?
A)It transmits low-pitched sounds.
B)It functionally converts to a diaphragm endpiece.
C)Assessment findings are more accurate.
D)Most sounds are occluded.
E)Abnormally low sounds are better transmitted.

Accepted Answer

Applying firm pressure to the bell endpiece causes the skin to act as a diaphragm, obliterating the low-pitched sounds.

Question 13

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure
A)vibratory sensations.
B)hearing from bone conduction.
C)hearing range of normal speech.
D)noise above the threshold level.
E)peripheral motor nerve damage.

Accepted Answer

Normal speech has a range of 300 to 3000 Hz; therefore, a 500- to 1000-Hz fork is used most often because it can estimate hearing loss in the range of normal speech.

Question 14

You are using an ophthalmoscope to examine a patient's inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for
A)amblyopia.
B)astigmatism.
C)cataracts.
D)strabismus.
E)myopia.

Accepted Answer

Rotating the lens selector compensates for myopia (nearsightedness) and hyperopia (farsightedness) in the examiner and the patient.

Question 15

Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope?
A)Diaphragm end of an acoustic stethoscope
B)Electronic
C)Ultrasonic
D)Magnetic
E)Bell end of an acoustic stethoscope

Accepted Answer

Only the ultrasonic stethoscope, the Doppler, can detect blood flow rather than amplify sounds, which is needed in assessing weak pulses, fetal heart activity, and vessel patency.

Question 16

An infant should be placed in which position to have his or her height or length measured?
A)Vertical, with the examiner's hands under the infant's axilla
B)Supine on a measuring board
C)While being held by a parent
D)In the lateral position with the toes against a measuring board
E)Prone on a measuring board

Accepted Answer

An infant should be placed supine on a measuring board to measure height or length.

Question 17

During auscultation, you can limit your perceptual field best by
A)asking patients to describe their symptoms.
B)listening through the patient's clothing.
C)closing your eyes.
D)performing palpation before percussion.
E)turning out the lights in the examination room.

Accepted Answer

By closing your eyes, your sense of hearing becomes more acute, increasing your ability to isolate sounds.

Question 18

The height-measuring attachment of the standing platform scale should be pulled out
A)before the patient steps on the scale.
B)before the scale is balanced.
C)after the patient steps on the scale.
D)while the weight is being determined.
E)only after the weight has been assessed.

Accepted Answer

To ensure patient safety, the arm of the height measuring attachment should be pulled up before the patient steps on the scale.

Question 19

You are auscultating a patient's chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?
A)Anticipate the next sounds.
B)Isolate each cycle segment.
C)Listen to all sounds together.
D)Move the stethoscope clockwise.
E)Ask the patient to whisper his or her name.

Accepted Answer

If you are hearing everything at once, it is more difficult to distinguish different sounds. Try isolating each segment and listen to that segment intently; then move on to another segment. For example, listen only to breath sounds, then only to inspiratory breath sounds, and then only to expiratory breath sounds.

Question 20

Which type of speculum should be used to examine a patient's tympanic membrane?
A)The smallest speculum that will illuminate the ear
B)The largest speculum that will fit comfortably in the ear
C)The shortest speculum available
D)Any speculum that will fit the otoscope head
E)The longest speculum available

Accepted Answer

To visualize the tympanic membrane adequately, the largest speculum that can comfortably fit in the car canal should be used. The other choices do not ensure greater visibility of the membrane and landmarks.

Quiz 3: Examination Techniques and Equipment

Which of the following statements is true regarding tympanic membrane temperature?

A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

A rubber or plastic ring should be around the bell endpiece of a stethoscope to

The Tumbling "E" vision acuity chart would most likely be used for _____ patients.

The stethoscope's diaphragm is most useful in the assessment of _____ sounds.

Which technique should be used to stabilize the stethoscope during auscultation?

When examining the abdomen, which technique should be used first?

A scale used to assess a patient's weight should be calibrated

Auscultation should be carried out last except when examining

The pneumatic attachment for the otoscope is used to evaluate

The patient tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using a(n)

Which of the following occurs when firm pressure is used to apply the stethoscope's bell endpiece to the skin?

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure

You are using an ophthalmoscope to examine a patient's inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for

Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope?

An infant should be placed in which position to have his or her height or length measured?

During auscultation, you can limit your perceptual field best by

The height-measuring attachment of the standing platform scale should be pulled out

You are auscultating a patient's chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

Which type of speculum should be used to examine a patient's tympanic membrane?