Deck 13: Ears, nose, mouth, and Throat

Question 1

Which paranasal sinus can be examined in the physical exam?

A) ethmoid
B) frontal
C) sphenoid
D) superior

Answer 1

frontal

Question 2

Which structure of the ear is responsible for balance and equilibrium?

A) cochlea
B) oval window
C) semicircular canals
D) round window

Answer 2

semicircular canals

Question 3

To perform the Weber test,you would first strike the tines of a 512 Hz tuning fork on the ulnar border of the palm of your hand and then place the stem firmly

A) against the middle of the forehead.
B) on the patient's jaw.
C) on top of the head over the right ear and then repeat over the left ear.
D) against the patient's right mastoid process.

Answer 3

against the middle of the forehead.

Question 4

A patient who is Native American comes to you complaining of left ear pain.He gives a history of frequent upper respiratory infections,smoking,and working construction in the cold weather.You suspect that he has

A) air bubbles behind his tympanic membrane.
B) spores in his external ear canal.
C) a foreign body in his ear.
D) otitis media.

Question 5

Which major pathogen is not a cause of acute otitis media?

A) Streptococcus pneumoniae
B) Moraxella catarrhalis
C) Candida albicans
D) Haemophilus influenzae

Question 6

To palpate a patient's frontal sinuses,you should gently apply pressure

A) over the infraorbital ridge with your thumb or middle finger.
B) over the bony ridge of the upper orbits with your thumbs.
C) under the bony ridge of the upper orbits with your thumbs.
D) under the infraorbital ridge with your thumb or middle finger.

Question 7

You observe a bony ridge in the midline of a patient's hard palate,which most likely indicates

A) a cancerous lesion.
B) changes due to syphilis.
C) torus palatinus, a benign condition.
D) Marfan's syndrome.

Question 8

The structures of the nose protect the lungs from noxious agents by doing all of the following,EXCEPT

A) filtering.
B) humidifying.
C) controlling temperature.
D) killing bacteria.

Question 9

A patient's breath smells of acetone,which most likely indicates which of the following?

A) diabetic ketoacidosis
B) fetor hepaticus
C) poor oral hygiene
D) uremia

Question 10

Vibrations of the tympanic membrane caused by sound waves traveling down the auditory canal are transmitted first to the

A) labyrinth.
B) malleus, incus, and stapes.
C) organ of Corti.
D) perilymph and endolymph.

Question 11

The nurse conducts an internal examination of a patient's nose.The examination reveals bilateral pale and edematous nasal mucus with clear,watery discharge.Which of the following do these findings most likely indicate?

A) an allergic response
B) nasal inhalation of cocaine or overuse of nasal spray
C) bacterial sinusitis
D) normal mucus with the presence of cerebrospinal fluid

Question 12

The results of a patient's Weber test indicate a conductive hearing loss in the right ear.This is based on a report of

A) hearing the sound equally in both ears.
B) hearing the sound louder in the left ear.
C) hearing the sound louder in the right ear.
D) not hearing the sound in either ear.

Question 13

To evaluate transillumination of a patient's maxillary sinuses,you would place a strong light source under each eye and then observe the red glow

A) in her ear canal.
B) in her nose.
C) on the hard palate in her mouth.
D) over her sinuses.

Question 14

Individuals who snort cocaine are likely to experience which problem?

A) cheilosis
B) nasopharyngeal cancer
C) perforation of the nasal septum
D) infection from herpes simplex virus I

Question 15

When the nurse inspects the gums of a patient who has periodontitis resulting from chronic gingivitis,the inspection would most likely reveal

A) brown coloration of the gums.
B) a grayish membrane over an inflamed and ulcerated area of the mucosa.
C) red gingival borders, receding gums, and purulent drainage.
D) blue lines approximately 1 mm from the gingival margin.

Question 16

A patient reports that her left lower molar is insensitive to cold foods and the tooth appears dark upon inspection.These findings most likely indicate

A) bruxism.
B) a dead tooth.
C) repetitive biting on hard substances.
D) dental caries.

Question 17

You would expect a patient who has normal hearing to report which of the following after a Rinne test?

A) hearing the sound longer through air conduction
B) hearing the sound longer through bone conduction
C) hearing the sound louder through bone conduction
D) hearing the sound through air and bone conduction for an equal period of time

Question 18

Flat-topped papules with thin,bluish white spider web lines resembling leukoplakia appearing on the buccal mucosa are

A) aphthous ulcers.
B) lichen planus.
C) normal findings.
D) xerostomia.

Question 19

Typical findings due to allergic reactions to medications or foods that affect the lips include

A) atrophic, irritated, and cracked skin at the outer corners of the mouth.
B) clusters of painful vesicles with serous fluid on the lips.
C) dry, cracked lips.
D) swollen lips.

Question 20

The submaxillary salivary glands secrete fluid

A) through the papillae of the mouth.
B) into the floor of the mouth posterior to Wharton's ducts.
C) through Stensen's ducts just opposite the upper second molars.
D) through Wharton's ducts on either side of the frenulum.

Question 21

When examining your patient's mouth and throat,you note a grayish membrane over the mucus membranes in the mouth and oropharynx.You hypothesize that this is an indication of which of the following?

A) herpes
B) tonsillitis
C) diphtheria
D) pharyngitis

Question 22

Which structures of the middle ear are involved in movement of the ossicles?

A) vestibule and stapedius
B) tensor tympani and stapedius
C) stapedius and eustachian tube
D) eustachian tube and tensor tympani

Question 23

When examining a patient's gums,the nurse would do which of the following? Select all that apply.

A) Instruct the patient to open the mouth.
B) Observe dentures or orthodontics for fit.
C) Remove any dentures or removable orthodontia.
D) Shine the penlight in the mouth.
E) Use the right index finger to move the tongue to visualize the gums.
F) Observe for redness, swelling, bleeding, retraction from the teeth, or
Discoloration.

Question 24

Thin,pearly white lesions that coalesce and are palpable on the sides of the tongue are characteristic of ____________________.

Question 25

The large parotid glands,located in the cheeks,secrete amylase-rich fluid through which of the following?

A) Wharton ducts
B) Stensen's ducts
C) Sulcus terminalis
D) Semicircular canals

Question 26

The tongue assists with which of the following? Select all that apply.

A) Speech
B) Breathing
C) Mastication
D) Swallowing
E) Taste sensation
F) Mechanical cleansing of the teeth

Question 27

You are conducting an auditory screening on your patients.Which of the following findings would require further exploration? Select all that apply.

A) During the voice-whisper test, the patient is unable to repeat the words correctly or states that he was unable to hear anything.
B) During the Rinne test, the patient reports hearing the sound longer through bone conduction; that is, bone conduction is equal to or greater than air conduction.
C) During the Weber test, the patient should perceive the sound equally in both ears or "in the middle."
D) During the Rinne test, bone conduction is prolonged in the context of a normal tympanic membrane, patent eustachian tube, and middle ear disease.
E) During the Weber test, the sound lateralizes to the affected ear.
F) During the Rinne test, air conduction is heard twice as long as bone conduction when the patient hears the sound through the external auditory canal (air) after it is no longer heard at the mastoid process (bone).

Question 28

The ossicles are three tiny bones: the malleus (hammer),the incus (anvil),
And the

A) ampule
B) stapes
C) labyrinth
D) tympanic membrane

Question 29

You observe redness,swelling,and narrowing of the external ear,which most likely indicate acute otitis ____________________.

Question 30

The nurse prepares to examine a young adult's tympanic membrane.To straighten the ear canal,in which direction should the pinna be pulled?

A) down and back
B) down and forward
C) up and forward
D) up and back

Question 31

Findings of a bright red pharynx with red,swollen tonsils,pillars,and uvula,as well as patches of white or yellow exudate on the tonsils are consistent with

A) diphtheria.
B) infectious mononucleosis.
C) streptococcal pharyngitis and tonsillitis.
D) the presence of a foreign body.

Question 32

To palpate and percuss the maxillary sinuses,the nurse would do which of the following? Select all that apply.

A) Stand in front of the patient.
B) Gently press the thumbs under the bony ridge of the upper orbits.
C) Avoid applying pressure on the globes themselves.
D) Observe for the presence of pain.
E) Percuss the area using the thumb.
F) Note the sound.

Question 33

Which portion of the ear has bony and membranous portions?

A) ossicles
B) labyrinth
C) tympanic cavity
D) tympanic membrane

Question 34

The nurse is performing an examination of a patient's ears.Which of the following findings needs immediate referral to a specialist?

A) purulent drainage from the ear
B) cerebrospinal fluid leaking from the ear
C) an ear that is permanently swollen and deformed resembling a "cauliflower"
D) pain or tenderness of the auricle of an ear

Question 35

The eustachian tubes are located in the ____________________ ear and equalize air pressure.

Question 36

The nurse is reviewing the normal limits of a hearing examination for a patient who presents with decreased hearing.Which of the following findings would indicate the need for additional investigation?

A) Bone conduction is heard twice as long as air conduction with the Rinne test.
B) The tympanic membrane observed with the otoscope is pearly gray.
C) Sound is heard equally in both ears with the Weber test.
D) Words whispered from a distance of 2 feet are repeated by the patient.

Question 37

What are the three tiny bones of the ossicles? Select all that apply.

A) Incus
B) Stapes
C) Stapedius
D) Malleus
E) Tensor tympani
F) Tympanic membrane

Question 38

The nurse is caring for a middle-aged man who complains of excessive daytime sleepiness.The nurse's examination reveals that the patient has large tonsils.He jokingly tells the nurse that his wife complains that he snores.The nurse hypothesizes that the patient has which of the following disorders?

A) deviated septum
B) obstructive sleep apnea
C) occlusion of the nostrils
D) upper respiratory infection