Quiz 4

Question 1

Which of the following findings in an older patient would be considered a normal process of aging?
  Narrowed palpebral fissures 
  Uneven movement of the tongue 
  Fibrosis of the thyroid gland 
  Pulsating fontanels

Answer 1

Fibrosis of the thyroid gland

Question 2

Which of the following findings suggests an inflammation of the thyroid gland?
Movement of the thyroid when the patient swallows
Swollen and red skin overlying the thyroid gland
Gritty sensation when the thyroid is palpated
Vertical ridges palpated on the thyroid

Answer 2

Gritty sensation when the thyroid is palpated

Question 3

The examiner screens a 5-year-old child for nystagmus by:
Palpating the globe while the child holds the eyelids closed
Inspecting the macula of the eye with an ophthlmoscope
Assessing visual acuity
Inspecting movement of the eyes to the six cardinal fields of gaze

Answer 3

Inspecting movement of the eyes to the six cardinal fields of gaze

Question 4

Which of the following correctly describes the method to assess accommodation?

Note constriction as gaze shifts from across the room to an object 6 inches away
Note ocular movement as patient follows an object through the six cardinal fields of gaze
Cover one eye of patient with card: then remove the card, noting any deviation from a fixed gaze
Shine a light into the pupil: note constriction

Answer 4

Note constriction as gaze shifts from across the room to an object 6 inches away

Question 5

To visualize the macula, the examiner should ask the patient to:
Look directly into the light of the ophthalmoschope
Lie in a supine position
Blink eye several times quickly
Direct his or her eye gaze on an object to the left and then to the right

Answer 5

Look directly into the light of the ophthalmoschope

Question 6

Which of the following is considered a routine part of a newborn examination?

Assessing red reflex
Visual acuity
Funduscopic examination
Assessing extraocular movements with six fields of gaze

Answer 6

Assessing red reflex

Question 7

Which of the following is the correct technique while performing an ophthalmoscopic examination? Examine the patient’s right:

Eye with your right eye, and the left eye with your left eye
And left eyes with your nondominant eye
And left eyes with your dominant eye
Eye with your left eye, and the left eye with your right eye

Answer 7

Eye with your right eye, and the left eye with your left eye

Question 8

A cobblestone appearance of the conjunctiva is most likely related to:
  Cytomegalovirus infection 
  Allergic or infectious conjunctivitis 
  Lagophthalmos 
  Subconjunctival hemorrhage

Answer 8

Allergic or infectious conjunctivitis

Question 9

When performing a Weber test, which of the following is considered a normal finding? The patient:
Hears the tone better in one ear than in the other
Is able to detect tones of varying frequencies and pitches from a tuning fork
Hears the tone equally in both ears
Hears sounds longer when conducted through air than when conducted through bone

Answer 9

Hears the tone equally in both ears

Question 10

Which of the following best explains why infants and toddlers are at greater risk for ear infections than are older children and adults?
Excess deposition of bone cells along the ossicle
Wider, shorter, and horizontal Eustachian tube
Poorly developed immune system
Immature tympanic membrane

Answer 10

Wider, shorter, and horizontal Eustachian tube

Question 11

Which of the following situations is an indication for transillumination?
The parotid gland is palpable and tender
The patient complains of epitaxis
The patient complains of pain over sinuses with palpitation
The patient has crepitus with jaw movement

Answer 11

The patient complains of pain over sinuses with palpitation

Question 12

Which of the following statements made by a parent should raise the examiner’s suspicion that the tympanic membrane of a young child as ruptured?
“My child’s earwax is dark brown.”
“She has been crying all night, but feels better this morning.”
“She has some bloody, yellowish-looking stuff coming out of her ear.”
“My child has a fever and earache.”

Answer 12

“She has some bloody, yellowish-looking stuff coming out of her ear.”

Question 13

Which of the following statements made by a 72-year-old patient would indicate a normal process of aging?
“Food does not have the same taste it used to.”
“My tongue feels swollen.”
“My tonsils are large and sore.”
“I have white and black spots under my tongue.”

Answer 13

“Food does not have the same taste it used to.”

Question 14

Chronic sniffling, nasal congestion, nosebleeds, mucosal scabs, and septum perforation are signs of:
  Fungal infection 
  Turbinate hypertrophy 
  Cocaine abuse 
  Chronic allergies

Answer 14

Cocaine abuse

Question 15

Using the tooth numbering system for an adult with 32 permanent teeth, which of the following sets of numbers will be associated with the 4 wisdom teeth?
  2, 10, 18, 32 
  1, 18, 19, 32 
  2, 16, 17, 32 
  1, 16, 17, 32

Answer 15

1, 16, 17, 32

Question 16

The NP has completed vision screens on the children who attend a daycare and preschool center. Which of the following children should be referred for further testing?
A 3 year old child (tested using the Allen chart) with the following results : right eye, 20/30; left eye , 20/30
A 4 year old child (tested using a Snellen E chart) with the following results right eye, 20/20; left eye , 20/30
A 4 year old child (tested using a HOTV chart) with the following results : right eye ,20/40; left eye , 20/40
A 3-year-old child (tested suing a Sjogren hand chart) with the following results: right eye 20/40; left eye, 20/20.

Answer 16

A 3-year-old child (tested suing a Sjogren hand chart) with the following results: right eye 20/40; left eye, 20/20.

Question 17

Primary teeth eruption for an infant usually begins between the ages of:
  8 and 10 months 
  6 and 8 months 
  10 and 12 months 
  12 and 14 months

Answer 17

6 and 8 months

Question 18

When examining the ears of an infant, the NP will see the ear structures better by pulling the auricle of the ear in which direction:

Downward and inward

Backward and upward

Backward and downward

Upward and inward

Answer 18

Backward and downward

Question 19

What items should be noted while examining the face of your client?
Skin color, type of make-up, length of eye lashes

Expression, contour, asymmetry, involuntary movements, edema and masses

Movement, facial droop and use of make-up

Expression, paralysis, bone structure, eye size

Answer 19

Expression, contour, asymmetry, involuntary movements, edema and masses

Question 20

The Snellen chart expresses vision as two number written as a fraction. What is the correct interpretation of 20/80?

20 is the distance in inches at which your eye can read the letters on the chart and 80 is how far in inches it would be if you had normal vision

20 is the distance in feet at which a normal eye can read that line on the eye chart and 80 is the patient’s distance from the eye chart in feet

20 is the patient’s distance from the eye chart in feet and 80 is the distance in feet at which a normal eye can read that line on the eye chart

Your patient has cataracts and needs lens implants immediately

Answer 20

20 is the patient’s distance from the eye chart in feet and 80 is the distance in feet at which a normal eye can read that line on the eye chart

Question 21

When inspecting the palpebral conjunctiva, the health care provider must:

Invert the upper eyelid
Examine the upper eyelid with a light while pulling upper eyelashes
Refer to an ophthalmologist for the exam
Avoid as it causes significant pain

Answer 21

Invert the upper eyelid

Question 22

Bulging of the physiologic cup could indicate:

Congenital Cataracts
Glaucoma due to normal aging
Elevated intracranial pressure caused by intra-cranial hemorrhage or mass
Hypertension controlled with medication

Answer 22

Elevated intracranial pressure caused by intra-cranial hemorrhage or mass

Question 23

Based on information from “Knee-to-knee oral exam” reading, when examining a child with concerns of dental carries (early childhood carries), you note that the following statements are true EXCEPT:

To look for soft whitish plaque, you should scrap the upper teeth with a hard metal object
The front surface of the lower front teeth are almost never affected by caries in young children
Lift the upper lip to examine mucosa and the maxillary anterior teeth
The primary teeth should be uniform in color and translucent

Answer 23

To look for soft whitish plaque, you should scrap the upper teeth with a hard metal object

Question 24

While assessing a patient who presents with ear pain, you consider that the ear pain could be as a result of the following EXCEPT:
  Tempomandibular joint 
  Swollen tongue 
  Tooth abscess 
  Swollen tonsils

Answer 24

Swollen tongue

Question 25

In order to obtain the maximum field of view when examining the ear, the examiner should:
Use the largest size speculum which fits in the patient’s ear canal
Use a lighted curette since everybody has wax in their ears.
Use the smallest size speculum which fits loose in the patient’s ear canal
Use a pen light as it is usually available and cheaper

Answer 25

Use the largest size speculum which fits in the patient’s ear canal