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Lifespan > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

What structures are in the inner ear?

A

Vestibule and semicircular canals
Cochlea

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2
Q

What structures are the external ear?

A

Auricle or pinna
External auditory canal
Tympanic membrane

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3
Q

What structures in the middle ear?

A

Malleus, incus, stapes
Eustachian tube
Functions

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4
Q

What separates the external ear and the middle ear?

A

Tympanic membrane

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5
Q

T/F the Eustachian tube is usually closed but opens during swallowing and yawning.

A

True

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6
Q

What is the function of Eustachian Tube.

A

Equalizes pressure

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7
Q

What are the pathways of hearing?

A

Air conduction- transmits vibrations to signals
Bone conduction- bones vibrate and then sends signals to inner ear by CN8

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8
Q

Conductive hearing loss is what.

A

Mechanical hearing loss- partial loss. Pt can hear if volume is turned up
I.e. ear wax, perforated tympanic membrane, otosclorosis

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9
Q

T/F virdigo can cause hearing loss

A

True

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10
Q

The otoscopic examination, what are we looking for?

A

Color, characteristics, position (They ate at 5, and left at 7), integrity of membrane

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11
Q

What tests should we be conducting to test hearing acuity?

A

Conversational speech
Voice test (whisper 3 numbers and letters, correct repitition of 4/6 numbers of numbers)
Tuning fork test

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12
Q

Why are children more susceptible to ear infections?

A

Shorter, wider, and more horizontal

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13
Q

At what age do we stop pulling a child’s ear back and down, and pull them up and back?

A

At age 3

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14
Q

What is dysphasia

A

Trouble swallowing

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15
Q

What are the grades of the tonsils?

A

0-tonsils are not visible
1+ tonsils are visible
2+ tonsils are halfway between pillars and uvula
3+ touching the uvula
4+ are touching each other

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16
Q

What cranial nerves is gagging test?

A

Glossopharyngeal nerve and vagus nerve

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17
Q

What is palatosis

A

Mouth odor

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18
Q

A nurse is preparing to inspect the outer ears of a client who has been in a crash. The nurse should identify that which of the following findings indicate the client might have a skill fracture?
Edema around the ear
Watery, clear drainage
Yellow drainage
Crusted skin

A

Watery, clear drainage

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19
Q

A nurse is admitting a client who has had a stroke. Which of the following actions should the nurse take?
A. Keep the beside table at the end of the bed
B. Place a towel on the bathroom floor.
C. Raise the four side rails of the bed
D. Keep the bed in the lowest position

A

D

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20
Q

A nurse is assessing a client’s mouth. The nurse should identify that which of the following is an expected finding?
A. Yellowing of the hard palate
B. Red spots on the hard palate
C. White patches on the tongue
D. Large vein on the ventral surface of the tongue

A

D

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21
Q

A nurse is assessing the mouth of a client with candidiasis, and oral fungal infection. Which of the following findings should the nurse expect?
A. Overgrowth of gum tissue
B. Beefy red tongue
C. Petachiae on hard palate
D. White patches on the tongue

A

D

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22
Q

A nurse is performing a head and neck assessment on a client. After checking the vision, the nurse notes the client has difficulty reading fine print. In which of the following sections of the client’s electronic health record should the nurse document this findings?
A. Vital signs.
B review of systems
C. Allergies and home medications.
D. Patient information

A

B

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23
Q

A nurse is assessing the mouth of a client has a Vit b12 insufficiency. Which of the following finding should the nurse expect?
A. White patches on the tongue
B. Bleeding of the gums
C. Beefy red tongue
D. Petechiae of the hard palate

A

C

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24
Q

What is the sequence of taking the following actions.
A. Instruct the client to look upwards
B. Gently pull the client’s skin down to the top edge of the orbital rim
C. Apply examination gloves.
D place the thumbs below reach of the client’s lower eye lids
E. Inspect the color and condition of the conjunctiva and sclera, noting any color change, swelling, drainage, or lesions

A

C, A, D, B, E

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24
Q

Identify the sequence the nurse should take.
A. Firmly press upward on the ridge and make sure not the apply pressure to the client’s eyes.
B. Ask the client if they detect tenderness or pain
C. Position the thumbs on the Supra orbital ridge just below the eyebrows to assess the client’s frontal sinus
D. Position the thumbs below the client’s cheekbones with fingers alongside the client’s head to assess the client’s maxillary sinuses
E. Apply firm, upward pressure and ask the client if they detect tenderness or pain.

A

C, A, B, D E

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25
Q

A nurse is inspecting the sinuses of a client who has allergies. Which of the following findings should the nurse expect?
A. Pale mucosa
B. Bright red mucosa
C. Green discharge
D. Yellow discharge

A

A

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26
Q

A nurse is performing a head and neck assessment on a client. The client reports a high -pitched ringing in their ears. Which of the following terms should the nurse use when documenting?
A. Tinnitus
B. Strabismus
C. Bell’s Palsy
D. Hirsutism

A

A

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27
Q

A nurse is assessing a client who has a lump on their neck. Which of the following questions should the nurse ask the client. Select all that apply
A. Are you having difficulty swallowing?
B. How long has the lump been on your neck?
C. Is the lump causing you discomfort?
D. Are you experiencing difficulty breathing?
E. Have you started taking a new medication?

A

A, B, C, D

E is not correct because the beginning of a new medication, an allergic reaction would cause the throat to swell, anaphylaxis.

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28
Q

A nurse is caring for a client with suspected stroke. Which of the following actions should the nurse take?
A. Assess muscle strength
B. Obtain vital signs
C. Assess orientation
D. Assess for strabismus
E. Make the client NPO

A

A, B, C, E

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29
Q

Which of the following questions should the nurse ask the client in order to obtain a focused health history of the ear?
A. Do you have problems with nasal drainage? sata
B. Have you had a trouble hearing?
C. Do you ever lose your balance?
D. Do you have ringing in your ears?
E. Have you ever used a hearing aid?

A

B, C, D, E

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30
Q

Which of the following should the nurse identify as an unexpected finding?
A. A lesion on the scalp
B. Edema around the eyes
C. Protrusions on the head
D. Oval white patches on the hair
E. Protrusions on the mastoid bone

A

A, B, C, D

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31
Q

A nurse is assessing the eye of a client who has experienced a subconjunctival hemorrhage as a result of vomiting. Which of the following findings should the nurse expect?
A defined reddened area of the sclera
B. Drooping in the eyelid
C. Cloudy pupil
D. Bulging eyes

A

A

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31
Q

A nurse is preparing to assess the eyes of a client who has liver disease. Which of the following findings should the nurse expect?
A. Ptosis of the eyelid
B. Yellow sclera
C. Edema of the eyelids.
D. Reddened conjunctiva

A

Yellow sclera

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32
Q

A nurse is performing an eye assessment on a client. Which of the following should the nurse identify as the cornea of the eye?
A. Outer layer of the eyeball
B. Mucous membrane that lines the eyeball
C. Transparent layer that covers the iris and pupil
D. Colored portion in the center of the eye.

A

C

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33
Q

What is strabismus?

A

Strabismus is a misalignment of the axes of the eyes.

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34
Q

What is Hirsutism?

A

Hirsutism is the presence of coarse facial hair on a female client, indicating a hormonal or endocrine disorder.

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34
Q

What is bell’s palsy

A

Bell’s palsy is weakness of the facial muscles causing asymmetry of facial features

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35
Q

A nurse is assessing a clients wrist and hands. Which of the following findings indicates the client might have arthritis?
select all that apply
A. A large mound below the thumb
B. Slight extension of the wrist
C. Fingers deviate toward the ulnar
D. Nodules on the joints
E. Fingers are linear in shape

A

C, D

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36
Q

A nurse is providing teaching to client about adequate daily intake of Vitamin D. Which of the following intake amounts should the nurse recommend.
A. 500 IU
B. 800 IU
C 1500 IU
D. 1800 IU

A

B

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37
Q

A nurse is caring for a client with a traumatic injury to a lower extremity. Which of the following actions should the nurse take.
A. Apply heat therapy after the first 24 hours following the injury.
B. Place an ice pack directly on the injured area.
C. Apply compression to the injured area of the extremity
D. Encourage the client to use the extremity as much as possible.

A

C

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38
Q

A nurse is assessing a client’s head and neck. Which of the following findings should the nurse report to the provider.
A. Prominent C-7 vertebra
B. Clicking the temporomadibular joint
C. Firm neck muscles
D. Locking of the jaw joint

A

D

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39
Q

Place the following in the correct order.
A. Assist the client into a sitting position with their legs dangling at the edge of the table
B. Follow the lower edge of the patella and locate the tibiofemoral joint.
C. Palpate the hollows on either side of the patella with the thumbs
D. Palpate the tibiofemoral joint where the femur and tibia meet.
E. Palpate the quadriceps muscle above the knee

A

A, E, C, B, D

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40
Q

Place the following in the correct order.
A. Face the client and palpate along the clavicle
B. Palpate the greater tubercle of the humerus from the back.
C. Face the client and palpate the acromioclavicular joint
D. Palpate the scapula from the back

A

A, C, D, B

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41
Q

A nurse is recommending sources of food rich in calcium. Which of the foods should the nurse recommend. Select all that apply
A. Apples
B. Milk
C. Broccoli
D. Legumes
E. Corn

A

B, C, D

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42
Q

A nurse is performing ROM exercises on a client’s hip. The nurse assesses which of the following motions by instructing the client to bend the knee and bring it up towards the chest.
A. External rotation of the hip
B. Abduction of the hip
C. Flexion of the hip
D. Hypertension of the hip

A

C

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43
Q

A nurse is performing musculoskeletal and neurological assessment. Which of the following actions should the nurse take.
A. Perform the asssessment from the toes to the head
B. Assess the extremities from distal to proximal
C. Perform passive ROM before active ROM movements.
D. Inspect both sides of the body for symmetry

A

D

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44
Q

A nurse is assessing the ROM of a clients hands. Which of the following instructions should the nurse provide to assess abduction and abduction of the client’s fingers.
A. Spread your fingers apart and then move them back together.
B. Make a fist and then straighten your fingers
C. Bend your thumb in towards the palm of the hand and then move it back out.
D. Bend your thumb to though the tip of each finger

A

A

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45
Q

What is flexion of the elbow?

A

Start with your arms straight out in front of you. Then bend your elbows up and bring your fingers toward your shoulders.

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46
Q

The nurse is preparing to perform a neurological assessment on the client. The nurse should use a ______ and _____ when performing the assessment.

A

Pen lights, and cotton ball

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47
Q

A nurse is assessing a client’s spinal ROM. Which of the following motions is the nurse assessing by asking the client to bend backwards as far as they can go?
A. Flexion
B. Rotation
C. Lateral flexion
D. Hyperextension

A

D

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48
Q

A nurse is assessing the spine of a client. Which of the following findings requires further investigation?
A. The clients spinous process protrudes
B the spine is concave a the cervical and lumbar areas.
C. The spine is convex at the thoracic area.
D. The client walks with a shuffling gait.

A

D

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49
Q

Which of the following statements by the client requires further questioning by the nurse.
A. The bruise on my leg is from running into the base of a chair
B. I’m sleeping better since I gave up caffeine in the afternoon
C. For some reason, I have been falling recently
D. I no longer have back pain since I started walking 2 miles every day

A

C

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50
Q

The nurse should provide which of the following instructions to the client to assess plantar flexion of the feet.
A. Point your toes toward the floor.
B. Turn the soles of your feet out, away from the body
C. Point your toes up, toward your nose
D. Turn the bottoms of your feet in, toward the midline

A

A

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51
Q

What is kyphosis?

A

Kyphosis is an exaggerated posterior curvature of the thoracic spine.

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52
Q

Which of the following instructions should the nurse provide to assess hyperextension?
A. Turn your head from side to side and look back over your shoulders.
B. Bend your neck to the side and bring your ear close to your shoulder
C. Lower your chin to your chest and raise it back up
D. Tilt your head back and look up at the ceiling

A

D

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53
Q

Define bursa.

A

Enclosed fluid filled sac that serves as a cushion

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54
Q

What is crepidation

A

Crackling in joins

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55
Q

How much does skeletal muscle account for in the body weight

A

40-50%

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56
Q

Define tendon.

A

Strong fibrous cord connecting muscle to bone

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57
Q

Define cartilage

A

Hard rigid and very dense connective tissue

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58
Q

Define ligament

A

Fibrous bands running directly from one bone to another strengthening the joint

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59
Q

Define joint

A

The place of union of two or more bones

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60
Q

What does musculoskeletal system do

A

Support
Movement
Protection (encase organs)
Produce (red and white blood cells and platelets)
Storage (storing essential minerals)

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61
Q

What kind of joints Do not Move

A

Fibrous—skull sutures

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62
Q

What kind of joints slightly move

A

Cartilaginous —vertebrae

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63
Q

What is an example of a synovial joint

A

Knee

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64
Q

What is the description of muscle ROM grading system?

A

5- full ROM against gravity;full resistance
4- full ROM against gravity, some resistance
3-Full ROM with gravity
2-Full ROM and passive motion
1- slight contraction
0- no contraction

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65
Q

When are growth plates fully gone?

A

20 years

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66
Q

What questions do you ask the parent of infants and Children when assessing developmental competence?

A

Any trauma during birth? Forceps? Resuscitation?
Hitting motor milestones?
Involved in sports?

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67
Q

T/F a single palmar crease could be a sign of genetic disorder

A

True, could be

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68
Q

What age could a child lift their head independently

A

2 months

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69
Q

T/F does sclerosis indicate hair on the spine as a child?

A

False, spinal bifida can be indicated with hair patches and dimpling on the back

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70
Q

When do arches form in children?

A

3 years
Children are flat footed until about 3 years

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71
Q

What is the get up and go test? What are they at a risk of if they do not pass?

A

Sit on a chair, get up, walk, and sit down.
If they do not pass in the 12 second range, they are at a greater risk of falling.

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72
Q

What does tobacco use on bone density?

A

Lower bone density

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73
Q

Does the body make its own calcium?

A

No, it has to be ingested

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74
Q

What is the optimal exercise plan

A

5 days a week, 30 minutes a day

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75
Q

What medication is risky for fall risk patients?

A

Beta blockers
A

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76
Q

When assessing a muscle group what are you looking for?

A

Swelling, shape, size, contour

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77
Q

How do we know the nervous system is working effectively

A

You can control movement, feel pain, reaction to stimuli, reflexes

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78
Q

What are the parts of the CNS

A

Brain and Spinal cord

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79
Q

What are the parts of the peripheral nervous system?

A

Cranial nerves, Spinal nerves, all branches

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80
Q

What is wernicke’s area responsible for

A

Language compensation

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81
Q

What does the hypothalamus responsible for

A

Control respiratory system

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82
Q

From top to bottom, name the structures of the brain stem

A

Corpus callosum
Thalamus
Hypothalamus
Pituitary
Midbrain
Pons
Medulla oblangata

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83
Q

What is Broca’s area responsible for and what cortex is it in?

A

Broca’s area is responsible for motor speech and is in the frontal lobe

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84
Q

What is the frontal lobe responsible for?

A

Personality, behavior, emotion, intellectual functions

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85
Q

What is the parietal lobe responsible for?

A

Sensation

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86
Q

What is the occipital lobe responsible for>

A

Visual reception

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87
Q

What is the cerebellum responsible for?

A

Motor coordination, equilibrium, balance

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88
Q

Name the cranial nerves and their type (mix, sensory, motor)

A
  1. Olfactory —sensory
  2. Optic—sensory
  3. Oculomotor—motor
  4. Trochlear —-motor
  5. Trigeminal—both
    6 abducens —-motor
    7 Facial —both
    8 vestibulocochlear—sensory
    9 glossopharyngeal—both
    10 vagus—both
    11 accessory—motor
    12 hypoglossal—motor
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89
Q

What are the regions of the spine

A

8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

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90
Q

At birth what do we expect of the developmental competence

A

Alert
Eyes open
Strong sucking
Cry is loud
Sleeping a lot

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91
Q

What is rooting

A

A baby’s head turns towards the finger you touch the cheek
3-4 months

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92
Q

When does babinski’s reflex go away

A

24 months

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93
Q

What are the main cranial bones

A

Frontal bone, parietal bone, temporal bone, occipital bone

94
Q

What is the suture that connects the parietal bone to the temporal bone?

A

Lamboid suture

95
Q

What is the suture that connects the frontal bone to the parietal bone?

A

Coronal suture

96
Q

What is the suture that connects the R and L parietal bones

A

Sagittal

97
Q

What are the names of the C1 and C2 vertebrae.

A

C1- Atlas
C2- Axis

98
Q

From ear to chin, name the lymph nodes along the jaw.

A

Parotid gland, submandiular gland, sublingual gland

99
Q

On an infant, what are the names of the fontanels? And where are they?

A

Anterior fontanels- between the frontal bone and the parietal bone
Posterior fontanel- between the occipital and the parietal bone
Sphenoid fontanel- the corner of frontal bone, parietal bone, and temporal bone

100
Q

In what order do we palpate lymph nodes of the head and neck.

A

Pre-auricular
Posterior auricular
Occipital
Cubmental
Submandibular
Jugular-digastric
Superficial cervical
Deep cervical chain
Posterior cervical
Supraclavicular

101
Q

How does a nurse assess the thyroid gland

A

Palpate the thyroid from behind the client and ask them to swallow

102
Q

What are the 4 sinuses in the head

A

Frontal sinus, ethmoid sinuses, maxillary sinus, sphenoid

103
Q

What muscles does the cranial nerve XI, spinal accessory, intervate?

A

Sternomastoid and trapezius

104
Q

At what age does a child’s head reach 90% of its final size?

A

6 years old

105
Q

Where are the common tension headaches?

A

Occipital, frontal, or with band like tightness

106
Q

Where are migraines usually occur?

A

Supraorbital, retro-orbital, frontotemporal; sinus headaches produce pain around the eye or cheek

107
Q

What is unique about cluster headaches?

A

They a re always unilateral, on one side of the head

108
Q

How do you test for fine movement skills

A

Touch each finger with thumb
Assess smoothness of transition

109
Q

How do assess the olfactory nerve

A

Plug each nostril, assess smelling ability

110
Q

How do you assess the accessory cranial nerve

A

Shoulder shrug
Push back resistance of the head turn

111
Q

How do you assess the hypoglossal cranial nerve`

A

LTD test. Pronouncing precisely

112
Q

What is the confrontation test?

A

Peripheral test
They say stop when they see your fingers

113
Q

What is the diagnostic positions test

A

Also known as the cardinal test
3 sides of each side
Must follow all 6 positions with their eyes

114
Q

How do you test for visual acuity

A

SNELLEN

115
Q

What is PERRLA

A

Pupils are equal, round, and reactive to light briskly

116
Q

What is the difference between succedaneum and cephalhematoma

A

Caput succedaneum edematus swelling (birth trauma)
Cephalhematoma-subperiostal hemorrhage (birth trauma)

117
Q

What is tonic neck reflex in the infant

A

The neck is turned to one side when in supine position

118
Q

Where would you search the isthmus of the thyroid gland on a pregnant woman?

A

Below the mandible

119
Q

What findings would you expect for cluster headaches

A

They tend to be supraorbital, retro-orbital or frontotemporal

120
Q

A newborn has soft, fluctuating swelling just over one cranial bone. What is your next action?

A

Inform the parents that this will go away over the next few weeks. Request an order for blood results to screen for possible jaundice

121
Q

You are testing active ROM. When turning his head to right and left, he turns more at his shoulders than his neck. What is your next most appropriate action.
A. Palpate his shoulders for any pain or tenderness
B direct him to bend over and touch his toes for ROM of spine
C continue with the exam, this is a common finding in older adults
D refer him to an orthopedic specialist

A

C

122
Q

You palpate the anterior fontanel on a 6 month old, you note it feels about 2 cm wide and dips inward. What is the next action

A

Move on with the examination; the data is expected.

123
Q

What lymph node is deep under the sternomastoid muscle

A

Deep cervical

124
Q

What lymph node is in the posterior triangle along the edge of the pezius muscle?

A

Posterior cervical

125
Q

What lymph node is superficial to the mastoid process

A

Posterior auricular

126
Q

What lymph node is halfway between the angle and the tip of the dibble

A

Submandibular

127
Q

What lymph node is behind the tip of the mandible?
What lymph node is under the angle of the mandible?

A

Submental
Jugulodigastric

128
Q

What lymph node is overlying the sternomastoid muscle

A

Superficial cervical

129
Q

What is accommodation with the eye

A

Adaptation of the eye for near vision

130
Q

What is conjunctivitis

A

Red beefy looking vessels from viral and bacterial infections

131
Q

What is subconjunctival hemorrhage

A

Red patch on the sclera. Occurs from increased ocular pressure

132
Q

What is iritis

A

Deep dull red halo around iris cornea. Constricted pupil blurred throbbing pain

133
Q

What is glaucoma

A

Redness around iris, dialed and oval pupil, steamy cornea

134
Q

A 78 year old gardener reports blurry vision existing for about 5 to 6 years. Her pupils look milky. What is the most appropriate response?
A. Does your blurry vision affect you daily activities
B continue with the health history, this is expected with aging
C do object appear out of focus
D I am going to refer you to our ED now, so that a specialist will check your eyes

A

A and C

135
Q

You are doing a diagnostic position test, you observe a back and forth movement of the iris when he looks to the extreme side. Your best action would be to
A. Proceed with the exam, this is a normal finding
B inquire about the amount of daily alcohol drinking
C ask about dizziness when changing positions, as this eye movement is associated with inflammation of the semicircular canals in the ears.
D refer to a physician, as this eye movement associated with MS

A

A

136
Q

You are inspecting the conjunctiva and sclera of a 53 yo black woman. Which of the findings below are abnormal and worthy of referral (SATA)
A overall reddening of the blood vessels on sclera of one eye but clearer near the iris
B a gray blue or middy color of the sclera
C an even yellow color of both sclera, extending up to the iris
D a small brown macule on the sclera that the person says has always been there.

A

A and C

137
Q

During an examination of a 60
yo women, the red reflex is interrupted and appears with a black center. This finding is associated with
A an opacity in the cornea or lens
B a pathologic disease in the optic tract
C tortuous and crossing blood vessels in the ocular fundus
D constricted pupils

A

A

138
Q

During the opthalmoscopic exam, the mechanisms causing the red reflex is
A petechial hemorrhages in the sclera
B diabetic retinopathy
C light reflecting from the retina
D blood in the vitreous humor

A

C

139
Q

You plan to assess the pupillary light reflex on a hospitalized 20 yo soccer player suspected of concussion. What is your next actions
A ask the person to stare in to the distance behind you
B advance your penlight in from the front to test both pupil responses
C use a pupil gauge to assess the findings in mm
D refer unequal pupil response to the physician

A

A C and D

140
Q

You are assessing infants during screening examination in a pediatric outpatient clinic. You are alert for the following attending behaviors that suggest the infant can receive visual images and indeed see
A at 2 to 4 weeks of age, the infant can fixate on an object
B at 6 weeks of age, the infant can make some visual response to your face.
C at 6 to 10 months of age, the infant can fixate at a toy and follow it as you move it in all directions.
D at 12 months of age, the infant refuses to reopen eyes for about 20 seconds after exposure to your penlight

A

A B C

141
Q

Which of the following of a 4 yo are abnormal responses and indicate a referral to an eye specialist?
A unable to read letters on the snellen alphabet chart
B during the corneal light reflex, the reflected light in the left eye is off center but the reflected light in the right eye is centered on the pupil
C during the cover test, one eye jumps in gaze following removal of the opaque card.
D the child has an extra fold of skin at the epicanthus of both eyes.

A

B and C

142
Q

19 yo has a tissue pressed to his eye. A yellow raised pustule in in the upper eye lid margin, it has a small red area around it and is extremely painful. He sclera are white and vision is normal. What is your next actions
A inspect the other eye for a similar lesion
B request prescriptions for antibiotic drops
C instruct the man this will resolve on its own, no treatment
D instruct the an to avoid touching both eyes with the same tissue
D refer the man to the ED of the hospital

A

A B and D

143
Q

Which are abnormal vision findings of a 65 year old.
A the tissue of the upper eyelid is relaxed and rests close to the upper eyelashes
B bulging exists on the tissue of the lower eyelids
C an opaque wedge-shaped tissue is present on the sclera and continues over the cornea
D a gray white circle is present around the cornea on the iris
E yellow papules are present on the upper lids near the inner canthus
F pupils are small with a resting size of 2 mm
G during the ophthalmoscope exam, a black spot is present in the red reflex

A

C and g

144
Q

Which of the following eye disorders prompt urgent referral to an ED
A sudden acute loss of vision in one eye
B obvious trauma to the eyeball
C unequal resting pupil size of 1-2mm, both constrict to light
D diagnosis of herpes zoster infection on the face
E one unequal pupil is dilated, distorted in shape, with redness around iris

A

A b d e

145
Q

What are 3 functions of the. Middle ear?

A

Conduct sound vibrations
Protect inner ear
Equalization of air pressure

146
Q

What are the different kinds of hearing loss and give examples

A

Conductive-mechanical dysfunction
Sensorineural- loss in pathology
Mixed- both

147
Q

You are assessing hearing acuity using the whispered voice test on a 74 yo, she is able to repeat 2 of the 6 numbers/letters you present. What is your next action?
A consider a high tone hearing sensorineural loss and refer for audiology
B assume this is an expected response to aging and proceed with exam
C inspect the ear canal for foreign bodies
D inquire id the woman experienced recent head trauma

A

A

148
Q

You are assessing a person’s tympanic membrane and the findings suggest an infection of acute otitis media. Which of the following findings support this?
A absent light reflex, blusih drum, oval dark areas
B absent light reflex, reddened drum, buldging drum
C avail dark areas on drum
D absent light reflex, air fluid level, and bubbles behind drum

A

B

149
Q

You are preparing to examine a person’s ear with the otoscope. Your correct action would be to palpate which areas for tenderness?
A helix, external auditory meats, and lobule.
B mastoid process, tympanic membrane, and malleus
C pinna, pars flaccida, and antitragus
D pinna, tragus, and mastoid process

A

D

150
Q

Is a more white and more opaque eardrum a normal finding of age? T/F

A

T

151
Q

What are 4 of the functions of the nose?

A

Of action
Respiration
Warming air
Humidifaction and filtering

152
Q

Where do 80% to 90% of nose bleeds occur?
A the turbinates
B the columellae
C kiesselbach plexus
D the meatus

A

C

153
Q

During an inspection of a patients nares, you observe a deviated septum. What is our next most appropriate action?
A request a consultation
B proceed with exam, this not significant unless airflow is obstructed
C teach the person what to do if a nosebleed occurs
D explore further because polyps frequently accompany a deviated septum

A

B

154
Q

What are the characteristics of a polyp (SATA)
A the polyp is highly vascular
B the polyp is movable
C the polyp is pale gray in color
D the polyp is nontender

A

B C D

155
Q

When assessing the tongue, your best technique includes..
A palpating the U shaped area under the tongue
B checking tongue color for cyanosis
C using tongue blade to elevate the tongue while placing a finger under the jaw
D asking the person to say ahhh and note the tongue rise in the midline

A

A

156
Q

Are Epstein pears, small round white shinny papules on hard palate and gums, a normal finding of a 2 month old?

A

Yes

157
Q

What is contracture

A

Shortening of muscle=limited ROM

158
Q

What is ankylosis?

A

Stiffness or fixation

159
Q

What is a normal spinal curvature
A posterior curve of lumbar
B c shaped curvature of spine
C lateral s shaped curve develops
D anterior curve in lumbar
E anterior curve in C-spine
F spinal curvature disappears

A

B D E

160
Q

You are assessing a pt with a suspected rotator cuff tear. What assessment findings do you expect if the rotator cuff is torn? SATA
A upright positioning
B hunched position
C limited adduction
D atrophy of shoulder girdle
E fluctuating to palpation
F limited abduction
G positive arm drop test

A

B f g

161
Q

During a neurologist exam, you place a key in the person’s hand with their eyes closed and ask them what it is? This is measuring what ability
A sterognosis
B graphesthesia
C two point discrimination
D kinesthesia

A

A

162
Q

Ring an exam, you ask the person to stand with feet together, arms at sides, eye closed, and hole. This text demonstrates intactness of..
A cerebral cortex
B cerebral medulla
C motor system
D cerebellum

A

D

163
Q

Body temperature is controlled by…
A wernicke’s area
B thalamus
C cerebellum
D hypothalamus

A

D

164
Q

What test tests olfactory

A

Ask the pt to smell

165
Q

What test tests the optic nerve

A

Ask the pt to read

166
Q

What test tests the oculomotor

A

Pen light far to near

167
Q

What test tests the trochlear nerve

A

Eye following down and out

168
Q

What test test the trigeminal nerve

A

Blink reflex
Sensation dull/sharp

169
Q

What test tests abducens nerve

A

6 cardinal fields

170
Q

What nerve tests facial nerve

A

Smile, raise eyebrows, frown puff cheeks

171
Q

What test tests vestibulocochlear

A

Whisper test
Gait/balance

172
Q

What test tests glossopharyngeal

A

Gag reflex

173
Q

What test tests vagus nerve

A

Speaking
Swallowing

174
Q

What test tests the accessory nerve

A

Shrugging shoulders

175
Q

What test test hypoglossal nerve

A

Protrude tongue side to side
LTD

176
Q

What is the purpose of the ortolani maneuver in infants?
A to assess for hip dislocation or subluxation
B to evaluate for scoliosis
C to measure leg length discrepancies
D to check for flat feet

A

A. To assess for hip dislocation or subluxation

177
Q

How is the Allis Test performed?
A) By measuring the distance between the knees while standing
B) By flexing the infant’s knees and hips and observing knee height
C) By pressing on the infant’s hip joints and feeling for clunks
D) By having the infant walk and checking gait

A

B) By flexing the infant’s knees and hips and observing knee height

178
Q

What might an abnormal finding in the palmar creases of an infant indicate?
A) Developmental dysplasia of the hip
B) Down syndrome or other developmental disorders
C) Genu Varum or Genu Valgum
D) Flatfoot or pes planus

A

B) Down syndrome or other developmental disorders

179
Q

Genu Varum is characterized by:
A) Outward angulation of the knees
B) Inward angulation of the knees
C) Flat feet
D) Excessive arch in the feet

A

A) Outward angulation of the knees

180
Q

What is the primary assessment for flatfoot in preschool and school-aged children?
A) Observing the alignment of the knees
B) Checking for arch presence while standing and walking
C) Measuring the length of the legs
D) Evaluating the range of motion in the ankles

A

B) Checking for arch presence while standing and walking

181
Q

What is lordosis and how does it typically change during pregnancy?
A) Increased curvature of the lumbar spine, which increases during pregnancy
B) Decreased curvature of the cervical spine, which remains unchanged
C) Flat back posture, which becomes more pronounced during pregnancy
D) Normal spinal alignment, which improves during pregnancy

A

A) Increased curvature of the lumbar spine, which increases during pregnancy

182
Q

What impact can excessive cervical flexion have during pregnancy?
A) Increased lumbar curvature
B) Strain and discomfort in the neck
C) Decreased arch in the feet
D) Improved posture and reduced back pain

A

B) Strain and discomfort in the neck

183
Q

What is the purpose of the Get Up and Go Test in older adults?
A) To assess muscle strength in the upper body
B) To evaluate balance, mobility, and fall risk
C) To measure joint flexibility
D) To test cardiovascular endurance

A

B) To evaluate balance, mobility, and fall risk

184
Q

How is the Get Up and Go Test administered?
A) Timing how long it takes to stand from a seated position, walk a short distance, and sit back down
B) Measuring the distance walked in a set time
C) Assessing the ability to lift weights
D) Evaluating the range of motion in the knees and hips

A

A) Timing how long it takes to stand from a seated position, walk a short distance, and sit back down

185
Q

How should you chart a patient who has successfully completed cranial nerve testing?
A) “Patient completed cranial nerve testing with no abnormalities detected.”
B) “Patient demonstrated deficits in cranial nerve testing.”
C) “Cranial nerve testing results are inconclusive.”
D) “Patient failed cranial nerve testing.”

A

A) “Patient completed cranial nerve testing with no abnormalities detected.”

186
Q

How should you chart a patient who was unsuccessful in cranial nerve testing?
A) “Patient successfully completed cranial nerve testing with normal findings.”
B) “Patient showed abnormalities in cranial nerve testing and needs further evaluation.”
C) “Cranial nerve testing results are within normal limits.”
D) “Patient did not attempt cranial nerve testing.”

A

B) “Patient showed abnormalities in cranial nerve testing and needs further evaluation.”

187
Q

Which groups of cranial nerves are commonly tested together?
A) Olfactory, Optic, Oculomotor
B) Trigeminal, Abducens, Facial
C) Vagus, Accessory, Hypoglossal
D) Optic, Trochlear, Trigeminal

A

A) Olfactory, Optic, Oculomotor

188
Q

Which of the following is NOT a common cause of damage to the nervous system?
A) Trauma
B) Stroke
C) Infection
D) Vitamin D deficiency

A

D) Vitamin D deficiency

189
Q

What can be observed when damage occurs in specific areas of the cerebral cortex?
A) Increased muscle strength
B) Improved cognitive function
C) Motor weakness, paralysis, or loss of sensation
D) Enhanced reflexes

A

C) Motor weakness, paralysis, or loss of sensation

190
Q

What does the term “proprioception” refer to?
A) The ability to recognize objects by touch
B) The awareness of body position and movement in space
C) The sense of taste and smell
D) The perception of visual stimuli

A

B) The awareness of body position and movement in space

191
Q

What is stereognosis?
A) The ability to distinguish between different sounds
B) The ability to identify objects by touch without seeing them
C) The perception of temperature changes
D) The recognition of different smells

A

B) The ability to identify objects by touch without seeing them

192
Q

What is the main function of reflexes?
A) To provide voluntary muscle control
B) To facilitate learning and memory
C) To protect the body and respond to stimuli automatically
D) To improve sensory perception

A

C) To protect the body and respond to stimuli automatically

193
Q

Explain how the Glasgow Coma Scale score is calculated. How are the scores from each component combined?

A

The total score is the sum of the scores from eye opening (1-4), verbal response (1-5), and motor response (1-6), with the maximum total score being 15.

194
Q

Describe the difference between a verbal response score of 4 and 2 on the Glasgow Coma Scale.
A) A score of 4 indicates confused conversation, while a score of 2 indicates inappropriate or incomprehensible words.
B) A score of 4 indicates appropriate responses, while a score of 2 indicates inappropriate or incomprehensible words.
C) A score of 4 indicates disoriented responses, while a score of 2 indicates no response to verbal stimuli.
D) A score of 4 indicates a normal conversation, while a score of 2 indicates incomprehensible sounds.

A

D) A score of 4 indicates a normal conversation, while a score of 2 indicates incomprehensible sounds.

195
Q

How would you document a patient who opens their eyes only to pain, makes incoherent sounds, and shows abnormal flexion (decorticate posturing) to painful stimuli using the Glasgow Coma Scale?
A) Eye opening: 1, Verbal response: 2, Motor response: 3; Total GCS score: 6
B) Eye opening: 2, Verbal response: 2, Motor response: 4; Total GCS score: 8
C) Eye opening: 2, Verbal response: 3, Motor response: 2; Total GCS score: 7
D) Eye opening: 1, Verbal response: 3, Motor response: 2; Total GCS score: 6

A

C) Eye opening: 2, Verbal response: 3, Motor response: 2; Total GCS score: 7

196
Q

How does the Glasgow Coma Scale differ from other neurological assessment tools such as the Rancho Los Amigos Scale or the Mini-Mental State Examination (MMSE)?

A

The GCS focuses on consciousness level and motor responses, while the Rancho Los Amigos Scale evaluates cognitive and behavioral recovery, and the MMSE assesses overall cognitive function

197
Q

Which of the following is a late sign of a closed head injury that family members should watch for?
A) Temporary loss of consciousness
B) Headache
C) Memory or concentration problems
D) Vomiting

A

C

198
Q

Which specific primitive reflexes are commonly assessed in infants, and what role do they play in evaluating neurological development?

A

A) Moro reflex, rooting reflex, and grasp reflex; these reflexes help determine if the central nervous system is developing appropriately and if there are any signs of neurological impairment.

199
Q

How would persistence of the Moro reflex beyond 6 months of age be interpreted in an infant’s neurological assessment?

A

It indicates possible developmental delay or neurological dysfunction.
Usually fades 4 to 6 months

200
Q

What is the Asymmetric Tonic Neck Reflex (ATNR), and how is it typically elicited in infants?

A

The ATNR is a reflex that causes an infant to extend the arm and leg on the side to which their head is turned, while flexing the opposite limbs. It is elicited by turning the infant’s head to one side.

201
Q

What strategies or interventions might be recommended for an infant who exhibits a persistent Asymmetric Tonic Neck Reflex (ATNR)?

A

Recommending more time in prone position and engaging in activities that encourage reaching and turning the head to both sides.

202
Q

In what way does the progression of myelination from head to extremities reflect the development of an infant’s motor skills and sensory processing?
A) It indicates a gradual shift in focus from basic sensory processing to advanced motor skills.
B) It reflects the development of gross motor skills first, followed by fine motor skills and sensory integration.
C) It shows that sensory processing improves before motor skills, with myelination supporting complex movements as the infant matures.
D) It suggests that motor skills develop independently of sensory processing, with no direct correlation.

A

C) It shows that sensory processing improves before motor skills, with myelination supporting complex movements as the infant matures.

203
Q

Located in the frontal lobe; damage to this dominant hemisphere results in expressive aphasia

A

Broca’s

204
Q

Located in the temporal lobe, damage to this area results in receptive aphasia

A

Wernicke’s area

205
Q

This occurs in a cephalocaudal and proximodistal order and is needed for motor control and coordination.

A

Motor development

206
Q

What nerve: Assessing the muscles of mastication and the sensation of light touch on the face tests the function of this.

A

Trigeminal nerve

207
Q

What nerve is responsible for hearing

A

Vestibulocochlear

208
Q

This nerve is responsible for facial symmetry and mobility, taste on anterior 2/3rds tongue, saliva and tear secretion

A

Facial nerve

209
Q

To test balance, ask the client to stand up with feet together, arms at sides, and eyes closed. This test should last about 20 seconds or more and is called what?

A

Romberg test

210
Q

Asking the client to pat the knees with the hands, lift up, and pat the knees with the backs of the hands is called Rapid Alternating Movements (RAM) and is used for this.

A

Cerebellar function and coordination

211
Q

This is the earliest and most sensitive index of change in neurologic status.

A

Alertness

212
Q

Fibrous bands the strengthen the joint and prevent movement in undesirable directions.

A

Ligaments

213
Q

Moving a body part forward and parallel to the ground is known as this.

A

Protraction

214
Q

This test reproduces numbness and burning in a person with carpal tunnel syndrome

A

Phalen’s test

215
Q

This test confirms small amounts of fluid in a joint

A

Bulge test

216
Q

In an infant, which of the following is NOT a typical feature of the fontanels?

A) Anterior fontanel is diamond-shaped
B) Posterior fontanel closes by 6 months of age
C) Anterior fontanel is triangular in shape
D) Fontanels allow for brain growth

A

C

217
Q

When inspecting the ocular fundus, which structure is typically examined for abnormalities such as diabetic retinopathy?

A) Cornea
B) Retina
C) Iris
D) Lens

A

B retina

218
Q

Which condition is characterized by an overproduction of growth hormone leading to enlarged facial features and extremities?

A) Cushing’s syndrome
B) Parkinson’s syndrome
C) Acromegaly
D) Myxedema

A

C

219
Q

What is a key characteristic of Graves’ disease (Hyperthyroidism)?

A) Decreased metabolic rate
B) Cold intolerance
C) Exophthalmos (bulging eyes)
D) Dry skin

A

C exophtalmos

220
Q

The corneal light reflex (Hirschberg test) is used to assess which condition?

A) Visual acuity
B) Eye alignment
C) Retinal health
D) Pupil size

A

B eye alignment

221
Q

What test tests peripheral vision

A

B confrontation test

222
Q

What is the primary difference between conductive hearing loss and sensorineural hearing loss?

A

Conductive hearing loss is due to problems in the middle ear, while sensorineural hearing loss is due to problems in the inner ear.

223
Q

Which test involves asking the patient to follow an object with their eyes while keeping their head still and assesses extraocular muscle function?

A

Diagnostic positions test (cardinal)

224
Q

How is the Weber test conducted, and what does it primarily assess?

A

By placing a vibrating tuning fork on the forehead to assess lateralization of sound and differentiate between conductive and sensorineural hearing loss.

225
Q

In a pediatric eye examination, what is a common method used to assess for strabismus?

A

Hirschberg test (Corneal Light Reflex)

226
Q

Which examination test involves using a tuning fork to differentiate between conductive and sensorineural hearing loss by comparing air conduction (AC) and bone conduction (BC)?

A

Rinne test

227
Q

If the light reflex in the Hirschberg test appears asymmetrical, what condition might this suggest?

A

Strabismus

228
Q

What does the Rinne test primarily assess?

A

The type of hearing loss (conductive vs. sensorineural)

229
Q

In the Rinne test, what is the expected normal finding when comparing air conduction (AC) to bone conduction (BC)?

A

AC > BC (Air conduction should be heard longer than bone conduction)

230
Q

During the Rinne test, what result is indicative of conductive hearing loss?

A

Longer bone conduction (BC) than air conduction (AC)

231
Q

How is the Rinne test conducted?

A

By placing a tuning fork on the mastoid bone and then in front of the ear canal to compare hearing duration

232
Q

How is the Rinne test conducted?

A

By placing a tuning fork on the mastoid bone and then in front of the ear canal to compare hearing duration

233
Q

What are the palpatable landmarks of the TMJ
Temporomandibular joint

A

In front of the ear
Place tour fingers in front of the ear and ask the patient to open and close their mouth

234
Q

What are the palpatable landmarks of the shoulder

A

Acromion process
Greater tuberosity
Coracoid process of scapula

235
Q

What are the palpatable landmarks of elbows

A

Olecranon process
Medial and lateral epicondyles

236
Q

What are the palpatable landmarks of the foot and ankle? Ankle-tibiotalar joint

A

Medial malleolus
Lateral malleolus
Calcaneus

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