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NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM QUESTIONS AND ANSWERS
WITH EXPLATATIONS (LATEST)
Question 1 The function of the auditory ossicles is to: transmit the light reflex to the light cone. transform sound vibrations into mechanical waves for the inner ear. to capture sound waves from the external ear for transmission into the middle ear. to separate the inner ear from the middle ear. Explanation: The function of the auditory ossicles is to transform sound vibrations into mechanical waves for the inner ear Question 2 A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of: an arrhythmia. a neurological condition. an inner ear infection.
orthostatic hypotension.
Question 4 Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This means that:
at 200 feet the patient can read printed information that a person with normal vision could read at 20 feet. at 20 feet the patient can read printed information that a person with normal vision could read at 200 feet. the patient has normal visual acuity. the patient may not be able to read so he should be tested with the picture or "E" eye charts. Explanation: Visual acuity that is corrected to 20/200 constitutes legal blindness. The larger the number under 20, the worse the visual acuity. If this is a new finding, the patient needs ophthalmologic evaluation. Question 5 Findings following assessment of a person's left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with: a conjugate gaze. left cranial nerve III (oculomotor) paralysis cranial nerve IV (trochlear) paralysis. cranial nerve VI (abducens) paralysis. Explanation: With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. In conjugate or normal gaze, the normal movement of the two eyes appears
esotropia is maximum in the left eye when looking to the left. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question 6 Findings following assessment of a person's eye gaze include both eyes moving in the same direction simultaneously. This condition is most consistent with: a conjugate gaze. left cranial nerve III (oculomotor) paralysis cranial nerve IV (trochlear) paralysis. cranial nerve VI (abducens) paralysis. Explanation: In conjugate or normal gaze, the normal movement of the two eyes appears simultaneously in the same direction to bring something into view. With a left cranial nerve VI paralysis, a person's gaze would include eyes conjugate when looking to the right, esotropia (one or both eyes turn inward) in the left eye when looking straight ahead, and esotropia is maximum in the left eye when looking to the left. With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question 7 A patient was diagnosed as being farsighted. The term for this condition is:
hyperopia
. myopia. strabismu s.
dorsal surface of the tongue.
area beneath the mandible at the angle of the jaw. buccal mucosa opposite the second molar. small openings along the sublingual fold under the tongue. Explanation: The largest salivary gland is the parotid gland and it lies within the cheeks in front of the ear extending from the zygomatic arch down to the angle of the jaw. Its duct, Stensen's duct, runs forward to an opening on the buccal mucosa opposite the second molar. If blood comes out through Stensen's duct when it is palpated, this could suggest parotid cancer. If pus is expelled, it suggests suppurative parotitis. With mumps, the orifice of the Stensen duct appears erythematous and enlarged. The submandibular gland is the size of a walnut. It lies beneath the mandible at the angle of the jaw. Wharton's duct runs up and forward to the floor of the mouth and opens at either side of the frenulum. The smallest, the almond-shaped sublingual gland, lies within the floor of the mouth under the tongue. It has many small openings along the sublingual fold under the tongue. Question 10 What connects the middle ear to the nasopharynx? The tympanic membrane The proximal end of the eustachian tube The malleus The ossicles
Question 11 The fleshly projection of the earlobe is known as the: lobule. tragus. auricle. helix. Explanation: The fleshy projection of the earlobe is known as the lobule. The auditory canal opens behind a nodular protuberance that points backward over the entrance to the canal. This is known as the tragus. The auricle is made of cartilage covered by skin and has a firm elastic consistency. The auricle has a prominent curved outer ridge known as the helix. Question 12 When examining the pupils, the left pupil is noted to be fixed and dilated to light and near accommodation. This condition may be suggestive of: a tonic pupil. oculomotor nerve (CN III) paralysis. Horner's syndrome. Argyll Robertson pupils. Explanation:
Paralysis of the oculomotor cranial nerve (CN III), the dilated pupil is fixed to light and near accommodation. Ptosis and lateral deviation of the eye are usually present. When the pupil is
chondrodermatitis.
Question 14 On the outer ear, anterior and parallel to the helix, is a curved prominence known as the: Antihelix Helix Auricle Tragus Explanation: The antihelix is a curved prominence that is parallel and anterior to the helix and is part of the auricle. The external ear consists of the auricle and ear canal. The auricle is made of cartilage covered by skin and has a firm elastic consistency. The auricle has a prominent curved outer ridge known as the helix. The ear canal opens behind a nodular protuberance that points backward over the entrance to the canal. This is called the tragus. Question 15 On examination of the pupils, both are round but the right pupil appears larger than the left and reacts much slower to light. This condition may be indicative of: a tonic pupil. oculomotor nerve (CN III) paralysis. Horner's syndrome.
Explanation: When the pupil is large, regular, and usually unilateral and the reaction to light is severely reduced and slowed, or even absent, this condition is referred to as a tonic pupil or Adele's pupil. Paralysis of the oculomotor cranial nerve (CN III), the dilated pupil is fixed to light and near accommodation. Ptosis and lateral deviation of the eye are usually present. In Horner's syndrome, the affected pupil reacts briskly to light and near effort but the pupil is small. The pupils in Argyll Robertson condition appear small and irregular shaped and accommodate but do not react to light. Question 16 Leukoplakia was noted during an exam of the mouth. This symptom may be: a normal finding. precancerous. associated with periodontal disease. consistent with gingivitis. Explanation: Leukoplakia are thickened white patches located on any area of the mouth. These patches cannot be rubbed off. Most are not serious but some can be considered precancerous. Therefore, they should be evaluated. These lesions are not considered normal findings. Periodontal disease usually includes an infection of the gums and may involve the teeth. Generally, the infection causes redness and swelling but not white patches.
Question 17 The majority of people who present with non-24 hour sleep-wake disorder are: legally blind.
