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Chamberlain College OF Nursing NR 509 APEA TEST Heent NR 509 APEA EXAM 2019 Heent Advanced Physi
Pharmacology (NUR 3145)
Santa Fe College
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QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question 1
The function of the auditory ossicles is to:
a. transmit the light reflex to the light cone. b. transform sound vibrations into mechanical waves for the inner ear. c. to capture sound waves from the external ear for transmission into the middle ear. d. 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:
a. an arrhythmia. b. a neurological condition. c. an inner ear infection. d. orthostatic hypotension.
Explanation:
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Vertigo symptoms associated with neurologic conditions include: ataxia, diplopia, and dysarthria. Symptoms associated with cardiovascular conditions and vertigo include arrhythmias, orthostatic hypotension, vasovagal stimulation, lightheadedness, weakness, or presyncope.
Question 3:
A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with:
a. a pinguecula. b. a chalazion. c. episcleritis. d. xanthelasma.
Explanation:
Slightly raised, yellowish, well-circumscribed plaques appearing along the nasal area of one or both eyelids are consistent with lipid disorders and called xanthelasma. Pinguecula refer to harmless, yellowish, triangular nodules in the bulbar conjunctiva on either side of the iris. A chalazion is a nontender nodule usually on the underside of the eyelid. Episcleritis is an ocular inflammation of the episcleral vessels.
Question 4
Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This means that:
a. at 200 feet the patient can read printed information that a person with normal vision could read at 20 feet.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
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. a conjugate gaze. b. left cranial nerve III (oculomotor) paralysis c. cranial nerve IV (trochlear) paralysis. d. 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:
a. hyperopia. b. myopia. c. strabismus. d. astigmatism.
Explanation:
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Myopia, nearsightedness, occurs when light rays focus anterior to the retina. Hyperopia, farsightedness, occurs when light rays focus posterior to the retina. Strabismus, heterotropia, is a condition in which the eyes are not properly aligned with each other. In astigmatism, light rays do not focus correctly on the retina. This causes blurriness.
Question 8
A buildup of excess fluid around the periphery of the eye orbits is known as:
a. episcleritis. b. pinguecula. c. ptosis. d. periorbital edema.
Explanation:
An accumulation of fluid around the periphery of the eye orbits is known as periorbital edema.
Question 9
In order to visualize the opening of Stensen's duct, examine the:
a. dorsal surface of the tongue. b. area beneath the mandible at the angle of the jaw. c. buccal mucosa opposite the second molar. d. 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
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
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?
a. The tympanic membrane b. The proximal end of the eustachian tube c. The malleus d. The ossicles
Explanation:
The proximal end of the eustachian tube connects the middle ear to the nasopharynx.
Question 11
The fleshly projection of the earlobe is known as the: a.
lobule. b. tragus. c. auricle. d. 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
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
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. a tonic pupil. b. oculomotor nerve (CN III) paralysis. c. Horner's syndrome. d. 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 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. 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 13
A deposit of uric acid crystals appearing as hard nodules on the helix or antihelix is termed:
a. a keloid. b. a tophi. c. a cutaneous cyst. d. chondrodermatitis.
Explanation:
The antihelix divides the helix from the lobe. Tophi is a deposit of uric acid crystals (that appear commonly in patients with chronically elevated uric acid levels) on the helix or antihelix. They can also appear near the joints, hands, or feet. It is also seen in chronic tophaceous gout. A firm, nodular, hypertrophic mass of scar tissue extending beyond the area
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
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
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
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. a normal finding. b. precancerous. c. associated with periodontal disease. d. 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:
a. legally blind. b. attention deficit. c. color blind. d. totally blind.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Explanation:
When inspecting the neck for the thyroid gland, slightly tilt the patient's head back and using tangential lighting (light coming in from the side at a right angle) directed downward from the tip of the patient's chin, inspect the region below the cricoid cartilage; located
between the thyroid cartilage and the thyroid gland. The area of sternomastoid border allows palpation of the superficial cervical nodes. The posterior cervical lymph nodes are located at the anterior edge of the trapezius.
Question 20
A condition in which the eyes are not properly aligned with each other is termed:
a. hyperopia. b. myopia. c. strabismus. d. astigmatism.
Explanation:
Strabismus, heterotropia, is a condition in which the eyes are misaligned. "Crossed-eyed", "wall eye", or "lazy eye" are all associated with strabismus. Hyperopia, farsightedness, occurs when light rays focus posterior to the retina. Myopia, nearsightedness, occurs when light rays focus anterior to the retina. In astigmatism, light rays do not focus correctly on the retina. This causes blurriness.
Question 21
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Round or oval shaped lesions surrounded by erythematous mucosa and noted on an area of the oral mucosa may be:
a. leukoplakia. b. aphthous ulcers. c. Koplik's spots. d. ulcerative gingivitis.
Explanation:
Aphthous ulcers can appear anywhere on the buccal mucosa or tongue. They usually appear as round or oval ulcers, can be white or yellowish gray in color, and are surrounded by a halo of reddened mucosa. They are usually painful. Leukoplakia presents as thickened white patches anywhere on the oral mucosa. Koplik's spots appear in the early stages of measles (rubeola). They appear as small white specks that resemble grains of salt on a red background on the buccal mucosa. They are not usually painful. Ulcerative gingivitis is a painful form of gingivitis that is characterized by the development of ulcers in the interdental papillae. If untreated they can become necrotizing along the gum margins and appear as erythematous ulcers.
Question 22
On physical exam, an abnormal Rinne test might indicate:
impaired physical mobility.
impaired visual acuity.
impaired hearing ability.
impaired swallowing ability.
Explanation:
The Rinne test uses a tuning fork to compare air conduction to bone conduction and so is used to assess hearing. The other choices are not assessed using the Rinne test.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Explanation:
Vitreous floaters may be seen as dark specks or strands between the fundus and the lens. They could be a symptom of retinal detachment, retinal tear, or bleeding within the eye. Superficial retinal hemorrhages appear as small, linear, flame-shaped, red streaks in the fundus and are seen in hypertension, papilledema, and occlusion of the retinal vein. Cataracts are opacities in the lens of the eye. Drusen appear as yellowish round spots posteriorly between the optic disc and the macula and are associated with cellular debris.
Question 24
A 60- year-old patient presents with severe, deep left eye pain. Findings reveal dilated and fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These findings are most likely consistent with:
a. acute iritis. b. corneal injury. c. corneal infection. d. acute angle closure glaucoma.
Explanation:
With acute angle closure glaucoma, the pain is described as severe, aching, and deep. The pupils are dilated and fixed and the cornea appears steamy or cloudy. If an increase in intraocular pressure is present, this would be an emergency situation. Acute iritis presents with a moderate aching pain deep within the eye. The pupils are small and irregular and vision is decreased and photophobia is usually present. The cornea is clear or slightly cloudy with injection confined to the corneal limbus. This is considered an emergency and is usually related to Herpes zoster infection or tuberculosis. Corneal injury or infection usually presents with watery or purulent ocular discharge and the pain is severe.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question 25
The function of the labyrinth in the inner ear is to:
a. assist with air conduction. b. maintain equilibrium. c. maintain acoustic transmission. d. capture sound waves.
Explanation:
The inner ear has 2 main functions: hearing and balance. The cochlear system is dedicated to hearing and the vestibular system is dedicated to balance. The labyrinth is part of the semicircular canals and the vestibular system and is responsible for balance.
Question 26
The curved outer ridge of the auricle of the ear is known as the:
a. Antihelix b. Helix c. Auricle d. Tragus
Explanation:
The auricle has a prominent curved outer ridge known as the helix. 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 antihelix is a curved prominence that is parallel and anterior to the helix. The auditory canal opens behind a nodular protuberance that points backward over the entrance to the canal, known as the tragus.
Question 27
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Question 29
Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the: a.
vein "winds" down on either side of the artery. b. vein is twisted on the distal side of the artery. c. vein crosses beneath the artery. d. vein stops abruptly on either side of the artery.
Explanation:
When the arterial walls lose their transparency, changes appear in the arteriovenous crossings. Decreased transparency of the retina probably contributes to AV nicking and AV tapering. In tapering, the vein appears to taper or "wind" down either side of the artery. In AV nicking, the vein appears to stop abruptly on either side of the artery. In the normal eye, the vein appears to cross beneath the artery. With banking, the vein appears to be twisted on the distal side of the artery and forms a dark wide knuckle appearance.
Question 30
A patient presents with complaints of burning, itching, tearing, and some pain in the eye. Findings reveal red, scaly, greasy flakes and thickened, crusted lid margins. This would be suggestive of:
a. a chalazion. b. blepharitis. c. a hordeolum. d. dacryocystitis.
Explanation:
Red, scaly, greasy flakes and thickened, crusted lid margins are consistent with blepharitis. Symptoms include burning, itching, tearing, foreign body sensation, and some pain.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
QUESTIONS AND ANSWERS WITH EXPLANATIONS.
Chalazion is an inflammatory lesion that develops in a meibomian tear gland. Hordeolum is a localized staphylococcal infection of the hair follicles at the lid margin. Dacryocystitis is infection and blockage of lacrimal sac and duct.
Question 31
Ophthalmoscopic examination of the fundus reveals small, rounded, slightly irregular red spots embedded in the retina. These findings are consistent with:
a. superficial retinal hemorrhages. b. preretinal hemorrhages. c. microaneurysms. Incorrect d. deep retinal hemorrhages.
Explanation:
Deep retinal hemorrhages appear as small, rounded, slightly irregular red spots and are sometimes called dot or blot hemorrhages. They occur in a deeper layer of the retina than flame-shaped hemorrhages. Diabetes is a common cause. Superficial retinal hemorrhages appear as small, linear, flame-shaped, red streaks in the fundi and are seen in hypertension, papilledema, and occlusion of the retinal vein. Preretinal hemorrhages lie anteriorly between the retina and the vitreous and are typically larger than retinal hemorrhages. These hemorrhages obscure any underlying retinal vessel. Microaneurysms present as tiny, round, red spots commonly seen in and around the macular area. These are classic in diabetic retinopathy.
Question 32
Redness, bleeding, pain, and swelling of the gums is most likely:
a. stomatitis. b. gingivitis. c. leukoplakia.
NURS 509 APEA EXAM- ADVANCED PHYSICAL ASSESSMENT
Chamberlain College OF Nursing NR 509 APEA TEST Heent NR 509 APEA EXAM 2019 Heent Advanced Physi
Course: Pharmacology (NUR 3145)
University: Santa Fe College
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