NR304: CJE REVIEW
FREQUENTLY ASKED
QUESTIONS WITH VERIFIED
SOLUTIONS 100% CORRECT
2026/2027 STUDY
EYES & EARS OVERVIEW
VISUAL ACUITY
- MEASURED BY SNELLEN
- 20/40 MEANS: THE PERSON SEES AT 20 FEET WHAT SOMEONE WITH NORMAL VISION SEES
AT 40 FEET
ACCOMMODATION TEST
- ASK PATIENT TO LOOK AT A DISTANT OBJECT, THEN SHIFT GAZE TO A NEAR OBJECT
- OBSERVE FOR PUPIL CONSTRICTION AND EYE CONVERGENCE
ANISOCORIA
UNEQUAL PUPILS, MAY BE ACCOMPANIED BY PAIN AND VISION CHANGES
PERRLA
- PUPILS ARE EQUAL, ROUND, REACTIVE TO LIGHT, AND ACCOMMODATION
PUPIL GAUGE:
- NORMAL: 3-5MM
- SIZE VARIATION UP TO 1MM IS NORMAL
, - MIOSIS: <2MM OR NO DILATION IN DARK
- MYDRIASIS: >6MM OR NO CONSTRICTION IN LIGHT
CARDINAL FIELDS OF GAZE
- MOVE EYES THROUGH 6 POSITIONS USING H METHOD OR WAGON WHEEL
- TESTS CN III (OCULOMOTOR), IV (TROCHLEAR), VI (ABDUCENS)
- WATCH FOR NYSTAGMUS (INVOLUNTARY EYE MOVEMENT)
OTOSCOPE USE
- ADULTS: PULL PINNA UP AND BACK
- CHILDREN <3: PULL PINNA DOWN AND BACK
- TYMPANIC MEMBRANE: PEARLY GRAY, TRANSLUCENT
HEARING TESTS
RINNE TEST:
- COMPARES AIR CONDUCTION TO BONE CONDUCTION
- NORMAL: AC > BC (2:1 RATIO)
WEBER TEST:
- TUNING FORK ON HEAD, SOUND SHOULD BE EQUAL IN BOTH EARS
- CONDUCTIVE LOSS: SOUND LOUDER IN AFFECTED EAR
- SENSORINEURAL LOSS: SOUND LOUDER IN UNAFFECTED EAR
AGE-RELATED HEARING LOSS (PRESBYCUSIS)
- SENSORINEURAL LOSS THAT AFFECTS THE MIDDLE EAR STRUCTURES OR CAUSES DAMAGE
TO NERVE CELLS IN THE INNER EAR OR CN VIII
- ACCENTUATED WITH COMPETING BACKGROUND NOISE
FREQUENTLY ASKED
QUESTIONS WITH VERIFIED
SOLUTIONS 100% CORRECT
2026/2027 STUDY
EYES & EARS OVERVIEW
VISUAL ACUITY
- MEASURED BY SNELLEN
- 20/40 MEANS: THE PERSON SEES AT 20 FEET WHAT SOMEONE WITH NORMAL VISION SEES
AT 40 FEET
ACCOMMODATION TEST
- ASK PATIENT TO LOOK AT A DISTANT OBJECT, THEN SHIFT GAZE TO A NEAR OBJECT
- OBSERVE FOR PUPIL CONSTRICTION AND EYE CONVERGENCE
ANISOCORIA
UNEQUAL PUPILS, MAY BE ACCOMPANIED BY PAIN AND VISION CHANGES
PERRLA
- PUPILS ARE EQUAL, ROUND, REACTIVE TO LIGHT, AND ACCOMMODATION
PUPIL GAUGE:
- NORMAL: 3-5MM
- SIZE VARIATION UP TO 1MM IS NORMAL
, - MIOSIS: <2MM OR NO DILATION IN DARK
- MYDRIASIS: >6MM OR NO CONSTRICTION IN LIGHT
CARDINAL FIELDS OF GAZE
- MOVE EYES THROUGH 6 POSITIONS USING H METHOD OR WAGON WHEEL
- TESTS CN III (OCULOMOTOR), IV (TROCHLEAR), VI (ABDUCENS)
- WATCH FOR NYSTAGMUS (INVOLUNTARY EYE MOVEMENT)
OTOSCOPE USE
- ADULTS: PULL PINNA UP AND BACK
- CHILDREN <3: PULL PINNA DOWN AND BACK
- TYMPANIC MEMBRANE: PEARLY GRAY, TRANSLUCENT
HEARING TESTS
RINNE TEST:
- COMPARES AIR CONDUCTION TO BONE CONDUCTION
- NORMAL: AC > BC (2:1 RATIO)
WEBER TEST:
- TUNING FORK ON HEAD, SOUND SHOULD BE EQUAL IN BOTH EARS
- CONDUCTIVE LOSS: SOUND LOUDER IN AFFECTED EAR
- SENSORINEURAL LOSS: SOUND LOUDER IN UNAFFECTED EAR
AGE-RELATED HEARING LOSS (PRESBYCUSIS)
- SENSORINEURAL LOSS THAT AFFECTS THE MIDDLE EAR STRUCTURES OR CAUSES DAMAGE
TO NERVE CELLS IN THE INNER EAR OR CN VIII
- ACCENTUATED WITH COMPETING BACKGROUND NOISE
