NR 509 LATEST 2026 MAIN FINALS EXAM QUESTIONS AND
ANSWERS GRADED A+
✔✔The physiologic cup is located centrally or somewhat temporally. It may be
conspicuous or absent. Its diameter from side to side is usually less than half that of the
dis - ✔✔
✔✔ - ✔✔PAPILLEDEMA
✔✔Caused by elevated intracranial pressure causes intraaxonal edema along the optic
nerve, leading to engorgement and swelling of the optic disc. - ✔✔
✔✔Appearance: Color pink, hyperemic, loss of vein pulsations, disc vessels more
visible & more numerous. Disc is swollen, with margins blurred. - ✔✔
✔✔The physiologic cup is not visible. Seen in intracranial mass, lesion, or hemorrhage,
meningitis. - ✔✔
✔✔EAR Assessment - ✔✔
✔✔At the end of the ear canal lies the lateral tympanic membrane, or eardrum,marking
the medial limit of the external ear. The external ear captures sound waves for
transmission into the middle and inner ear - ✔✔
✔✔Hearing disorders of the external and middle ear cause conductive hearing loss. -
✔✔
✔✔Middle ear disorders include otitis media, congen-tal conditions, cholesteatomas and
otosclerosis, tumors, and perforation of the tympanic membrane. - ✔✔
✔✔Inner ear disorders cause sensorineural hearing loss. - ✔✔
✔✔External ear causes include cerumen impaction, infection (otitis externa) - ✔✔
✔✔to see the ear canal and drum, use an otoscope with the largest ear speculum that
inserts easily into the canal. - ✔✔
✔✔Follow these steps to detect if a patient has hearing loss: - ✔✔
✔✔1st: Ask the question, "Do you feel you have a hearing loss or difficulty hearing?" if
yes - ✔✔
✔✔2nd: Whispered voice test is done 1st. If they fail the whisper test... - ✔✔
, ✔✔3rd: Weber and Rinne fork tests will help determine if the hearing loss is conductive
or sensorineural. - ✔✔
✔✔Weber Test: tests for lateralization: Place the base of the lightly vibrating tuning fork
firmly on top of the patient's head or on the midforehead. - ✔✔
✔✔In Unilateral sensorineural hearing loss, sound is heard in the good ear. - ✔✔
✔✔In Conductive hearing loss: sound is heard through bone as long as or longer than it
is through air. - ✔✔
✔✔Chronic otitis externa:the skin of the canal is often thickened, red, and itchy. - ✔✔
✔✔Otitis media: acute purulent, red bulging drum - ✔✔
✔✔Serous effusion will produce an amber colored drum. - ✔✔
✔✔Acute otitis media is commonly caused by bacterial infection from S. pneumoniae or
H. influenzae. Common in children than in adults. - ✔✔
✔✔Symptoms: earache, fever, hearing loss, & reddened eardrum.The eardrum loses its
landmarks, and bulges laterally, toward the examiner's eye. The canal is often swollen,
narrowed, moist, pale, and tender. - ✔✔
✔✔Redness is most obvious near the umbo, but dilated vessels can be seen in all
segments of the drum. A diffuse redness of the entire drum often develops. - ✔✔
✔✔Spontaneous rupture (perforation) of the drum may follow, with discharge of purulent
material into the ear canal. - ✔✔
✔✔Perforated Eardrum - ✔✔
✔✔Perforations are holes in the eardrum, usually from purulent infections of the middle
ear. - ✔✔
✔✔A reddened ring of granulation tissue surrounds the perforation, indicating chronic
infection. The eardrum itself is scarred, and no landmarks are visible. - ✔✔
✔✔Discharge from the infected middle ear may drain out through the perforated
opening, which often closes in the healing process, as in the next photo. - ✔✔
ANSWERS GRADED A+
✔✔The physiologic cup is located centrally or somewhat temporally. It may be
conspicuous or absent. Its diameter from side to side is usually less than half that of the
dis - ✔✔
✔✔ - ✔✔PAPILLEDEMA
✔✔Caused by elevated intracranial pressure causes intraaxonal edema along the optic
nerve, leading to engorgement and swelling of the optic disc. - ✔✔
✔✔Appearance: Color pink, hyperemic, loss of vein pulsations, disc vessels more
visible & more numerous. Disc is swollen, with margins blurred. - ✔✔
✔✔The physiologic cup is not visible. Seen in intracranial mass, lesion, or hemorrhage,
meningitis. - ✔✔
✔✔EAR Assessment - ✔✔
✔✔At the end of the ear canal lies the lateral tympanic membrane, or eardrum,marking
the medial limit of the external ear. The external ear captures sound waves for
transmission into the middle and inner ear - ✔✔
✔✔Hearing disorders of the external and middle ear cause conductive hearing loss. -
✔✔
✔✔Middle ear disorders include otitis media, congen-tal conditions, cholesteatomas and
otosclerosis, tumors, and perforation of the tympanic membrane. - ✔✔
✔✔Inner ear disorders cause sensorineural hearing loss. - ✔✔
✔✔External ear causes include cerumen impaction, infection (otitis externa) - ✔✔
✔✔to see the ear canal and drum, use an otoscope with the largest ear speculum that
inserts easily into the canal. - ✔✔
✔✔Follow these steps to detect if a patient has hearing loss: - ✔✔
✔✔1st: Ask the question, "Do you feel you have a hearing loss or difficulty hearing?" if
yes - ✔✔
✔✔2nd: Whispered voice test is done 1st. If they fail the whisper test... - ✔✔
, ✔✔3rd: Weber and Rinne fork tests will help determine if the hearing loss is conductive
or sensorineural. - ✔✔
✔✔Weber Test: tests for lateralization: Place the base of the lightly vibrating tuning fork
firmly on top of the patient's head or on the midforehead. - ✔✔
✔✔In Unilateral sensorineural hearing loss, sound is heard in the good ear. - ✔✔
✔✔In Conductive hearing loss: sound is heard through bone as long as or longer than it
is through air. - ✔✔
✔✔Chronic otitis externa:the skin of the canal is often thickened, red, and itchy. - ✔✔
✔✔Otitis media: acute purulent, red bulging drum - ✔✔
✔✔Serous effusion will produce an amber colored drum. - ✔✔
✔✔Acute otitis media is commonly caused by bacterial infection from S. pneumoniae or
H. influenzae. Common in children than in adults. - ✔✔
✔✔Symptoms: earache, fever, hearing loss, & reddened eardrum.The eardrum loses its
landmarks, and bulges laterally, toward the examiner's eye. The canal is often swollen,
narrowed, moist, pale, and tender. - ✔✔
✔✔Redness is most obvious near the umbo, but dilated vessels can be seen in all
segments of the drum. A diffuse redness of the entire drum often develops. - ✔✔
✔✔Spontaneous rupture (perforation) of the drum may follow, with discharge of purulent
material into the ear canal. - ✔✔
✔✔Perforated Eardrum - ✔✔
✔✔Perforations are holes in the eardrum, usually from purulent infections of the middle
ear. - ✔✔
✔✔A reddened ring of granulation tissue surrounds the perforation, indicating chronic
infection. The eardrum itself is scarred, and no landmarks are visible. - ✔✔
✔✔Discharge from the infected middle ear may drain out through the perforated
opening, which often closes in the healing process, as in the next photo. - ✔✔
