NURS 5220: ADVANCED HEALTH
ASSESSMENT - EENT, RESPIRATORY,
AND CARDIOVASCULAR EXAM
1. During a funduscopic examination, the nurse practitioner observes a patient with
hypertension and notices silver-wire arteries. What does this finding indicate?
A. Acute retinal detachment
B. Early signs of macular degeneration
C. Normal aging of the retinal vasculature
D. Ocular manifestations of chronic hypertension
Answer: D
Conceptual Explanation: Silver-wiring occurs when the wall of the retinal artery becomes
so thickened and opaque that it reflects all the light, a common sign of chronic hypertensive
retinopathy.
2. A patient presents with a ‘curtain’ closing over their vision in one eye, accompanied by
flashing lights and floaters. Which condition is most likely?
A. Acute angle-closure glaucoma
,B. Cataracts
C. Retinal detachment
D. Vitreous hemorrhage
Answer: C
Conceptual Explanation: A ‘curtain’ over the visual field, photopsia (flashing lights), and
new floaters are classic symptoms of a retinal detachment, which is a medical emergency.
3. When performing the Weber test, the sound lateralizes to the patient’s right ear. What is
the most appropriate interpretation?
A. Sensorineural loss in the right ear or conductive loss in the left ear
B. Conductive loss in the right ear or sensorineural loss in the left ear
C. Normal hearing bilaterally
D. Presbycusis in both ears
Answer: B
Conceptual Explanation: In the Weber test, sound lateralizes to the affected ear in
conductive loss (masking room noise) and to the unaffected ear in sensorineural loss.
4. A 45-year-old male complains of severe, unilateral periorbital pain that occurs daily for
several weeks, then disappears. What is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
, C. Tension headache
D. Trigeminal neuralgia
Answer: A
Conceptual Explanation: Cluster headaches are characterized by severe unilateral orbital
or temporal pain, occurring in clusters over weeks followed by remission.
5. Upon inspection of the tympanic membrane, the practitioner notes a ‘chalky white’ patch.
This is most likely indicative of:
A. Acute otitis media
B. Tympanosclerosis
C. Cholesteatoma
D. Serous effusion
Answer: B
Conceptual Explanation: Tympanosclerosis is a deposition of hyaline cartilage and
calcium within the tympanic membrane, appearing as chalky white patches, often after
chronic inflammation.
6. Which physical finding is pathognomonic for measles (rubeola) during an oral examination?
A. Aphthous ulcers
B. Koplik spots
C. Leukoplakia
ASSESSMENT - EENT, RESPIRATORY,
AND CARDIOVASCULAR EXAM
1. During a funduscopic examination, the nurse practitioner observes a patient with
hypertension and notices silver-wire arteries. What does this finding indicate?
A. Acute retinal detachment
B. Early signs of macular degeneration
C. Normal aging of the retinal vasculature
D. Ocular manifestations of chronic hypertension
Answer: D
Conceptual Explanation: Silver-wiring occurs when the wall of the retinal artery becomes
so thickened and opaque that it reflects all the light, a common sign of chronic hypertensive
retinopathy.
2. A patient presents with a ‘curtain’ closing over their vision in one eye, accompanied by
flashing lights and floaters. Which condition is most likely?
A. Acute angle-closure glaucoma
,B. Cataracts
C. Retinal detachment
D. Vitreous hemorrhage
Answer: C
Conceptual Explanation: A ‘curtain’ over the visual field, photopsia (flashing lights), and
new floaters are classic symptoms of a retinal detachment, which is a medical emergency.
3. When performing the Weber test, the sound lateralizes to the patient’s right ear. What is
the most appropriate interpretation?
A. Sensorineural loss in the right ear or conductive loss in the left ear
B. Conductive loss in the right ear or sensorineural loss in the left ear
C. Normal hearing bilaterally
D. Presbycusis in both ears
Answer: B
Conceptual Explanation: In the Weber test, sound lateralizes to the affected ear in
conductive loss (masking room noise) and to the unaffected ear in sensorineural loss.
4. A 45-year-old male complains of severe, unilateral periorbital pain that occurs daily for
several weeks, then disappears. What is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
, C. Tension headache
D. Trigeminal neuralgia
Answer: A
Conceptual Explanation: Cluster headaches are characterized by severe unilateral orbital
or temporal pain, occurring in clusters over weeks followed by remission.
5. Upon inspection of the tympanic membrane, the practitioner notes a ‘chalky white’ patch.
This is most likely indicative of:
A. Acute otitis media
B. Tympanosclerosis
C. Cholesteatoma
D. Serous effusion
Answer: B
Conceptual Explanation: Tympanosclerosis is a deposition of hyaline cartilage and
calcium within the tympanic membrane, appearing as chalky white patches, often after
chronic inflammation.
6. Which physical finding is pathognomonic for measles (rubeola) during an oral examination?
A. Aphthous ulcers
B. Koplik spots
C. Leukoplakia
