WGU D344 ACTUAL EXAM SCRIPT WITH
SOLVED QUESTIONS AND VERIFIED
SOLUTIONS
◉ Palpate skin
Answer: temp turgor lesions edema texture
◉ Indicative of heat stroke shock or other cardiac complications
Answer: pale cool moist skin
◉ Posterior fontanel
Answer: triangle shaped closes 1-2 months
◉ anterior fontanel
Answer: diamond shaped closes at 9months - 2 years
◉ Assess ears using otoscope
Answer: 1. Hold the otoscope upside down with your thumb and
fingers so that the ulnar aspect of your hand makes contact with
the pt
2. for adults pull the ear upwards and backwards to straighten
canal
3. For PEDS pul the ear down and back
,4. Use the largest speculum that will fit comfortably
◉ Normal color of eardrum
Answer: shiny translucent, pearly gray
◉ Ear Abnormal findings
Answer: Erythema-suppurative ottis media, purulent drainage
Dull nontransparent gray serous otitis media effusion
◉ Conductive hearing Loss
Answer: Due to mechanical dysfunction of inner or middle ear
◉ Sensory neural loss
Answer: Due to pathological problem of inner ear, CNS or cerebral
cortex
◉ Hearing in older adults
Answer: there may be some normal high tone hearing loss
◉ Tubinates
Answer: should be pink and moist in the nose
◉ maxillary sinuses
Answer: are below the zygomatic arch
,◉ hard palate
Answer: located in the anterior part of the mouth it is made of
bone and is pale or whitish
◉ soft palate
Answer: located in the posterior part of the mouth it is softer
more mobile and pink in color
◉ deep cervical chain of lymph nodes
Answer: lies below the sternomastoid and cannot be palpated
without getting underneath the muscle inform the pt this
procedure will cause discomfort
◉ Lymph nodes
Answer: note the size and location of any palpable nodes and
weather they were soft or hard non tender or tender and mobile
or fixed
◉ thyroid glan
Answer: one way to look is to have a person swallow sip of water
the thyroid gland will move upward with a swallow
◉ sinus transillumination
Answer: 1. Darken the room as much as possible.
, 2. Place a bright otoscope or other point light source on the
maxilla.
3. Ask the patient to open their mouth and look for an orange
glow on the hard palate.
4. A decreased or absent glow suggests that the sinus is filled with
something other than air.
5. Not always definitive of disease process.
◉ Visual Acuity
Answer: In cases of eye pain, injury, or visual loss, always check
______ ___________ before proceeding with the rest of the exam or
putting medications in your patients eyes.
1. Allow the patient to use their glasses or contact lens if available.
You are interested in the patient's best corrected vision
2. Position the patient 20 feet in front of the Snellen eye chart (or
hold a Rosenbaum pocket card at 14 inch "reading" distance)
3. Have the patient cover one eye at a time with an opaque card.
◉ Visual Fields, by Confrontation
Answer: 1. Stand two feet in front of the patient and have them
look into your eyes.
2. Hold your hands to the side half way between you and the
patient.
3. Wiggle the fingers on one hand.
4. Ask the patient to indicate which side they see your fingers
move.
SOLVED QUESTIONS AND VERIFIED
SOLUTIONS
◉ Palpate skin
Answer: temp turgor lesions edema texture
◉ Indicative of heat stroke shock or other cardiac complications
Answer: pale cool moist skin
◉ Posterior fontanel
Answer: triangle shaped closes 1-2 months
◉ anterior fontanel
Answer: diamond shaped closes at 9months - 2 years
◉ Assess ears using otoscope
Answer: 1. Hold the otoscope upside down with your thumb and
fingers so that the ulnar aspect of your hand makes contact with
the pt
2. for adults pull the ear upwards and backwards to straighten
canal
3. For PEDS pul the ear down and back
,4. Use the largest speculum that will fit comfortably
◉ Normal color of eardrum
Answer: shiny translucent, pearly gray
◉ Ear Abnormal findings
Answer: Erythema-suppurative ottis media, purulent drainage
Dull nontransparent gray serous otitis media effusion
◉ Conductive hearing Loss
Answer: Due to mechanical dysfunction of inner or middle ear
◉ Sensory neural loss
Answer: Due to pathological problem of inner ear, CNS or cerebral
cortex
◉ Hearing in older adults
Answer: there may be some normal high tone hearing loss
◉ Tubinates
Answer: should be pink and moist in the nose
◉ maxillary sinuses
Answer: are below the zygomatic arch
,◉ hard palate
Answer: located in the anterior part of the mouth it is made of
bone and is pale or whitish
◉ soft palate
Answer: located in the posterior part of the mouth it is softer
more mobile and pink in color
◉ deep cervical chain of lymph nodes
Answer: lies below the sternomastoid and cannot be palpated
without getting underneath the muscle inform the pt this
procedure will cause discomfort
◉ Lymph nodes
Answer: note the size and location of any palpable nodes and
weather they were soft or hard non tender or tender and mobile
or fixed
◉ thyroid glan
Answer: one way to look is to have a person swallow sip of water
the thyroid gland will move upward with a swallow
◉ sinus transillumination
Answer: 1. Darken the room as much as possible.
, 2. Place a bright otoscope or other point light source on the
maxilla.
3. Ask the patient to open their mouth and look for an orange
glow on the hard palate.
4. A decreased or absent glow suggests that the sinus is filled with
something other than air.
5. Not always definitive of disease process.
◉ Visual Acuity
Answer: In cases of eye pain, injury, or visual loss, always check
______ ___________ before proceeding with the rest of the exam or
putting medications in your patients eyes.
1. Allow the patient to use their glasses or contact lens if available.
You are interested in the patient's best corrected vision
2. Position the patient 20 feet in front of the Snellen eye chart (or
hold a Rosenbaum pocket card at 14 inch "reading" distance)
3. Have the patient cover one eye at a time with an opaque card.
◉ Visual Fields, by Confrontation
Answer: 1. Stand two feet in front of the patient and have them
look into your eyes.
2. Hold your hands to the side half way between you and the
patient.
3. Wiggle the fingers on one hand.
4. Ask the patient to indicate which side they see your fingers
move.
