HESI NUR 209 Medical Surgical Nursing 7th
Edition 2026/2027 Questions with 100%
Answers Edited by Brian
During history, notice clues from normal conversation
indicating possible hearing loss
- Lip reading or watching your face and lips rather than
your eyes
- Frowning or straining forward to hear
- Posturing of head to catch sounds with better ear
- Misunderstands questions; frequently asks you to
repeat
- Irritable or shows startle reflex when you raise your
voice
- Person's speech sounds garbled, vowel sounds distorted
- Inappropriately loud voice
- Flat, monotonous tone of voice
Tinnitus Questions
- Ever felt ringing, crackling, or buzzing in your ears?
When did this occur?
- Does it seem louder at night?
- Are you taking any medications?
Vertigo Questions
,- Ever felt vertigo, that the room is spinning around or
feel that you are spinning?
- Ever felt dizzy, like you are not quite steady, or falling or
losing your balance? Giddy, lightheaded?
Two pairs of sinuses are accessible to examine during
HEENT assessment
- Frontal sinuses in frontal bone above and medial to
orbits
- Maxillary sinuses in maxilla (cheekbone) along side
walls of nasal cavity
Other two sets are smaller and deeper and cannot be
examined during a HEENT assessment
- Ethmoid sinuses between the orbits
- Sphenoid sinuses deep within skull in the sphenoid
bone
Sinuses present at birth
- Only maxillary and ethmoid sinuses are present at birth.
- Maxillary sinuses reach full size after all permanent
teeth have erupted.
- Ethmoid sinuses grow rapidly between 6 and 8 years of
age and after puberty.
- Frontal sinuses are absent at birth, fairly well developed
,between ages 7 and 8, and reach full size after puberty.
- Sphenoid sinuses are minute at birth and develop after
puberty.
Tonsils
- Behind folds, each is a mass of lymphoid tissue
Nasal cavity Inspection and Palpation
- View each nasal cavity with person's head erect and
then with head tilted back.
- Inspect nasal mucosa, noting its normal red color and
smooth moist surface.
- Note any swelling, discharge, bleeding, or foreign body.
Nasal septum Inspection and Palpation
- Observe nasal septum for deviation; deviated septum is
common and is not significant unless air flow is
obstructed.
- If present in hospitalized patient, document deviated
septum in event that person needs nasal suctioning or a
nasogastric tube
- Note any perforation or bleeding in septum.
Palpation of Sinus Areas
- Using thumbs, press frontal sinuses by pressing up and
under the eyebrows and over maxillary sinuses below
, cheekbones.
- Transillumination
You may use this technique when you suspect sinus
inflammation, although it is of limited usefulness.
A diffuse red glow is a normal response; comes from light
shining through air in the healthy sinus.
Inspection of Teeth and Gums
Condition of teeth is an index of person's general health.
Tonsil Grade
1+ Visible
2+ Halfway between tonsillar pillars and uvula
3+ Touching uvula
4+ Touching each other
Tonsils in healthy people, and children
You may normally see 1+ or 2+ tonsils in healthy people,
especially in children, because lymphoid tissue is
proportionately enlarged until puberty
Cooper's ligaments
- Suspensory ligaments
- Fibrous bands extending vertically from surface to
attach on chest wall muscles
- Support breast tissue
Edition 2026/2027 Questions with 100%
Answers Edited by Brian
During history, notice clues from normal conversation
indicating possible hearing loss
- Lip reading or watching your face and lips rather than
your eyes
- Frowning or straining forward to hear
- Posturing of head to catch sounds with better ear
- Misunderstands questions; frequently asks you to
repeat
- Irritable or shows startle reflex when you raise your
voice
- Person's speech sounds garbled, vowel sounds distorted
- Inappropriately loud voice
- Flat, monotonous tone of voice
Tinnitus Questions
- Ever felt ringing, crackling, or buzzing in your ears?
When did this occur?
- Does it seem louder at night?
- Are you taking any medications?
Vertigo Questions
,- Ever felt vertigo, that the room is spinning around or
feel that you are spinning?
- Ever felt dizzy, like you are not quite steady, or falling or
losing your balance? Giddy, lightheaded?
Two pairs of sinuses are accessible to examine during
HEENT assessment
- Frontal sinuses in frontal bone above and medial to
orbits
- Maxillary sinuses in maxilla (cheekbone) along side
walls of nasal cavity
Other two sets are smaller and deeper and cannot be
examined during a HEENT assessment
- Ethmoid sinuses between the orbits
- Sphenoid sinuses deep within skull in the sphenoid
bone
Sinuses present at birth
- Only maxillary and ethmoid sinuses are present at birth.
- Maxillary sinuses reach full size after all permanent
teeth have erupted.
- Ethmoid sinuses grow rapidly between 6 and 8 years of
age and after puberty.
- Frontal sinuses are absent at birth, fairly well developed
,between ages 7 and 8, and reach full size after puberty.
- Sphenoid sinuses are minute at birth and develop after
puberty.
Tonsils
- Behind folds, each is a mass of lymphoid tissue
Nasal cavity Inspection and Palpation
- View each nasal cavity with person's head erect and
then with head tilted back.
- Inspect nasal mucosa, noting its normal red color and
smooth moist surface.
- Note any swelling, discharge, bleeding, or foreign body.
Nasal septum Inspection and Palpation
- Observe nasal septum for deviation; deviated septum is
common and is not significant unless air flow is
obstructed.
- If present in hospitalized patient, document deviated
septum in event that person needs nasal suctioning or a
nasogastric tube
- Note any perforation or bleeding in septum.
Palpation of Sinus Areas
- Using thumbs, press frontal sinuses by pressing up and
under the eyebrows and over maxillary sinuses below
, cheekbones.
- Transillumination
You may use this technique when you suspect sinus
inflammation, although it is of limited usefulness.
A diffuse red glow is a normal response; comes from light
shining through air in the healthy sinus.
Inspection of Teeth and Gums
Condition of teeth is an index of person's general health.
Tonsil Grade
1+ Visible
2+ Halfway between tonsillar pillars and uvula
3+ Touching uvula
4+ Touching each other
Tonsils in healthy people, and children
You may normally see 1+ or 2+ tonsils in healthy people,
especially in children, because lymphoid tissue is
proportionately enlarged until puberty
Cooper's ligaments
- Suspensory ligaments
- Fibrous bands extending vertically from surface to
attach on chest wall muscles
- Support breast tissue
