Chapter 13: Ears, Nose, and Throat
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using
recreational drugs. On examination, you have noted a septal perforation. Which of the following
recreational drugs is commonly associated with nasal septum perforation?
a. Heroin
b. Cocaine
c. PCP
d. Ecstasy
ANS: B
Long-term cocaine snorting causes ischemic necrosis of the septal cartilage and leads to
perforation of the nasal septum.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A 5-year-old child presents with nasal congestion and a headache. To assess for sinus
tenderness, you should palpate over the:
a. sphenoid and frontal sinuses.
b. maxillary and frontal sinuses.
c. maxillary sinuses only.
d. sphenoid sinuses only.
ANS: C
Only the maxillary and the frontal sinuses are accessible for physical examination; however, the
young child does not develop frontal sinuses until 7 to 8 years of age.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear
drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the
otoscope against the head while using the other hand to:
a. pull the auricle down and back.
b. hold the speculum in the canal.
c. distract the infant.
d. stabilize the chest.
ANS: A
The nurse should use the other hand to pull the auricle down and back in an effort to straighten
the upward curvature of the canal.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with
healthcare information, you will explain that she can expect to experience:
a. more nasal stuffiness.
b. a sensitive sense of smell.
c. drooling.
d. enhanced hearing.
ANS: A
Physiologic changes of pregnancy include nasal stuffiness, a decreased sense of smell, impaired
hearing, epistaxis, and a sense of fullness in the ears.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. You are performing hearing screening tests. Who would be expected to find difficulty in
hearing the highest frequencies?
a. A 7-year-old
b. An 18-year-old
c. A 30-year-old
d. A 50-year-old
ANS: D
Sensorineural hearing loss begins after 50 years of age, initially with losses of high-frequency
sounds and then progressing to tones of lower frequency.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mr. Spencer presents with the complaint of hearing loss. You specifically inquire about current
medications. Which medications, if listed, are likely to contribute to his hearing loss?
a. Chlorothiazide
b. Acetaminophen
c. Salicylates
d. Cephalosporins
ANS: C
Ototoxic medications include aminoglycoside, salicylates, furosemide, streptomycin, quinine,
ethacrynic acid, and cisplatin.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. To approximate vocal frequencies, which tuning fork should be used to assess hearing?
a. 100 to 300 Hz
b. 200 to 400 Hz
c. 500 to 1000 Hz
d. 1500 to 2000 Hz
ANS: C
Use of a 500- to 1000-Hz tuning fork approximates vocal frequencies.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using
recreational drugs. On examination, you have noted a septal perforation. Which of the following
recreational drugs is commonly associated with nasal septum perforation?
a. Heroin
b. Cocaine
c. PCP
d. Ecstasy
ANS: B
Long-term cocaine snorting causes ischemic necrosis of the septal cartilage and leads to
perforation of the nasal septum.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. A 5-year-old child presents with nasal congestion and a headache. To assess for sinus
tenderness, you should palpate over the:
a. sphenoid and frontal sinuses.
b. maxillary and frontal sinuses.
c. maxillary sinuses only.
d. sphenoid sinuses only.
ANS: C
Only the maxillary and the frontal sinuses are accessible for physical examination; however, the
young child does not develop frontal sinuses until 7 to 8 years of age.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear
drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the
otoscope against the head while using the other hand to:
a. pull the auricle down and back.
b. hold the speculum in the canal.
c. distract the infant.
d. stabilize the chest.
ANS: A
The nurse should use the other hand to pull the auricle down and back in an effort to straighten
the upward curvature of the canal.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with
healthcare information, you will explain that she can expect to experience:
a. more nasal stuffiness.
b. a sensitive sense of smell.
c. drooling.
d. enhanced hearing.
ANS: A
Physiologic changes of pregnancy include nasal stuffiness, a decreased sense of smell, impaired
hearing, epistaxis, and a sense of fullness in the ears.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. You are performing hearing screening tests. Who would be expected to find difficulty in
hearing the highest frequencies?
a. A 7-year-old
b. An 18-year-old
c. A 30-year-old
d. A 50-year-old
ANS: D
Sensorineural hearing loss begins after 50 years of age, initially with losses of high-frequency
sounds and then progressing to tones of lower frequency.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mr. Spencer presents with the complaint of hearing loss. You specifically inquire about current
medications. Which medications, if listed, are likely to contribute to his hearing loss?
a. Chlorothiazide
b. Acetaminophen
c. Salicylates
d. Cephalosporins
ANS: C
Ototoxic medications include aminoglycoside, salicylates, furosemide, streptomycin, quinine,
ethacrynic acid, and cisplatin.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. To approximate vocal frequencies, which tuning fork should be used to assess hearing?
a. 100 to 300 Hz
b. 200 to 400 Hz
c. 500 to 1000 Hz
d. 1500 to 2000 Hz
ANS: C
Use of a 500- to 1000-Hz tuning fork approximates vocal frequencies.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
