PHYSICAL DIAGNOSIS ENT, EYES,
HEAD AND NECK EXAM QUESTIONS
AND ANSWERS
You observe pupillary response as the patient looks at a distant object and then at
an object held 10 cm from the bridge of the nose.
You are assessing for: - ANSWER-accommodation
When inspecting the region of the lacrimal gland, palpate - ANSWER-the lower
orbital rim, near the inner canthus
Examination to assess for extraocular muscle imbalance is conducted by -
ANSWER-having the patient follow your finger through planes
Mr. Older is a 40-year-old patient who presents to the office for a follow-up eye
examination after the diagnosis of myopia. To see
retinal details in a myopic patient, you will need to - ANSWER-turn your
ophthalmoscope to a minus lens.
Ask the patient to look directly at the light of the ophthalmoscope when you are
ready to examine the: - ANSWER-Macula
Opacities of the red reflex may indicate the presence of: - ANSWER-Cataracts
If a patient has early papilledema, using an ophthalmoscope, the examiner will be
able to detect - ANSWER-Dilated retinal veins
Cupping of the optic disc may be a result of - ANSWER-Glaucoma
When drusen bodies are noted to be increasing in number or in intensity of color, the
patient should be further evaluated with a(n) - ANSWER-Amsler grid
Cotton wool spots are most closely associated with: - ANSWER-Hypertension
Which may be suggestive of Down syndrome? - ANSWER-Prominent epicanthal
folds
To differentiate between infants who have strabismus and those who have
pseudostrabismus, use the: - ANSWER-Corneal light reflex
You are attempting to examine the eyes of a newborn. To facilitate eye opening, you
would first - ANSWER-Dim the room lights
Dot hemorrhages, or microaneurysms, in the retina and the presence of hard and
soft exudates are most commonly seen in those
with - ANSWER-Diabetic retinopathies
, Which maneuver can be done to reduce the systemic absorption of cycloplegic and
mydriatic agents when examining a pregnant
woman if the examination is mandatory? - ANSWER-Use nasolacrimal occlusion
after instillation
Changes seen in proliferative diabetic retinopathy are the result of: - ANSWER-
Anoxic stimulation
Which are the signs and symptoms of infant retinoblastoma? (Select all that apply.)
a. White reflex
b. Red reflex
c. Corneal light reflex
d. Absence of a blink reflex
e. Autosomal dominant trait
f. Drainage from the affected eye
g. Visual acuity of 20/500 - ANSWER-White reflex and autosomal dominant trait
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? - ANSWER-Cocaine
A 5-year-old child presents with nasal congestion and a headache. To assess for
sinus tenderness, you should palpate over the: - ANSWER-Maxillary sinuses only
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: - ANSWER-Pull the auricle down and back
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: - ANSWER-more nasal stuffiness
You are performing hearing screening tests. Who would be expected to find difficulty
in hearing the highest frequencies? - ANSWER-A 50-year old
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? - ANSWER-Salicylates
Mr. Johnson presents with a freely movable cystic mass in the midline of the high
neck region, at the base of the tongue. This is
most likely a - ANSWER-thyroglossal duct cyst
The premature union of cranial sutures that involves the shape of the head without
mental retardation is - ANSWER-craniosynostosis
Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the
examiner, you are palpating his head during your
HEAD AND NECK EXAM QUESTIONS
AND ANSWERS
You observe pupillary response as the patient looks at a distant object and then at
an object held 10 cm from the bridge of the nose.
You are assessing for: - ANSWER-accommodation
When inspecting the region of the lacrimal gland, palpate - ANSWER-the lower
orbital rim, near the inner canthus
Examination to assess for extraocular muscle imbalance is conducted by -
ANSWER-having the patient follow your finger through planes
Mr. Older is a 40-year-old patient who presents to the office for a follow-up eye
examination after the diagnosis of myopia. To see
retinal details in a myopic patient, you will need to - ANSWER-turn your
ophthalmoscope to a minus lens.
Ask the patient to look directly at the light of the ophthalmoscope when you are
ready to examine the: - ANSWER-Macula
Opacities of the red reflex may indicate the presence of: - ANSWER-Cataracts
If a patient has early papilledema, using an ophthalmoscope, the examiner will be
able to detect - ANSWER-Dilated retinal veins
Cupping of the optic disc may be a result of - ANSWER-Glaucoma
When drusen bodies are noted to be increasing in number or in intensity of color, the
patient should be further evaluated with a(n) - ANSWER-Amsler grid
Cotton wool spots are most closely associated with: - ANSWER-Hypertension
Which may be suggestive of Down syndrome? - ANSWER-Prominent epicanthal
folds
To differentiate between infants who have strabismus and those who have
pseudostrabismus, use the: - ANSWER-Corneal light reflex
You are attempting to examine the eyes of a newborn. To facilitate eye opening, you
would first - ANSWER-Dim the room lights
Dot hemorrhages, or microaneurysms, in the retina and the presence of hard and
soft exudates are most commonly seen in those
with - ANSWER-Diabetic retinopathies
, Which maneuver can be done to reduce the systemic absorption of cycloplegic and
mydriatic agents when examining a pregnant
woman if the examination is mandatory? - ANSWER-Use nasolacrimal occlusion
after instillation
Changes seen in proliferative diabetic retinopathy are the result of: - ANSWER-
Anoxic stimulation
Which are the signs and symptoms of infant retinoblastoma? (Select all that apply.)
a. White reflex
b. Red reflex
c. Corneal light reflex
d. Absence of a blink reflex
e. Autosomal dominant trait
f. Drainage from the affected eye
g. Visual acuity of 20/500 - ANSWER-White reflex and autosomal dominant trait
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? - ANSWER-Cocaine
A 5-year-old child presents with nasal congestion and a headache. To assess for
sinus tenderness, you should palpate over the: - ANSWER-Maxillary sinuses only
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: - ANSWER-Pull the auricle down and back
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: - ANSWER-more nasal stuffiness
You are performing hearing screening tests. Who would be expected to find difficulty
in hearing the highest frequencies? - ANSWER-A 50-year old
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? - ANSWER-Salicylates
Mr. Johnson presents with a freely movable cystic mass in the midline of the high
neck region, at the base of the tongue. This is
most likely a - ANSWER-thyroglossal duct cyst
The premature union of cranial sutures that involves the shape of the head without
mental retardation is - ANSWER-craniosynostosis
Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the
examiner, you are palpating his head during your