NR 509 LATEST 2026 EXAM QUESTIONS AND ANSWERS
GRADED A+
✔✔Tests to detect hearing loss include a single-item screening test, namely asking
patients if they have difficulty hearing; multi-item questionnaires such as the Hearing
Handicap Inventory for the Elderly, handheld audiometers; the clinical "whisper test"; or
the finger rub test. - ✔✔
✔✔Aging is the most impt risk factor for hearing loss. - ✔✔
✔✔Presbycusis is the most common age related cause of hearing loss. This age related
factor is when hair cells of the ear degenerate over time contributing to high-frequency
hearing loss. - ✔✔
✔✔Other causes of hearing loss include: congenital, syphilis, rubella, meningitis,
diabetes, exposure to ototoxic drugs, recurring inner ear infections, frequent use of
headphones, hazardous nose levels at work, battlefield. - ✔✔
✔✔Oral Health - ✔✔
✔✔Saliva cleanses and lubricates the mouth. Many medications reduce salivary flow,
increasing risk for tooth decay, mucositis, and gum disease from xerostomia, especially
for the elderly. - ✔✔
✔✔To increase saliva due to medications that you can't discontinue: drink higher
amounts of water and chew sugarless gum. - ✔✔
✔✔Risk factors for periodontal disease: low income, male gender, smoking, diabetes,
and poor oral hygiene, signs of periodontal disease such as bleeding, pus, recession of
the gums, and bad breath. - ✔✔
✔✔Warning sign of oral cancer: Leukoplakia - ✔✔
✔✔Risk factors for oral cancer: Tobacco and alcohol account for a large amount of oral
cancers. Other causes include HPV (> age 30, male gender, high # ofsex partners,
smoking). - ✔✔
✔✔Head Exam/Assessment - ✔✔
✔✔Hair & Scalp - ✔✔
✔✔Fine hair is seen in hyperthyroidism, coarse hair in hypothyroidism. - ✔✔
, ✔✔Redness/Scaling= seborrheic dermatitis or psoriasis. - ✔✔
✔✔Soft lump=pilar cysts - ✔✔
✔✔Hirsutism (excessive facial hair) = polycystic ovary syndrome. - ✔✔
✔✔Eye Assessment: in accommodation the change in shape of the lenses brings near
objects into focus, - ✔✔
✔✔Visual acuity: is expressed as two numbers (e.g., 20/30) the first indicates the
distance of the patient from the chart, and the second, the distance at which a normal
eye can read the line of letters. person is usually considered legally blind when vision in
the better eye, corrected by glasses, is 20/200 or less. - ✔✔
✔✔Confrontation testing of the visual fields is a valuable screening technique for
detection of lesions in the anterior and posterior visual pathway. - ✔✔
✔✔Anterior pathway defects include glaucoma, optic neuropathy, optic neuritis, and
glioma. - ✔✔
✔✔Posterior pathway defects include stroke and chiasmal tumors. - ✔✔
✔✔Blepharitis: A chronic inflammation of the eyelids at the base of the hair follicles,
often from S. aureus. There is also a scaling seborrheic variant. - ✔✔
✔✔Sjögren syndromey: Dryness from impaired eye secretion. - ✔✔
✔✔open-angle glaucoma, the common form of glaucoma, the normal spatial relation
between iris and cornea is preserved and the iris is fully lit. - ✔✔
✔✔Acute narrow-angle glaucoma is a sudden increase in IOP when drainage of the
aqueous humor is blocked. - ✔✔
✔✔Nystagmus: a fine rhythmic oscillation of the eyes. A few beats of nystagmus on
extreme lateral gaze are normal. - ✔✔
✔✔Test the Six EOMs Ask the patient to follow your finger or pencil as you sweep
through the six cardinal directions of gaze. Making a wide H in the air, lead the patient's
gaze - ✔✔
✔✔Absence of a red reflex suggests an opacity of the lens (cataract) or, possibly, the
vitreous (or even an artificial eye. - ✔✔
GRADED A+
✔✔Tests to detect hearing loss include a single-item screening test, namely asking
patients if they have difficulty hearing; multi-item questionnaires such as the Hearing
Handicap Inventory for the Elderly, handheld audiometers; the clinical "whisper test"; or
the finger rub test. - ✔✔
✔✔Aging is the most impt risk factor for hearing loss. - ✔✔
✔✔Presbycusis is the most common age related cause of hearing loss. This age related
factor is when hair cells of the ear degenerate over time contributing to high-frequency
hearing loss. - ✔✔
✔✔Other causes of hearing loss include: congenital, syphilis, rubella, meningitis,
diabetes, exposure to ototoxic drugs, recurring inner ear infections, frequent use of
headphones, hazardous nose levels at work, battlefield. - ✔✔
✔✔Oral Health - ✔✔
✔✔Saliva cleanses and lubricates the mouth. Many medications reduce salivary flow,
increasing risk for tooth decay, mucositis, and gum disease from xerostomia, especially
for the elderly. - ✔✔
✔✔To increase saliva due to medications that you can't discontinue: drink higher
amounts of water and chew sugarless gum. - ✔✔
✔✔Risk factors for periodontal disease: low income, male gender, smoking, diabetes,
and poor oral hygiene, signs of periodontal disease such as bleeding, pus, recession of
the gums, and bad breath. - ✔✔
✔✔Warning sign of oral cancer: Leukoplakia - ✔✔
✔✔Risk factors for oral cancer: Tobacco and alcohol account for a large amount of oral
cancers. Other causes include HPV (> age 30, male gender, high # ofsex partners,
smoking). - ✔✔
✔✔Head Exam/Assessment - ✔✔
✔✔Hair & Scalp - ✔✔
✔✔Fine hair is seen in hyperthyroidism, coarse hair in hypothyroidism. - ✔✔
, ✔✔Redness/Scaling= seborrheic dermatitis or psoriasis. - ✔✔
✔✔Soft lump=pilar cysts - ✔✔
✔✔Hirsutism (excessive facial hair) = polycystic ovary syndrome. - ✔✔
✔✔Eye Assessment: in accommodation the change in shape of the lenses brings near
objects into focus, - ✔✔
✔✔Visual acuity: is expressed as two numbers (e.g., 20/30) the first indicates the
distance of the patient from the chart, and the second, the distance at which a normal
eye can read the line of letters. person is usually considered legally blind when vision in
the better eye, corrected by glasses, is 20/200 or less. - ✔✔
✔✔Confrontation testing of the visual fields is a valuable screening technique for
detection of lesions in the anterior and posterior visual pathway. - ✔✔
✔✔Anterior pathway defects include glaucoma, optic neuropathy, optic neuritis, and
glioma. - ✔✔
✔✔Posterior pathway defects include stroke and chiasmal tumors. - ✔✔
✔✔Blepharitis: A chronic inflammation of the eyelids at the base of the hair follicles,
often from S. aureus. There is also a scaling seborrheic variant. - ✔✔
✔✔Sjögren syndromey: Dryness from impaired eye secretion. - ✔✔
✔✔open-angle glaucoma, the common form of glaucoma, the normal spatial relation
between iris and cornea is preserved and the iris is fully lit. - ✔✔
✔✔Acute narrow-angle glaucoma is a sudden increase in IOP when drainage of the
aqueous humor is blocked. - ✔✔
✔✔Nystagmus: a fine rhythmic oscillation of the eyes. A few beats of nystagmus on
extreme lateral gaze are normal. - ✔✔
✔✔Test the Six EOMs Ask the patient to follow your finger or pencil as you sweep
through the six cardinal directions of gaze. Making a wide H in the air, lead the patient's
gaze - ✔✔
✔✔Absence of a red reflex suggests an opacity of the lens (cataract) or, possibly, the
vitreous (or even an artificial eye. - ✔✔
