EXAM 3 (NUR 202) | COMPREHENSIVE STUDY GUIDE, NCLEX-STYLE PRACTICE QUESTIONS AND
ANSWERS 2026/2027
Snellen Wall Chart - ANS ✔✔Tests CN II: Hung at a distance 20 feet from the patient, Top
number indicates distance between patient and chart, Bottom number represents distance at
which a person with normal vision should be able to read that line on the chart
corneal light reflex - ANS ✔✔sparkle in the eye in the same place
→ If abnormal make sure to test EOMs, Accommodation, and perform
PERRLA - ANS ✔✔pupils equal, round, reactive to light and accommodation
strabismus - ANS ✔✔crossed eyes, Strabismus is abnormal ocular alignment, Visualized when
observing corneal light reflex.
Ptosis - ANS ✔✔Lid covers a portion of the pupil
Conjunctivitis - ANS ✔✔Conjunctivitis is inflammation of palpebral or bulbar conjunctiva
Caused by infection either local or systemic, allergic reaction, chemical irritation
Corneal Abrasion - ANS ✔✔Corneal abrasion or ulcer is disruption of corneal epithelium and
stroma:
→ Infections
→ Desiccation because of incomplete lid closure
→ Poor lacrimal gland function.
→ May also be caused by scratches, foreign bodies, or contact lenses
Middle Ear - ANS ✔✔Air-filled cavity separated from external ear canal by tympanic membrane
,Eustachian tube is cartilaginous passage between middle ear and nasopharynx
Acute Otitis Media - ANS ✔✔Tympanic membrane inflamed, red, bulging
Acute: Infectious, resolves on its own
OME: non-infectious, fluid can make it difficult to hear
Conductive hearing loss - ANS ✔✔caused by interference of air conduction to middle ear.
→ May result from blockage of external auditory canal, problems with TM, or problems within
the middle ear.
Clinical findings:
→ Decreased ability to hear and report muffled tones.
→ Obstructions within the auditory canal or problems with TM may be visible with otoscopic
examination.
→ Problems within the middle ear may not be visible.
Sensorineural hearing loss (SNHL) - ANS ✔✔caused by structural changes, disorders of inner
ear, or problems with auditory nerve
SNHL accounts for more than 90% of hearing loss.
Clinical findings:
→ Usually manifests as gradual and progressive bilateral deafness with a loss of high-pitched
tones.
→ Patients have difficulty filtering background noise, making listening difficult
Epistaxis - ANS ✔✔Common causes include forceful sneezing or coughing, trauma, picking of
nose, or heavy exertion. Some nosebleeds occur spontaneously
The Oropharynx - ANS ✔✔Oropharynx includes structures at back of mouth that are visible on
examination:
, → Uvula is suspended from soft palate and extends to form anterior pillar.
→ Tonsils are lymphoid tissue between pillars.
→ Posterior pharyngeal wall is visible when tongue is extended or depressed.
→ Epiglottis, a cartilaginous structure, protects laryngealopening.
Tonsils - ANS ✔✔Graded by size:
1+ visible
2+ ½ way between tonsillar pillars and uvula
3+ almost touching uvula
4+ touching uvula (airway blockage)
Herpes Simplex Type 1 - ANS ✔✔Inflammation/infection: Herpes simplex type 1 (cold sore) is a
highly contagious, viral infection spread by direct contact.
Clinical findings: Typically a prodromal burning, tingling, or pain sensation before outbreak of
lesions.
→ Lesions appear on lip and skin junction as groups with an erythematous base.
Candidiasis - ANS ✔✔(thrush) is oral infection caused by Candida albicans.
Appears as soft white plaques on tongue, buccal mucosa, or posterior pharynx.
Lymph Nodes - ANS ✔✔Lymph nodes are in chains or clusters:
→ Tiny clumps of lymphatic tissue
→ Superficial nodes in subcutaneous tissue become enlarged and tender
Cranial Nerve VII Evaluation - ANS ✔✔Inspect Face for Symmetry and Motion (Cranial Nerve VII)
Ask patient to
A. Raise eyebrows
ANSWERS 2026/2027
Snellen Wall Chart - ANS ✔✔Tests CN II: Hung at a distance 20 feet from the patient, Top
number indicates distance between patient and chart, Bottom number represents distance at
which a person with normal vision should be able to read that line on the chart
corneal light reflex - ANS ✔✔sparkle in the eye in the same place
→ If abnormal make sure to test EOMs, Accommodation, and perform
PERRLA - ANS ✔✔pupils equal, round, reactive to light and accommodation
strabismus - ANS ✔✔crossed eyes, Strabismus is abnormal ocular alignment, Visualized when
observing corneal light reflex.
Ptosis - ANS ✔✔Lid covers a portion of the pupil
Conjunctivitis - ANS ✔✔Conjunctivitis is inflammation of palpebral or bulbar conjunctiva
Caused by infection either local or systemic, allergic reaction, chemical irritation
Corneal Abrasion - ANS ✔✔Corneal abrasion or ulcer is disruption of corneal epithelium and
stroma:
→ Infections
→ Desiccation because of incomplete lid closure
→ Poor lacrimal gland function.
→ May also be caused by scratches, foreign bodies, or contact lenses
Middle Ear - ANS ✔✔Air-filled cavity separated from external ear canal by tympanic membrane
,Eustachian tube is cartilaginous passage between middle ear and nasopharynx
Acute Otitis Media - ANS ✔✔Tympanic membrane inflamed, red, bulging
Acute: Infectious, resolves on its own
OME: non-infectious, fluid can make it difficult to hear
Conductive hearing loss - ANS ✔✔caused by interference of air conduction to middle ear.
→ May result from blockage of external auditory canal, problems with TM, or problems within
the middle ear.
Clinical findings:
→ Decreased ability to hear and report muffled tones.
→ Obstructions within the auditory canal or problems with TM may be visible with otoscopic
examination.
→ Problems within the middle ear may not be visible.
Sensorineural hearing loss (SNHL) - ANS ✔✔caused by structural changes, disorders of inner
ear, or problems with auditory nerve
SNHL accounts for more than 90% of hearing loss.
Clinical findings:
→ Usually manifests as gradual and progressive bilateral deafness with a loss of high-pitched
tones.
→ Patients have difficulty filtering background noise, making listening difficult
Epistaxis - ANS ✔✔Common causes include forceful sneezing or coughing, trauma, picking of
nose, or heavy exertion. Some nosebleeds occur spontaneously
The Oropharynx - ANS ✔✔Oropharynx includes structures at back of mouth that are visible on
examination:
, → Uvula is suspended from soft palate and extends to form anterior pillar.
→ Tonsils are lymphoid tissue between pillars.
→ Posterior pharyngeal wall is visible when tongue is extended or depressed.
→ Epiglottis, a cartilaginous structure, protects laryngealopening.
Tonsils - ANS ✔✔Graded by size:
1+ visible
2+ ½ way between tonsillar pillars and uvula
3+ almost touching uvula
4+ touching uvula (airway blockage)
Herpes Simplex Type 1 - ANS ✔✔Inflammation/infection: Herpes simplex type 1 (cold sore) is a
highly contagious, viral infection spread by direct contact.
Clinical findings: Typically a prodromal burning, tingling, or pain sensation before outbreak of
lesions.
→ Lesions appear on lip and skin junction as groups with an erythematous base.
Candidiasis - ANS ✔✔(thrush) is oral infection caused by Candida albicans.
Appears as soft white plaques on tongue, buccal mucosa, or posterior pharynx.
Lymph Nodes - ANS ✔✔Lymph nodes are in chains or clusters:
→ Tiny clumps of lymphatic tissue
→ Superficial nodes in subcutaneous tissue become enlarged and tender
Cranial Nerve VII Evaluation - ANS ✔✔Inspect Face for Symmetry and Motion (Cranial Nerve VII)
Ask patient to
A. Raise eyebrows
