Exam (elaborations) NUR 6521 Exam

Exam (elaborations) NUR 6521 Exam The function of the auditory ossicles is to: transmit the light reflex to the light form sound vibrations into mechanical waves for the inner ear. Correctto capture sound waves from the external ear for transmission into the middle separate the inner ear from the middle ear. Explanation: The function of the auditory ossicles is to transform sound vibrations into mechanical waves for the inner ear Question: A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of: an arrhythmia.a neurological condition. Correctan inner ear infection. Incorrectorthostatic hypotension. Explanation: Vertigo symptoms associated with neurologic conditions include: ataxia, diplopia, and dysarthria. Symptoms associated with cardiovascular conditions and vertigo include arrhythmias, orthostatic hypotension, vasovagal stimulation, lightheadedness, weakness, or presyncope. Question: A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with: a pinguecula.a elasma. Correct Explanation: NUR 6521 Exam Slightly raised, yellowish, well-circumscribed plaques appearing along the nasal area of one or both eyelids are consistent with lipid disorders and called xanthelasma. Pinguecula refer to harmless, yellowish, triangular nodules in the bulbar conjunctiva on either side of the iris. A chalazion is a nontender nodule usually on the underside of the eyelid. Episcleritis is an ocular inflammation of the episcleral vessels. Question: Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This means that: at 200 feet the patient can read printed information that a person with normal vision could read at 20 20 feet the patient can read printed information that a person with normal vision could read at 200 feet. Correctthe patient has normal visual patient may not be able to read so he should be tested with the picture or "E" eye charts. Explanation: Visual acuity that is corrected to 20/200 constitutes legal blindness. The larger the number under 20, the worse the visual acuity. If this is a new finding, the patient needs ophthalmologic evaluation. Question: Findings following assessment of a person's left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with: a conjugate cranial nerve III (oculomotor) paralysis Correctcranial nerve IV (trochlear) al nerve VI (abducens) paralysis. Explanation: With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. In conjugate or normal gaze, the normal movement of the two eyes appears simultaneously in the same direction to bring something into view. With a left cranial nerve VI paralysis, a person's gaze would include eyes conjugate when looking to the right, esotropia (one or both eyes turn inward) appears in the left eye when looking straight ahead, and esotropia is maximum in the left eye when looking to the left. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question: Findings following assessment of a person's eye gaze include both eyes moving in the same direction simultaneously. This condition is most consistent with: a conjugate gaze. Correctleft cranial nerve III (oculomotor) paralysis cranial nerve IV (trochlear) al nerve VI (abducens) paralysis. Explanation: In conjugate or normal gaze, the normal movement of the two eyes appears simultaneously in the same direction to bring something into view. With a left cranial nerve VI paralysis, a person's gaze would include eyes conjugate when looking to the right, esotropia (one or both eyes turn inward) in the left eye when looking straight ahead, and esotropia is maximum in the left eye when looking to the left. With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question: A patient was diagnosed as being farsighted. The term for this condition is: hyperopia. Cmatism. Explanation: Myopia, nearsightedness, occurs when light rays focus anterior to the retina. Hyperopia, farsightedness, occurs when light rays focus posterior to the retina. Strabismus, heterotropia, is a condition in which the eyes are not properly aligned with each other. In astigmatism, light rays do not focus correctly on the retina. This causes blurriness. Question: A buildup of excess fluid around the periphery of the eye orbits is known as: rbital edema. Correct Explanation: An accumulation of fluid around the periphery of the eye orbits is known as periorbital edema. Question: In order to visualize the opening of Stensen's duct, examine the: dorsal surface of the beneath the mandible at the angle of the l mucosa opposite the second molar. Correctsmall openings along the sublingual fold under the tongue. Explanation: The largest salivary gland is the parotid gland and it lies within the cheeks in front of the ear extending from the zygomatic arch down to the angle of the jaw. Its duct, Stensen's duct, runs forward to an opening on the buccal mucosa opposite the second molar. If blood comes out through Stensen's duct when it is palpated, this could suggest parotid cancer. If pus is expelled, it suggests suppurative parotitis. With mumps, the orifice of the Stensen duct appears erythematous and enlarged. The submandibular gland is the size of a walnut. It lies beneath the mandible at the angle of the jaw. Wharton's duct runs up and forward to the floor of the mouth and opens at either side of the frenulum. The smallest, the almond-shaped sublingual gland, lies within the floor of the mouth under the tongue. It has many small openings along the sublingual fold under the tongue. Question: What connects the middle ear to the nasopharynx? The tympanic membraneThe proximal end of the eustachian tube CorrectThe malleusThe ossicles Explanation: The proximal end of the eustachian tube connects the middle ear to the nasopharynx. Question: The fleshly projection of the earlobe is known as the: lobule. C. Explanation: The fleshy projection of the earlobe is known as the lobule. The auditory canal opens behind a nodular protuberance that points backward over the entrance to the canal. This is known as the tragus. The auricle is made of cartilage covered by skin and has a firm elastic consistency. The auricle has a prominent curved outer ridge known as the helix. Question: When examining the pupils, the left pupil is noted to be fixed and dilated to light and near accommodation. This condition may be suggestive of: a tonic pupil. Incorrectoculomotor nerve (CN III) paralysis. CorrectHorner's syndrome.Argyll Robertson pupils. Explanation: Paralysis of the oculomotor cranial nerve (CN III), the dilated pupil is fixed to light and near accommodation. Ptosis and lateral deviation of the eye are usually present. When the pupil is large, regular, and usually unilateral and the reaction to light is severely reduced and slowed, or even absent, this condition is referred to as a tonic pupil or Adele's pupil. In Horner's syndrome, the affected pupil reacts briskly to light and near effort but the pupil is small. The pupils in Argyll Robertson condition appear small and irregular shaped and accommodate but do not react to light. Question: A deposit of uric acid crystals appearing as hard nodules on the helix or antihelix is termed: a keloid.a tophi. Correcta cutaneous rodermatitis. Explanation: The antihelix divides the helix from the lobe. Tophi is a deposit of uric acid crystals (that appear commonly in patients with chronically elevated uric acid levels) on the helix or antihelix. They can also appear near the joints, hands, or feet. It is also seen in chronic tophaceous gout. A firm, nodular, hypertrophic mass of scar tissue extending beyond the area of injury is classified as a keloid. A cutaneous cyst has a characteristic dome shaped lump in the dermis forming a benign closed firm sac attached to the epidermis. This lesion was formerly known as a sebaceous cyst. A chronic inflammatory lesion that starts as a painful, tender papule on the helix or antihelix is known as chondrodermatitis. Question: On the outer ear, anterior and parallel to the helix, is a curved prominence known as the: Antihelix CorrectHelixAuricleTragus Explanation: The antihelix is a curved prominence that is parallel and anterior to the helix and is part of the auricle. The external ear consists of the auricle and ear canal. The auricle is made of cartilage covered by skin and has a firm elastic consistency. The auricle has a prominent curved outer ridge known as the helix. The ear canal opens behind a nodular protuberance that points backward over the entrance to the canal. This is called the tragus. Question: On examination of the pupils, both are round but the right pupil appears larger than the left and reacts much slower to light. This condition may be indicative of: a tonic pupil. Correctoculomotor nerve (CN III) paralysis. IncorrectHorner's syndrome.Argyll Robertson pupils. Explanation: When the pupil is large, regular, and usually unilateral and the reaction to light is severely reduced and slowed, or even absent, this condition is referred to as a tonic pupil or Adele's pupil. Paralysis of the oculomotor cranial nerve (CN III), the dilated pupil is fixed to light and near accommodation. Ptosis and lateral deviation of the eye are usually present. In Horner's syndrome, the affected pupil reacts briskly to light and near effort but the pupil is small. The pupils in Argyll Robertson condition appear small and irregular shaped and accommodate but do not react to light. Question: Leukoplakia was noted during an exam of the mouth. This symptom may be: a normal ncerous. Correctassociated with periodontal stent with gingivitis. Explanation: Leukoplakia are thickened white patches located on any area of the mouth. These patches cannot be rubbed off. Most are not serious but some can be considered precancerous. Therefore, they should be evaluated. These lesions are not considered normal findings. Periodontal disease usually includes an infection of the gums and may involve the teeth. Generally, the infection causes redness and swelling but not white patches. Question: The majority of people who present with non-24 hour sleep-wake disorder are: legally tion ly blind. Correct Explanation: The majority of people who present with non-24 hour sleep-wake disorder are totally blind. This chronic circadian rhythm sleep disorder is defined as a condition of insomnia related to abnormal synchronization between the 24-hour light -dark cycle and the endogenous circadian rhythms of sleep and wake cycles. Question: The most common cause of bacterial pharyngeal infections in children is: Corynebacterium.C A beta-hemolytic Streptococcus. Correct Explanation: Pharyngitis is caused by swelling between the tonsils and the larynx. Most sore throats are caused by colds, the flu, Coxsackie virus or mononucleosis. Bacteria that cause pharyngitis include group A betahemolytic Streptococcus, and less commonly, Corynebacterium, gonorrhea, and Chlamydia can cause sore throat. Question: When inspecting the neck for the thyroid gland, slightly tilt the patient's head back, and using tangential lighting directed downward from the tip of the patient's chin, inspect the: region above the thyroid n below the cricoid cartilage. Correctarea along the sternomastoid along the anterior edge of the trapezius. Explanation: When inspecting the neck for the thyroid gland, slightly tilt the patient's head back and using tangential lighting (light coming in from the side at a right angle) directed downward from the tip of the patient's chin, inspect the region below the cricoid cartilage; located between the thyroid cartilage and the thyroid gland. The area of sternomastoid border allows palpation of the superficial cervical nodes. The posterior cervical lymph nodes are located at the anterior edge of the trapezius. Question: A condition in which the eyes are not properly aligned with each other is termed: ismus. Correctastigmatism. Explanation: Strabismus, heterotropia, is a condition in which the eyes are misaligned. "Crossed-eyed", "wall eye", or "lazy eye" are all associated with strabismus. Hyperopia, farsightedness, occurs when light rays focus posterior to the retina. Myopia, nearsightedness, occurs when light rays focus anterior to the retina. In astigmatism, light rays do not focus correctly on the retina. This causes blurriness. Question: Round or oval shaped lesions surrounded by erythematous mucosa and noted on an area of the oral mucosa may be: leukoplakia. aphthous ulcers. CorrectKoplik's ative gingivitis. Explanation: Aphthous ulcers can appear anywhere on the buccal mucosa or tongue. They usually appear as round or oval ulcers, can be white or yellowish gray in color, and are surrounded by a halo of reddened mucosa. They are usually painful. Leukoplakia presents as thickened white patches anywhere on the oral mucosa. Koplik's spots appear in the early stages of measles (rubeola). They appear as small white specks that resemble grains of salt on a red background on the buccal mucosa. They are not usually painful. Ulcerative gingivitis is a painful form of gingivitis that is characterized by the development of ulcers in the interdental papillae. If untreated they can become necrotizing along the gum margins and appear as erythematous ulcers. Question: On physical exam, an abnormal Rinne test might indicate: impaired physical red visual red hearing ability. Correctimpaired swallowing ability. Explanation: The Rinne test uses a tuning fork to compare air conduction to bone conduction and so is used to assess hearing. The other choices are not assessed using the Rinne test. Question: Ophthalmoscopic examination reveals dark specks noted between the fundus and the lens. These specks are most likely: superficial retinal hemorrhages. Ious floaters. Correct Explanation: Vitreous floaters may be seen as dark specks or strands between the fundus and the lens. They could be a symptom of retinal detachment, retinal tear, or bleeding within the eye. Superficial retinal hemorrhages appear as small, linear, flame-shaped, red streaks in the fundus and are seen in hypertension, papilledema, and occlusion of the retinal vein. Cataracts are opacities in the lens of the eye. Drusen appear as yellowish round spots posteriorly between the optic disc and the macula and are associated with cellular debris. Question: A 60- year-old patient presents with severe, deep left eye pain. Findings reveal dilated and fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These findings are most likely consistent with: acute al injury. Incorrectcorneal angle closure glaucoma. Correct Explanation: With acute angle closure glaucoma, the pain is described as severe, aching, and deep. The pupils are dilated and fixed and the cornea appears steamy or cloudy. If an increase in intraocular pressure is present, this would be an emergency situation. Acute iritis presents with a moderate aching pain deep within the eye. The pupils are small and irregular and vision is decreased and photophobia is usually present. The cornea is clear or slightly cloudy with injection confined to the corneal limbus. This is considered an emergency and is usually related to Herpes zoster infection or tuberculosis. Corneal injury or infection usually presents with watery or purulent ocular discharge and the pain is severe. Question: The function of the labyrinth in the inner ear is to: assist with air ain equilibrium. Correctmaintain acoustic re sound waves. Explanation: The inner ear has 2 main functions: hearing and balance. The cochlear system is dedicated to hearing and the vestibular system is dedicated to balance. The labyrinth is part of the semicircular canals and the vestibular system and is responsible for balance. Question: The curved outer ridge of the auricle of the ear is known as the: AntihelixHelix CorrectAuricle IncorrectTragus Explanation: The auricle has a prominent curved outer ridge known as the helix. The external ear consists of the auricle and ear canal. The auricle is made of cartilage covered by skin and has a firm elastic consistency. The antihelix is a curved prominence that is parallel and anterior to the helix. The auditory canal opens behind a nodular protuberance that points backward over the entrance to the canal, known as the tragus. Question: A person who has been blind since birth presents for a physical exam. Expected findings of the pupillary reaction when light is shown would be: constriction of both ion of both reaction from either depends. Correct Explanation: It depends on the type of blindness. Pupillary reaction is controlled by the muscles which are innervated by nerves. As long as there is no damage to the nerve or the muscle, the pupil will still contract or dilate. Question: A six-year-old complains that something is in her left eye. There is a red raised area of the left lid. There is redness and tenderness of the eye and tearing. These findings are consistent with: nctivitis. Incorrecta corneal ulcer.a hordeolum. Correct Explanation: A hordeolum, or stye, is an infection of the sebaceous gland of the eyelid. Symptoms include a raised area of the lid, pain, redness, tenderness, possible photophobia, tearing, and a sensation of a foreign body in the eye. Conjunctivitis presents with a reddened conjunctiva and presence of a watery or purulent discharge depending on the etiology. A corneal ulcer produces a visible area of ulceration. Blepharitis presents with an erythematous eyelid margin with a mucous discharge, crusting, and scaling of the eyelid margins. Question: Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the: vein "winds" down on either side of the artery. Correctvein is twisted on the distal side of the crosses beneath the stops abruptly on either side of the artery. Explanation: When the arterial walls lose their transparency, changes appear in the arteriovenous crossings. Decreased transparency of the retina probably contributes to AV nicking and AV tapering. In tapering, the vein appears to taper or "wind" down either side of the artery. In AV nicking, the vein appears to stop abruptly on either side of the artery. In the normal eye, the vein appears to cross beneath the artery. With banking, the vein appears