Health Assessment: Chapter 10 - Head, Eyes, Ears,
Nose, and Throat questions with verified answers
A 24-year-old female patient has a 2-day history of clear nasal drainage.
Based on these data, which question is the most logical for the nurse to
ask?
a. "Is there a foul odor coming from your nose?"
b. "Have you recently had nosebleeds?"
c. "Do you snore when sleeping?"
d. "Do you have allergies?" Ans✓✓✓d. "Do you have allergies?"
A 32-year-old woman has a 4-day history of sore throat and difficulty
swallowing. The nurse observes tonsils, covered with yellow patches.
The tonsils are so large that they fill the entire oropharynx and appear to
be touching. How does the nurse document these findings?
a. "Tonsils yellow and swollen."
b. "Enlarged tonsils 4+ with yellow exudate."
c. "Strep infection to tonsils with 3+ swelling
d. "1+ edema of tonsils with pus." Ans✓✓✓b. "Enlarged tonsils 4+
with yellow exudate."
A nurse assesses neck range of movement of several adults. Which
patient has an expected range of motion of the neck?
,a. Patient A is unable to resist the nurse's attempt to move the head
upright.
b. Patient B bends the head to the right and left (ear to shoulder) 15
degrees.
c. Patient C flexes chin toward the chest 45 degrees.
d. Patient D hyperextends the head 30 degrees from midline.
Ans✓✓✓c. Patient C flexes chin toward the chest 45 degrees.
A nurse assessing the hearing of a patient with presbycusis expects
which finding on a test for hearing?
a. Bone conduction will be longer than air conduction on the Rinne test
(BC > AC).
b. Air conduction will be longer than bone conduction on the Rinne test
(AC > BC).
c. Sound lateralizes to the affected ear on the Weber test.
d. Sound lateralizes to both ears equally on the Weber test. Ans✓✓✓b.
Air conduction will be longer than bone conduction on the Rinne test
(AC > BC).
A nurse examines a patient's auditory canal and tympanic membrane
with an otoscope and observes which finding as normal?
a. Clear fluid lining the auditory canal
b. A firm tympanic membrane without fluctuation with puffs of air
c. A small hole within the cone of light
,d. A shiny, translucent tympanic membrane Ans✓✓✓d. A shiny,
translucent tympanic membrane
A nurse is assessing a patient who was hit at the base of the skull with a
blunt instrument causing a skull fracture. What assessment finding does
this nurse anticipate during the inspection?
a. Tinnitus, vertigo, and dizziness
b. Clear drainage from the ear and nose
c. Loss of hearing and smell
d. Purulent drainage from the ear and bloody drainage from the nose
Ans✓✓✓b. Clear drainage from the ear and nose
A nurse is assessing the eyes of a healthy 72-year-old adult. What
findings does the nurse expect? Select all that apply.
a. Bulbar conjunctiva pink and clear, with small red vessels noted
b. Sclera yellow and moist, cornea transparent
c. Extraocular movement symmetric with peripheral vision noted
d. Newspaper held at 18 inches to see clearly
e. Sclera visible between upper lid and iris
f. Gray to white circle noted where the sclera merges with the cornea
g. Light reflects on the cornea at 12 o'clock in each eye Ans✓✓✓A, C,
G
, A nurse is obtaining a health history from a 52-year-old male patient
with a red lesion at the base of the tongue. What additional data does the
nurse specifically collect about this patient?
a. Alcohol and tobacco use
b. The date of his last dental examination
c. The presence of dentures
d. A history of pyorrhea Ans✓✓✓a. Alcohol and tobacco use
A nurse observes a student using the whisper test to screen a patient with
hearing loss. Which behavior by the student requires a corrective
comment from the nurse?
a. Instructing the patient to cover the ear not being tested
b. Standing beside the patient on the side of the ear being tested
c. Shielding the mouth to prevent the patient from reading lips
d. Whispering one or two syllable words and ask the patient to repeat
what is heard Ans✓✓✓b. Standing beside the patient on the side of the
ear being tested
A nurse reads in the history that a patient has a new onset of acute otitis
media. Based on this information, how does the nurse expect this
patient's tympanic membrane to appear?
a. Dull
Nose, and Throat questions with verified answers
A 24-year-old female patient has a 2-day history of clear nasal drainage.
Based on these data, which question is the most logical for the nurse to
ask?
a. "Is there a foul odor coming from your nose?"
b. "Have you recently had nosebleeds?"
c. "Do you snore when sleeping?"
d. "Do you have allergies?" Ans✓✓✓d. "Do you have allergies?"
A 32-year-old woman has a 4-day history of sore throat and difficulty
swallowing. The nurse observes tonsils, covered with yellow patches.
The tonsils are so large that they fill the entire oropharynx and appear to
be touching. How does the nurse document these findings?
a. "Tonsils yellow and swollen."
b. "Enlarged tonsils 4+ with yellow exudate."
c. "Strep infection to tonsils with 3+ swelling
d. "1+ edema of tonsils with pus." Ans✓✓✓b. "Enlarged tonsils 4+
with yellow exudate."
A nurse assesses neck range of movement of several adults. Which
patient has an expected range of motion of the neck?
,a. Patient A is unable to resist the nurse's attempt to move the head
upright.
b. Patient B bends the head to the right and left (ear to shoulder) 15
degrees.
c. Patient C flexes chin toward the chest 45 degrees.
d. Patient D hyperextends the head 30 degrees from midline.
Ans✓✓✓c. Patient C flexes chin toward the chest 45 degrees.
A nurse assessing the hearing of a patient with presbycusis expects
which finding on a test for hearing?
a. Bone conduction will be longer than air conduction on the Rinne test
(BC > AC).
b. Air conduction will be longer than bone conduction on the Rinne test
(AC > BC).
c. Sound lateralizes to the affected ear on the Weber test.
d. Sound lateralizes to both ears equally on the Weber test. Ans✓✓✓b.
Air conduction will be longer than bone conduction on the Rinne test
(AC > BC).
A nurse examines a patient's auditory canal and tympanic membrane
with an otoscope and observes which finding as normal?
a. Clear fluid lining the auditory canal
b. A firm tympanic membrane without fluctuation with puffs of air
c. A small hole within the cone of light
,d. A shiny, translucent tympanic membrane Ans✓✓✓d. A shiny,
translucent tympanic membrane
A nurse is assessing a patient who was hit at the base of the skull with a
blunt instrument causing a skull fracture. What assessment finding does
this nurse anticipate during the inspection?
a. Tinnitus, vertigo, and dizziness
b. Clear drainage from the ear and nose
c. Loss of hearing and smell
d. Purulent drainage from the ear and bloody drainage from the nose
Ans✓✓✓b. Clear drainage from the ear and nose
A nurse is assessing the eyes of a healthy 72-year-old adult. What
findings does the nurse expect? Select all that apply.
a. Bulbar conjunctiva pink and clear, with small red vessels noted
b. Sclera yellow and moist, cornea transparent
c. Extraocular movement symmetric with peripheral vision noted
d. Newspaper held at 18 inches to see clearly
e. Sclera visible between upper lid and iris
f. Gray to white circle noted where the sclera merges with the cornea
g. Light reflects on the cornea at 12 o'clock in each eye Ans✓✓✓A, C,
G
, A nurse is obtaining a health history from a 52-year-old male patient
with a red lesion at the base of the tongue. What additional data does the
nurse specifically collect about this patient?
a. Alcohol and tobacco use
b. The date of his last dental examination
c. The presence of dentures
d. A history of pyorrhea Ans✓✓✓a. Alcohol and tobacco use
A nurse observes a student using the whisper test to screen a patient with
hearing loss. Which behavior by the student requires a corrective
comment from the nurse?
a. Instructing the patient to cover the ear not being tested
b. Standing beside the patient on the side of the ear being tested
c. Shielding the mouth to prevent the patient from reading lips
d. Whispering one or two syllable words and ask the patient to repeat
what is heard Ans✓✓✓b. Standing beside the patient on the side of the
ear being tested
A nurse reads in the history that a patient has a new onset of acute otitis
media. Based on this information, how does the nurse expect this
patient's tympanic membrane to appear?
a. Dull
