NURS 612 EXAM 3 MARYVILLE
NURS 612 Maryville Advanced Health Assessment
Exam Questions and Correct Detailed Answers
with Rationales Already Graded A+ Latest
Versions 2025
A 15 month old is brought to you for a fever of 101 F and fussiness. The ear examination is as follows:
external ear - normal appearance and no tenderness with manipulation; canal - normal diameter
without evidence of inflammation; tympanic membrane - bulging, erythematous, and the light reflex
is dull. Insufflation is deferred due to pain. What is your diagnosis?
A) ruptured tympanic membrane
B) cholesteatoma
C) otitis media
D) otitis externa
C) otitis media
Acute otitis media in a symptomatic child typically has a red, bulging tympanic membrane, with a dull
or absent light reflex.
The nurse practitioner is assessing a patient who may have hearing loss. Which of these statements
is true concerning air conduction?
A) Air conduction is the normal pathway for hearing.
B) Vibrations of the bones in the skull cause air conduction.
C) Amplitude of sound determines the pitch that is heard.
D) Loss of air conduction is called a conductive hearing loss.
A) Air conduction is the normal pathway for hearing.
The normal pathway of hearing is air conduction, which starts when sound waves produce vibrations
on the tympanic membrane. Conductive hearing loss results from a mechanical dysfunction of the
external or middle ear. The other statements are not true concerning air conduction.
A+ TEST BANK 1
, NURS 612 EXAM 3 MARYVILLE
.!
When examining the ear of a young child, which of the following is the proper technique to use?
A) Examine the ear canal and tympanic membrane as the last steps in the exam if the child is
sensitive or fearful.
B) Pull the auricle downward, outward, and backward for the best view.
C) Use the largest speculum possible on the otoscope.
D) All of the above.
D) All of the above.
If a child is fearful or sensitive because she can't see the ear exam, you might need to restrain her so
wait until the end of the exam. Use the largest speculum for the best view. For best visualization, pull
the auricle downward, outward, and backward (Bates 867-869).
The nurse practitioner might see which of the following physical findings in a patient with otitis
externa?
A) a bulging, red tympanic membrane
B) an unusually prominent short process and prominent handle.
C) a chalky, white patch with irregular margins on the inferior part of the tympanic membrane.
D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed, moist, pale and
tender ear canal.
D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed, moist, pale and
tender ear canal.
Frank blood or clear watery drainage (cerebrospinal leak) after trauma suggest a basal skull fracture
and warrants immediate referral. Purulent drainage indicates otitis externa or otitis media. (Bates,
245-246)
An Annual Low Dose Computed Tomography (LDCT) screening would be recommended for which
patient?
A) Tammy, age 57, who smokes a half pack of cigarettes a day for the last 20 years.
B) Bob, age 72, who quit smoking 10 years ago after a 30-pack year history.
C) Angela, age 43, and started smoking when she was 15 years old.
D) George, age 80, who lives with his wife and is a smoker.
B) Bob, age 72, who quit smoking 10 years ago after a 30-pack year history.
LDCT screenings are recommended to patients 55-74 years, a 30-pack year smoking history or current
smoking or have quit in the last 15 years (Bates, p315-316).
A+ TEST BANK 2
, NURS 612 EXAM 3 MARYVILLE
NP is preparing to perform an otoscopic examination of a newborn infant. Which statement is true
regarding this examination?
A) Immobility of the drum is a normal finding.
B) The light reflex is cone shaped in the first few days of life.
C) The appearance of the membrane is identical to that of an adult.
D) The normal membrane may appear thick and opaque because of the vernix caseosa obscuring the
tympanic membrane for the first few days of life.
D) The normal membrane may appear thick and opaque because of the vernix caseosa obscuring the
tympanic membrane for the first few days of life.
During the first few days, the tympanic membrane often looks thickened and opaque because there
is vernix caseosa obscuring the tympanic membrane (Bates, p825).
The projections in the nasal cavity that increase the surface area are called the:
A) Kiesselbach plexus
B) turbinates
C) meatus
D) septum
B) turbinates
The lateral walls of each nasal cavity contain 3 parallel bony projections: the superior, middle, and
inferior turbinates. They increase the surface area so that more blood vessels and mucous
membrane are available to warm, humidify, and filter the inhaled air (Bates, p250).
All of the following are true of the nasal inspection EXCEPT:
A) Tilt the patient's head back a bit and insert the speculum gently into the vestibule of each nostril.
Avoid contact with the nasal septum. You should inspect the inferior and middle turbinates, the nasal
septum, and the narrow passage between them.
B) In viral rhinitis, the mucosa is usually reddened and swollen, and in allergic rhinitis the mucosa is
often pale, bluish, or red.
C) Examine the inside of the nose without a speculum on the otoscope keeping the otoscope 6-10
inches away from the tip of the patient's nose are you look at each nostril.
D) Use the largest available ear speculum on the otoscope during inspection.
C) Examine the inside of the nose without a speculum on the otoscope keeping the otoscope 6-10
inches away from the tip of the patient's nose are you look at each nostril.
A+ TEST BANK 3
, NURS 612 EXAM 3 MARYVILLE
Tilt the patient's head back a bit and insert the speculum gently into the vestibule of each nostril.
Avoid contact with the nasal septum. Use the largest available speculum. In viral rhinitis, the mucosa
is usually reddened and swollen, and in allergic rhinitis the mucosa is often pale, bluish, or red.
A 46 year old female patient is in the clinic with a chief complaint of chest pain. You are wanting to
best understand the patient's perception of the chest pain. Which fo the following questions would
you ask first?
A) How do you rate your pain on a scale of 0-10?
B) Is the pain related to exertion?
C) Tell me about your chest discomfort.
D) Are you taking all of your medications?
C) Tell me about your chest discomfort.
Move from open ended to focused questions to allow for the flow of ideas and thoughts from the
patient.
The nurse practitioner is doing an assessment on a 21 year old patient and notices that his nasal
mucosa appears pale and bluish. What would be the most appropriate question to ask the patient?
A) Have you had any symptoms of a cold?
B) Don't ask any questions. This is a normal finding.
C) Are you aware of having any allergies?
D) Have you been having frequent nosebleeds?
C) Are you aware of having any allergies?
With chronic allergy, mucosa looks swollen, boggy, pale, and gray. Colds and nosebleeds do not
cause these mucosal changes.
A 10-year-old is at the clinic for "a sore throat lasting 6 days." The nurse is aware that which of these
findings would be consistent with an acute infection?
A) Tonsils 3+/1-4+ with large white spots
B) Tonsils 1+/1-4+ with pale coloring
C) Tonsils 1+/1-4+ and pink, same color as oral mucosa
D) Tonsils 2+/1-4+ and pink with white particles inside deep crypts
A) Tonsils 3+/1-4+ with large white spots
A+ TEST BANK 4
NURS 612 Maryville Advanced Health Assessment
Exam Questions and Correct Detailed Answers
with Rationales Already Graded A+ Latest
Versions 2025
A 15 month old is brought to you for a fever of 101 F and fussiness. The ear examination is as follows:
external ear - normal appearance and no tenderness with manipulation; canal - normal diameter
without evidence of inflammation; tympanic membrane - bulging, erythematous, and the light reflex
is dull. Insufflation is deferred due to pain. What is your diagnosis?
A) ruptured tympanic membrane
B) cholesteatoma
C) otitis media
D) otitis externa
C) otitis media
Acute otitis media in a symptomatic child typically has a red, bulging tympanic membrane, with a dull
or absent light reflex.
The nurse practitioner is assessing a patient who may have hearing loss. Which of these statements
is true concerning air conduction?
A) Air conduction is the normal pathway for hearing.
B) Vibrations of the bones in the skull cause air conduction.
C) Amplitude of sound determines the pitch that is heard.
D) Loss of air conduction is called a conductive hearing loss.
A) Air conduction is the normal pathway for hearing.
The normal pathway of hearing is air conduction, which starts when sound waves produce vibrations
on the tympanic membrane. Conductive hearing loss results from a mechanical dysfunction of the
external or middle ear. The other statements are not true concerning air conduction.
A+ TEST BANK 1
, NURS 612 EXAM 3 MARYVILLE
.!
When examining the ear of a young child, which of the following is the proper technique to use?
A) Examine the ear canal and tympanic membrane as the last steps in the exam if the child is
sensitive or fearful.
B) Pull the auricle downward, outward, and backward for the best view.
C) Use the largest speculum possible on the otoscope.
D) All of the above.
D) All of the above.
If a child is fearful or sensitive because she can't see the ear exam, you might need to restrain her so
wait until the end of the exam. Use the largest speculum for the best view. For best visualization, pull
the auricle downward, outward, and backward (Bates 867-869).
The nurse practitioner might see which of the following physical findings in a patient with otitis
externa?
A) a bulging, red tympanic membrane
B) an unusually prominent short process and prominent handle.
C) a chalky, white patch with irregular margins on the inferior part of the tympanic membrane.
D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed, moist, pale and
tender ear canal.
D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed, moist, pale and
tender ear canal.
Frank blood or clear watery drainage (cerebrospinal leak) after trauma suggest a basal skull fracture
and warrants immediate referral. Purulent drainage indicates otitis externa or otitis media. (Bates,
245-246)
An Annual Low Dose Computed Tomography (LDCT) screening would be recommended for which
patient?
A) Tammy, age 57, who smokes a half pack of cigarettes a day for the last 20 years.
B) Bob, age 72, who quit smoking 10 years ago after a 30-pack year history.
C) Angela, age 43, and started smoking when she was 15 years old.
D) George, age 80, who lives with his wife and is a smoker.
B) Bob, age 72, who quit smoking 10 years ago after a 30-pack year history.
LDCT screenings are recommended to patients 55-74 years, a 30-pack year smoking history or current
smoking or have quit in the last 15 years (Bates, p315-316).
A+ TEST BANK 2
, NURS 612 EXAM 3 MARYVILLE
NP is preparing to perform an otoscopic examination of a newborn infant. Which statement is true
regarding this examination?
A) Immobility of the drum is a normal finding.
B) The light reflex is cone shaped in the first few days of life.
C) The appearance of the membrane is identical to that of an adult.
D) The normal membrane may appear thick and opaque because of the vernix caseosa obscuring the
tympanic membrane for the first few days of life.
D) The normal membrane may appear thick and opaque because of the vernix caseosa obscuring the
tympanic membrane for the first few days of life.
During the first few days, the tympanic membrane often looks thickened and opaque because there
is vernix caseosa obscuring the tympanic membrane (Bates, p825).
The projections in the nasal cavity that increase the surface area are called the:
A) Kiesselbach plexus
B) turbinates
C) meatus
D) septum
B) turbinates
The lateral walls of each nasal cavity contain 3 parallel bony projections: the superior, middle, and
inferior turbinates. They increase the surface area so that more blood vessels and mucous
membrane are available to warm, humidify, and filter the inhaled air (Bates, p250).
All of the following are true of the nasal inspection EXCEPT:
A) Tilt the patient's head back a bit and insert the speculum gently into the vestibule of each nostril.
Avoid contact with the nasal septum. You should inspect the inferior and middle turbinates, the nasal
septum, and the narrow passage between them.
B) In viral rhinitis, the mucosa is usually reddened and swollen, and in allergic rhinitis the mucosa is
often pale, bluish, or red.
C) Examine the inside of the nose without a speculum on the otoscope keeping the otoscope 6-10
inches away from the tip of the patient's nose are you look at each nostril.
D) Use the largest available ear speculum on the otoscope during inspection.
C) Examine the inside of the nose without a speculum on the otoscope keeping the otoscope 6-10
inches away from the tip of the patient's nose are you look at each nostril.
A+ TEST BANK 3
, NURS 612 EXAM 3 MARYVILLE
Tilt the patient's head back a bit and insert the speculum gently into the vestibule of each nostril.
Avoid contact with the nasal septum. Use the largest available speculum. In viral rhinitis, the mucosa
is usually reddened and swollen, and in allergic rhinitis the mucosa is often pale, bluish, or red.
A 46 year old female patient is in the clinic with a chief complaint of chest pain. You are wanting to
best understand the patient's perception of the chest pain. Which fo the following questions would
you ask first?
A) How do you rate your pain on a scale of 0-10?
B) Is the pain related to exertion?
C) Tell me about your chest discomfort.
D) Are you taking all of your medications?
C) Tell me about your chest discomfort.
Move from open ended to focused questions to allow for the flow of ideas and thoughts from the
patient.
The nurse practitioner is doing an assessment on a 21 year old patient and notices that his nasal
mucosa appears pale and bluish. What would be the most appropriate question to ask the patient?
A) Have you had any symptoms of a cold?
B) Don't ask any questions. This is a normal finding.
C) Are you aware of having any allergies?
D) Have you been having frequent nosebleeds?
C) Are you aware of having any allergies?
With chronic allergy, mucosa looks swollen, boggy, pale, and gray. Colds and nosebleeds do not
cause these mucosal changes.
A 10-year-old is at the clinic for "a sore throat lasting 6 days." The nurse is aware that which of these
findings would be consistent with an acute infection?
A) Tonsils 3+/1-4+ with large white spots
B) Tonsils 1+/1-4+ with pale coloring
C) Tonsils 1+/1-4+ and pink, same color as oral mucosa
D) Tonsils 2+/1-4+ and pink with white particles inside deep crypts
A) Tonsils 3+/1-4+ with large white spots
A+ TEST BANK 4
