NR 509 APEA ADVANCED PHYSICAL ASSESSMENT
EXAM WITH CORRECT ANSWERS GRADED A+
Question 1
The function of the auditory ossicles is to:
a. transmit the light reflex to the light cone.
b. transform sound vibrations into mechanical waves for the inner ear.
c. to capture sound waves from the external ear for transmission into the middle ear.
d. to 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 2
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:
a. an arrhythmia.
b. a neurological condition.
c. an inner ear infection.
d. orthostatic 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 3:
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. a pinguecula.
b. a chalazion.
c. episcleritis. d.
xanthelasma.
Explanation:
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 4
Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This
means that:
a. at 200 feet the patient can read printed information that a person with normal
vision could read at 20 feet.
, b. at 20 feet the patient can read printed information that a person with normal vision
could read at 200 feet.
c. the patient has normal visual acuity.
d. the 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 5
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. a conjugate gaze.
b. left cranial nerve III (oculomotor) paralysis
c. cranial nerve IV (trochlear) paralysis.
d. cranial 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 6
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. a conjugate gaze.
b. left cranial nerve III (oculomotor) paralysis
c. cranial nerve IV (trochlear) paralysis.
d. cranial 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 7
A patient was diagnosed as being farsighted. The term for this condition is:
a. hyperopia.
b. myopia.
c. strabismus.
d. astigmatism.
Explanation:
EXAM WITH CORRECT ANSWERS GRADED A+
Question 1
The function of the auditory ossicles is to:
a. transmit the light reflex to the light cone.
b. transform sound vibrations into mechanical waves for the inner ear.
c. to capture sound waves from the external ear for transmission into the middle ear.
d. to 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 2
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:
a. an arrhythmia.
b. a neurological condition.
c. an inner ear infection.
d. orthostatic 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 3:
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. a pinguecula.
b. a chalazion.
c. episcleritis. d.
xanthelasma.
Explanation:
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 4
Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This
means that:
a. at 200 feet the patient can read printed information that a person with normal
vision could read at 20 feet.
, b. at 20 feet the patient can read printed information that a person with normal vision
could read at 200 feet.
c. the patient has normal visual acuity.
d. the 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 5
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. a conjugate gaze.
b. left cranial nerve III (oculomotor) paralysis
c. cranial nerve IV (trochlear) paralysis.
d. cranial 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 6
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. a conjugate gaze.
b. left cranial nerve III (oculomotor) paralysis
c. cranial nerve IV (trochlear) paralysis.
d. cranial 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 7
A patient was diagnosed as being farsighted. The term for this condition is:
a. hyperopia.
b. myopia.
c. strabismus.
d. astigmatism.
Explanation:
