Chapter 19 Disease Of The Ears, Eyes, Nose and Throat Flashcards

1
Q
1.  The \_\_\_\_\_\_\_, also called the eyeball, is a spherical structure measuring about 1 inch in diameter.
A)  iris
B)  globe
C)  retina
D)  cornea
A

Ans: B
Page: 1091
Type: General Knowledge

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2
Q
  1. In contrast to the oculomotor nerve, the optic nerve:
    A) is the second cranial nerve and provides the sense of vision.
    B) carries parasympathetic nerve fibers that constrict the pupil.
    C) is the third cranial nerve and regulates movement of the eyes.
    D) innervates the muscles that cause motion of the upper eyelids.
A

Ans: A
Page: 1091
Type: General Knowledge

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3
Q
3.  Icteric sclera are:
A)  white.
B)  cloudy.
C)  yellow.
D)  bloodshot.
A

Ans: C
Page: 1091
Type: General Knowledge

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4
Q
4.  Cataracts are caused by clouding of the:
A)  iris.
B)  cornea.
C)  retina.
D)  sclera.
A

Ans: B
Page: 1091
Type: General Knowledge

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5
Q
5.  In dark-skinned patients, cyanosis can be detected in the:
A)  sclera.
B)  iris.
C)  cornea.
D)  conjunctiva.
A

Ans: D
Page: 1091-1092
Type: General Knowledge

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6
Q
6.  Which of the following structures receives light impulses and converts them to nerve signals that are conducted to the brain by the optic nerve and interpreted as vision?
A)  Retina
B)  Cornea
C)  Pupil
D)  Lens
A

Ans: A
Page: 1092
Type: General Knowledge

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7
Q
  1. Central vision is processed by the ________, which is the ________.
    A) retina, central portion of the macula
    B) pupil, circular opening within the iris
    C) macula, central portion of the retina
    D) iris, circular opening within the pupil
A

Ans: C
Page: 1092
Type: General Knowledge

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8
Q
8.  The \_\_\_\_\_\_\_\_\_\_ are cone-shaped fossae that enclose and protect the eyes.
A)  zygomas
B)  orbits
C)  condyles
D)  crista galli
A

Ans: B
Page: 1091
Type: General Knowledge

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9
Q
  1. Which of the following statements regarding vitreous humor is correct?
    A) Vitreous humor can be replenished, but it takes many years.
    B) Vitreous humor is contained within the posterior chamber of the eye.
    C) Vitreous humor is a jelly-like substance that maintains the shape of the globe.
    D) Vitreous humor is a clear fluid that is responsible for tear production.
A

Ans: C
Page: 1092
Type: General Knowledge

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10
Q
  1. Aqueous humor:
    A) is contained in the anterior chamber of the eye.
    B) cannot be replenished by the body if it is lost.
    C) is contained in the posterior chamber of the eye.
    D) is found between the iris and the lens of the eye.
A

Ans: A
Page: 1092
Type: General Knowledge

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11
Q
11.  The \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ secretes and drains tears from the eye.
A)  nasolacrimal duct
B)  conjunctiva
C)  aqueous humor
D)  nasolacrimal apparatus
A

Ans: D
Page: 1092
Type: General Knowledge

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12
Q
  1. Cardiac monitoring is recommended when caring for a patient with an eye-related emergency because:
    A) eye drops or medication can cause a marked elevation in the heart rate.
    B) ocular pressure can stimulate the vagus nerve and cause bradycardia.
    C) vitreous humor loss can result in a variety of ventricular dysrhythmias.
    D) AV heart blocks commonly occur when vitreous humor is lost.
A

Ans: B
Page: 1093
Type: General Knowledge

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13
Q
13.  Common symptoms of diabetic retinopathy include all of the following, EXCEPT:
A)  floaters.
B)  blurred vision.
C)  yellow vision.
D)  blind spots.
A

Ans: C
Page: 1093
Type: General Knowledge

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14
Q
  1. Which of the following statements regarding the nasal septum is correct?
    A) It may be slightly deviated to one side or the other.
    B) The nasal septum is comprised mainly of cartilage.
    C) Inflammation of the nasal septum is common during infection.
    D) The nasal septum separates the oropharynx and nasopharynx.
A

Ans: A
Page: 1106
Type: General Knowledge

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15
Q
15.  Which cranial nerve innervates the muscles that cause motion of the eyeballs and upper eyelids?
A)  Optic
B)  Trigeminal
C)  Oculomotor
D)  Hypoglossal
A

Ans: C
Page: 1091
Type: General Knowledge

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16
Q
16.  The anterior chamber is the portion of the globe between the \_\_\_\_\_ and the \_\_\_\_\_, and is filled with \_\_\_\_\_ humor.
A)  iris, lens, vitreous
B)  cornea, iris, aqueous
C)  lens, iris, vitreous
D)  lens, cornea, aqueous
A

Ans: D
Page: 1092
Type: General Knowledge

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17
Q
  1. Which of the following statements regarding vitreous humor is correct?
    A) Vitreous humor is a jelly-like substance that is replenished if lost.
    B) Vitreous humor fills the posterior chamber and maintains the shape of the globe.
    C) Vitreous humor is a clear watery fluid that fills the anterior chamber.
    D) The most significant risk caused by a loss of vitreous humor is infection
A

Ans: B
Page: 1092
Type: General Knowledge

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18
Q
18.  A patient with a loss of peripheral vision MOST likely has damage to the:
A)  retina.
B)  pupil.
C)  cornea.
D)  lens.
A

Ans: A
Page: 1092
Type: General Knowledge

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19
Q
19.  The large cartilaginous external portion of the ear is called the:
A)  ossicle.
B)  cochlea.
C)  auricle.
D)  oval window.
A

Ans: C
Page: 1102
Type: General Knowledge

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20
Q
  1. The middle ear consists of the:
    A) cochlea and semicircular canals.
    B) organ of Corti and the external auditory canal.
    C) inner portion of the tympanic membrane and the ossicles.
    D) pinna and the exterior portion of the tympanic membrane.
A

Ans: C
Page: 1102
Type: General Knowledge

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21
Q
21.  \_\_\_\_\_\_\_\_\_ forms the principal mass of the tooth and is much denser and stronger than bone.
A)  Pulp
B)  Dentin
C)  Enamel
D)  Gingiva
A

Ans: B
Page: 1109
Type: General Knowledge

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22
Q
22.  The \_\_\_\_\_\_\_\_\_\_\_ nerve provides motor function to the muscles of the tongue.
A)  hypoglossal
B)  trigeminal
C)  accessory
D)  glossopharyngeal
A

Ans: A
Page: 1110
Type: General Knowledge

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23
Q
  1. Hyphema is defined as:
    A) severe ecchymosis to the orbital region.
    B) blood in the anterior chamber of the eye.
    C) marked swelling of the globe of the eye.
    D) double vision following blunt eye trauma.
A

Ans: B
Page: 1100
Type: General Knowledge

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24
Q
  1. Signs and symptoms of retinal detachment include:
    A) flashing lights, specks, or floaters in the field of vision.
    B) double vision and partial or complete loss of peripheral vision.
    C) immediate pain and total loss of vision following blunt eye trauma.
    D) paralysis of upward gaze and greater than 50% loss of central vision.
A

Ans: A
Page: 1101
Type: General Knowledge

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25
Q
25.  What part of the eye is MOST commonly injured following a thermal burn?
A)  Globe
B)  Retina
C)  Cornea
D)  Eyelids
A

Ans: D
Page: 1094
Type: General Knowledge

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26
Q
  1. Which of the following statements regarding anisocoria is correct?
    A) Anisocoria is a condition in which the pupils are unequal.
    B) Anisocoria is a normal finding in the majority of the population.
    C) Physiologic anisocoria indicates significant intracranial pressure.
    D) Anisocoria is a condition characterized by bilateral pupillary dilation.
A

Ans: A
Page: 1094
Type: General Knowledge

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27
Q
  1. A patient with a dysconjugate gaze following an ocular injury:
    A) most likely has a concomitant basilar skull fracture.
    B) should have ice applied to the eyes to prevent blindness.
    C) has discoordination between the movements of both eyes.
    D) should be treated by irrigating both eyes for 20 minutes.
A

Ans: C
Page: 1093
Type: General Knowledge

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28
Q
28.  Movement of both of the eyes in unison is called:
A)  dysconjugate gaze.
B)  sympathetic eye movement.
C)  extraocular movement.
D)  physiologic anisocoria.
A

Ans: B
Page: 1098, 1120
Type: General Knowledge

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29
Q
29.  Alkali or strong acid burns to the eye should be irrigated for at least \_\_\_\_ minutes.
A)  10
B)  15
C)  20
D)  30
A

Ans: C
Page: 1095
Type: General Knowledge

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30
Q
30.  The ONLY indication for removing contact lenses in the prehospital setting is:
A)  chemical eye burns.
B)  acute conjunctivitis.
C)  cardiopulmonary arrest.
D)  a foreign body in the eye.
A

Ans: A
Page: 1097
Type: General Knowledge

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31
Q
  1. A ruptured tympanic membrane:
    A) commonly results in permanent hearing loss.
    B) is characterized by CSF leakage from the ears.
    C) commonly leads to an infection of the middle ear.
    D) is extremely painful but typically heals spontaneously
A

Ans: D
Page: 1106
Type: General Knowledge

32
Q
  1. Retinal injuries that are caused by exposure to extremely bright light:
    A) are generally not painful but may result in permanent damage.
    B) cause immediate intense pain and result in permanent blindness.
    C) are painless and almost always heal without permanent damage.
    D) cause severe pain but heal quickly and without permanent damage.
A

Ans: A
Page: 1094
Type: General Knowledge

33
Q
33.  In which of the following situations is the Morgan lens NOT appropriate to use?
A)  Eye burn from a strong alkali
B)  An object impaled in the eye
C)  Eye burn from a strong acid
D)  Any foreign body in the eye
A

Ans: B
Page: 1095
Type: General Knowledge

34
Q
  1. Which of the following statements regarding conjunctivitis is correct?
    A) Allergic conjunctivitis is extremely contagious.
    B) Conjunctivitis usually spreads to the opposite eye.
    C) Viral and bacterial conjunctivitis are not contagious.
    D) Lower respiratory infections often cause conjunctivitis.
A

Ans: B
Page: 1097-1098
Type: General Knowledge

35
Q
35.  Metal filings are particularly inflammatory because they cause a “rust ring” of the \_\_\_\_\_\_\_\_ after 24 hours.
A)  iris
B)  sclera
C)  cornea
D)  retina
A

Ans: C
Page: 1098
Type: General Knowledge

36
Q
36.  Patients with a corneal abrasion may present with all of the following, EXCEPT:
A)  hyphema.
B)  severe pain.
C)  photophobia.
D)  excess tearing.
A

Ans: A
Page: 1098
Type: General Knowledge

37
Q
37.  A red, tender lump in the eyelid or at the lid margin is called a:
A)  rust ring.
B)  hyphema.
C)  chalazion.
D)  hordeolum.
A

Ans: D
Page: 1098-1099
Type: General Knowledge

38
Q
38.  Glaucoma is a condition caused by:
A)  a loss of peripheral vision.
B)  retinal artery occlusion.
C)  increased intraocular pressure.
D)  decreased vitreous humor.
A

Ans: C
Page: 1100
Type: General Knowledge

39
Q
  1. Patients with glaucoma often complain of:
    A) a blind spot toward the center of vision.
    B) a sudden painless complete loss of vision.
    C) specks or floaters in the field of vision.
    D) intense burning or itching around the eyes.
A

Ans: A
Page: 1100
Type: General Knowledge

40
Q
40.  Headaches, nausea and vomiting, narrowing vision fields, and a “graying” in the field of vision are consistent with:
A)  glaucoma.
B)  papilledema.
C)  corneal abrasion.
D)  anterior uveitis.
A

Ans: B
Page: 1101
Type: General Knowledge

41
Q
41.  Retinal detachment is especially common in:
A)  boxing.
B)  football.
C)  diabetics.
D)  water sports.
A

Ans: A
Page: 1101
Type: General Knowledge

42
Q
42.  Within the cochlea, at the \_\_\_\_\_\_\_\_\_\_\_\_\_\_, vibration stimulates hair movements that form nerve impulses that travel to the brain via the auditory nerve.
A)  oval window
B)  cochlear duct
C)  semicircular canals
D)  organ of Corti
A

Ans: D
Page: 1102
Type: General Knowledge

43
Q
43.  Which of the following is NOT an inner ear structure?
A)  Cochlea
B)  Oval window
C)  Eustachian tube
D)  Semicircular canal
A

Ans: C
Page: 1102-1103
Type: General Knowledge

44
Q
44.  Vertigo or loss of balance following an ear infection or upper respiratory infection is MOST consistent with:
A)  labyrinthitis.
B)  Meniere disease.
C)  otitis externa.
D)  impacted cerumen.
A

Ans: A
Page: 1104
Type: General Knowledge

45
Q
  1. What is the pathophysiology of Meniere disease?
    A) Irritation and swelling in the inner ear affect the nerves of the inner ear and produce dizziness, loss of balance, and tinnitus.
    B) Dysfunction of the eustachian tube leads to increased pressure within the middle ear, which causes damage to the malleus, incus, and stapes.
    C) The angle of the eustachian tube does not allow for proper drainage, which allows infective material to collect in the middle ear and cause infection.
    D) Endolymphatic rupture creates increased pressure in the cochlear duct, which then leads to damage to the organ of Corti and the semicircular canals.
A

Ans: D
Page: 1105
Type: General Knowledge

46
Q
46.  Treatment for Meniere disease includes:
A)  tubes placed in the ears.
B)  diuretics and antiemetics.
C)  hearing aids and analgesics.
D)  hydration and antipyretics.
A

Ans: B
Page: 1105
Type: General Knowledge

47
Q
47.  Signs or symptoms of otitis media include:
A)  hypersensitivity to sound.
B)  bilateral chronic tinnitus.
C)  bulging tympanic membrane.
D)  vertigo and violent vomiting.
A

Ans: C
Page: 1105
Type: General Knowledge

48
Q
48.  Common causes of a ruptured tympanic membrane include all of the following, EXCEPT:
A)  diving injuries.
B)  otitis externa.
C)  foreign bodies.
D)  blast injuries.
A

Ans: B
Page: 1106
Type: General Knowledge

49
Q
  1. Signs and symptoms of a ruptured tympanic membrane include:
    A) permanent deafness and a unilateral headache.
    B) CSF leakage from the ear and severe tinnitus.
    C) a low-grade fever and fullness in the ear.
    D) hearing loss and blood drainage from the ear.
A

Ans: D
Page: 1106
Type: General Knowledge

50
Q
50.  A distorted sense of smell in which a person perceives unpleasant odors when the odors do not exist is called:
A)  dysosmia.
B)  hyperosmia.
C)  presbyosmia.
D)  anosmia.
A

Ans: A
Page: 1106
Type: General Knowledge

51
Q
51.  The \_\_\_\_\_\_\_\_\_\_\_\_\_\_ decrease(s) the weight of the skull and provide(s) resonance for the voice.
A)  turbinates
B)  nasal septum
C)  paranasal sinuses
D)  nasal mucosa
A

Ans: C
Page: 1106
Type: General Knowledge

52
Q
52.  Causes of rhinitis may include all of the following, EXCEPT:
A)  chemical irritants.
B)  high humidity.
C)  antihypertensives.
D)  cold temperature.
A

Ans: B
Page: 1107
Type: General Knowledge

53
Q
53.  Paralysis of cranial nerve \_\_\_\_ can cause unilateral facial and gag reflex paralysis.
A)  V
B)  VI
C)  VII
D)  X
A

Ans: C
Page: 1108
Type: General Knowledge

54
Q
54.  Which of the following is a complication associated with dysfunction of cranial nerves VI, VII, IX, and XII?
A)  Hearing impairment
B)  Acute ischemic stroke
C)  Aspiration pneumonia
D)  Upper airway obstruction
A

Ans: C
Page: 1108
Type: General Knowledge

55
Q
55.  The bony sockets for the teeth that reside in the mandible and maxilla are called:
A)  cusps.
B)  pulp.
C)  dentin.
D)  alveoli.
A

Ans: D
Page: 1109
Type: General Knowledge

56
Q
56.  Mastication is defined as:
A)  chewing.
B)  swallowing.
C)  digesting.
D)  teeth clenching.
A

Ans: A
Page: 1109
Type: General Knowledge

57
Q
57.  Which cranial nerve provides taste sensation to the posterior portions of the tongue and carries parasympathetic fibers to the salivary glands?
A)  Vagus
B)  Glossopharyngeal
C)  Hypoglossal
D)  Vestibulocochlear
A

Ans: B
Page: 1110
Type: General Knowledge

58
Q
58.  Systemic signs of a dental abscess include:
A)  fever and chills.
B)  inflammation.
C)  swelling and pain.
D)  mandibular pain.
A

Ans: A
Page: 1110
Type: General Knowledge

59
Q
59.  A yeast infection that causes white patches in the mouth or on the tongue is called:
A)  thrush.
B)  gingivitis.
C)  leukoplakia.
D)  halitosis.
A

Ans: A
Page: 1111
Type: General Knowledge

60
Q
  1. Leukoplakia:
    A) is caused by the fungus Candida albicans.
    B) presents with red swollen gums that bleed easily during brushing.
    C) is a smoker’s disease that causes excess cell growth in the mouth.
    D) presents with dark yellow or brown patches in the oral cavity.
A

Ans: C
Page: 1111
Type: General Knowledge

61
Q
61.  You would MOST likely encounter oral candidiasis in a patient:
A)  who has had numerous cavities.
B)  who takes oral corticosteroids.
C)  with a history of gingivitis.
D)  who is immunocompromised.
A

Ans: D
Page: 1112
Type: General Knowledge

62
Q
62.  Which of the following has the greatest potential for causing an airway problem?
A)  Oral candidiasis
B)  Leukoplakia
C)  Ludwig angina
D)  A dental abscess
A

Ans: C
Page: 1113
Type: General Knowledge

63
Q
  1. Which of the following statements regarding epiglottitis is correct?
    A) It is caused by the Staphylococcus bacterium.
    B) It now occurs more often in adults.
    C) It is much less severe than croup.
    D) It affects children under 2 years of age.
A

Ans: B
Page: 1113
Type: General Knowledge

64
Q
64.  Patients with epiglottitis present with:
A)  dysphagia.
B)  wheezing.
C)  dentalgia.
D)  hyperosmia.
A

Ans: A
Page: 1113
Type: General Knowledge

65
Q
65.  Fever, hoarseness, and swollen lymph nodes in the neck are common clinical signs of:
A)  tracheitis.
B)  oral candidiasis.
C)  laryngitis.
D)  Ludwig angina.
A

Ans: C
Page: 1113
Type: General Knowledge

66
Q
66.  A 4-year-old child presents with a deep “croup-like” cough, difficulty breathing, and a high fever. You should suspect:
A)  epiglottitis.
B)  pharyngitis.
C)  laryngitis.
D)  tracheitis.
A

Ans: D
Page: 1113
Type: Critical Thinking

67
Q
  1. A young female presents with a headache, severe aching around her right ear, and difficulty chewing. Assessment and treatment for her should focus on:
    A) anticipating airway compromise.
    B) analgesia as needed and transport.
    C) placing her in a semi-Fowler position.
    D) avoiding the use of a nasopharyngeal airway.
A

Ans: B
Page: 1114
Type: Critical Thinking

68
Q
  1. A construction worker was hammering when he experienced a sudden severe pain to his right eye. Assessment of his eye reveals that it is irritated and you can see a small sliver of metal imbedded in the globe. He is also wearing contact lenses. You should:
    A) remove his contact lenses and irrigate his eye with copious amounts of water.
    B) leave his contact lenses in place and cover both eyes with a sterile dressing.
    C) attempt to remove the foreign object only if he has any visual disturbances.
    D) remove his contact lenses and administer a narcotic analgesic for pain.
A

Ans: B
Page: 1093-1097
Type: Critical Thinking

69
Q
  1. A man who was using an arc welder without eye protection presents with bilateral eye pain and diminished vision. He is conscious and alert, has a patent airway, and has stable vital signs. Treatment should include:
    A) covering his eyes with sterile, moist dressings; applying cool compresses lightly over his eyes; and placing him in a supine position.
    B) immediately irrigating his eyes with sterile saline or water; covering both eyes with dry, sterile dressings; and allowing him to sit up.
    C) placing him in a lateral recumbent position, keeping his eyelids closed with tape, and applying chemical warm compresses to his eyes.
    D) mixing baking powder with sterile water or saline and irrigating his eyes to prevent further damage caused by the ultraviolet light.
A

Ans: A
Page: 1094-1095
Type: Critical Thinking

70
Q
  1. A chemistry student accidentally splashed a strong acid chemical into his eyes. He wears rigid gas-permeable contact lenses and is experiencing intense pain. You should:
    A) leave his contact lenses in place and irrigate his eyes throughout transport.
    B) carefully remove his contact lenses and cover both eyes with dry dressings.
    C) carefully remove his contact lenses and flush his eyes for at least 20 minutes.
    D) leave his contact lenses in place and neutralize the acid with a strong alkali.
A

Ans: C
Page: 1095-1097
Type: Critical Thinking

71
Q
  1. A 34-year-old female states that she feels like she has a grain of sand in her eye. Assessment reveals that her eye and the surrounding area are red. Treatment for her should include:
    A) carefully assessing her eye for an object imbedded in the globe and removing it if one is present.
    B) instructing her to continue rapid eye blinking and administering analgesia as indicated.
    C) gently rubbing the surface of the eye with a cotton-tipped applicator to remove the foreign body.
    D) gently irrigating her eye and taping the affected eye closed to prevent it from drying out.
A

Ans: D
Page: 1098
Type: Critical Thinking

72
Q
72.  You are assessing an unresponsive patient and note the presence of a hyphema to his left eye. This is evidence of:
A)  a foreign body in the eye.
B)  a chemical burn to the eye.
C)  lacrimal gland dysfunction.
D)  blunt force trauma to the eye.
A

Ans: D
Page: 1100
Type: Critical Thinking

73
Q
73.  You are assessing a man who was boxing with his friend. He complains of seeing flashing lights and “floaters” in his field of vision. The MOST important intervention is:
A)  high-flow oxygen.
B)  immediate transport.
C)  irrigation of his eyes.
D)  covering both of his eyes.
A

Ans: B
Page: 1101
Type: Critical Thinking

74
Q
  1. A 55-year-old female complains of severe vertigo, tinnitus, nausea, and a sense of fullness in her right ear. You should:
    A) administer an antiemetic and monitor her airway in case she vomits.
    B) carefully inspect her ear with an otoscope and administer furosemide.
    C) administer diphenhydramine to reduce any swelling in her inner ear.
    D) keep her supine, administer crystalloid fluid boluses, and inspect her ear.
A

Ans: A
Page: 1105
Type: Critical Thinking

75
Q
  1. You are assessing an elderly man who has asthma and uses an inhaled corticosteroid on a regular basis. He has white patches on his tongue and the inside of his mouth. He is conscious and alert and his airway is patent. You should:
    A) suspect that he has leukoplakia.
    B) irrigate his mouth with sterile water.
    C) provide supportive care and transport.
    D) carefully scrape the lesions from his tongue.
A

Ans: C
Page: 1111-1113
Type: Critical Thinking