Exam

Question 1

Conductive hearing loss

Answer 1

Reduced transmission of sound to the middle ear

Question 2

Sensorineural hearing loss

Answer 2

Reduced transmission of sound in the inner ear

Question 3

Whispered voice test

Answer 3

For adults
Eval one ear at a time, occlude other ear, whispers 1-2 feet behind

Question 4

Weber test

Answer 4

For hearing
Use tuning fork at top of head
Normal feels or hears in both ears
“Weber wears a hat”

Question 5

Rinne test

Answer 5

“Rene wears earrings”
Tuning fork to Mastoid
Ask when they do not hear it anymore and time

Question 6

Cranial nerve 7

Answer 6

Facial
Clench teeth and smile

Question 7

Cranial nerve 12

Answer 7

Protrude tongue

Question 8

Cranial 9 and 10

Answer 8

Say ahhhh
Gag reflex
And vagus nerve

Question 9

Ear assessment

Answer 9

Palpate before otoscope exam, pull on lobe
Inspect canal
Up and back for adult
Back and down for kids

Question 10

Cranial nerve 1

Answer 10

Olfactory

Question 11

Cranial nerve 5

Answer 11

Entire face sensation

Question 12

Cranial nerve 2

Answer 12

Eye sight

Question 13

Cranial nerve 3

Answer 13

Eyebrows

Question 14

Cranial nerve 4

Answer 14

Inner eye

Question 15

Cranial nerve 6

Answer 15

Outer eye

Question 16

Cranial nerve 8

Answer 16

Hearing

Question 17

Cranial nerve 11

Answer 17

Shoulders

Question 18

Macular rash

Answer 18

Flat up to 1cm

Question 19

Papular rash

Answer 19

Raised

Question 20

Wheal

Answer 20

Irregular raised rash

Question 21

Vesicular

Answer 21

0.5 cm or less with serous fluid

Question 22

Bulla

Answer 22

Greater than 0.6 cm with serous fluid

Question 23

Pustule

Answer 23

Pus

Question 24

Erosion

Answer 24

Scrape

Question 25

Ulcers

Question 26

Fissure

Answer 26

Crack in skin

Question 27

Eye assessment

Answer 27

Start with visual acuity via snellen or rosenbaum Peripheral vision Follow finger Light reflex

Question 28

Anisocoria

Answer 28

Different size of pupil no more than 1mm

Question 29

Ideal body weight

Answer 29

Women 100 for first 5 feet plus 5 lbs for each inch Men- 106 pounds for first 5 feet plus 6 pounds for each inch thereafter +10% large frame -10% small frame

Question 30

BMI

Answer 30

Kg weight/height in meters (2) Lbs X inches (2) X703

Question 31

History outline

Answer 31

Cc HPI- symptoms analysis-OLDCARTS PMHX- med list, allergies FH PH/SH ROS

Question 32

Placing the bar of a vibrating tuning fork in the midline vertex of the patients head is a test for (Weber test)

Answer 32

Lateralization of sound

Question 33

What weight in pounds would be considered ideal for a 40 year old women who is 5 feet 4 inches tall with medium frame

Answer 33

120 lbs

Question 34

An ear auricle with a low set or unusual angle may indicate chromosomal aberration or

Answer 34

Renal disease

Question 35

Nasal symptoms that imply an allergic response include

Answer 35

Blusish grey boggy turbinates

Question 36

In the fetus the right ventricle pumps the blood through

Answer 36

Ductus arteriosus

Question 37

If the apical impulse is more vigorous than expected to the chest wall it is called a

Answer 37

Lift

Question 38

What measurement best assesses skeletal mass

Answer 38

Mid arm circumference

Question 39

What would the nurse palpate when assessing submental lymph nodes

Answer 39

Behind the tip of the mandible

Question 40

Tracheal tugging

Answer 40

Indicated aortic aneurysm

Question 41

Tender lymph node

Answer 41

Inflammatory process, slow growing

Question 42

Hard firm lymph node

Answer 42

Concern for malignancy especially if fast growing and supraclavicular

Question 43

Chest assessment

Answer 43

RUL, RML, RLL LUL, LLL

Question 44

Normal chest diameter

Answer 44

1:2 ratio Anterior to transverse 1:1 indicates barrel chest

Question 45

Pectus excavatum

Answer 45

Hollow in sternum

Question 46

Pectus carinatum

Answer 46

Pigeon chest Raised sternum

Question 47

Tactile fremitus

Answer 47

Palms on lateral surface of chest Patient says “99” Increase sound can mean consolidation Decreased sound can be pleural effusion

Question 48

Chest percussion

Answer 48

Expect resonance

Question 49

Chest auscultation

Answer 49

Vesicular- low pitched Bronchovesicular- major bronchi, moderate pitch Bronchial- highest pitch over trachea

Question 50

Advantageous breathe sounds

Answer 50

Crackles Wheeze Rhonchi- air through mucus cleared with cough Pleural friction rub- heard with inspiration or expiration, grating sound and painful

Question 51

Heart sounds

Answer 51

S1 opening and closing of mitral and tricuspid S2 aortic and pulmonic

Question 52

Murmurs

Answer 52

Systolic murmur occurs after S1 like AS or Pulmonic stenosis, mitral regurg, tri regurg, mitral valve prolapse Diastolic occurs between S2 and S1 pulmonic regurg, aortic regurgitation, mitral stenosis, tricuspid stenosis

Question 53

Aortic stenosis

Answer 53

Systolic murmur ejection click, crescendo decrescendo murmur, right 2nd intercostal space, can radiate to neck or carotids Pulmonic can sound similar due to site, but no neck radiation

Question 54

Mortal regurgitation

Answer 54

Best heard at apex Holo/pan systolic murmur, flat murmur Murmur starts right at S1, atrial enlargement, intensity the same until S2 Radiates to axilla

Question 55

Mitral valve prolapse

Answer 55

Systolic murmur Non ejection click, mid to late systolic, may have a MR murmur after

Question 56

Aortic regurgitation

Answer 56

Diastolic murmur Listen at erbs point ish area left sternal border Early murmur, decrescendo Again pulmonic similar

Question 57

Mitral stenosis

Answer 57

Diastolic murmur Opening snap, decrescendo, pre systolic accentuation, gets louder at very end before S1 Opening snap plus mid diastolic rumble Tricuspid similar but over tricuspid area

Question 58

S3, S4

Answer 58

S3-volume overload early diastolic, ok in young people, elderly can indicate CHF, ventricular gallop S4- pressure overload, end of diastole, atrial gallop, always pathological Both can be heard on Left lateral decubitus (on left side) at mitral point