Exam #2 Flashcards
(182 cards)
1
Q
The hair cells of Corti and membrane of Corti:
Select one:
a. maintain equilibrium.
b. protect the ear from foreign particles.
c. stimulate the eighth cranial nerve.
d. transmit vibrations to the ossicles.
e. produce a waxy lubricant.
A
c. stimulate the eighth cranial nerve.
2
Q
Deep pressure tests are used mostly for patients who are experiencing:
Select one:
a. absent superficial pain sensation.
b. gait and stepping disturbances.
c. lordosis, osteoporosis, or arthritis.
d. brisk reflexes.
e. tonic neck or torso spasms.
A
a. absent superficial pain sensation.
Deep pressure sensation is tested by squeezing the trapezius, calf, or biceps muscle, thus causing discomfort. When superficial pain sensation is not intact, then further assessments of temperature and deep pressure sensation are performed.
3
Q
Cafe au lait patches are numbered with each assessment of infants and young children because:
Select one:
a. their numbers are expected to increase each year.
b. coalescent lesions are a more serious finding.
c. the presence of more than six patches suggests neurofibromatosis.
d. decreasing numbers are expected with growth.
e. a higher number correlates with the development of erythema toxicum.
A
c. the presence of more than six patches suggests neurofibromatosis.
4
Q
Mr. S presents with the complaint of hearing loss. You specifically inquire about current medications. Which medications, if listed, are likely to contribute to his hearing loss?
Select one:
a. Chlorothiazide
b. Acetaminophen
c. Salicylates
d. Cephalosporins
e. Penicillins
A
c. Salicylates
Ototoxic medications include aminoglycoside, salicylates, furosemide, streptomycin, quinine, ethacrynic acid, and cisplatin. Chlorothiazide diuretics, acetaminophen, penicillins, and cephalosporins are considered non-ototoxic.
5
Q
The awareness of body position is known as:
Select one:
a. extrapyramidal.
b. graphesthesia.
c. stereognosis.
d. two-point discrimination.
e. proprioception.
A
e. proprioception.
6
Q
Skin lesions are transilluminated to determine:
Select one:
a. vascular from nonvascular lesions.
b. furuncles from folliculitis lesions.
c. fluid-filled lesions in solid cysts or masses.
d. herpes zoster from varicella.
e. macules from papules.
A
c. fluid-filled lesions in solid cysts or masses.
7
Q
Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
Select one:
a. cutaneous tags from lentigines.
b. furuncles from folliculitis.
c. sebaceous hyperplasia from eczema.
d. seborrheic keratoses from actinic keratoses.
e. herpes zoster from varicella.
A
d. seborrheic keratoses from actinic keratoses.
8
Q
Which nodes are most often associated with inflammation?
Select one:
a. Shotty
b. Movable
c. Fixed
d. Tender
e. Matted
A
?
9
Q
Term infants have a visual acuity of about:
Select one:
a. 20/20.
b. 20/100.
c. 20/200.
d. 20/300.
e. 20/400.
A
?
10
Q
The adipose tissue in the hypodermis serves to:
Select one:
a. provide sensory input.
b. generate heat and insulate.
c. create tensile strength.
d. restrict water loss.
e. secrete collagen.
A
?
11
Q
Horner syndrome is manifested by:
Select one:
a. proptosis and contralateral mydriasis.
b. excessive watering of the eyes.
c. blurring of vision when glucose levels fall.
d. ipsilateral miosis and mild ptosis.
e. band keratopathy and miosis.
A
?
12
Q
Which of the following is true regarding cephalhematoma?
Select one:
a. It is bound by suture lines.
b. The affected part feels soft.
c. It is obvious at birth.
d. The margins are poorly defined.
e. It never feels fluctuant on palpation.
A
a. It is bound by suture lines?
13
Q
To see retinal details in a patient with myopia, the examiner will need to:
Select one:
a. adjust the ophthalmoscope into the plus lenses.
b. move the ophthalmoscope backward.
c. move the hand farther forward.
d. examine the patient in a well-lighted room.
e. turn the ophthalmoscope to a minus lens.
A
?
14
Q
The parasympathetic nervous system maintains the day-to-day function of:
Select one:
a. digestion.
b. response to stress.
c. lymphatic supply to the brain.
d. lymphatic drainage of the brain.
e. coordinating fine motor movements.
A
a. digestion?
15
Q
An allergy can cause the conjunctiva to have a:
Select one:
a. cobblestone pattern.
b. dry surface.
c. subconjunctival hemorrhage.
d. rust-colored pigment.
e. pale appearance.
A
?
16
Q
You are using a pneumonic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to:
Select one:
a. remove all cerumen from the canal.
b. make sure the speculum is sealed form outside air.
c. squeeze the bulb with more force.
d. insert the speculum to depth of 2 cm.
e. use a smaller plastic speculum.
A
?
17
Q
A bruit heard over the thyroid is suggestive of:
Select one:
a. hypothyroidism.
b. hyperthyroidism.
c. thyroid cancer.
d. thyroid cyst.
e. thyroid nodule.
A
?
18
Q
The immune system attacks the synaptic junction between the nerve and muscle fibers blocking acetylcholine receptor sites in:
Select one:
a. myasthenia gravis.
b. encephalitis.
c. multiple sclerosis.
d. cerebral palsy.
e. trigeminal neuralgia.
A
?
19
Q
Dot hemorrhages, or microaneurysms, and the presence of hard and soft exudates are most commonly seen in:
Select one:
a. Down syndrome.
b. diabetic retinopathy.
c. systemic lupus.
d. glaucoma.
e. retinitis pigmentosa.
A
?
20
Q
Emotional lability, personality changes, and contralateral hemiplegia greater in the lower than upper extremities indicates a cerebrovascular accident (CVA) occurring in the:
Select one:
a. anterior spinal artery.
b. internal or middle cerebral artery.
c. posterior inferior cerebellar artery.
d. vertebral or basilar arteries.
e. anterior cerebral artery.
A
?
21
Q
The medial border of the sternocleidomastoid muscles and the mandible form the _____ triangle.
Select one:
a. dorsal
b. posterior
c. lateral
d. medial
e. anterior
A
e. anterior
22
Q
The brown or tan pigmentation on the forehead, nose, and malar prominence of some pregnant women is called:
Select one:
a. hormonal acne.
b. erythema.
c. alopecia.
d. chloasma.
e. craniotabes.
A
d. chloasma.
23
Q
The criterion for adequacy of a patient’s visual field is:
Select one:
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
e. pupillary constriction when an object is moved close to the nose.
A
c. correspondence with the visual field of the examiner.
24
Q
It is not unusual to find postauricular and occipital nodes in:
Select one:
a. children younger than 2 years of age.
b. school-age children.
c. adolescents.
d. adults.
e. older adults.
A
a. children younger than 2 years of age.
25
A flat, nonpalpable lesion is described as a macule if the diameter is:
Select one:
a. greater than 1 cm.
b. less than 1 cm.
c. greater than 2 cm.
d. too irregular to measure.
e. exactly 5 mm.
b. less than 1 cm.
26
The motor cortex of the brain is in the:
Select one:
a. corpus callosum.
b. frontal lobe.
c. limbic system.
d. occipital lobe.
e. parietal lobe.
b. frontal lobe.
27
Painful vesicles are associated with:
Select one:
a. psoriasis.
b. pityriasis rosea.
c. paronychia.
d. herpes zoster.
e. rosacea.
d. herpes zoster.
28
Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:
Select one:
a. retina.
b. lens.
c. retinal vessels.
d. macula.
e. optic disc.
d. macula.
The macula is the site of central vision and is observed when the patient looks directly at the ophthalmoscope light.
29
To palpate the inguinal nodes, you should have the patient
Select one:
a. bend over a table and cough.
b. lie supine, with the knees slightly flexed.
c. lie supine, with the legs extended.
d. stand with the back extended.
e. lie prone, with the knees slightly flexed.
b. lie supine, with the knees slightly flexed.
30
To inspect the lateral borders of the tongue, you should:
Select one:
a. ask the patient to extend the tongue outward.
b. insert the tongue blade obliquely against the tongue.
c. lift the tongue upward with gloved fingers.
d. pull the gauze-wrapped tongue to each side.
e. ask the patient to lift the tongue upward.
d. pull the gauze-wrapped tongue to each side.
31
Fluorescing lesions are best distinguished using a(n):
Select one:
a. incandescent lamp.
b. magnifying glass.
c. transilluminator.
d. Wood’s lamp.
e. halogen lamp.
d. Wood’s lamp.
32
Mydriasis accompanies:
Select one:
a. coma.
b. diabetes.
c. hyperopia
d. astigmatism.
e. morphine administration.
c. hyperopia
33
A congenital defect in the immune system of a 2-week-old infant may be suspected if:
Select one:
a. there are small, palpable inguinal nodes.
b. the umbilical cord has not yet dropped off.
c. the tonsils are visible.
d. the thymus is visible on a chest radiograph.
e. the small postauricular nodes are palpable.
b. the umbilical cord has not yet dropped off.
34
When assessing a 17-year-old patient for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test result, you would also perform a test for the _____ sign.
Select one:
a. Kernig
b. Babinski
c. obturator
d. Brudzinski Murphy
a. Kernig
35
You are conducting a preschool examination on a 5-year-old child. Which injury would most likely raise your suspicion that the child was being abused?
Select one:
a. Recent bruising over both knees
b. A healed laceration under the chin
c. A bruise on the right shin with associated abrasion of tissue
d. Bruises in various stages of resolution over body soft tissues
e. A scab on the elbow
d. Bruises in various stages of resolution over body soft tissues
Toddlers and older children who bruise themselves accidentally are bruised over bony prominences, such as the knees, elbows, chin, and shin. Bruises over soft tissues are more consistent with abuse.
36
It is especially important to test for ankle clonus if:
Select one:
a. deep tendon reflexes are hyperactive.
b. the patient has a positive Kernig sign.
c. the Romberg sign is positive.
d. the patient has peripheral neuropathy.
e. deep tendon reflexes are hypoactive.
a. deep tendon reflexes are hyperactive.
37
A red streak that follows the course of the lymphatic collecting duct is a finding associated with:
Select one:
a. Hodgkin lymphoma.
b. lymphangitis.
c. lymphedema.
d. non-Hodgkin lymphoma.
e. roseola infantum.
b. lymphangitis.
38
The skin repairs epidermal wounds by:
Select one:
a. exaggerating cell replacement.
b. excreting lactic acid.
c. producing vitamins.
d. providing a mechanical barrier.
e. increasing the vascularity of the epidermis.
?
39
At what age does an infant usually develop the ability to distinguish color?
Select one:
a. At birth
b. 2 months
c. 6 months
d. 12 months
e. 16 months
?
40
Moist skin with fine hair, prominent eyes, eyelid retraction, and a staring expression are characteristics associated with:
Select one:
a. Cushing syndrome.
b. Graves disease.
c. myxedema.
d. systemic lupus erythematosus.
e. Hippocratic facies.
?
41
The finger-to-nose test allows assessment of:
Select one:
a. coordination and fine motor function.
b. point location.
c. sensory function.
d. two-point discrimination.
e. stereognosis.
a. coordination and fine motor function.
To perform the finger-to-nose test, the patient closes both eyes, and touches his or her nose with the index finger, alternating hands while gradually increasing the speed. This tests coordination and fine motor skills. All of the other choices test sensory function without motor function.
42
If a patient has early papilledema, the examiner will be able to detect:
Select one:
a. dilated retinal veins.
b. retinal vein pulsations.
c. sharply defined optic discs.
d. visual defects.
e. narrowed retinal veins.
a. dilated retinal veins.
Papilledema is caused by increased intracranial pressure along the optic nerve, pushing the vessels forward (cup protrudes forward) and dilating the retinal veins. On examination, papilledema is characterized by loss of definition of the optic disc. Vein pulsations and visual defects are not visible with an ophthalmoscope.
43
All of the following are recommendations of the American Academy of Pediatrics to reduce the risk of sleep-related infant deaths including SIDS except:
Select one:
a. firm sleep surface.
b. breast-feeding.
c. routine immunizations.
d. prone sleeping position.
e. avoidance of tobacco smoke.
d. prone sleeping position.
44
Brittle nails are typical findings in:
Select one:
a. adolescents.
b. infants.
c. pregnant patients.
d. older adults.
e. children.
d. Older adults
Older adults typically have decreased peripheral circulation to the nails, causing the nails characteristically to develop longitudinal ridges that are more brittle and susceptible to splitting into layers.
45
Which type of headache occurs at night, is precipitated by alcohol consumption, and occurs more often in men than in women?
Select one:
a. Classic migraine
b. Temporal arteritis
c. Muscular tension
d. Hypertensive
e. Cluster
e. Cluster
46
The secretory activity of the sebaceous glands is stimulated by:
Select one:
a. body heat.
b. ambient temperature.
c. sex hormones.
d. dietary protein.
e. emotional stimuli.
c. sex hormones.
47
he predominant formed elements of normal lymph fluid are:
```
Select one:
a. red blood cells.
b. white blood cells.
c. platelets.
d. antigens.
e. antibodies.
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b. white blood cells.
48
Transient mottling of the patient’s skin in a cool room is a common finding in:
Select one:
a. menopausal women.
b. newborn infants.
c. pregnant patients.
d. sedentary adults
e. older adults.
b. newborn infants.
49
The most common cutaneous neoplasm is:
Select one:
a. basal cell carcinoma.
b. compound nevus.
c. seborrheic keratosis.
d. senile actinic keratosis.
e. malignant melanoma.
a. basal cell carcinoma.
50
White specks scattered in a linear pattern around the entire circumference of the iris are called:
Select one:
a. drusen bodies.
b. cotton wool spots.
c. rust spots.
d. Brushfield spots.
e. band keratopathy.
d. Brushfield spots.
51
When conducting an adult otoscopic examination, you should:
Select one:
a. position the patient’s head leaning toward you.
b. grasp the handle of the otoscope as you would a baseball bat.
c. select the largest speculum that will fit in the canal.
d. ask the patient to keep his or her eyes closed.
e. pull the auricle down and forward.
c. select the largest speculum that will fit in the canal.
52
An increased level of lysozyme in the tears will occur normally during which life stage?
Select one:
a. Adolescence
b. Childhood
c. Infancy
d. Pregnancy
e. Older adults
d. Pregnancy
53
The most common form of birth trauma of the scalp is:
Select one:
a. caput succedaneum.
b. cephalhematoma.
c. cranial bossing.
d. torticollis.
e. dilated scalp veins.
a. caput succedaneum.
54
A pterygium is more common in people heavily exposed to:
Select one:
a. high altitudes.
b. tuberculosis.
c. ultraviolet light.
d. cigarette smoke.
e. lead.
c. ultraviolet light.
55
Which of the following findings would be consistent with fetal alcohol syndrome?
Select one:
a. Corneal clouding
b. Eye slanting
c. Mild ptosis
d. Symmetric bulging fontanels
e. Maxillary hypoplasia
c. Mild ptosis
56
The thalamus is the major integration center for perception of:
Select one:
a. speech.
b. olfaction.
c. pain
d. thoughts.
e. visceral responses to emotions.
c. pain
57
A 30-year-old woman presents with rapid swelling beneath her jaw that suddenly appears while she is eating. The swelling is mildly painful but is not hot or red. You suspect Wharton salivary duct stones and proceed to palpate:
Select one:
a. bilaterally along the buccal mucosa.
b. under the tongue, along each side of the frenulum.
c. dorsum of the tongue.
d. beside the gingivae near each molar.
e. along the roof of the mouth.
b. under the tongue, along each side of the frenulum.
The vast majority of these stones occur in the Wharton duct from the submaxillary gland, which can be palpated along each side of the frenulum under the tongue.
58
Assessment of poor hygiene, healed fractures with deformity, or unexplained trauma in older adults indicates:
Select one:
a. sexual abuse.
b. physical neglect.
c. psychologic abuse.
d. violated rights.
e. financial abuse.
b. physical neglect.
The question describes is the most common form of elder abuse—physical neglect.
59
Cotton wool spots are most closely associated with:
Select one:
a. glaucoma.
b. normal aging processes.
c. hypertension.
d. eye trauma.
e. hyperthyroidism.
c. hypertension.
60
Which of the following organs does not have lymphatic vessels?
Select one:
a. Brain
b. Kidneys
c. Liver
d. Lungs
e. Appendix
a. Brain
Lymphatic tissues are found abundantly throughout the body except in two places, the placenta and the brain (central nervous system).
61
The middle ear contains the:
Select one:
a. cerumen and sebaceous glands.
b. umbo and malleus.
c. vestibule and cochlea.
d. pars tensa and semicircular canals.
e. helix and antihelix.
b. umbo and malleus.
62
For best results, an otoscopic and oral examination in a child should be:
Select one:
a. conducted at the beginning of the assessment.
b. done after inspection.
c. performed at the end of the examination.
d. performed before palpation
e. deferred until they can fully cooperate.
c. performed at the end of the examination.
63
Xanthelasma may suggest that the patient has an abnormality of:
Select one:
a. lipid metabolism.
b. cognitive function.
c. renal metabolism.
d. bone marrow function.
e. thyroid disease.
a. lipid metabolism.
64
You observe a pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for:
Select one:
a. confrontation reaction.
b. accommodation.
c. pupillary light reflex.
d. nystagmus.
e. corneal arcus senilis.
b. accommodation.
65
Skin turgor checks are performed to determine:
Select one:
a. the temperature of the skin.
b. hydration status.
c. skin texture.
d. the extent of an ecchymosis.
e. skin moisture.
b. hydration status.
66
hich structure is the site of new nail growth?
Select one:
a. Cuticle
b. Paronychium
c. Eponychium
d. Nail bed
e. Matrix
e. Matrix
67
Ptosis may be secondary to:
Select one:
a. blepharitis.
b. hyperthyroidism.
c. psoriasis.
d. paresis of a branch of cranial nerve III.
e. entropion.
d. paresis of a branch of cranial nerve III.
68
An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or:
Select one:
a. digestive disorder.
b. skeletal anomaly.
c. renal disorder.
d. Ménière disease.
e. heart defect.
c. renal disorder.
69
You have asked a patient to close his eyes and identify an object placed in his hand. You are evaluating:
Select one:
a. stereognosis.
b. graphesthesia.
c. vibratory sense.
d. two-point discrimination.
e. extinction phenomenon.
a. stereognosis.
70
piscleritis may indicate:
Select one:
a. lipid abnormalities.
b. an autoimmune disorder
c. an anaphylactoid reaction.
d. severe anemia.
e. thyroid disease.
b. an autoimmune disorder
71
Lymphoid tissue normally regresses to adult size by:
Select one:
a. 2 years of age.
b. 5 years of age.
c. 10 years of age.
d. puberty.
e. the early 20s.
d. puberty.
72
Which landmark is the dividing line between the anterior and posterior cervical triangles?
Select one:
a. Clavicle
b. Cervical spine
c. Sternocleidomastoid muscle
d. Sternum
e. Hyoid bone
c. Sternocleidomastoid muscle
73
A postinfectious disorder following a nonspecific gastrointestinal or respiratory infection that causes an acute neuromuscular paralysis is:
Select one:
a. cerebral palsy.
b. HIV encephalopathy.
c. Guillain-Barré syndrome.
d. Rett syndrome.
e. myasthenia gravis.
c. Guillain-Barré syndrome.
Guillain-Barré syndrome is an autoimmune disorder triggered by a bacterial or viral infection that damages the peripheral nerves, leading to denervation and atrophy.
74
Which of the following is true regarding caput succedaneum?
Select one:
a. It is a subperiosteal collection of blood.
b. It is firm and its edges are well defined.
c. It develops several days after delivery.
d. It is seen over the presenting part of the head.
e. It is a head circumference increasing faster than expected.
d. It is seen over the presenting part of the head.
75
What is the significance of a patient with asymmetry of the entire side of the face?
Select one:
a. A degenerative process may be developing.
b. A peripheral trigeminal nerve problem exists.
c. Asymmetry of body sides is a normal finding.
d. Visual and hearing problems will be present.
e. Facial nerve paralysis may be present.
e. Facial nerve paralysis may be present.
76
The thyroid gland is partially obscured by the:
Select one:
a. cricoid cartilage.
b. carotid artery.
c. external jugular.
d. sternocleidomastoid.
e. hyoid bone.
d. sternocleidomastoid.
77
A 29-year-old white woman appears jaundiced. A cause of liver disease has been excluded. What history questions should the nurse ask?
Select one:
a. Whether she had unprotected sex
b. If she has a history of diabetes mellitus
c. Whether she has unusual bleeding problems
d. If she eats a lot of yellow and orange vegetables
e. If she has a family history of peripheral vascular disease
d. If she eats a lot of yellow and orange vegetables
78
The major portion of brain growth and myelinization occurs between ____ year(s) of age.
Select one:
a. birth and 1
b. 2 and 3
c. 4 and 7
d. 11 and 14
e. 16 and 21
a. birth and 1
79
The most important clue to the diagnosis of a child with an immunodeficiency disease is:
Select one:
a. family history.
b. illness in siblings.
c. previous hospitalizations.
d. serious recurring infections.
e. cervical adenitis.
d. serious recurring infections.
80
When examining the skull of a 4-month-old baby, you should normally find:
Select one:
a. closure of the anterior fontanel.
b. closure of the posterior fontanel.
c. ossification of the all sutures.
d. overlap of the cranial bones.
e. closure of the sagittal and coronal sutures.
b. closure of the posterior fontanel.
81
Tracheal tug suggests the presence of a(n):
Select one:
a. enlarged thyroid.
b. swallowing disorder.
c. aortic aneurysm.
d. thoracic carcinoma
e. hyperparathyroidism.
c. aortic aneurysm.
82
Which risk factor is least likely to result in contracting HIV?
Select one:
a. Prostitution
b. Hemophilia
c. Intravenous drug use
d. Working with AIDS patients
e. Sexual contact with intravenous drug users
e. Sexual contact with intravenous drug users
83
Speech with a monotonous tone and erratic volume may indicate:
Select one:
a. otitis externa.
b. hearing loss.
c. serous otitis media.
d. sinusitis.
e. dry cerumen.
b. hearing loss
84
Periorbital edema is:
Select one:
a. an abnormal sign.
b. expected with aging.
c. more common in males.
d. present in children.
e. an abnormality of lipid metabolism.
a. an abnormal sign.
85
Which disorder is characterized by a single node that is chronically enlarged and nontender in a patient with no other symptoms?
Select one:
a. Retropharyngeal abscess
b. Streptococcal pharyngitis
c. Mononucleosis
d. Toxoplasmosis
e. Herpes simplex
d. Toxoplasmosis
86
The premature union of cranial sutures that involves the shape of the head without mental retardation is:
Select one:
a. craniosynostosis.
b. encephalocele.
c. microcephaly.
d. myxedema.
e. fetal alcohol syndrome.
a. craniosynostosis
87
Opacities of the red reflex may indicate the presence of:
Select one:
a. hypertension.
b. hydrocephalus.
c. cataracts.
d. myopia.
e. diabetes.
c. cataracts
88
To find the infection site associated with acute lymphangitis, the examiner should look _____ to the inflammation.
Select one:
a. proximal
b. distal
c. contralateral
d. anterior
e. posterior
b. distal
89
You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, the air conduction to bone conduction-to-ratio was less than 2:1. You interpret these findings as suggestive of:
Select one:
a. a defect in the inner ear.
b. a defect in the middle ear.
c. otitis externa.
d. impacted cerumen.
e. serous otitis.
a. a defect in the inner ear.
90
Intense pain with movement of the pinna is most closely associated with:
Select one:
a. sinusitis.
b. otitis externa.
c. purulent otitis media.
d. bacterial otitis media.
e. otitis media with effusion.
b. otitis externa.
91
Lymph ducts merge into the venous system at the:
Select one:
a. portal vein.
b. pulmonic vein.
c. subclavian veins.
d. vena cava.
e. jugular veins.
c. subclavian veins.
92
Contraction or relaxation of the ciliary body:
Select one:
a. allows voluntary blinking.
b. changes lens thickness.
c. regulates peripheral vision.
d. sends light impulses to the brain.
e. regulates tear production.
b. changes lens thickness.
93
Entropion implies that the eyelid is:
Select one:
a. drooping.
b. everted.
c. edematous.
d. turned inward.
e. inflamed.
d. turned inward.
94
The largest endocrine gland in the body lies in the _____ triangle.
Select one:
a. anterior
b. posterior
c. lateral
d. medial
e. ventral
a. anterior
95
Which structures disproportionately enlarge in males during adolescence?
Select one:
a. Coronal sutures
b. Hyoid and cricoid cartilages
c. Mandible and maxilla bones
d. Nose and thyroid cartilages
e. Mastoid processes and ears
d. Nose and thyroid cartilages
96
After focusing on a blood vessel in the retina with your ophthalmoscope, you attempt to locate the optic disc. You should:
Select one:
a. follow the vessel as it branches out.
b. have the patient move his or her eye laterally.
c. have the patient move his or her eye up.
d. have the patient move his or her eye down.
e. follow the vessel as it converges into larger vessels.
e. follow the vessel as it converges into larger vessels.
97
A condition that typically develops by the age of 45 years is:
Select one:
a. presbyopia.
b. hyperopia.
c. myopia.
d. astigmatism.
e. cataracts.
a. presbyopia.
98
Women with terminal hair growth in a male distribution pattern should receive further evaluation for a(n):
Select one:
a. circulation condition.
b. gastrointestinal disorder.
c. inflammatory state.
d. nutritional deficit.
e. endocrine disorder.
e. endocrine disorder.
99
A hairy tongue with yellowish brown to black elongated papillae on the dorsum:
Select one:
a. is indicative of oral cancer.
b. is sometimes seen after antibiotic therapy.
c. usually indicates a vitamin deficiency.
d. usually indicates anemia.
e. is characteristic of a geographic tongue.
b. is sometimes seen after antibiotic therapy.
100
When enlarged, which lymph nodes are most likely to be a sign of malignancy?
Select one:
a. Occipital
b. Anterior cervical
c. Posterior cervical
d. Femoral
e. Supraclavicular
e. Supraclavicular
101
The autonomic nervous system coordinates which of the following?
Select one:
a. High-level cognitive function
b. Balance and affect
c. Internal organs of the body
d. Balance and equilibrium
e. Emotions and behavior
c. Internal organs of the body
102
A single transverse crease seen on the palm of a small child may imply:
Select one:
a. Down syndrome.
b. Turner syndrome.
c. systemic sclerosis.
d. profound dehydration.
e. neurofibromatosis.
a. Down syndrome.
103
Which cranial nerves innervate the face?
Select one:
a. II and V
b. III and VI
c. V and VII
d. VIII and IX Incorrect
e. I and VII
c. V and VII
104
When inspecting the region of the lacrimal gland, palpate:
Select one:
a. the lower orbital rim near the inner canthus.
b. in the area between the arch of the eyebrow and the upper eyelid.
c. beneath the lower eyelid adjacent to the inner canthus.
d. adjacent to the lateral aspect of the eye, just beneath the upper eyelid.
e. medially above the eyebrow.
a. the lower orbital rim near the inner canthus.
105
Which cultural group has the lowest incidence of nevi?
Select one:
a. Native Americans
b. African Americans
c. Mexican Americans
d. Asians
e. Eastern Europeans
b. African Americans
106
Which ear structure is responsible for equalizing atmospheric pressure when swallowing, sneezing, and yawning?
Select one:
a. Eustachian tube
b. Inner ear
c. Semicircular canals
d. Triangular fossa
e. Oval window
a. Eustachian tube
107
Drusen bodies are most commonly a consequence of:
Select one:
a. glaucoma.
b. aging.
c. presbyopia.
d. papilledema.
e. hypertension.
b. aging
108
To perform the Rinne test, place the tuning fork on the:
Select one:
a. top of the head.
b. mastoid bone.
c. forehead.
d. preauricular area.
e. occiput.
b. mastoid bone
109
When using a monofilament to assess sensory function, the examiner:
Select one:
a. uses two simultaneous monofilaments on similar bilateral points and then compares results.
b. applies both a monofilament and a pin on similar bilateral points and then compares results.
c. applies pressure to the monofilament until the filament bends.
d. strokes the monofilament along the skin from proximal to distal areas.
e. assesses only the dorsal surface of the foot with the patient’s eyes open.
c. applies pressure to the monofilament until the filament bends.
110
When examining lymph nodes near a joint in the arm or leg, which of the following maneuvers is likely to facilitate the examination?
Select one:
a. Extension of the extremity
b. Circumduction of the extremity
c. Abduction of the extremity
d. Rotation of the extremity
e. Flexion of the extremity
e. Flexion of the extremity
111
Transillumination is done during an examination of the lymphatic system to:
Select one:
a. detect lymphatic pulsation.
b. distinguish nodes from cysts
c. evaluate nodal contours.
d. observe erythematous lesions.
e. distinguish blood vessels from nodes.
b. distinguish nodes from cysts
112
The characteristic that best differentiates psoriasis from other skin abnormalities is the:
Select one:
a. color of the scales.
b. formation of tiny papules.
c. general distribution over the body.
d. recurrence.
e. loss of hair.
a. color of the scales
113
Which is the best way to position a patient’s neck for palpation of the thyroid?
Select one:
a. Flexed away from the side being examined
b. Flexed directly forward
c. Flexed toward the side being examined
d. Hyperextended directly backward
e. Rotated away from the side being examined
c. Flexed toward the side being examined
114
As adults age, their ability to resist infection decreases because of lymphatic nodes becoming more:
Select one:
a. hematopoietic.
b. mucoid.
c. porous.
d. profuse.
e. fibrotic
e. fibrotic
115
The thyroid gland should:
Select one:
a. be slightly left of midline.
b. have a clear vascular sound.
c. feel nodular.
d. tug with each heartbeat.
e. move when the patient swallows.
e. move when the patient swallows.
116
Inspection to determine color variations of the skin is best conducted:
Select one:
a. using an episcope.
b. under fluorescent lighting.
c. with illumination provided by daylight.
d. using a Wood’s lamp.
e. using a pen light.
c. with illumination provided by daylight.
117
Cranial nerve XII may be assessed in an infant by:
Select one:
a. watching the infant’s facial expressions when crying.
b. observing the infant suck and swallow.
c. clapping hands and watching the infant blink.
d. observing the infant’s rooting reflex.
e. checking the infant’s gag reflex.
b. observing the infant suck and swallow.
118
The most common causes of acute suppurative lymphadenitis are:
Select one:
a. HIV and herpes zoster.
b. Haemophilus influenzae and adenovirus.
c. herpes simplex type 1 and type 2.
d. streptococcal and staphylococcal organisms
e. mumps.
d. streptococcal and staphylococcal organisms
119
Cupping of the optic disc may be a result of:
Select one:
a. migraine headaches.
b. diabetes.
c. glaucoma.
d. dehydration.
e. cataracts.
c. glaucoma
120
You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the:
Select one:
a. back.
b. palms.
c. fingertips.
d. upper arms.
e. chest.
c. fingertips
121
Normal hormone-related changes of adolescence include:
Select one:
a. increased oil production.
b. the development of fine silky lanugo hair.
c. depletion of apocrine glands.
d. decreased sebaceous gland activity.
e. slowed hair growth.
a. increased oil production.
122
Peripheral vision can be estimated by means of which test?
Select one:
a. Confrontation
b. Pupillary reaction
c. Accommodation
d. Snellen E chart
e. Swinging flashlight
c. Confrontation
123
Retinal hemorrhages in an infant require investigation for:
Select one:
a. retinoblastoma.
b. retrolental fibroplasia.
c. pituitary tumor.
d. child abuse.
e. strabismus.
d. child abuse
124
Initial signs and symptoms of Epstein-Barr virus mononucleosis most often include:
Select one:
a. pharyngitis, fever, and malaise.
b. bleeding gums and spontaneous nosebleeds.
c. headache, visual disturbance, and rash.
d. inguinal adenopathy and painful urination.
e. discrete labial and gingival ulcers and high-grade fever.
a. pharyngitis, fever, and malaise.
125
What maneuver can be done to reduce the systemic absorption of cycloplegic and mydriatic agents when examining a pregnant patient if the examination is mandatory?
Select one:
a. Have the woman keep her eyes closed for several minutes.
b. Instill half the usual dosage.
c. Keep the patient supine.
d. Use nasolacrimal occlusion after instillation.
e. Have the patient keep her head turned and flexed.
d. Use nasolacrimal occlusion after instillation.
126
Newborns are more vulnerable to hypothermia because of:
Select one:
a. the presence of coarse terminal hair.
b. desquamation of the stratum corneum.
c. their covering of vernix caseosa.
d. a poorly developed subcutaneous fat layer.
e. excessive secretion of eccrine sweat glands.
d. a poorly developed subcutaneous fat layer.
127
During what developmental stage are hoarseness, voice cracking, and a persistent cough a common finding?
Select one:
a. Adolescence
b. Infancy
c. Menopause
d. Pregnancy
e. Childhood
d. Pregnancy
128
As Mr. B enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B’s pattern as:
Select one:
a. dystonic ataxia.
b. cerebellar ataxia
c. steppage gait.
d. tabetic stamping.
e. Parkinsonian gait.
b. cerebellar ataxia
A cerebellar gait (cerebellar ataxia) occurs when the patient’s feet are wide based with a staggering gait, lurching from side to side, often accompanied by swaying of the trunk. Dystonic ataxia is jerky dancing movements that appear nondirectional. Steppage gait is noted when the hip and knee are elevated excessively high to lift the plantar flexed foot off the ground. The foot is brought down with a slap, and the patient is unable to walk on the heels. Tabetic stamping occurs when the legs are positioned far apart, lifted high, and forcibly brought down with each step; in this case, the heel stamps on the ground. In Parkinsonian gait, the patient’s posture is stooped, and the body is held rigid; steps are short and shuffling, with hesitation on starting and difficulty stopping.
129
The trapezius and sternocleidomastoid muscles and the clavicle form a landmark called the _____ triangle.
Select one:
a. anterior
b. posterior
c. lateral
d. medial
e. ventral
b. posterior
130
Cherry angiomas are a common finding in:
Select one:
a. adults older than 30 years.
b. newborns.
c. pregnant patients.
d. sunbathers.
e. adolescents.
a. adults older than 30 years.
131
A smooth red tongue with a slick appearance may indicate:
Select one:
a. a niacin or vitamin B12 deficiency.
b. oral cancer.
c. recent use of antibiotics.
d. a fungal infection.
e. a geographic tongue.
a. a niacin or vitamin B12 deficiency.
132
Obstruction of the nasopharynx, pulmonary hypertension, and risk of sleep apnea may be associated with excessively enlarged:
Select one:
a. branchial cleft cysts.
b. cystic hygromas.
c. palatine tonsils.
d. thyroglossal duct cysts.
e. lymphangiomas.
?
133
When noting a bulging fontanel with marked pulsations in a 6-month-old infant, you suspect:
Select one:
a. normal development.
b. Down syndrome.
c. increased intracranial pressure.
d. fever response to a viral infection.
e. cephalhematoma.
?
134
You are initially evaluating the equilibrium of Ms. Q You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive:
Select one:
a. Kernig sign.
b. Homan sign.
c. McMurray test.
d. Romberg sign.
e. Murphy sign.
?
135
A stethoscope is used in a head and neck examination to assess:
Select one:
a. intracranial fluid.
b. pulsating fontanels.
c. skull bone development.
d. thyroid vascular sounds.
e. parotid glands.
?
136
Which of the following is associated with age-related hearing loss?
Select one:
a. Degeneration of the hair cells of the organ of Corti
b. Excess resorption of bone cells of the ossicle chain
c. Increased pliability of the tympanic membrane
d. More serous cerumen
e. Proliferation of the stria vascularis
?
137
Changes seen in proliferative diabetic retinopathy are the result of:
Select one:
a. anoxic stimulation.
b. macular damage.
c. papilledema.
d. minute hemorrhages.
e. chorioretinal scarring.
?
138
Nasal symptoms that imply an allergic response include:
Select one:
a. purulent nasal drainage.
b. bluish gray turbinates.
c. small, atrophied nasal membranes.
d. a firm consistency of the turbinates.
e. a deviated septum.
?
139
Which nodes are also called Virchow nodes?
Select one:
a. Internal mammary
b. Anterior axillary
c. Deep cervical
d. Supraclavicular
e. Preauricular
?
140
Mr. C’s visual acuity is 20/50. This means that he:
Select one:
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart’s 20/50 line.
d. can read letters while standing 20 feet from the chart that the average person could read at 50 feet.
e. is legally blind
d. can read letters while standing 20 feet from the chart that the average person could read at 50 feet.
141
A clinical syndrome of intracranial hypertension that mimics brain tumors is:
Select one:
a. meningitis.
b. myasthenia gravis.
c. Guillain-Barré syndrome.
d. pseudotumor cerebri.
e. Bell palsy.
d. pseudotumor cerebri.
Pseudotumor cerebri is a clinical syndrome of intracranial hypertension that mimics brain tumors. Etiology is unknown, but proposed causes are excess cerebrospinal fluid (CSF) production or malabsorption. Obstructed venous drainage of CSF is also a potential cause. Obesity is considered a contributing factor.
142
The unit of measurement in describing lesion size and location on the fundus is the:
Select one:
a. disc diameter.
b. macular diameter.
c. pupillary diameter.
d. centimeter.
e. diopter.
a. disc diameter.
143
To approximate vocal frequencies, which tuning fork should be used to assess hearing?
Select one:
a. 100 to 300 Hz
b. 200 to 400 Hz
c. 500 to 1000 Hz
d. 1500 to 2000 Hz
e. Greater than 2000 Hzc.
c. 500 to 1000 Hz
144
An infant’s auditory canal, when compared with an adult’s, is:
Select one:
a. short, narrow, and straight.
b. short and curved upward.
c. long, narrow, and curved forward.
d. short and curved downward.
e. long, wide, and straight.
b. short and curved upward.
145
Unusual white areas on the skin may be caused by:
```
Select one:
a. adrenal disease.
b. polycythemia.
c. vitiligo.
The absence of melanin produces unpigmented white areas known as vitiligo.
d. Down syndrome.
e. lentigo.
```
C. Vitiligo
146
Serum sickness is usually characterized first by the appearance of:
Select one:
a. diffuse lymph node enlargement.
b. joint pain.
c. urticaria.
d. fever.
e. a single enlarged posterior cervical node.
c. urticaria.
147
A neurologic past medical history should include data about:
Select one:
a. family patterns of dexterity and dominance.
b. circulatory problems.
c. educational level.
d. immunizations.
e. allergies.
b. circulatory problems.
148
Which of the following is a relatively benign condition that may occur during pregnancy or labor?
Select one:
a. Macular degeneration
b. Papilledema
c. Subconjunctival hemorrhage
d. Cupping of the optic disc
e. Presbyopia
c. Subconjunctival hemorrhage
149
Motor maturation proceeds in an orderly progression from:
Select one:
a. peripheral to central.
b. head to toe.
c. lateral to medial.
d. pedal to cephalic.
e. toe to head.
b. head to toe.
150
If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation?
Select one:
a. CN I, olfactory
b. CN V, trigeminal Incorrect
c. CN IX, glossopharyngeal
d. CN XI, spinal accessory
e. CN XII, hypoglossal
d. CN XI, spinal accessory
151
Severe vertigo, tinnitus, and episodes of hearing loss are the characteristics of:
Select one:
a. cholesteatoma.
b. Ménière disease.
c. otosclerosis.
d. cocaine abuse.
e. labyrinthitis.
b. Ménière disease.
Ménière disease is an inner ear disorder characterized by episodes of hearing loss, vertigo, tinnitus, and ear fullness
152
Normal supraclavicular lymph nodes are:
Select one:
a. clustered in a capsule.
b. firm and discrete.
c. less than 3 cm in diameter.
d. not palpable
e. matted.
d. not palpable
153
You are palpating a patient’s thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data indicate:
Select one:
a. a congenital anomaly.
b. a normal thyroid gland.
c. a multinodular goiter.
d. thyroiditis.
e. a hypothyroid goiter.
b. a normal thyroid gland.
154
Which one of the following conditions is consistent with Brown-Séquard syndrome?
Select one:
a. Central sensory loss that is generalized
b. Motor paralysis on lesion side of the body
c. Multiple peripheral neuropathy of the joints
d. Spinal root paralysis below the umbilicus
e. Pain and temperature loss on lesion side of body
b. Motor paralysis on lesion side of the body
155
The most common inflammatory skin condition is:
Select one:
a. cutis marmorata.
b. eczematous dermatitis.
c. intradermal nevus.
d. pityriasis rosea.
e. psoriasis.
b. eczematous dermatitis.
156
Evidence-based practice suggests that the strongest predictor of sinusitis is:
Select one:
a. a maxillary toothache.
b. dull or opaque sinus transilluminations.
c. ineffective decongestants and colored nasal drainage.
d. purulent nasal secretions.
e. any combination of the above.
e. any combination of the above.
157
Expected hair distribution changes in the older adults include:
Select one:
a. increased terminal hair follicles to the scalp.
b. more prominent axillary and pubic hair production.
c. increased terminal hair follicles to the tragus of men’s ears.
d. more prominent peripheral extremity hair production.
e. women possibly developing less coarse facial hair.
c. increased terminal hair follicles to the tragus of men’s ears.
158
Bone spicule pigmentation is a hallmark of:
Select one:
a. chorioretinal pigmentosa.
b. cytomegalovirus infection.
c. lipemia retinalis.
d. retinitis pigmentosa.
e. choroidal nevus.
d. retinitis pigmentosa.
159
Which of the following is a concern, rather than an expected finding, in older adults?
Select one:
a. Reduced ability to differentiate colors
b. Bilateral pillrolling of the fingers
c. Absent plantar reflex
d. Diminished senses of smell and taste
e. Reduced gag reflex
b. Bilateral pillrolling of the fingers
160
Which of the following is a genetic eye disorder that should be included in the history and physical examination, under family history, for all members of the affected family?
Select one:
a. Constrictive iritis
b. Retinoblastoma
c. Oval pupils
d. Retinal hemorrhages
e. Maculates
b. Retinoblastoma
161
The harder and more discrete a node, the more likely a(n):
Select one:
a. innocent cause.
b. infection.
c. malignancy.
d. metabolic disease.
e. drug reaction.
c. malignancy.
162
Coarse, dry, and brittle hair is associated with which metabolic disorder?
Select one:
a. Hypothyroidism
b. Diabetes mellitus
c. Addison disease
d. Cushing syndrome
e. Fetal alcohol syndrome
a. Hypothyroidism
163
Which of the following is an ABCD characteristic of malignant melanoma?
Select one:
a. Asymmetric borders
b. Borders well demarcated
c. Color of lesion is uniform
d. Diameter less than 6 mm
e. Severe blistering or sunburns as a child
a. Asymmetric borders
164
RJ presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a:
Select one:
a. torticollis.
b. branchial cleft cyst.
c. Stensen duct stone.
d. thyroglossal duct cyst.
e. parotid gland tumor.
?
165
Which of the following findings, when seen in an infant, is most ominous?
Select one:
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at face
d. White pupils on photographs
e. The appearance of convergence
d. White pupils on photographs
166
Expected physical changes associated with older adults include:
Select one:
a. shiny buccal mucosa.
b. teeth appear shorter.
c. wetter nasal mucosa.
d. bristly hairs in the vestibule.
e. smoothing of the tongue.
d. bristly hairs in the vestibule.
167
When examining an infant’s middle ear, the practitioner should use one hand to stabilize the otoscope against the head while using the other hand to:
Select one:
a. pull the auricle down and back.
b. hold the speculum in the canal.
c. distract the infant.
d. stabilize the chest.
e. pull the auricle up.
a. pull the auricle down and back.
168
Which variation may be an expected finding in the ear examination of a newborn?
Select one:
a. Diffuse light reflex
b. Purulent material in the ear canal
c. Redness and swelling of the mastoid process
d. Small perforations of the tympanic membrane
e. Increased mobility and clarity of the tympanic membrane
a. Diffuse light reflex
169
A condition in which the eyelids do not completely meet to cover the globe is called:
Select one:
a. glaucoma.
b. lagophthalmos.
c. exophthalmos.
d. hordeolum.
e. blepharitis.
b. lagophthalmos.
170
The major function of the sympathetic nervous system is to:
Select one:
a. orchestrate the stress response.
b. coordinate fine motor movement.
c. determine proprioception.
d. contribute input from visual, labyrinthine, and proprioceptive sources.
e. perceive stereognosis.
a. orchestrate the stress response.
171
The pregnant patient can expect to experience:
Select one:
a. more nasal stuffiness.
b. a sensitive sense of smell.
c. drooling.
d. enhanced hearing.
e. decreased vascularity of the gums.
a. more nasal stuffiness.
172
The nails of older adults grow slowly because of:
Select one:
a. decreased circulation.
b. dietary deficiencies.
c. fungal infections.
d. low hormone levels.
e. high estrogen levels.
a. decreased circulation.
173
Cells that line the lymph node sinuses perform the specific function of:
Select one:
a. fat absorption.
b. fetal immunization.
c. hematopoiesis
d. platelet production.
e. phagocytosis.
e. phagocytosis.
174
An organ that is essential to the development of protective immune function in infants but has little or no demonstrated function in adults is the:
Select one:
a. spleen
b. appendix.
c. thymus.
d. pancreas.
e. liver.
c. thymus.
175
Mr. B was admitted from the emergency department, and you are completing his physical examination. His pupils are 2 mm bilaterally, and you notice that they fail to dilate when the penlight is moved away. This is characteristic in patients who are or have been:
Select one:
a. in a coma.
b. taking sympathomimetic drugs (e.g., cocaine).
c. taking opioid drugs (e.g., morphine).
d. treated for head trauma.
e. atropine overdosed.
c. taking opioid drugs (e.g., morphine).
176
Lymph flows faster in response to:
Select one:
a. massage.
b. decreased blood volume.
c. decreased metabolic rate.
d. decreased permeability of the capillary walls
e. decreased capillary pressure.
a. massage.
177
Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:
Select one:
a. air conduction of sound.
b. bone versus air conduction.
c. otitis externa.
d. otitis media.
e. lateralization of sound.
e. lateralization of sound.
178
You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the:
Select one:
a. back.
b. palms.
c. fingertips.
d. upper arms.
e. chest.
c. fingertips.
179
White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:
Select one:
a. Fordyce spots.
b. aphthous ulcers.
c. Stensen ducts.
d. leukoedema.
e. angular cheilitis.
b. aphthous ulcers.
180
Mydriasis accompanies:
Select one:
a. coma.
b. diabetes.
c. hyperopia
d. astigmatism.
e. morphine administration.
a. coma.
181
Changes seen in proliferative diabetic retinopathy are the result of:
Select one:
a. anoxic stimulation.
b. macular damage.
c. papilledema.
d. minute hemorrhages.
e. chorioretinal scarring.
a. anoxic stimulation.
182
Which nodes are also called Virchow nodes?
Select one:
a. Internal mammary
b. Anterior axillary
c. Deep cervical
d. Supraclavicular
e. Preauricular
d. Supraclavicular
