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TEST BANK CHAPTER 12: EARS,NOSE AND THROAT

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1.The middle ear contains the: a.cerumen and sebaceous glands. b.umbo and malleus. c.vestibule and cochlea. d.pars tensa and semicircular canals. ANS: B The middle ear contains the ossicles, thr... ee small bones—the malleus (umbo is part of the malleus), the incus, and the stapes. Cerumen and sebaceous glands lie outside the middle ear. The vestibule and the cochlea lie in the inner ear. The tympanic membrane separates the external ear from the middle ear and is composed of the pars tensa, and the semicircular canals lie in the inner ear. 2.The middle ear is normally filled with: a.air. b.blood. c.serous fluid. d.cerebrospinal fluid. ANS: A The middle ear normally is an air-filled cavity in the temporal bone. 3.The hair cells of Corti and membrane of Corti: a.produce a waxy lubricant. b.protect the ear from foreign particles. c.stimulate the eighth cranial nerve. d.transmit vibrations to the ossicles. ANS: C Vibrations from the tympanic membrane cause the delicate hair cells of the organ of Corti to strike against the membrane of Corti, stimulating impulses in the sensory endings of the auditory division of the eighth cranial nerve. 4.The organ of Corti is a coiled structure located inside the: a.cochlea in the inner ear. b.pars flaccida in the tympanic membrane. c.eustachian tube. d.lateral aspect of the pinna. ANS: A The cochlea is a coiled structure within the inner ear that contains the organ of Corti. 5.Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning? a.Eustachian tube b.Inner ear c.Pars flaccida d.Triangular fossa ANS: A The eustachian tube is a cartilaginous and bony passageway between the nasopharynx and middle ear that opens briefly to equalize the middle ear pressure with that of the atmospheric pressure when swallowing, yawning, or sneezing. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ TEST BANK CHAPTER 12: EARS,NOSE AND THROAT 6.Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which of the following recreational drugs is commonly associated with nasal septum perforation? a.Heroin b.Cocaine c.PCP d.Ecstasy ANS: B Long-term cocaine snorting causes ischemic necrosis of the septal cartilage and leads to perforation of the nasal septum. 7.A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the: a.sphenoid and frontal sinuses. b.maxillary and frontal sinuses. c.maxillary sinuses only. d.sphenoid sinuses only. ANS: C Only the maxillary and the frontal sinuses are accessible for physical examination; however, the young child does not develop frontal sinuses until 7 to 8 years of age. 8.An infant’s auditory canal, compared with an adult’s, is: a.short, narrow, and straight. b.short and curved upward. c.long, narrow, and curved forward. d.short and curved downward. ANS: B Compared with the adult’s, the infant’s auditory canal is shorter and has an upward curve, which is why pulling the pinna down straightens the canal. 9.Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to: a.pull the auricle down and back. b.hold the speculum in the canal. c.distract the infant. d.stabilize the chest. ANS: A The nurse should use the other hand to pull the auricle down and back in an effort to straighten the upward curvature of the canal. 10.The eruption of permanent teeth usually begins with: a.upper central incisors. b.upper canines. c.lower central incisors. d.lower canines. ANS: C The central incisors on the lower jaw usually erupt between 6 and 7 years of age as the first permanent teeth. Upper central incisors appear at 7 to 8 years of age. Upper canines appear at 11 to 12 years of age. Lower canines appear at 9 to 10 years of age. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ 11.Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with health care information, you will explain that she can expect to experience: a.more nasal stuffiness. b.a sensitive sense of smell. c.drooling. d.enhanced hearing. ANS: A Physiologic changes of pregnancy include nasal stuffiness, a decreased sense of smell, impaired hearing, epistaxis, and a sense of fullness in the ears. 12.During which developmental stage are hoarseness, voice cracking, and a persistent cough common findings in females? a.Adolescence b.Infancy c.Menopause d.Pregnancy ANS: D Laryngeal changes in pregnancy include hoarseness, deepening or cracking of the voice, vocal changes, and a persistent cough. 13.Hearing tends to decline after 50 years of age because of deterioration of: a.hair cells of the organ of Corti. b.the eustachian tube. c.the helix. d.cerumen. ANS: A Hearing declines after 50 years of age because of degeneration of hair cells in the organ of Corti, as well as atrophy of the hair cells in the cochlea. 14.You are performing hearing screening tests. Who would be expected to find difficulty in hearing the highest frequencies? a.A 7-year-old b.An 18-year-old c.A 30-year-old d.A 50-year-old ANS: D Sensorineural hearing loss begins after 50 years of age, initially with losses of high-frequency sounds and then progressing to tones of lower frequency. 15.Mr. Spencer 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? a.Chlorothiazide b.Acetaminophen c.Salicylates d.Cephalosporins ANS: C Ototoxic medications include aminoglycoside, salicylates, furosemide, streptomycin, quinine, ethacrynic acid, and cisplatin. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ 16.Mr. Williams, age 25 years, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented in which section of his history? a.Age-specific data b.Past medical data c.Past surgical data d.Social history ANS: B Information concerning the patient’s chronic postnasal drip is part of the past medical history. 17.A 6-month-old who can hear well can be expected to: a.exhibit the Moro reflex. b.stop breathing in response to sudden noise. c.turn his or her head toward the source of sound. d.imitate simple words. ANS: C Six-month-old infants turn their head toward the source of sound; they start babbling, but they begin imitating speech sounds closer to 10 months of age. The Moro reflex and cessation of breathing in response to noise are lost by 3 months of age. 18.Which risk factor is associated with the highest rate of oral cancers? a.Women b.Being younger than 55 years c.excessive caffeine use d.Fanconi anemia ANS: D Risk factors for oral cancer include age older than 55years, male gender, excessive alcohol use, dental lesions, tobacco use, occupational hazards (e.g., textile industry, leather manufacturing), and systemic disease (e.g., pernicious or iron deficiency anemia, HIV infection, lichen planus, previous malignancy). 19.To approximate vocal frequencies, which tuning fork should be used to assess hearing? a.100 to 300 Hz b.200 to 400 Hz c.500 to 1000 Hz d.1500 to 2000 Hz ANS: C Use of a 500- to 1000-Hz tuning fork approximates vocal frequencies. 20.You are using a pneumatic 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: a.remove all cerumen from the canal. b.change to a larger speculum. c.squeeze the bulb with more force. d.insert the speculum to a depth of 2 cm. ANS: B To see tympanic movement when using the pneumatic attachment, there should be a seal around the speculum to block outside air. In this manner, the normal tympanic membrane moves as a result of pressure changes from the insufflator bulb. A soft rubber speculum is recommended to establish the seal. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ 21.An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or: a.digestive disorders. b.skeletal anomalies. c.renal disorders. d.heart defects. ANS: C An auricle with a low-set or unusual angle may indicate chromosomal aberrations or renal disorders. 22.When conducting an adult otoscopic examination, you should: 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. ANS: C When conducting an adult otoscopic examination, select the largest speculum that will comfortably fit in the patient’s ear. When you are conducting an adult otoscopic examination, the patient’s head should be positioned toward the opposite shoulder. Hold the handle of the otoscope between the thumb and index finger, supporting it on the middle finger. There is no reason for the patient to keep her or his eyes shut. 23.Normal tympanic membrane color is: a.amber. b.chalky white. c.green. d.pearly gray. ANS: D The expected normal tympanic membrane color is pearly gray. 24.Bulging of an amber tympanic membrane without mobility is usually associated with: a.middle ear effusion. b.healed tympanic membrane perforation. c.impacted cerumen in the canal. d.repeated and prolonged crying cycles. ANS: A An amber color, with bulging of the tympanic membrane and without mobility or redness, usually indicates the presence of fluid in the middle ear. 25.Severe vertigo, tinnitus, and progressive hearing loss are characteristic of: a.cholesteatoma. b.Ménière disease. c.otosclerosis. d.cocaine abuse. ANS: B The classic triad of Ménière disease is vertigo, tinnitus, and progressive hearing loss. 26.When hearing is evaluated, which cranial nerve is being tested? a.III b.IV c.VIII d.XII ANS: C Cranial nerve VIII, the vestibulocochlear nerve, is associated with hearing. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ 27.Speech with a monotonous tone and erratic volume may indicate: a.otitis externa. b.hearing loss. c.serous otitis media. d.sinusitis. ANS: B Speech with a monotonous tone and erratic volume may indicate hearing loss. 28.Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for: a.air conduction of sound. b.bone versus air conduction. c.lateralization of sound. d.mallear auditory ability. ANS: C Placing the fork on the midline vertex of the patient’s head is the Weber test, a test for conductive hearing loss that lateralizes to the affected ear. 29.To perform the Rinne test, place the tuning fork on the: a.top of the head. b.mastoid bone. c.forehead. d.preauricular area. ANS: B The fork is initially placed against the mastoid bone for the Rinne test, a test for sensorineural loss. 30.You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, air conduction–to–bone conduction ratio is less than 2:1. You interpret these findings as suggestive of: a.a defect in the inner ear. b.a defect in the middle ear. c.otitis externa. d.impacted cerumen. ANS: A These results are consistent with a sensorineural hearing loss, a defect in the inner ear. Otitis externa and impacted cerumen are conditions of the external ear that can cause conductive hearing problems. 31.Nasal symptoms that imply an allergic response include: a.purulent nasal drainage. b.bluish gray turbinates. c.small, atrophied nasal membranes. d.firm consistency of turbinates. ANS: B Nasal symptoms that imply an allergic response include bluish gray or pale pink nasal turbinates that are swollen and boggy and a transverse crease at the junction between the cartilage and bone of the nose. 32.You are interviewing a parent whose child has a fever, is pulling at her right ear, and is irritable. You ask the parent about the child’s appetite and find that the child has a decreased appetite. This additional finding is more suggestive of: a.acute otitis media. b.otitis externa. c.serous otitis media. This study source was downloaded by 100000841990434 from CourseHero.com on 05-12-2022 07:08:56 GMT -05:00 https://www.coursehero.com/file/59384518/Chapter-12-Ears-Nose-and-Throatdocx/ d.middle ear effusion. ANS: A Anorexia is an initial symptom of acute otitis media. 33.A smooth red tongue with a slick appearance may indicate: a.niacin or vitamin B12 deficiency. b.oral cancer. c.recent use of antibiotics. d.fungal infection. ANS: A A smooth red tongue with a slick appearance may indicate a niacin or vitamin B12 deficiency. Oral cancer involves lesions, recent use of antibiotics can turn the tongue yellow-brown to black and hairy, and fungal infections result in slightly raised white, cream-colored, or yellow spots in the mouth. 34.White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are: a.Fordyce spots. b.aphthous ulcers. c.Stensen ducts. d.leukoedema. ANS: B Aphthous ulcers are white, round, or oval lesions surrounded by a red halo that appear on the buccal mucosa. Fordyce spots are ectopic sebaceous glands that appear on the buccal mucosa and lips as numerous small, yellowwhite, raised lesions. Stensen ducts are parotid gland outlets and should appear as whitish yellow or whitish pink protrusions in approximate alignment with the second upper molar. Leukoedema appears on the buccal mucosa as a diffuse filmy grayish surface with white streaks, wrinkles, or milky alterations. 35.A hairy tongue with yellowish brown to black elongated papillae on the dorsum: a.is indicative of oral cancer. b.is sometimes seen following antibiotic therapy. c.usually indicates vitamin deficiency. d.usually indicates anemia. ANS: B Recent antibiotic use can turn the tongue yellow-brown to black and make it appear hairy. Oral cancer involves lesions. A smooth red tongue with a slick appearance may indicate a niacin or vitamin B12 deficiency. Pallor usually indicates anemia. 36.To inspect the lateral borders of the tongue, you should: 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. ANS: D To inspect the lateral borders of the tongue, you should wrap the tongue with a piece of gauze and then pull the tongue to each side for inspection. 37.A newborn whose serum bilirubin level is greater than 20 mg/100 mL has a risk of later: a.hearing loss. b.sinusitis. c.tooth decay. d.meningitis. This study source was downloaded by 100000841990434 from CourseH [Show More]

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