Sherpath Chapter 16, EarsEars, Nose, and Throat

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Question 1 of 25

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What structure prevents food from entering the lungs?

    • UvulaThe uvula does not prevent food from entering the lungs.
    • Hard palateThe hard palate does not prevent food from entering the lungs.
    • Palatine tonsilsThe palatine tonsils do not prevent food from entering the lungs.
  • Correct
    • EpiglottisThe epiglottis prevents food from entering the lungs.

Question 2 of 25

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Label the structures of the ear.

1

2

3

4

5

Correct Answers:

1

2

3

4

5

Submitted Answers:

Correct

1 Semicircular canals

Correct

2 Auditory ossicles

Correct

3 External auditory canal

Correct

4 Eardrum

Correct

5 Cochlea

Question 3 of 25

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The ossicles of the middle ear include which small bones?

    • TympanicThe tympanic bone is not an ossicle of the middle ear.
  • Correct
    • MalleusThe malleus is an ossicle of the middle ear.
  • Correct
    • StapesThe stapes is an ossicle of the middle ear.
  • Correct
    • IncusThe incus is an ossicle of the middle ear.
    • MaxillaThe maxilla is not an ossicle of the middle ear.

Question 4 of 25

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As part of the history of present illness, which questions should the nurse ask a patient presenting with a nosebleed to learn more about the potential predisposing factors?

  • Correct
    • “Are you experiencing any nasal congestion or fever?”The nurse should ask a patient with a nosebleed about a concurrent upper respiratory tract infection as part of the history of present illness to learn about predisposing factors.
  • Correct
    • “Have you been struck in the nose recently?”The nurse should ask a patient with a nosebleed about any recent nasal trauma as part of the history of present illness to learn about predisposing factors.
  • Correct
    • “Have you noticed your nasal passages feeling dry?”The nurse should ask a patient with a nosebleed about exposure to dry air as part of the history of present illness to learn about predisposing factors.
    • “When did the nosebleed start?”The nurse should ask about the onset of the nosebleed, but this does not assess for predisposing factors.
    • “How long do the nosebleeds last when you have them?”The nurse should ask about the duration of the nosebleeds, but this does not assess for predisposing factors.

Question 5 of 25

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Which questions should the nurse ask a patient who has difficulty swallowing as part of the history of present illness?

  • Correct
    • “When did you first notice the difficulty swallowing?”The nurse should ask a patient with difficulty swallowing about the onset of symptoms as part of the history of present illness.
  • Correct
    • “When you try to swallow liquid, does it come out of your nose?”The nurse should ask a patient with difficulty swallowing about associated symptoms and severity of the problem as part of the history of present illness.
  • Correct
    • “Do you cough or have a choking sensation when you swallow?”The nurse should ask a patient with difficulty swallowing about associated symptoms and severity of the problem, such as coughing or choking, as part of the history of present illness.
    • “Have you ever been diagnosed with acid reflux or esophageal problems?”The nurse should ask about past diagnoses, but this is a part of the medical-surgical history, not the history of present illness.
    • “How many cigarettes do you smoke daily?”The nurse should ask a patient with difficulty swallowing about smoking history, but this is a part of the personal/social history, not the history of present illness.

Question 6 of 25

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Choose which medical-surgical history questions to ask a patient presenting with ear pain.

    • “Did your parents have tubes put in their ears as children?”A question about the patient’s parents’ ears is part of the family history, not the medical-surgical history.
  • Correct
    • “Did you experience frequent ear infections during childhood?”The nurse should ask a patient with ear pain about a childhood history of frequent ear infections as part of the medical-surgical history.
  • Correct
    • “Have you ever been diagnosed with labyrinthitis?”The nurse should ask a patient with ear pain about a past diagnosis of labyrinthitis as part of the medical-surgical history.
    • “Do you clean your ears with cotton-tipped applicators?”The nurse should ask the patient with ear pain about use of cotton-tipped applicators, but this is part of the personal/social history, not the medical-surgical history.
    • “Do you use ear drops for the pain?”The nurse should ask a patient with ear pain about the use of ear drops, but this is a part of the history of present illness, not the medical-surgical history.

Question 7 of 25

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When gathering medical-surgical history about a patient who presents with postnasal drip, which conditions should the nurse ask about?

    • HeadachesThe nurse should not ask a patient with postnasal drip about past headaches.
    • Thyroid diseaseThe nurse should not ask a patient with postnasal drip about a history of thyroid disease.
  • Correct
    • Seasonal allergiesThe nurse should ask a patient with postnasal drip about the onset or diagnosis of seasonal allergies as part of the medical-surgical history.
  • Correct
    • Recurrent sinusitisThe nurse should ask a patient with postnasal drip about a diagnosis of chronic sinusitis as part of the medical-surgical history.
  • Correct
    • Chronic postnasal dripThe nurse should ask a patient with postnasal drip about a diagnosis of chronic postnasal drip as part of the medical-surgical history.

Question 8 of 25

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Which question about environmental exposure should the nurse ask a patient presenting with hearing loss as part of the personal/social history?

    • Hot, dry airThe nurse should not ask a patient with hearing loss about exposure to hot, dry air.
    • Air pollutantsThe nurse should not ask a patient with hearing loss about exposure to air pollutants.
    • Dust and allergensThe nurse should not ask a patient with hearing loss about exposure to dust and allergens.
  • Correct
    • Loud, continuous noisesThe nurse should ask a patient with hearing loss about exposure to loud, continuous noises as part of the personal/social history.

Question 9 of 25

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Which features of the buccal mucosa should be inspected as part of a thorough ears, nose, and throat examination?

  • Correct
    • ColorThe nurse should inspect the buccal mucosa for color.
    • MassesThe nurse should palpate, not inspect, the buccal mucosa for masses.
  • Correct
    • SwellingThe nurse should inspect the buccal mucosa for swelling.
  • Correct
    • SymmetryThe nurse should inspect the buccal mucosa for symmetry.
  • Correct
    • UlcerationsThe nurse should inspect the buccal mucosa for ulcerations.

Question 10 of 25

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When inspecting the nasal septum, which features should the nurse assess?

  • Correct
    • CrustingThe nurse should assess the nasal septum for crusting.
  • Correct
    • BleedingThe nurse should assess the nasal septum for bleeding.
  • Correct
    • AlignmentThe nurse should assess the nasal septum for alignment.
  • Correct
    • PerforationThe nurse should assess the nasal septum for perforation.
    • TendernessThe nurse should assess for tenderness during palpation, not inspection.

Question 11 of 25

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In which ways should the nurse evaluate a young child’s hearing?

    • Use the Snellen E chart or HOVT chart.The Snellen E and HOVT charts assess visual acuity, not hearing.
  • Correct
    • Whisper words with meaning to the child.The nurse should assess a child’s hearing by whispering words with meaning to the child.
    • Have the child repeat phrases the nurse yells.Having the child repeat phrases yelled by the nurse does not assess hearing.
    • Inspect the tympanic membrane for perforations.Inspection of the tympanic membrane does not assess hearing.
  • Correct
    • Ask the child to perform tasks using a soft voice.The nurse should assess a child’s hearing by asking the child to perform tasks using a soft voice.

Question 12 of 25

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To assist in the examination of the soft palate of a young child, what question should the nurse ask the patient?

    • “Do you brush your own teeth?”Asking about oral care habits does not assess the palate’s ability to rise.
  • Correct
    • “Can you pant like a puppy?”Having the child pant causes the palate to rise during the ear, nose, and throat assessment.
    • “Can you take a deep breath?”Having the child take a deep breath does not assess the palate’s ability to rise.
    • “Did you have any surgeries on your mouth when you were a baby?”Asking about surgical history does not assess the palate’s current ability to rise.

Question 13 of 25

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Which finding should the nurse note as normal when assessing the mouth and throat of an infant?

    • Adherent white patches on the buccal mucosaAdherent white patches on the buccal mucosa would be noted as an abnormal, not normal, finding.
  • Correct
    • Epstein pearlsPearl-like retention cysts on gums are normal finding in an infant up to 2 months old.
    • Persistent drooling after age 6 months not associated with teethingPersistent drooling after age 6 months not associated with teething is considered an abnormal finding and may require further evaluation.
    • Presence of natal teethPresence of natal teeth would be considered an abnormal, not normal, finding.

Question 14 of 25

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Which finding is expected when assessing the tonsils?

    • Dark red tonsilsDark red tonsils are an abnormal finding and may indicate infection.
    • Hypertrophied tonsilsHypertrophied tonsils are an abnormal finding and may indicate infection.
    • Exudate on the tonsilsExudate found on the tonsils is an abnormal finding and may indicate infection.
  • Correct
    • Crypts with food particlesThe tonsils may have crypts with debris or food particles found within them.

Question 15 of 25

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Which mouth and oropharynx assessment finding is expected for the child?

    • Mottled teethMottled teeth are an abnormal finding and may be the result of tetracycline therapy.
  • Correct
    • Deciduous teethDeciduous teeth are a normal finding in children and erupt between 6 and 24 months of age.
    • Black or grey teethBlack or grey teeth are an abnormal finding and may indicate pulp decay or staining from oral iron therapy.
    • Caries on upper incisorsCaries are an unexpected finding and may be the result of drinking juice at bedtime.

Question 16 of 25

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Which age-related finding is expected in a 55-year-old patient?

    • Hearing lossHearing loss is common in adults over the age of 65 but would be an unexpected finding in a 55-year-old patient.
    • Loss of visionAlthough loss of visual acuity occurs with age, loss of vision would not be expected in a 55-year-old patient.
    • Loss of sense of smellSense of smell deteriorates with age, but a loss of sense of smell would be an unexpected finding in a 55-year-old patient.
  • Correct
    • Decrease in sense of tasteThe sense of taste begins to deteriorate at 50 years of age, and some loss of taste would be expected in a 55-year-old patient.

Question 17 of 25

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Which ear assessment findings would be considered abnormal?

  • Correct
    • VertigoVertigo is an abnormal finding and may be associated with Meniere disease.
  • Correct
    • TinnitusTinnitus is an abnormal finding and may be associated with Meniere disease.
    • Darwin tubercleDarwin tubercle is a normal, not abnormal, finding on assessment of the ear.
    • Preauricular pitsPreauricular pits are normal, not abnormal, findings on assessment of the ear.
  • Correct
    • Hearing lossHearing loss is an abnormal finding and may be associated with Meniere disease.

Question 18 of 25

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Which nose assessment findings should be considered abnormal?

  • Correct
    • Noisy breathing or occlusionNoisy breathing or occlusion is an abnormal finding in an assessment of the nose.
  • Correct
    • Patient unable to smellPatient unable to smell is an abnormal finding in an assessment of the nose.
  • Correct
    • Perforated or deviated septumPerforated or deviated septum is an abnormal finding in an assessment of the nose.
    • Deviation of uvulaDeviation of uvula is an abnormal finding on assessment of the throat, not the nose.
  • Correct
    • Hyperemia, rhinorrhea, and edema of mucosaHyperemia, rhinorrhea, and edema of mucosa are abnormal findings and may indicate cocaine use.

Question 19 of 25

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Which nasal assessment findings, suggestive of inhaled cocaine abuse, are considered abnormal?

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    • HyperemiaHyperemia is an abnormal finding suggestive of cocaine abuse.
    • PolypsPolyps are an abnormal finding, but they are not suggestive of cocaine abuse.
  • Correct
    • RhinorrheaRhinorrhea is an abnormal finding suggestive of cocaine abuse.
    • Clear nasal dischargeClear nasal discharge is a normal finding.
  • Correct
    • Edema of the nasal mucosaEdema of the nasal mucosa is an abnormal finding suggestive of cocaine abuse.

Question 20 of 25

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Match the conditions with the associated abnormal mouth and throat assessment findings.

  • Acute pharyngitis
  • Peritonsillar abscess
  • Oral cancer
  • Periodontal disease

Question 21 of 25

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When the sinuses are assessed, which findings should be considered abnormal?

  • Correct
    • PainPain on palpation of the sinuses is an abnormal finding and may indicate infection or obstruction.
  • Correct
    • SwellingSwelling of the sinuses is an abnormal finding and may indicate infection or obstruction.
  • Correct
    • TendernessTenderness on palpation of the sinuses is an abnormal finding and may indicate infection or obstruction.
  • Correct
    • Opaque glow on transilluminationAn opaque glow on transillumination is an abnormal finding and may indicate infection or obstruction.
    • Dim red glow on transilluminationA dim red glow on transillumination is an expected finding.

Question 22 of 25

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The nurse is caring for a patient with complaints of hoarseness, sore throat, and difficulty swallowing. The nurse notes redness in the oropharynx and swollen tonsils. Which information suggestive of tonsillitis should the nurse document as history of present illness?

  • Correct
    • HoarsenessThe patient’s hoarseness is part of the history of present illness suggestive of tonsillitis.
  • Correct
    • Sore throatThe patient’s sore throat is part of the history of present illness suggestive of tonsillitis.
    • Swollen tonsilsThe patient’s swollen tonsils, as identified by the nurse, are objective data, not part of the history of present illness.
  • Correct
    • Difficulty swallowingThe patient’s difficulty swallowing is part of the history of present illness suggestive of tonsillitis.
    • Redness of the oropharynxThe redness of the patient’s oropharynx, as identified by the nurse, is objective data, not part of the history of present illness.

Question 23 of 25

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During ear assessment of a 62-year-old patient, the nurse notes a buildup of cerumen and irritation in the ear canal. The patient reports a family history of Meniere disease and complains of muffled hearing. Which subjective assessment information should be documented as a part of the family history related to the ear assessment?

    • Muffled hearingThe patient’s muffled hearing is part of the history of present illness, not family history.
    • Buildup of cerumenThe patient’s buildup of cerumen, as determined by the nurse, is objective data, not part of the family history.
    • Irritation of the ear canalThe patient’s ear canal irritation, as determined by the nurse, is objective data, not part of the family history.
  • Correct
    • History of Meniere diseaseThe patient’s family history of Meniere disease is family history data related to the ear assessment.

Question 24 of 25

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A patient presents with a complaint of impaired smell and nasal stuffiness. The patient reports use of intranasal cocaine and oral tobacco products. The nurse notes inflamed oral and nasal mucosa. Which subjective information should the nurse document as a part of the personal/social history related to the ear, nose, and throat (ENT) assessment?

    • Nasal stuffinessThe patient’s nasal stuffiness is part of the history of present illness, not the personal/social history.
  • Correct
    • Oral tobacco useThe patient’s oral tobacco use is part of the personal/social history related to the ENT assessment.
    • Impaired smellThe patient’s impaired smell is part of the history of present illness, not the personal/social history.
  • Correct
    • Intranasal cocaine useThe patient’s intranasal cocaine use is part of the personal/social history related to the ENT assessment.
    • Inflamed oral mucosaThe patient’s inflamed oral mucosa is objective data, not part of the personal/social history.

Question 25 of 25

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A patient complains of hoarseness, throat pain, and difficulty swallowing. The nurse notes a bruit over the thyroid and neck swelling. Which information should the nurse document as objective data?

    • HoarsenessThe patient’s hoarseness is part of the history of present illness, not objective data.
    • Throat painThe patient’s throat pain is part of the history of present illness, not objective data.
  • Correct
    • Neck swellingThe nurse’s observation of neck swelling is objective data suggestive of thyroid disease.
    • Difficulty swallowingThe patient’s difficulty swallowing is part of the history of present illness, not objective data.
  • Correct
    • Bruit over the thyroidThe nurse’s observation of a bruit is objective data suggestive of thyroid disease.