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PNCB Prep Ear, Nose and Throat Exam
Questions With 100% Verified Answers
2026 Latest Edition
The nurse is assessing a client's tonsils and note that they touch the uvula. The nurse
would document this finding as which of the following? <<Answer>> 3+
Explanation: Tonsils that touch the uvula are identified as 3+. Tonsils that are visible are
graded as 1+; midway between tonsillar pillars and uvula as 2+; touch each other as 4+.
During examination of the oral cavity, the nurse examines the salivary glands. Which
area of the mouth should the nurse assess to inspect for the Wharton's ducts?
<<Answer>> either side of the frenulum on the floor of the mouth
Explanation: The nurse should inspect the Wharton's duct on either side of the frenulum
on the floor of the mouth. Stenson's ducts, not Wharton's ducts, are visible on the
buccal mucosa across from the second upper molars. The right sides of the frenulum at
the base of the gums and on the posterior aspect of the tongue bilaterally are not
appropriate to inspect salivary ducts.
While inspecting the client's tympanic membrane, the nurse notes a pearly gray and
shiny appearance. The nurse would interpret this finding as what? <<Answer>>
Normal tympanic membrane
Explanation: The tympanic membrane is normally a pearly gray color with a shiny
appearance. White spots would indicate scarring. A yellowish bulging membrane would
suggest serous otitis media; a red bulging membrane would suggest acute otitis media.
Otitis externa does not directly affect the appearance of the tympanic membrane.
An alternate pathway that bypasses the external and middle ear is called what?
<<Answer>> Bone conduction
Explanation: An alternate pathway, known as bone conduction, bypasses the external
and middle ear and is used for testing purposes.
A client describes headaches as severe and lasting for days. Which question would be
most appropriate to use to determine if these headaches are migraines? <<Answer>>
"Do you have any visual changes before the headache?"
A client comes to the trauma unit in respiratory distress following a motor vehicle
accident. On examination, the nurse notices that the trachea is deviated from the
midline. What does this finding indicate? <<Answer>> Tension pneumothorax
The nurse is assessing a client complaining of swelling in the neck. While palpating the
,2
neck, the nurse finds a 2-cm lump that is fixed and hard. Why does this finding require
emergency investigation? <<Answer>> This could be a sign of cancer
The nurse's assessment of an older adult client's ears and hearing suggests the
possible presence of conductive hearing loss. What is the most likely etiology of this
abnormal assessment finding? <<Answer>> Otitis media
The nurse tests the distant visual acuity of several clients and records the findings.
Which finding indicates that the client with the poorest vision? <<Answer>> 20/60
When performing the cover test, the nurse would cover one of the client's eyes and then
ask the client to do which of the following? <<Answer>> Focus on a distant object,
looking for movement in the other eye
A nurse shines a light into one eye during ocular exam and the pupil of the other
constricts. The nurse interprets this as which of the following? <<Answer>>
Consensual response
A nurse palpates a client's ear and finds that the tragus is tender. The nurse suspects
which of the following? <<Answer>> Otitis externa
Explanation: A tender tragus is associated with otitis externa. Tenderness behind the
ear would suggest otitis media. A ruptured tympanic membrane would be associated
with ear pain and a popping sensation. Tenderness over the mastoid process would
suggest mastoiditis.
Which characteristic of the gums should a nurse expect to assess in a client who is
healthy? <<Answer>> Pink, moist, firm
A medical nurse is preparing to administer a topical antifungal medication to a client
who has just been diagnosed with an oral candida infection. On inspection of the
patient's tongue, the nurse should anticipate what appearance? <<Answer>> Thick,
white plaques on the tongue surface
A nurse is examining a client's nose. Which characteristics of the nasal mucosa should
the nurse expect to find if the client is healthy? <<Answer>> Dark pink, moist, and free
of discharge
The nurse is preparing to examine the ears of an adult client with an otoscope. The
nurse should plan to <<Answer>> firmly pull the auricle out, up, and back.
After describing how to assess the sinuses to a group of students, the students
demonstrate understanding of the teaching when they identify which sinuses as being
located in the upper jaw? <<Answer>> Maxillary
,3
Explanation: The maxillary sinuses are located in the upper jaw. The frontal sinuses are
located above the eyes. The ethmoidal and sphenoidal sinuses are located deeper in
the skull and not accessible for examination.
What action should the nurse implement when assessing the ear of an adult client using
an otoscope? <<Answer>> Pull the auricle out, up, and back.
Explanation: The nurse should pull the auricle out, up, and back to straighten the
external auditory canal. This is because the external auditory canal is S-shaped in the
adult. The outer part of the canal curves up and back, and the inner part of the canal
curves down and forward. The nurse should choose the largest speculum that fits the
client's ear. The nurse should hold the speculum in the dominant hand and insert the
speculum gently down and forward.
Which statement reflects accurate documentation by the nurse of a normal, left
tympanic membrane? <<Answer>> Pearly gray, translucent, with cone of light at 7
o'clock position
Explanation: A normal tympanic membrane should be pearly gray, shiny, translucent.
The cone of light in the left ear is located at the 7 o'clock position. The cone of light will
be located at the 5 o'clock position in the right ear. A tympanic membrane that is pink or
red may exhibit an absent light reflex and indicate acute otitis media. A yellow color to
the tympanic membrane with bulging or protrusion indicates the presence of fluid
Which action by the nurse is consistent with Weber's test? <<Answer>> The nurse
activates the tuning fork and places it on the midline of the parietal bone in line with both
ears.
A nurse is assessing the mouth of an older client. Which of the following findings is
common among older adults? <<Answer>> Receding and ischemic gums
Explanation: The gums recede, become ischemic, and undergo fibrotic changes as a
person ages. A bifid uvula is a common finding in Native Americans, not among older
adults. Brown spots on the chewing surface of teeth is an indication of tooth decay and
is not associated with aging per se, nor are enlarged palatine tonsils, which are an
indicator of tonsillitis.
The nurse is performing an ear assessment of an adult client. Which action constitutes
the correct procedure for using an otoscope when examining the client's ears?
<<Answer>> Inserting the speculum down and forward into the ear canal
Explanation: The nurse should insert the speculum gently down and forward into the
canal. Using the dominant hand, the nurse should position the hand holding the
otoscope against the client's head or face. The largest speculum that fits comfortably
into the client's ear canal is used.
, 4
The nurse is completing a client's ear assessment. What assessment finding would
indicate the need to perform Weber's test? <<Answer>> The client has unilateral
hearing loss.
Explan: The whisper test evaluates loss of high-frequency sounds. The Weber test
helps to differentiate the cause of unilateral hearing loss. In the Rinne test, use of a
tuning fork helps the nurse determine if hearing is equal in both ears and if there is
either a conductive or a sensorineural hearing loss by allowing the nurse to compare the
difference in bone conduction (BC) versus air conduction (AC). Remember AC has less
resistance than BC. Option D is a distracter for this question.
The roof of the oral cavity of the mouth is formed by the anterior hard palate and the
<<Answer>> soft palate.
Explanation: The roof of the oral cavity is formed by the anterior hard palate and the
posterior soft palate.
The nurse is preparing to examine a client's internal ear. Which equipment would be
necessary? <<Answer>> Ottoscope
Explanation: An otoscope is needed to examine a client's internal ear. A watch with a
second hand would be important when performing the Romberg test. A tuning fork is
needed to perform the Weber and Rinne tests. A measuring tape would not be needed
for any portion of the ear assessment.
A client presents to the health care clinic with reports of a 3-day history of fever, sore
throat, and trouble swallowing. The nurse notes that the client is febrile, with a
temperature of 101.5°F, tonsils are 2+ and red, and transillumination of the sinuses is
normal. Which nursing diagnosis should the nurse confirm based on this data?
<<Answer>> Acute Pain
Explanation: The nursing diagnosis of Acute Pain can be confirmed because it meets
the major defining characteristic of verbalization of sore throat. Impaired swallowing is
not related to impaired neurologic or neuromuscular function. There is no criterion to
confirm that this client cannot maintain health maintenance because this is an acute
problem. No data exist to confirm the nursing diagnoses of Self-Care Deficit or
Hopelessness.
The nurse is interviewing an adult client in the context of a focused mouth, nose, sinus,
and throat assessment. After asking the client about his history of environmental
allergies, the client states, "I'm pretty sure that I'm allergic to something, but I'm not
exactly sure what triggers my allergies." What would the nurse do next? <<Answer>>
Ask the client about the timing of his allergy symptoms.
PNCB Prep Ear, Nose and Throat Exam
Questions With 100% Verified Answers
2026 Latest Edition
The nurse is assessing a client's tonsils and note that they touch the uvula. The nurse
would document this finding as which of the following? <<Answer>> 3+
Explanation: Tonsils that touch the uvula are identified as 3+. Tonsils that are visible are
graded as 1+; midway between tonsillar pillars and uvula as 2+; touch each other as 4+.
During examination of the oral cavity, the nurse examines the salivary glands. Which
area of the mouth should the nurse assess to inspect for the Wharton's ducts?
<<Answer>> either side of the frenulum on the floor of the mouth
Explanation: The nurse should inspect the Wharton's duct on either side of the frenulum
on the floor of the mouth. Stenson's ducts, not Wharton's ducts, are visible on the
buccal mucosa across from the second upper molars. The right sides of the frenulum at
the base of the gums and on the posterior aspect of the tongue bilaterally are not
appropriate to inspect salivary ducts.
While inspecting the client's tympanic membrane, the nurse notes a pearly gray and
shiny appearance. The nurse would interpret this finding as what? <<Answer>>
Normal tympanic membrane
Explanation: The tympanic membrane is normally a pearly gray color with a shiny
appearance. White spots would indicate scarring. A yellowish bulging membrane would
suggest serous otitis media; a red bulging membrane would suggest acute otitis media.
Otitis externa does not directly affect the appearance of the tympanic membrane.
An alternate pathway that bypasses the external and middle ear is called what?
<<Answer>> Bone conduction
Explanation: An alternate pathway, known as bone conduction, bypasses the external
and middle ear and is used for testing purposes.
A client describes headaches as severe and lasting for days. Which question would be
most appropriate to use to determine if these headaches are migraines? <<Answer>>
"Do you have any visual changes before the headache?"
A client comes to the trauma unit in respiratory distress following a motor vehicle
accident. On examination, the nurse notices that the trachea is deviated from the
midline. What does this finding indicate? <<Answer>> Tension pneumothorax
The nurse is assessing a client complaining of swelling in the neck. While palpating the
,2
neck, the nurse finds a 2-cm lump that is fixed and hard. Why does this finding require
emergency investigation? <<Answer>> This could be a sign of cancer
The nurse's assessment of an older adult client's ears and hearing suggests the
possible presence of conductive hearing loss. What is the most likely etiology of this
abnormal assessment finding? <<Answer>> Otitis media
The nurse tests the distant visual acuity of several clients and records the findings.
Which finding indicates that the client with the poorest vision? <<Answer>> 20/60
When performing the cover test, the nurse would cover one of the client's eyes and then
ask the client to do which of the following? <<Answer>> Focus on a distant object,
looking for movement in the other eye
A nurse shines a light into one eye during ocular exam and the pupil of the other
constricts. The nurse interprets this as which of the following? <<Answer>>
Consensual response
A nurse palpates a client's ear and finds that the tragus is tender. The nurse suspects
which of the following? <<Answer>> Otitis externa
Explanation: A tender tragus is associated with otitis externa. Tenderness behind the
ear would suggest otitis media. A ruptured tympanic membrane would be associated
with ear pain and a popping sensation. Tenderness over the mastoid process would
suggest mastoiditis.
Which characteristic of the gums should a nurse expect to assess in a client who is
healthy? <<Answer>> Pink, moist, firm
A medical nurse is preparing to administer a topical antifungal medication to a client
who has just been diagnosed with an oral candida infection. On inspection of the
patient's tongue, the nurse should anticipate what appearance? <<Answer>> Thick,
white plaques on the tongue surface
A nurse is examining a client's nose. Which characteristics of the nasal mucosa should
the nurse expect to find if the client is healthy? <<Answer>> Dark pink, moist, and free
of discharge
The nurse is preparing to examine the ears of an adult client with an otoscope. The
nurse should plan to <<Answer>> firmly pull the auricle out, up, and back.
After describing how to assess the sinuses to a group of students, the students
demonstrate understanding of the teaching when they identify which sinuses as being
located in the upper jaw? <<Answer>> Maxillary
,3
Explanation: The maxillary sinuses are located in the upper jaw. The frontal sinuses are
located above the eyes. The ethmoidal and sphenoidal sinuses are located deeper in
the skull and not accessible for examination.
What action should the nurse implement when assessing the ear of an adult client using
an otoscope? <<Answer>> Pull the auricle out, up, and back.
Explanation: The nurse should pull the auricle out, up, and back to straighten the
external auditory canal. This is because the external auditory canal is S-shaped in the
adult. The outer part of the canal curves up and back, and the inner part of the canal
curves down and forward. The nurse should choose the largest speculum that fits the
client's ear. The nurse should hold the speculum in the dominant hand and insert the
speculum gently down and forward.
Which statement reflects accurate documentation by the nurse of a normal, left
tympanic membrane? <<Answer>> Pearly gray, translucent, with cone of light at 7
o'clock position
Explanation: A normal tympanic membrane should be pearly gray, shiny, translucent.
The cone of light in the left ear is located at the 7 o'clock position. The cone of light will
be located at the 5 o'clock position in the right ear. A tympanic membrane that is pink or
red may exhibit an absent light reflex and indicate acute otitis media. A yellow color to
the tympanic membrane with bulging or protrusion indicates the presence of fluid
Which action by the nurse is consistent with Weber's test? <<Answer>> The nurse
activates the tuning fork and places it on the midline of the parietal bone in line with both
ears.
A nurse is assessing the mouth of an older client. Which of the following findings is
common among older adults? <<Answer>> Receding and ischemic gums
Explanation: The gums recede, become ischemic, and undergo fibrotic changes as a
person ages. A bifid uvula is a common finding in Native Americans, not among older
adults. Brown spots on the chewing surface of teeth is an indication of tooth decay and
is not associated with aging per se, nor are enlarged palatine tonsils, which are an
indicator of tonsillitis.
The nurse is performing an ear assessment of an adult client. Which action constitutes
the correct procedure for using an otoscope when examining the client's ears?
<<Answer>> Inserting the speculum down and forward into the ear canal
Explanation: The nurse should insert the speculum gently down and forward into the
canal. Using the dominant hand, the nurse should position the hand holding the
otoscope against the client's head or face. The largest speculum that fits comfortably
into the client's ear canal is used.
, 4
The nurse is completing a client's ear assessment. What assessment finding would
indicate the need to perform Weber's test? <<Answer>> The client has unilateral
hearing loss.
Explan: The whisper test evaluates loss of high-frequency sounds. The Weber test
helps to differentiate the cause of unilateral hearing loss. In the Rinne test, use of a
tuning fork helps the nurse determine if hearing is equal in both ears and if there is
either a conductive or a sensorineural hearing loss by allowing the nurse to compare the
difference in bone conduction (BC) versus air conduction (AC). Remember AC has less
resistance than BC. Option D is a distracter for this question.
The roof of the oral cavity of the mouth is formed by the anterior hard palate and the
<<Answer>> soft palate.
Explanation: The roof of the oral cavity is formed by the anterior hard palate and the
posterior soft palate.
The nurse is preparing to examine a client's internal ear. Which equipment would be
necessary? <<Answer>> Ottoscope
Explanation: An otoscope is needed to examine a client's internal ear. A watch with a
second hand would be important when performing the Romberg test. A tuning fork is
needed to perform the Weber and Rinne tests. A measuring tape would not be needed
for any portion of the ear assessment.
A client presents to the health care clinic with reports of a 3-day history of fever, sore
throat, and trouble swallowing. The nurse notes that the client is febrile, with a
temperature of 101.5°F, tonsils are 2+ and red, and transillumination of the sinuses is
normal. Which nursing diagnosis should the nurse confirm based on this data?
<<Answer>> Acute Pain
Explanation: The nursing diagnosis of Acute Pain can be confirmed because it meets
the major defining characteristic of verbalization of sore throat. Impaired swallowing is
not related to impaired neurologic or neuromuscular function. There is no criterion to
confirm that this client cannot maintain health maintenance because this is an acute
problem. No data exist to confirm the nursing diagnoses of Self-Care Deficit or
Hopelessness.
The nurse is interviewing an adult client in the context of a focused mouth, nose, sinus,
and throat assessment. After asking the client about his history of environmental
allergies, the client states, "I'm pretty sure that I'm allergic to something, but I'm not
exactly sure what triggers my allergies." What would the nurse do next? <<Answer>>
Ask the client about the timing of his allergy symptoms.
