NURS 612 Advanced Health Assessment - Week 6: HEENT and
Lymphatics 2026 |Maryville
1. A 45-year-old patient presents with a sudden onset of ‘curtain-like’ vision loss
in the right eye. Upon funduscopic examination, the retina appears gray and
opaque. What is the most likely diagnosis?
A. Retinal detachment
B. Acute angle-closure glaucoma
C. Central retinal artery occlusion
D. Diabetic retinopathy
Answer: A
Rationale: Retinal detachment often presents as a ‘curtain’ being drawn over the eye. The
gray, opaque appearance of the retina is characteristic of the detachment from the choroid.
2. When examining the thyroid gland, the clinician asks the patient to swallow.
What is the anatomical reason for this maneuver?
A. To relax the sternocleidomastoid muscles
B. To move the thyroid gland upward with the larynx
C. To check for the presence of a carotid bruit
D. To assess for tracheal deviation
Answer: B
Rationale: The thyroid gland is attached to the trachea and larynx; therefore, it moves
upward during swallowing, making it easier to palpate against the fingers.
,3. While performing a Weber test on a patient with unilateral hearing loss in the
left ear, the sound lateralizes to the left ear. This finding suggests:
A. Sensorineural hearing loss in the left ear
B. Conductive hearing loss in the left ear
C. Normal hearing in both ears
D. Conductive hearing loss in the right ear
Answer: B
Rationale: In the Weber test, sound lateralizing to the affected (impaired) ear indicates a
conductive loss, as the affected ear is not distracted by ambient noise.
4. Which of the following lymph node characteristics is most suggestive of a
malignant process?
A. Hard, fixed, and painless
B. Soft, mobile, and tender
C. Rubbery, mobile, and discrete
D. Small, smooth, and non-tender
Answer: A
Rationale: Malignant lymph nodes are typically hard, fixed to underlying tissues, and
painless, whereas inflammatory nodes are usually soft and tender.
5. A patient reports a deep, boring pain in the right ear that worsens at night,
associated with drainage. Otoscopy reveals granulation tissue at the junction of
the cartilaginous and bony canals. This is most suspicious for:
A. Otitis media with effusion
B. Cholesteatoma
C. Acute otitis externa
D. Malignant otitis externa
Answer: D
, Rationale: Malignant otitis externa is a severe infection (often Pseudomonas) seen in
elderly diabetics, characterized by deep pain and granulation tissue in the canal.
6. During an ophthalmoscopic exam, you observe ‘cotton wool’ spots. These are
caused by:
A. Microaneurysms of the retinal vessels
B. Lipid deposits from leaky vessels
C. Chronic hypertension causing A-V nicking
D. Infarction of the nerve fiber layer
Answer: D
Rationale: Cotton wool spots are yellow-white clouds with ill-defined margins that result
from localized ischemia and infarction of the nerve fiber layer.
7. Which cranial nerve is primarily responsible for the sensation of the face and
the muscles of mastication?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN XI (Spinal Accessory)
D. CN IX (Glossopharyngeal)
Answer: A
Rationale: The Trigeminal nerve (CN V) provides sensory innervation to the face and
motor innervation to the muscles used for chewing (mastication).
8. A 3-year-old child presents with a ‘white reflex’ (leukocoria) in the left eye
during a routine screening. This finding requires immediate referral to rule out:
A. Congenital cataracts
B. Amblyopia
C. Strabismus
D. Retinoblastoma
Answer: D
Lymphatics 2026 |Maryville
1. A 45-year-old patient presents with a sudden onset of ‘curtain-like’ vision loss
in the right eye. Upon funduscopic examination, the retina appears gray and
opaque. What is the most likely diagnosis?
A. Retinal detachment
B. Acute angle-closure glaucoma
C. Central retinal artery occlusion
D. Diabetic retinopathy
Answer: A
Rationale: Retinal detachment often presents as a ‘curtain’ being drawn over the eye. The
gray, opaque appearance of the retina is characteristic of the detachment from the choroid.
2. When examining the thyroid gland, the clinician asks the patient to swallow.
What is the anatomical reason for this maneuver?
A. To relax the sternocleidomastoid muscles
B. To move the thyroid gland upward with the larynx
C. To check for the presence of a carotid bruit
D. To assess for tracheal deviation
Answer: B
Rationale: The thyroid gland is attached to the trachea and larynx; therefore, it moves
upward during swallowing, making it easier to palpate against the fingers.
,3. While performing a Weber test on a patient with unilateral hearing loss in the
left ear, the sound lateralizes to the left ear. This finding suggests:
A. Sensorineural hearing loss in the left ear
B. Conductive hearing loss in the left ear
C. Normal hearing in both ears
D. Conductive hearing loss in the right ear
Answer: B
Rationale: In the Weber test, sound lateralizing to the affected (impaired) ear indicates a
conductive loss, as the affected ear is not distracted by ambient noise.
4. Which of the following lymph node characteristics is most suggestive of a
malignant process?
A. Hard, fixed, and painless
B. Soft, mobile, and tender
C. Rubbery, mobile, and discrete
D. Small, smooth, and non-tender
Answer: A
Rationale: Malignant lymph nodes are typically hard, fixed to underlying tissues, and
painless, whereas inflammatory nodes are usually soft and tender.
5. A patient reports a deep, boring pain in the right ear that worsens at night,
associated with drainage. Otoscopy reveals granulation tissue at the junction of
the cartilaginous and bony canals. This is most suspicious for:
A. Otitis media with effusion
B. Cholesteatoma
C. Acute otitis externa
D. Malignant otitis externa
Answer: D
, Rationale: Malignant otitis externa is a severe infection (often Pseudomonas) seen in
elderly diabetics, characterized by deep pain and granulation tissue in the canal.
6. During an ophthalmoscopic exam, you observe ‘cotton wool’ spots. These are
caused by:
A. Microaneurysms of the retinal vessels
B. Lipid deposits from leaky vessels
C. Chronic hypertension causing A-V nicking
D. Infarction of the nerve fiber layer
Answer: D
Rationale: Cotton wool spots are yellow-white clouds with ill-defined margins that result
from localized ischemia and infarction of the nerve fiber layer.
7. Which cranial nerve is primarily responsible for the sensation of the face and
the muscles of mastication?
A. CN V (Trigeminal)
B. CN VII (Facial)
C. CN XI (Spinal Accessory)
D. CN IX (Glossopharyngeal)
Answer: A
Rationale: The Trigeminal nerve (CN V) provides sensory innervation to the face and
motor innervation to the muscles used for chewing (mastication).
8. A 3-year-old child presents with a ‘white reflex’ (leukocoria) in the left eye
during a routine screening. This finding requires immediate referral to rule out:
A. Congenital cataracts
B. Amblyopia
C. Strabismus
D. Retinoblastoma
Answer: D
