NURS 612 Advanced Health Assessment: HEENT and Lymphatics 2026
|Maryville
1. When assessing the supraclavicular lymph nodes, the clinician understands
that a palpable node on the left side, often referred to as Virchow’s node, is
highly suggestive of:
A. Primary lung malignancy
B. Chronic lymphocytic leukemia
C. Occult intra-abdominal malignancy
D. Systemic lupus erythematosus
Answer: C
Rationale: Virchow’s node is an enlarged left supraclavicular node that often signifies
metastatic spread from an abdominal or thoracic malignancy, most commonly gastric
cancer.
2. During an ophthalmoscopic examination, you observe a localized ‘cotton
wool’ spot on the retina. This finding is most characteristic of:
A. Hypertensive retinopathy
B. Advanced age-related macular degeneration
C. Open-angle glaucoma
D. Micro-infarctions of the nerve fiber layer
Answer: D
Rationale: Cotton wool spots are small, yellowish-white deposits in the retina caused by
micro-infarction of the retinal nerve fiber layer, often seen in diabetes and hypertension.
,3. A patient presents with a sensorineural hearing loss in the right ear. During
the Weber test, the sound would be expected to:
A. Lateralize to the right ear
B. Be heard equally in both ears
C. Lateralize to the left ear
D. Not be heard at all
Answer: C
Rationale: In sensorineural hearing loss, the sound lateralizes to the ‘good’ ear (the
contralateral side) during the Weber test.
4. When evaluating a patient for suspected Graves’ disease, the nurse
practitioner auscultates the thyroid gland. The presence of a bruit indicates:
A. Increased vascularity associated with hyperthyroidism
B. The presence of a thyroid nodule
C. Compression of the carotid artery
D. Normal physiological finding in pregnancy
Answer: A
Rationale: A thyroid bruit is a continuous sound resulting from hyper-vascularity,
commonly found in Graves’ disease.
5. Which of the following physical findings is most diagnostic of acute otitis
externa?
A. Pain when pulling on the tragus or pinna
B. Loss of the light reflex on the tympanic membrane
C. Bulging of the pars flaccida
D. Immobility of the tympanic membrane with pneumatic otoscopy
Answer: A
Rationale: Tenderness of the tragus or pinna (the ‘tug test’) is a hallmark sign of otitis
externa, distinguishing it from otitis media.
, 6. In a patient presenting with Horner’s syndrome, the classic triad of symptoms
includes:
A. Photophobia, lacrimation, and chemosis
B. Mydriasis, exophthalmos, and hyperhidrosis
C. Nystagmus, strabismus, and diplopia
D. Miosis, ptosis, and anhidrosis
Answer: D
Rationale: Horner’s syndrome is caused by a disruption of the sympathetic nerve supply
and results in miosis (constricted pupil), ptosis (drooping eyelid), and anhidrosis (lack of
sweating) on the affected side.
7. An 8-year-old child presents with a ‘strawberry tongue’ and a fine,
sandpaper-like rash. This combination is highly suggestive of:
A. Infectious mononucleosis
B. Scarlet fever
C. Herpetic stomatitis
D. Oral candidiasis
Answer: B
Rationale: Scarlet fever, caused by Group A Streptococcus, typically presents with a
strawberry tongue and a characteristic scarlatiniform rash.
8. The clinician performs the Rinne test and finds that Bone Conduction (BC) is
longer than Air Conduction (AC) in the left ear. This indicates:
A. Conductive hearing loss in the left ear
B. Sensorineural hearing loss in the left ear
C. A normal finding
D. Central auditory processing disorder
Answer: A
|Maryville
1. When assessing the supraclavicular lymph nodes, the clinician understands
that a palpable node on the left side, often referred to as Virchow’s node, is
highly suggestive of:
A. Primary lung malignancy
B. Chronic lymphocytic leukemia
C. Occult intra-abdominal malignancy
D. Systemic lupus erythematosus
Answer: C
Rationale: Virchow’s node is an enlarged left supraclavicular node that often signifies
metastatic spread from an abdominal or thoracic malignancy, most commonly gastric
cancer.
2. During an ophthalmoscopic examination, you observe a localized ‘cotton
wool’ spot on the retina. This finding is most characteristic of:
A. Hypertensive retinopathy
B. Advanced age-related macular degeneration
C. Open-angle glaucoma
D. Micro-infarctions of the nerve fiber layer
Answer: D
Rationale: Cotton wool spots are small, yellowish-white deposits in the retina caused by
micro-infarction of the retinal nerve fiber layer, often seen in diabetes and hypertension.
,3. A patient presents with a sensorineural hearing loss in the right ear. During
the Weber test, the sound would be expected to:
A. Lateralize to the right ear
B. Be heard equally in both ears
C. Lateralize to the left ear
D. Not be heard at all
Answer: C
Rationale: In sensorineural hearing loss, the sound lateralizes to the ‘good’ ear (the
contralateral side) during the Weber test.
4. When evaluating a patient for suspected Graves’ disease, the nurse
practitioner auscultates the thyroid gland. The presence of a bruit indicates:
A. Increased vascularity associated with hyperthyroidism
B. The presence of a thyroid nodule
C. Compression of the carotid artery
D. Normal physiological finding in pregnancy
Answer: A
Rationale: A thyroid bruit is a continuous sound resulting from hyper-vascularity,
commonly found in Graves’ disease.
5. Which of the following physical findings is most diagnostic of acute otitis
externa?
A. Pain when pulling on the tragus or pinna
B. Loss of the light reflex on the tympanic membrane
C. Bulging of the pars flaccida
D. Immobility of the tympanic membrane with pneumatic otoscopy
Answer: A
Rationale: Tenderness of the tragus or pinna (the ‘tug test’) is a hallmark sign of otitis
externa, distinguishing it from otitis media.
, 6. In a patient presenting with Horner’s syndrome, the classic triad of symptoms
includes:
A. Photophobia, lacrimation, and chemosis
B. Mydriasis, exophthalmos, and hyperhidrosis
C. Nystagmus, strabismus, and diplopia
D. Miosis, ptosis, and anhidrosis
Answer: D
Rationale: Horner’s syndrome is caused by a disruption of the sympathetic nerve supply
and results in miosis (constricted pupil), ptosis (drooping eyelid), and anhidrosis (lack of
sweating) on the affected side.
7. An 8-year-old child presents with a ‘strawberry tongue’ and a fine,
sandpaper-like rash. This combination is highly suggestive of:
A. Infectious mononucleosis
B. Scarlet fever
C. Herpetic stomatitis
D. Oral candidiasis
Answer: B
Rationale: Scarlet fever, caused by Group A Streptococcus, typically presents with a
strawberry tongue and a characteristic scarlatiniform rash.
8. The clinician performs the Rinne test and finds that Bone Conduction (BC) is
longer than Air Conduction (AC) in the left ear. This indicates:
A. Conductive hearing loss in the left ear
B. Sensorineural hearing loss in the left ear
C. A normal finding
D. Central auditory processing disorder
Answer: A
