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Chapter 13

1. Bleeding into the periosteum during birth is known as:

A. caput succedaneum.
B. craniosynostosis.
C. molding.
D. cephalhematoma.
2. Craniosynostosis is a severe deformity caused by:

A. premature closure of the sutures.

B. increased intracranial pressure.
C. a localized bone disease that softens, thickens, and deforms bone.
D. excess growth hormone or deficit thyroid hormone.
3. Narrow palpebral fissures, epicanthal folds, and midfacial hypoplasia is characteristic of:

A. Down syndrome.
B. fetal alchohol syndrome.
C. chronic childhood allergies.
D. congenital hypothyroidism.
4. Kyphosis of the spine is common with aging. To compensate, older adults will:

A. increase their center of gravity.

B. extend their heads and jaws forward.
C. stiffen their gait.
D. shuffle.
5. Which of the following statements is accurate?

A. Alcohol and daytime napping may precipitate the onset of cluster migraines.
B. The absence of phonophobia is characteristic of migraine headaches.
C. Tension headaches may be treated, but not prevented.
D. Nuchal rigidity is associated with estrogen withdrawal headaches.
6. Unlike most facial bones that articulate at a suture, which facial bone articulates at a joint?

A. Nasal
B. Mandible
C. Zygomatic
D. Maxilla
7. A severe deficiency of thyroid hormone leading to nonpitting edema, coarse facial features, dry skin, and dry
coarse hair is known as:
A. congenital hypothyroidism.
B. scleroderma.
C. myxedema.
D. Hashimoto's thyroiditis.
8. Which of the following statements warrants an immediate referral?

A. "This is the worst migraine of my life."

B. "This is the worst headache I've had since puberty."
C. "I have never had a headache like this before; it is so bad I can't function."
D. "I have had daily headaches for years."
9. This disease is characterized by flat, expressionless, or mask-like facies, a staring gaze, oily skin, and elevated

A. Acromegaly
B. Scleroderma
C. Cushing's syndrome
D. Parkinson's syndrome

Chapter 15
1. Binaural interaction at the level of the brain stem permits which of the following to occur?

A. Interpretation of sound
B. Identification and location of the direction of the sound
C. Amplification of sound
D. Direction of sound toward the appropriate conduction pathway
2. Which of the following behaviors demonstrated by an individual may be indicative of hearing loss?

A. Not looking at the examiner when being questioned

B. Frequently asking for the question to be repeated
C. Talking in a high-pitched voice
D. Speaking slowly with well-articulated consonants
3. Which of the following individuals is at risk of being an "otitis prone" child?

A. An 18-month-old infant that lives with a smoker

B. A 2-year-old child that has had two ear infections in the past 6 months
C. A 6-month-old infant that has a sibling that has had tubes inserted at 3 years of age
D. An 18-month-old infant that has had three episodes of ear infections in a 5-month period
4. The external structure of the ear is identified as the:

A. auricle.
B. atrium.
C. aureole.
D. auriga.
5. The labyrinth of the inner ear is responsible for maintaining the body's:

A. binaural interaction.
B. air conduction.
C. equilibrium.
D. pressure equalization.
6. When performing an otoscope exam on an elderly client, the tympanic membrane may be observed to be which
of the following?

A. Pinker than expected

B. Thinner than expected
C. Whiter than expected
D. More mobile than expected
7. Which of the following is true related to alternate screening measures used in the clinical examination for

A. They give a precise determination of the degree of hearing loss.

B. They are able to document the presence of a hearing loss, but not the degree of loss.
C. They rely on the examiner's hearing ability.
D. They are only useful in instances in which the individual may have a conductive hearing loss.
8. The Weber test is generally performed on an individual who complains of:

A. hearing better in one ear than the other.

B. ringing in the ears.
C. pain in one ear.
D. pain while swallowing.
9. The position of the tympanic membrane in the infant is more ________________, making it more difficult to
visualize with the otoscope.

A. horizontal
B. vertical
C. perpendicular
D. oblique

Chapter 16
1. When inspecting the nasal mucosa, an individual who is experiencing rhinitis would demonstrate mucosa that is:

A. dry and pink in color.

B. swollen, boggy, and gray in color.
C. bright red and swollen.
D. resistant to transillumination.
2. When examining the mouth and throat, you ask the individual to stick out the tongue. Your observation of the
tongue notes the presence of a fine tremor that accompanies which of the following conditions?

A. Hyperthyroidism
B. Diabetic ketoacidosis
C. Halitosis
D. Alcoholism
3. Which of the following questions would you ask to determine if an individual experiences epistaxis?

A. "Do you have any difficulty with swallowing?"

B. "Have you ever noticed any unusual lesions on the inside of your mouth?"
C. "Do you experience nose bleeds?"
D. "Do you experience a runny nose frequently?"
4. On examination of a Native American's mouth, you notice the presence of a bifid uvula. What should your initial
reaction to this finding be?

A. This is an expected variation associated with this individual.

B. This condition is frequently associated with cleft palate.
C. This individual needs to be followed up for the presence of oral cancer.
D. This is an extremely rare finding and may be indicative of other congenital anomalies.
5. An enlarged tongue (macroglossia) may accompany which of the following conditions?

A. Cleft palate
B. Hairy tongue
C. Down syndrome
D. Fissured tongue
6. In addition to initiating digestion of food, saliva also:

A. augments taste sensation.

B. protects the mucosa from caustic substances.
C. inhibits overgrowth of bacteria in the mouth.
D. cleans and protects the mucosa.
7. One of the purposes of the paranasal sinuses is to:

A. lighten the weight of the skull bones.

B. warm and moisten the inspired air.
C. amplify sound.
D. augment the sensory sensation of smell.
8. The parotid gland's duct that opens into the mouth opposite the second molar is:

A. Wharton's duct.
B. the salivary duct.
C. Stenson's duct.
D. the sublingual duct.
9. Which of the following pairs of sinuses is absent at birth, is fairly well developed between 7 and 8 years of age,
and is fully developed after puberty?

A. Maxillary
B. Frontal
C. Sphenoid
D. Ethmoid
10. Under normal conditions, transillumination of the sinuses would produce a:

A. diffuse red glow.

B. well-outlined light pattern along the borders of the sinuses.
C. narrowed beam of light.
D. bright red ray of light that appears focused on the opposite side of the sinus.

Chapter 23
1. The extrapyramidal system is located in which of the following parts of the brain?

A. The hypothalamus
B. The cerebellum
C. The basal ganglia
D. The medulla
2. Testing the deep tendon reflexes gives the examiner information regarding the intactness of the:

A. corticospinal tract.
B. medulla.
C. reflex arc at specific levels in the spinal cord.
D. upper motor and lower motor neuron synaptic junction.
3. An abnormal sensation of burning and/or tingling is best described as:

A. paralysis.
B. paresis.
C. paresthesia.
D. paraphasia.
4. Automatic associated movements of the body are under the control and regulation of:

A. the basal ganglia.

B. the thalamus.
C. the hypothalamus.
D. Wernicke's area.
5. Involuntary muscle movements may be described by which of the following terms?

A. Ataxia
B. Flaccidity
C. Athetosis
D. Vestibular
6. Clonus that may be seen when testing deep tendon reflexes is characterized by a(n):

A. additional contraction of the muscle that is of greater intensity than the first.
B. set of short, jerking contractions of the same muscle.
C. parallel response in the opposite extremity.
D. contraction of the muscle that appears after hitting the tendon the second time.
7. The presence of primitive reflexes in a newborn is indicative of which of the following?

A. Immaturity of the nervous system

B. Prematurity of the infant
C. Mental retardation
D. Spinal cord alterations (e.g., spina bifida)
8. Which of the following procedures is associated with testing cerebellar function?

A. Muscle strength
B. Rapid alternating movements
C. Rhomboid maneuver
D. Superficial pain and touch
9. The complex motor system that coordinates movement, maintains equilibrium, and helps maintain posture is
identified as the:

A. extrapyramidal system.
B. cerebellum.
C. upper and lower motor neurons.
D. basal ganglia.
10. During your assessment of extraocular movements, you note that there is some back and forth oscillations of the
eyes in the extreme lateral gaze. Your impression of this response is:
A. the individual needs to be referred for a more complete eye examination.
B. this is indicative of a disease of the vestibular system and needs further evaluation.
C. this is an expected response during this exam and the movement of the eyes during this procedure.
D. this exam should be repeated in about 15 minutes after the eyes have had time to rest to determine if the
same phenomenon occurs.
11. Which of the following pairs represents a type of reflex arc and its corresponding response?

A. Deep tendon-Babinski
B. Superficial-abdominal
C. Pathologic-knee jerk
D. Visceral-corneal light reflex
12. An area of the body that is supplied mainly from one spinal segment through a particular spinal nerve is
identified as a:

A. dermatome.
B. dermatomee.
C. dermatophyte.
D. dermoblast.