Question 1

Both ears provide stereophonic hearing that gives us very specific hearing capabilities.Binaural hearing makes it possible for:

Accepted Answer

A)  determination of the source location of sounds. 
B)  enhanced voice recognition. 
C)  amplification and resolution of sound properties. 
D)  recognition of more than one sound at a time.

Question 2

The supraglottis,glottis,and the subglottis represent three portions of which structure of the throat?

Accepted Answer

A)  Epiglottis 
B)  Tongue 
C)  Larynx 
D)  Pharynx

Question 3

During endoscopic sinus surgery,patient eye protection includes:

Accepted Answer

A)  taping the eyelids closed. 
B)  placing moist gauze over the eyelids. 
C)  instilling eye lubricant into both eyes. 
D)  fitting the patient with appropriate sized goggles.

Question 4

Laryngoscopy is direct visual examination of the interior of the larynx by means of a rigid,lighted speculum known as a laryngoscope to obtain a specimen of tissue or secretions for pathologic examination.What risk reduction strategy should the perioperative nurse employ in preparing for the conclusion of the procedure?

Accepted Answer

A)  Maintain instrument setup until the patient leaves the operating room (OR). 
B)  Determine fire risk score. 
C)  Place O₂ tank, nasal cannula, and bag-valve-mask on the transport vehicle. 
D)  Assist anesthesia provider with anesthesia emergence and transfer to the postanesthesia care unit (PACU).

Question 5

An experienced perioperative nurse is orienting a new perioperative nurse to otolaryngologic surgery.The experienced nurse and the new nurse are the scrub persons and are preparing the sterile back table with instruments,accessory devices,and the medications used for the local anesthetics.They also set up a prep table with the initial local anesthetics to be given before the start of the procedure.The experienced nurse is determined to impart the critical nature of patient safety and prevention of medication errors during these procedures.The back table contains multiple medications that will be used for local anesthesia,vasoconstriction,and hemostasis.As a perioperative registered nurse (RN)scrub person,it is necessary that both the experienced and new nurse:

Accepted Answer

A)  verify all medications that are transferred to the sterile field. 
B)  observe the four rights of medication administration. 
C)  accept transfer of medications to the sterile field without distractions and one medication at a time. 
D)  use appropriate ancillary equipment and supplies, such as filter needles, transfer devices, and infusion pumps. 
E)  be aware of the maximum recommended dosage of all local anesthetics and be alert for signs of reaction.

Question 6

The external ear canal lining is protected and lubricated with cerumen (earwax),which traps foreign material and:

Accepted Answer

A)  liquefies foreign matter in the ear canal. 
B)  lubricates the external ear. 
C)  maintains the high acidic pH in the ear canal. 
D)  reduces bacterial levels in the outer ear.

Question 7

Of the three salivary glands,which one is the largest?

Accepted Answer

A)  Sublingual 
B)  Submandibular 
C)  Zygomatic 
D)  Parotid

Question 8

The nasal turbinates increase the turbulence of the airflow through the nose to humidify the air.The turbinates also serve another function to the accessory sinuses by:

Accepted Answer

A)  filtering inspired air and preventing sinusitis. 
B)  warming and humidifying inspired air. 
C)  giving resonance to the voice. 
D)  trapping particle matter before it reaches the nasopharynx.

Question 9

The nasal cavity is associated with the ear by way of the ____________,and communicates with the conjunctiva through the __________________.Select the options that are appropriate to complete the sentence.

Accepted Answer

A)  torus tubarius; canaliculi 
B)  eustachian tube; nasolacrimal duct 
C)  nasopharynx; medial caruncle 
D)  middle ear; lacrimal sac

Question 10

Uvulopalatopharyngoplasty (UPPP)is performed primarily to relieve obstructive sleep apnea (OSA)and snoring.Select two common indications for UPPP surgery.

Accepted Answer

A)  O₂ saturation below 92%, and snoring 
B)  Cardiac dysrhythmia during sleep and awake, and snoring 
C)  O₂ saturation below 80%, and apnea index worse than 20 
D)  O₂ saturation below 85% on continuous positive airway pressure (CPAP), and apnea index below 20

Question 11

The perioperative nurse and his orientee have returned from an airway fire simulation exercise with the otorhinolaryngologic surgeon,fellow,and anesthesia provider.They were amazed at the statistics for OR fires and the threat of serious injury to the patient and team.Patients undergoing otorhinolaryngologic procedures are at greater risk for fire injury because of the proximity of the surgical field to high concentrations of oxygen.The team discussed a plan to change their practices.An example of a valid fire prevention strategy that involves the entire surgical team during otorhinolaryngologic surgery would be:

Accepted Answer

A)  placing ESU active electrodes in a basin of sterile water. 
B)  keeping cottonoid patties and strings completely dry when used around the laser. 
C)  identifying the fire risk score during the postprocedure debriefing. 
D)  collaborating with the anesthesia provider and surgeon to prevent fire risks.

Question 12

Select the structure of the trachea that is a landmark during bronchoscopy.

Accepted Answer

A)  Cartilaginous ring 
B)  Cricoid cartilage 
C)  Carina 
D)  Right main bronchus

Question 13

Acoustic neuromas arise from the Schwann cells of the vestibular portion of the eighth cranial nerve and are benign tumors.What is the postauricular incisional approach that offers the best chance of saving the integrity of the facial nerve?

Accepted Answer

A)  Postauricular 
B)  Supra-aural 
C)  Translabyrinthine 
D)  Intravestibular

Question 14

A chain of three small articulated bones extends across the middle ear cavity and conducts vibrations from the tympanic membrane across the middle ear into the oval window and the fluid-filled inner ear.What are the names of those three small articulating bones?

Accepted Answer

A)  Ossicles, incus, and crura 
B)  Stapes, capitulum, and stirrup 
C)  Malleus, incus, and stapes 
D)  Anvil, head, and hammer

Question 15

Which mouth structure is considered the boundary between the buccal cavity and the lingual cavity?

Accepted Answer

A)  Hard palate 
B)  Soft palate 
C)  Teeth 
D)  Floor of the mouth

Question 16

A stapedotomy is removal of the stapes superstructure and creation of a fenestra (opening)in the fixed stapes footplate for treatment of abnormal bone growth around the footplate that results in its immobility.A prosthesis is placed to restore ossicular continuity and alleviate conductive hearing loss.The patient scheduled for a stapedotomy will probably have a surgical diagnosis of:

Accepted Answer

A)  otosclerosis. 
B)  ossicular stenosis. 
C)  indeterminate hearing loss. 
D)  ossicular interruption.

Question 17

FESS provides a more physiologic type of drainage by reducing trauma to normal tissues.FESS involves the endoscopic resection of inflammatory and anatomic defects of the sinuses.Select the appropriate indications for FESS.

Accepted Answer

A)  Inhibited mucociliary clearance 
B)  Outflow obstruction 
C)  Mucocele 
D)  Sinus infections

Question 18

Audible facial nerve monitors (nerve integrity monitor systems)are used intraoperatively during procedures in which the facial nerve is at risk for injury.The purpose of this monitoring technique is to assist in the early identification of the nerve,to increase the possibility of its preservation by minimizing trauma,and to assess its integrity after dissection.Communication with the anesthesia provider is essential because:

Accepted Answer

A)  the electrodes are often in proximity to the anesthetic airway. 
B)  manipulation of the anesthetic airway during the procedure can misplace the electrodes. 
C)  muscle relaxants, paralyzing agents, and some local anesthetics must be avoided. 
D)  the anesthesia provider is responsible for the facial nerve monitoring.

Question 19

The cricoid cartilage is a complete cartilaginous ring that resembles a signet ring; it rests beneath the thyroid cartilage and supports the airway.What membrane,attached to the midline of the upper thyroid cartilage,protects the larynx during swallowing?

Accepted Answer

A)  False vocal cords 
B)  True vocal cords 
C)  Arytenoids 
D)  Epiglottis

Question 20

Partial laryngectomy is removal of a portion of the larynx.It is done to remove superficial neoplasms that are confined to one vocal cord or to remove a tumor extending into the ventricle or the anterior commissure or a short distance below the cord.The perioperative nurse,in preparing the patient for surgery and postprocedure expectations,can describe the postoperative voice as:

Accepted Answer

A)  enhanced voice with assistive tracheoesphageal puncture stoma. 
B)  muteness, because the patient breathes through a tracheostoma. 
C)  normal as the patient's preoperative voice. 
D)  hoarse but serviceable voice.

Exam 19: Otorhinolaryngologic Surgery