Exam 12: Head, Neck Related Lymphatics

The nurse is palpating an adult client's neck and does not note any palpable lymph nodes.The nurse understands that this is:

A client complains of daily headaches.Which of the following would the nurse include in the focused interview?

The nurse is assessing the 1-month-old infant's fontanels.The infant's fontanels are sunken.What may this indicate to the nurse?

During a focused assessment and interview regarding the client's head and neck,the client states that she is currently suffering from a severe headache that has occurred intermittently over the course of 3 days.The client denies any aura.The pain is severe and unilateral over the right side of her face.Also,the client is complaining of nasal congestion.Which of the following is the most likely diagnosis?

The nurse is performing a physical examination on a 2-day-old infant and notes flattened areas on each side of the head.The mother expresses concern about the infant's appearance.Which of the following responses would be appropriate for the nurse?

The nurse finds the client's thyroid gland is enlarged during the physical assessment.The client states that she has had a history of a goiter in the past.Which of the following questions is a priority to ask during the focused interview?

During a focused interview of a client,the nurse learns about an open lesion on theclient's head that hasn't healed in several months.What might this indicate to the nurse?

The nurse is assessing the client's head and neck.The nurse provides the client with a glass of water.Which of the following structures will the nurse most likely need to assess as the client drinks?

The client has an enlarged lymph node in front of his right ear.In which of the following ways should the nurse accurately document this finding?

The nurse is assessing a newborn infant and notes that the infant's head is enlarged with prominent scalp veins visible.The nurse would correctly document this finding as which of the following?

The nurse is preparing an educational seminar about Healthy People 2020.The inclusion of which of the following topics in this presentation are unexpected and indicate that the nurse requires further education?

The pregnant female has entered her third trimester.The client has developed hypertension and has been diagnosed with preeclampsia.Which of the following would the nurse also expect to find during the assessment of this client?

The nurse is assessing the function of the client's cranial nerves.The nurse finds that the client is unable to demonstrate the ability to chew.The nurse suspects that which of the following cranial nerves is not functioning properly?

The nurse is assessing the client's neck.Draw an "X" over the location of the axis.

Which of the following information is true regarding the assessment of the thyroid or thyroid function in an infant or child?

The nurse is planning care for a client with hypothyroidism.Which of the following would be the priority nursing diagnosis for this client?

The nurse is performing an assessment of the client's head and neck.The client requests information about the assessment of her lymph nodes.Which of the following is the best response?

The nurse is auscultating the thyroid gland and notes a bruit.Which of the following would the nurse associate with this finding?

The nurse is assessing an infant diagnosed with Down syndrome.Which of the following characteristics would the nurse expect to find during the examination?

Which of the following findings is normal regarding assessment of the fontanels?