Question 1

A 19-year-old college student is brought to the emergency department with a severe headache he describes as, "Like nothing I've ever had before." His temperature is 40° C, and he has a stiff neck.The nurse recognizes that he needs testing for:

Accepted Answer

A)  A head injury.
B)  Cluster headaches.
C)  Migraine headaches.
D)  Meningeal inflammation. D

Question 2

During an examination of a patient in her third trimester of pregnancy, the nurse notices that the patient's thyroid gland is slightly enlarged.No enlargement had been previously noticed.The nurse recognizes that the patient:

Accepted Answer

A)  Has an iodine deficiency.
B)  Is exhibiting early signs of goitre.
C)  Is exhibiting a normal enlargement of the thyroid gland during pregnancy.
D)  Needs further testing for possible thyroid cancer. C

Question 3

The nurse is aware that the four areas in the body where lymph nodes are accessible are the:

Accepted Answer

A)  Head, breasts, groin, and abdomen.
B)  Arms, breasts, inguinal area, and legs.
C)  Head and neck, arms, breasts, and axillae.
D)  Head and neck, arms, inguinal area, and axillae. D

Question 4

The nurse is performing an assessment on a 7-year-old child who has symptoms of chronic watery eyes, sneezing, and clear nasal drainage.The nurse notices the presence of a transverse line across the bridge of the nose, dark blue shadows below the eyes, and a double crease on the lower eyelids.These findings are characteristic of:

Accepted Answer

A)  Allergies.
B)  Sinus infection.
C)  Nasal congestion.
D)  Upper respiratory infection.

Question 5

A patient is concerned that while studying for an examination he began to notice a severe headache in the left front and side of his head that was throbbing and was relieved when he lay down.He tells the nurse that his mother also had these headaches.The nurse suspects that he may be suffering from:

Accepted Answer

A)  Hypertension.
B)  Cluster headaches.
C)  Tension headaches.
D)  Migraine headaches.

Question 6

During an examination of a 3-year-old child, the nurse notices a bruit over the left temporal area.The nurse should:

Accepted Answer

A)  Continue the examination because a bruit is a normal finding for this age.
B)  Check for the bruit again in 1 hour.
C)  Notify the parents that a bruit has been detected in their child.
D)  Stop the examination, and notify the physician.

Question 7

A visitor from Poland, who does not speak English, seems to be somewhat apprehensive about the nurse examining his neck.He would probably be more comfortable with the nurse examining his thyroid gland from:

Accepted Answer

A)  Behind with the nurse's hands placed firmly around his neck.
B)  The side with the nurse's eyes averted toward the ceiling and thumbs on his neck.
C)  The front with the nurse's thumbs placed on either side of his trachea and his head tilted forward.
D)  The front with the nurse's thumbs placed on either side of his trachea and his head tilted backward.

Question 8

A patient is admitted to the hospital with paralysis to the left side of his mouth.On assessment, the nurse notes that the patient can close his eyes but is not able to whistle or smile when asked to.The nurse recognizes that the patient needs additional assessment for:

Accepted Answer

A)  Cushing's syndrome.
B)  Parkinson's disease.
C)  Lower motor lesion.
D)  Upper motor lesion.

Question 9

A mother brings her 2-month-old daughter in for an examination and says, "My daughter rolled over against the wall, and now I have noticed that she has this spot that is soft on the top of her head.Is something terribly wrong?" The nurse's best response would be:

Accepted Answer

A)  "Perhaps that is a result of your dietary intake during pregnancy."
B)  "Your baby may have craniosynostosis, a disease of the sutures of the brain."
C)  "That 'soft spot' may be an indication of cretinism or congenital hypothyroidism."
D)  "That 'soft spot' is normal, and actually allows for growth of the brain during the first year of your baby's life."

Question 10

A male patient with a history of AIDS has come in for an examination and he states, "I think that I have the mumps." The nurse would begin by examining the:

Accepted Answer

A)  Thyroid gland.
B)  Parotid gland.
C)  Cervical lymph nodes.
D)  Mouth and skin for lesions.

Question 11

When examining children affected with Down's syndrome (trisomy 21), the nurse looks for the possible presence of:

Accepted Answer

A)  Misshapen ears.
B)  Long, thin neck.
C)  Thin tongue sticking out.
D)  Narrow and raised nasal bridge.

Question 12

The nurse is assessing a 1-month-old infant at his well-baby checkup.Which assessment findings are appropriate for this age? (Select all that apply.)

Accepted Answer

A)  Head circumference equal to chest circumference
B)  Head circumference greater than chest circumference
C)  Head circumference less than chest circumference
D)  Fontanelles firm and slightly concave
E)  Absent tonic neck reflexF) Nonpalpable cervical lymph nodes

Question 13

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head.The nurse suspects damage to cranial nerve ______ and proceeds with the examination by ________________________.

Accepted Answer

A)  XI; palpating the anterior and posterior triangles
B)  XI; asking the patient to shrug her shoulders against resistance
C)  XII; percussing the sternomastoid and submandibular neck muscles
D)  XII; assessing for a positive Romberg sign

Question 14

A patient's laboratory data reveal an elevated thyroxine (T₄) level.The nurse would proceed with an examination of the _____ gland.

Accepted Answer

A)  Thyroid
B)  Parotid
C)  Adrenal
D)  Parathyroid

Question 15

When examining the face of a patient, the nurse is aware that the two pairs of salivary glands that are accessible for examination are the ___________ and ___________ glands.

Accepted Answer

A)  Occipital; submental
B)  Parotid; jugulodigastric
C)  Parotid; submandibular
D)  Submandibular; occipital

Question 16

A mother brings her newborn in for an assessment and asks, "Is there something wrong with my baby? His head seems so big." Which statement is true regarding the relative proportions of the head and trunk of the newborn?

Accepted Answer

A)  At birth, the head is one-fifth the total length.
B)  Head circumference should be greater than chest circumference at birth.
C)  The head size reaches 90% of its final size when the child is 3 years old.
D)  When the anterior fontanelle closes at 2 months, the head will be more proportionate to the body.

Question 17

A patient, an 85-year-old woman, is concerned that the bones in her face have become more noticeable.The nurse tells her that:

Accepted Answer

A)  Diets low in protein and high in carbohydrates may cause enhanced facial bones.
B)  Bones can become more noticeable if the person does not use a dermatologically approved moisturizer.
C)  More noticeable facial bones are probably caused by a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin.
D)  Facial skin becomes more elastic with age.This increased elasticity causes the skin to be more taught, drawing attention to the facial bones.

Question 18

A patient's thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid gland for the presence of a bruit.A bruit is a __________ sound that is heard best with the __________ of the stethoscope.

Accepted Answer

A)  Low gurgling; diaphragm
B)  Loud, whooshing, blowing; bell
C)  Soft, whooshing, pulsatile; bell
D)  High-pitched tinkling; diaphragm

Question 19

The nurse notices that a patient's palpebral fissures are unequal.On examination, the nurse may find that damage has occurred to which cranial nerve (CN)?

Accepted Answer

A)  III
B)  V
C)  VII
D)  VIII

Question 20

A mother brings in her newborn infant for an assessment and tells the nurse that she has noticed that whenever her newborn's head is turned to the right side, she straightens out the arm and leg on the same side and flexes the opposite arm and leg.After observing this on examination, the nurse tells her that this reflex is:

Accepted Answer

A)  Abnormal and is called the atonic neck reflex.
B)  Normal and should disappear by the first year of life.
C)  Normal and is called the tonic neck reflex, which should disappear between 3 and 4 months of age.
D)  Abnormal and the baby should be flexing the arm and leg on the right side of his body when the head is turned to the right.

Exam 14: Head, Face, and Neck, Including Regional Lymphatics