Deck 13: Head, Face, and Neck, Including Regional Lymphatics

Question 1

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

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.

Answer 1

head and neck, arms, inguinal area, and axillae.

Question 2

A patient,an 85-year-old woman,is complaining about the fact that the bones in her face have become more noticeable.What explanation should the nurse give to her?

A) Diets low in protein and high in carbohydrates may cause enhanced facial bones.
B) It is probably because she doesn't use a dermatologically approved moisturizer.
C) It is probably due to 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.

Answer 2

It is probably due to a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin.

Question 3

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

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 fontanel closes at 2 months, the head will be more proportioned to the body.

Answer 3

Head circumference should be greater than chest circumference at birth.

Question 4

A patient is unable to differentiate between sharp and dull stimulation to both sides of her face.The nurse suspects:

A) Bell's palsy.
B) damage to the trigeminal nerve.
C) frostbite with resultant paresthesia to the cheeks.
D) scleroderma.

Question 5

A patient has come in for an examination and states,"I have this spot in front of my ear lobe here on my cheek that seems to be getting bigger and is tender.What do you think it is?" The nurse notes swelling below the angle of the jaw and suspects that it could be an inflammation of his:

A) thyroid gland.
B) parotid gland.
C) occipital lymph node.
D) submental lymph node.

Question 6

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 there something terribly wrong?" The nurse's best response would be:

A) "Perhaps that could be 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' you are referring to 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 7

A patient says that she has recently noticed a lump in the front of her neck below her "Adam's apple" that seems to be getting bigger.During the assessment,the finding that leads the nurse to suspect that this may not be a cancerous thyroid nodule is that the lump (nodule):

A) is tender.
B) is mobile and not hard.
C) disappears when the patient smiles.
D) is hard and fixed to the surrounding structures.

Question 8

When examining the face,the nurse is aware that the two pairs of salivary glands that are accessible to examination are the _____ glands.

A) occipital and submental
B) parotid and jugulodigastric
C) parotid and submandibular
D) submandibular and occipital

Question 9

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:

A) thyroid gland.
B) parotid gland.
C) cervical lymph nodes.
D) mouth and skin for lesions.

Question 10

The nurse needs to palpate the temporomandibular joint for crepitation.This joint is located just below the temporal artery and anterior to the:

A) hyoid.
B) vagus nerve.
C) tragus.
D) mandible.

Question 11

When examining a patient's cranial nerve (CN)function,the nurse remembers that the muscles in the neck that are innervated by CN XI are the:

A) sternomastoid and trapezius.
B) spinal accessory and omohyoid.
C) trapezius and sternomandibular.
D) sternomandibular and spinal accessory.

Question 12

A patient presents with excruciating headache pain on one side of his head,especially around his eye,forehead,and cheek that lasts about 1/2 to 2 hours,occurring once or twice each day.The nurse should suspect:

A) hypertension.
B) cluster headaches.
C) tension headaches.
D) migraine headaches.

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 (CN)_____ and proceeds with the examination by _____.

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 level.The nurse would proceed with an examination of the _____ gland.

A) thyroid
B) parotid
C) adrenal
D) parathyroid

Question 15

A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down.He tells the nurse that his mother also had these headaches.The nurse suspects that he may be suffering from:

A) hypertension.
B) cluster headaches.
C) tension headaches.
D) migraine headaches.

Question 16

The nurse notices that a patient's submental lymph nodes are enlarged.In an effort to identify the cause of the node enlargement,the nurse would assess the patient's:

A) infraclavicular area.
B) supraclavicular area.
C) area distal to the enlarged node.
D) area proximal to the enlarged node.

Question 17

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 104° F,and he has a stiff neck.The nurse looks for other signs and symptoms of which problem?

A) Head injury
B) Cluster headache
C) Migraine headache
D) Meningeal inflammation

Question 18

During a well-baby check,the nurse notices that a 1-week-old infant's face looks small compared with his cranium,which seems enlarged.On further examination,the nurse also notices dilated scalp veins and downcast,or "setting sun," eyes.The nurse suspects which condition?

A) Craniotabes
B) Microcephaly
C) Hydrocephalus
D) Caput succedaneum

Question 19

A physician tells the nurse that a patient's vertebra prominens is tender and asks the nurse to reevaluate the area in 1 hour.The area of the body the nurse will assess is the area:

A) just above the diaphragm.
B) just lateral to the knee cap.
C) at the level of the C7 vertebra.
D) at the level of the T11 vertebra.

Question 20

The nurse notices that a patient's palpebral fissures are not symmetrical.On examination,the nurse may find that there has been damage to cranial nerve:

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

Question 21

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

A) continue the examination because this 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 22

The nurse has just completed a lymph node assessment on a 60-year-old healthy female patient.The nurse knows that most lymph nodes in healthy adults are normally:

A) shotty.
B) not palpable.
C) large, firm, and fixed to the tissue.
D) rubbery, discrete, and mobile.

Question 23

The physician reports that a patient with a neck tumor has a tracheal shift.The nurse is aware that this means that the patient's trachea is:

A) pulled to the affected side.
B) pushed to the unaffected side.
C) pulled downward.
D) pulled downward in a rhythmic pattern.

Question 24

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 noticed previously.The nurse suspects that:

A) she has an iodine deficiency.
B) she is exhibiting early signs of goiter.
C) this is a normal finding during pregnancy.
D) further tests are needed for possible thyroid cancer.

Question 25

During an examination,the nurse knows that Paget's disease would be indicated by which of these assessment findings?

A) Positive Macewen sign
B) Premature closure of the sagittal suture
C) Headache, vertigo, tinnitus, and deafness
D) Elongated head with heavy eyebrow ridge

Question 26

The nurse notices that an infant has a large,soft lump on the side of his head and that his mother is very concerned.She tells the nurse that she noticed the lump about 8 hours after her baby's birth,and that it seems to be getting bigger.One possible explanation for this is:

A) hydrocephalus.
B) craniosynostosis.
C) cephalhematoma.
D) caput succedaneum.

Question 27

During an examination of a female patient,the nurse notes lymphadenopathy and suspects an acute infection.Acutely infected lymph nodes would be:

A) clumped.
B) unilateral.
C) firm but freely movable.
D) firm and nontender.

Question 28

During an admission assessment,the nurse notices that a male patient has an enlarged and rather thick skull.The nurse suspects acromegaly and would further assess for:

A) exophthalmos.
B) bowed long bones.
C) coarse facial features.
D) an acorn-shaped cranium.

Question 29

While performing a well-child assessment on a 5 year old,the nurse notes the presence of palpable,bilateral,cervical,and inguinal lymph nodes.They are approximately 0.5 cm in size,round,mobile,and nontender.The nurse suspects that this:

A) child has chronic allergies.
B) child may have an infection.
C) is a normal finding for a well child of this age.
D) child should be referred for additional evaluation.

Question 30

During a well-baby checkup,a mother is concerned because her 2-month-old infant cannot hold her head up when she is pulled to a sitting position.Which response by the nurse is appropriate?

A) "Head control is usually achieved by 4 months of age."
B) "You shouldn't be trying to pull your baby up like that until she is older."
C) "This is a concern because head control should be achieved by this time."
D) "This is a concern because it indicates possible nerve damage to the neck muscles."

Question 31

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

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 32

The nurse suspects that a patient has hyperthyroidism and laboratory data indicate that the patient's thyroxine and tri-iodothyronine hormone levels are elevated.Which of these findings would the nurse most likely find on examination?

A) Tachycardia
B) Constipation
C) Rapid dyspnea
D) Atrophied nodular thyroid

Question 33

A patient's thyroid is enlarged,and the nurse is preparing to auscultate the thyroid for the presence of a bruit.A bruit is a __________ of the stethoscope.

A) low gurgling sound best heard with the diaphragm
B) loud, whooshing, blowing sound best heard with the bell
C) soft, whooshing, pulsatile sound best heard with the bell
D) high-pitched tinkling sound best heard with the diaphragm

Question 34

During an examination,the nurse knows that the best way to palpate the lymph nodes in the neck is described by which statement?

A) Using gentle pressure, palpate with both hands to compare the two sides.
B) Using strong pressure, palpate with both hands to compare the two sides.
C) Gently pinch each node between one's thumb and forefinger and move down the neck muscle.
D) Using the index and middle fingers, gently palpate by applying pressure in a rotating pattern.

Question 35

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:

A) allergies.
B) a sinus infection.
C) nasal congestion.
D) an upper respiratory infection.

Question 36

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

A) ear dysplasia.
B) a long, thin neck.
C) a protruding thin tongue.
D) a narrow and raised nasal bridge.

Question 37

A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed.He states that he cannot raise his eyebrow or whistle.The nurse suspects that he has:

A) Cushing's syndrome.
B) Parkinson disease.
C) Bell's palsy.
D) had a cerebrovascular accident (stroke).

Question 38

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 finding this on examination,the nurse would tell her that this is:

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

Question 39

During an assessment of an infant,the nurse notes that the fontanels are depressed and sunken.The nurse suspects which condition?

A) Rickets
B) Dehydration
C) Mental retardation
D) Increased intracranial pressure

Question 40

A woman comes to the clinic and states,"I've been sick for so long! My eyes have gotten so puffy,and my eyebrows and hair have become coarse and dry." The nurse will assess for other signs and symptoms of:

A) cachexia.
B) Parkinson's syndrome.
C) myxedema.
D) scleroderma.

Question 41

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

A) Head circumference equal to chest circumference
B) Head circumference greater than chest circumference
C) Head circumference less than chest circumference
D) Fontanels firm and slightly concave
E) Absent tonic neck reflex
F) Cervical lymph nodes not palpable

Question 42

During an examination,the nurse finds that a patient's left temporal artery is tortuous and feels hardened and tender compared with the right temporal artery.The nurse suspects which condition?

A) Crepitation
B) Mastoiditis
C) Temporal arteritis
D) Bell palsy