Deck 13: Head, face, and Neck, including Regional Lymphatics

Question 1

When examining children affected with Down syndrome (trisomy 21),the nurse looks for the possible presence of:
1)ear dysplasia.
2)a long,thin neck.
3)a protruding thin tongue.
4)a narrow and raised nasal bridge.

Answer 1

1
With the chromosomal aberration trisomy 21,also known as Down syndrome,head and face characteristics may include upslanting eyes with inner epicanthal folds,a flat nasal bridge,a small broad flat nose,a protruding thick tongue,ear dysplasia,a short broad neck with webbing,and small hands with a single palmar crease.

Question 2

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:
1)abnormal and is called the atonic neck reflex.
2)normal and should disappear by the first year of life.
3)normal and should disappear between 3 and 4 months of age.
4)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.

Answer 2

3
By 2 weeks the infant shows the tonic neck reflex when supine and the head is turned to one side (extension of same arm and leg,flexion of opposite arm and leg).The tonic neck reflex disappears between 3 and 4 months of age.

Question 3

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:
1)exophthalmos.
2)bowed long bones.
3)coarse facial features.
4)an acorn-shaped cranium.

Answer 3

3
Acromegaly is excessive secretion of growth hormone that creates an enlarged skull and thickened cranial bones.Patients will have elongated heads,massive faces,prominent noses and lower jaws,heavy eyebrow ridges,and coarse facial features.

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 notes 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:
1)allergies.
2)a sinus infection.
3)nasal congestion.
4)an upper respiratory infection.

Question 5

The nurse has just completed a lymph assessment on a 60-year-old healthy female patient.The nurse knows that most lymph nodes in healthy adults are normally:
1)shotty.
2)not palpable.
3)large,firm,and fixed to the tissue.
4)rubbery,discrete,and mobile.

Question 6

During an assessment of an infant,the nurse notes that the fontanels are depressed and sunken.The nurse suspects which condition?
1)Rickets
2)Dehydration
3)Mental retardation
4)Increased intracranial pressure

Question 7

A physician tells the nurse that a patient's vertebra prominens is tender and asks the nurse to re-evaluate the area in 1 hour.The area of the body the nurse will assess is the area:
1)just above the diaphragm.
2)just lateral to the knee cap.
3)at the level of the C7 vertebra.
4)at the level of the T11 vertebra.

Question 8

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:
1)low gurgling sound best heard with the diaphragm of the stethoscope.
2)loud,whooshing,blowing sound best heard with the bell of the stethoscope.
3)soft,whooshing,pulsatile sound best heard with the bell of the stethoscope.
4)high-pitched tinkling sound best heard with the diaphragm of the stethoscope.

Question 9

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.What do these signs and symptoms suggest?
1)Head injury
2)Cluster headache
3)Migraine headache
4)Meningeal inflammation

Question 10

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 suspects:
1)hypertension.
2)cluster headaches.
3)tension headaches.
4)migraine headaches.

Question 11

The nurse notices that a patient's palpebral fissures are not symmetrical.On examination,the nurse may find that there has been damage to:
1)CN III.
2)CN V.
3)CN VII.
4)CN VIII.

Question 12

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:
1)child has chronic allergies.
2)child may have an infection.
3)is a normal finding for a well child of this age.
4)child should be referred for additional evaluation.

Question 13

When examining the face,the nurse is aware that the two pairs of salivary glands that are accessible to examination are the _____ glands.
1)occipital and submental
2)parotid and jugulodigastric
3)parotid and submandibular
4)submandibular and occipital

Question 14

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?
1)Diets low in protein and high in carbohydrates may cause enhanced facial bones.
2)It is probably because she doesn't use a dermatologically approved moisturizer.
3)It is probably due to a combination of factors such as decreased elasticity,subcutaneous fat,and moisture in her skin.
4)Facial skin becomes more elastic with age.This increased elasticity causes the skin to be more taught,drawing attention to the facial bones.

Question 15

The physician reports that a patient has a tracheal shift.The nurse is aware that this means that the patient's trachea is:
1)pulled to the affected side with systole.
2)pushed to the unaffected side with a tumor.
3)pulled to the unaffected side with plural adhesions.
4)pushed to the affected side with thyroid enlargement.

Question 16

The nurse is aware that the four areas in the body where lymph nodes are accessible are the:
1)head,breasts,groin,and abdomen.
2)arms,breasts,inguinal area,and legs.
3)head and neck,arms,breasts,and axillae.
4)head and neck,arms,inguinal area,and axillae.

Question 17

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:
1)hypertension.
2)cluster headaches.
3)tension headaches.
4)migraine headaches.

Question 18

A patient is unable to differentiate between sharp and dull stimulation to both sides of her face.The nurse suspects:
1)Bell's palsy.
2)damage to the trigeminal nerve.
3)frostbite with resultant paresthesia to the cheeks.
4)scleroderma with a pronounced proliferation of connective tissue in the face and cheeks.

Question 19

A woman comes to the clinic and states,"My eyes have gotten so puffy,and my eyebrows and hair have become coarse and dry." The nurse suspects:
1)cachexia.
2)cretinism.
3)myxedema.
4)scleroderma.

Question 20

During an examination,the nurse knows that Paget's disease would be indicated by which of the following findings?
1)Positive Macewen's sign
2)Premature closure of the sagittal suture
3)Headache,vertigo,tinnitus,and deafness
4)Elongated head with heavy eyebrow ridge

Question 21

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

Question 22

During an examination,the nurse finds that a patient's left temporal artery is more tortuous and feels hardened and tender compared with the right temporal artery.The nurse suspects which condition?
1)Crepitation
2)Mastoiditis
3)Temporal arteritis
4)Bell's palsy

Question 23

MATCHING
During assessment of infants and children,the nurse measures the head circumference and compares the measure to the chest circumference.For each finding listed below,match to the appropriate age.
1.Newborn infant
2.Toddler,age 2 years
3.Child,age 4 years
Head circumference equal to chest circumference.

Question 24

MATCHING
During assessment of infants and children,the nurse measures the head circumference and compares the measure to the chest circumference.For each finding listed below,match to the appropriate age.
1.Newborn infant
2.Toddler,age 2 years
3.Child,age 4 years
Head circumference greater than chest circumference.

Question 25

MATCHING
During assessment of infants and children,the nurse measures the head circumference and compares the measure to the chest circumference.For each finding listed below,match to the appropriate age.
1.Newborn infant
2.Toddler,age 2 years
3.Child,age 4 years
Head circumference less than chest circumference.

Question 26

During an examination,the nurse knows that the best way to palpate the lymph nodes in the neck is described by which statement?
1)Using gentle pressure,palpate with both hands to compare the two sides.
2)Using strong pressure,palpate with both hands to compare the two sides.
3)Gently pinch each node between one's thumb and forefinger and move down the neck muscle.
4)Using the index and middle fingers,gently palpate by applying pressure in a rotating pattern.