Question 1

A patient who is 7 months pregnant is at the clinic for her routine checkup.During assessment the nurse notes that the patient's thyroid is palpable.The nurse will:

Accepted Answer

Usually the normal adult thyroid is not palpable.However, the thyroid gland may be palpable normally during pregnancy.

Question 2

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

The major neck muscles are the sternomastoid and the trapezius.They are innervated by cranial nerve XI, the spinal accessory.The innervated muscles assist with head rotation and head flexion, movement of the shoulders, and extension and turning of the head.

Question 3

A patient reports to the nurse that he has been experiencing excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts approximately one-half to 2 hours, occurring once or twice each day.The nurse suspects that he is having:

Accepted Answer

Cluster headaches produce pain around the eye, temple, forehead, and cheek and are unilateral and always on the same side of the head.They are excruciating and occur once or twice per day and last one-half to 2 hours each.

Question 4

A patient has come in for an examination and states, "I have this spot in front of my ear lobe 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:

Accepted Answer

Swelling of the parotid gland is evident below the angle of the jaw and is most visible when the head is extended.Painful inflammation occurs with mumps, and swelling also occurs with abscesses or tumours.Swelling occurs anterior to the lower ear lobe.

Question 5

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

The facial bones and orbits appear more prominent in the aging adult, and the facial skin sags, which is attributable to decreased elasticity, decreased subcutaneous fat, and decreased moisture in the skin.

Question 6

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:

Accepted Answer

The C7 vertebra has a long spinous process, called the vertebra prominens, which is palpable when the head is flexed.

Question 7

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

The nurse recognizes that during the fetal period, head growth predominates.Head size is greater than chest circumference at birth, and the head size grows during childhood, reaching 90% of its final size when the child is 6 years of age.

Question 8

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 assessment, the nurse suspects a noncancerous finding as the lump:

Accepted Answer

Multiple nodules usually indicate inflammation or a multinodular goitre, rather than a neoplasm.Any rapidly enlarging or firm nodule should be further investigated.
Painless, rapidly growing nodules may be cancerous, especially the appearance of a single nodule in a young person.Cancerous nodules tend to be hard and fixed to surrounding structures.

Question 9

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

Accepted Answer

The temporomandibular joint is just below the temporal artery and anterior to the tragus.

Question 10

During a well-baby checkup, 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?

Accepted Answer

The enlarged cranium, dilated scalp veins, and setting sun eyes are all indicative of hydrocephalus, which is an abnormal buildup of cerebrospinal fluid in the brain. Microcephaly is characterized by a small head size, but not an enlarged cranium. Craniotabes is a softening of the skull bones and would not cause an enlarged cranium. Caput succedaneum refers to swelling and bruising on the scalp from pressure during delivery and would not cause an enlarged cranium or dilated scalp veins.

Question 11

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

Accepted Answer

Nodes are located throughout the body, but they are accessible to examination only in four areas: head and neck, arms, inguinal region, and axillae.

Question 12

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

Migraine headaches tend to be supraorbital, retro-orbital, or frontotemporal with a throbbing quality.They are severe in quality and are relieved by lying down.Migraines are associated with a family history of migraine headaches.

Question 13

When examining a patient after a biopsy of the cervical lymph nodes, to ensure there is no damage to the major neck muscles, the nurse should check the function of cranial nerve:

Accepted Answer

The major neck muscles are the sternomastoid and the trapezius.They are innervated by cranial nerve XI, the spinal accessory.Injury or surgery to the neck region can cause trauma to the nerve.

Question 14

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

The acute onset of neck stiffness and pain along with headache and fever occurs with meningeal inflammation.A severe headache in an adult or child who has never had it before is a red flag.Head injury and cluster or migraine headaches are not associated with a fever or stiff neck.

Question 15

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

Accepted Answer

The thyroid gland is a highly vascular endocrine gland that secretes T₄ and triiodothyronine (T₃).The other glands do not secrete T₄.

Question 16

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

Facial muscles are mediated by CN VII; asymmetry of palpebral fissures may be attributable to damage to CN VII (Bell's palsy).

Question 17

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

Two pairs of salivary glands accessible to examination on the face are the parotid glands, which are in the cheeks over the mandible, anterior to and below the ear; and the submandibular glands, which are beneath the mandible at the angle of the jaw.The parotid glands are normally nonpalpable.

Question 18

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

Membrane-covered "soft spots" allow for growth of the brain during the first year of life.They gradually ossify; the triangular-shaped posterior fontanelle is closed by 1 to 2 months, and the diamond-shaped anterior fontanel closes between 9 months and 2 years.

Question 19

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

Accepted Answer

Facial sensations of pain or touch are mediated by cranial nerve V, which is the trigeminal nerve.Bell palsy is associated with cranial nerve VII damage.Frostbite and scleroderma are not associated with this problem.

Question 20

The nurse notices that a patient's submental lymph nodes are enlarged.To identify the cause of the enlargement of the patient's nodes, the nurse assesses the:

Accepted Answer

When nodes are abnormal, the nurse should check the area into which they drain for the source of the problem.The area proximal (upstream) to the location of the abnormal node should be explored.

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