nclex practice questions 2023 health assessment

Correct Answer: D

Rationale: The correct answer is D: "Have you noticed any dryness in your mouth?" This question is important as dryness in the mouth can be a side effect of certain medications used to manage hypertension and chronic lung disease. Dry mouth can lead to oral health issues and impact the patient's overall well-being. A: "Do you use a fluoride supplement?" is not directly relevant to the patient's medical history of hypertension and lung disease. B: "Have you had tonsillitis in the last year?" is not as crucial as dry mouth in relation to managing hypertension and lung disease. C: "At what age did you get your first tooth?" is not pertinent to the current medical conditions and management of hypertension and lung disease. In summary, the question about dryness in the mouth is the most relevant as it pertains to potential medication side effects and oral health implications for the patient with hypertension and chronic lung disease.

Correct Answer: D

Rationale: The correct answer is D because dry, flaky cerumen can indicate a change in cilia in the ear canal, potentially leading to conductive hearing loss. This warrants further assessment by the nurse to ensure the patient's aural health is not compromised. A: Eczema lesions typically present differently and are not directly related to dry cerumen. B: While hygiene can contribute to cerumen buildup, dry, flaky cerumen alone does not necessarily indicate poor hygiene. C: Dry, flaky cerumen is not considered a normal finding in a healthy ear and should prompt further evaluation.

Correct Answer: B

Rationale: The correct answer is B: Any recent drainage from the ear. This is crucial because drainage could indicate an infection or other underlying issue causing the auricle symptoms. Hearing changes (option A) may not be directly related to the auricle findings. Recent trauma (option C) would be more evident on inspection. Prolonged cold exposure (option D) is less likely to cause the described symptoms.

Correct Answer: D

Rationale: The correct answer is D because the movement of extraocular muscles is primarily controlled by cranial nerves III, IV, and VI. CN III controls most of the eye movements, CN IV controls the superior oblique muscle, and CN VI controls the lateral rectus muscle. These nerves work together to coordinate eye movements in all directions. Choices A and B are incorrect because age or cataracts do not directly impact the stimulation of extraocular muscles. Choice C is incorrect as CNs I and II are not involved in controlling extraocular muscle movement.

Correct Answer: C

Rationale: Step 1: Dark skin may not show cyanosis well, making choice A less reliable. Step 2: Erythema refers to redness, which may not be easily visible in dark skin, making choice B less suitable. Step 3: Palpating for edema and increased warmth allows for a more reliable assessment of inflammation in dark skin, making choice C the correct answer. Step 4: Palpating for tenderness and ecchymosis may be useful but not specific to inflammation assessment in dark skin, making choice D less relevant.