health assessment practice questions nursing

Questions 46

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health assessment practice questions nursing Questions

Question 1 of 5

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

Correct Answer: B

Rationale: The correct answer is B: damage to the trigeminal nerve. Trigeminal nerve damage can result in the inability to differentiate between sharp and dull sensations on the face. The trigeminal nerve is responsible for transmitting sensory information from the face to the brain. Bell's palsy (choice A) affects facial muscles, not sensory perception. Frostbite (choice C) typically causes numbness rather than loss of sensation discrimination. Scleroderma (choice D) is a connective tissue disorder that does not directly affect sensory perception on the face.

Question 2 of 5

When a light is directed across the iris of the eye from the temporal side, the examiner is assessing for:

Correct Answer: C

Rationale: The correct answer is C: the presence of shadows, which may indicate glaucoma. When a light is directed across the iris from the temporal side, it helps in evaluating the presence of shadows in the anterior chamber angle, which can suggest a narrow or closed angle glaucoma. This technique is known as transillumination test and is important in detecting potential glaucoma cases. A: Drainage from dacryocystitis is incorrect as it is typically assessed by pressing on the lacrimal sac area to observe for discharge. B: Conjunctivitis over the iris is incorrect as conjunctivitis is an inflammation of the conjunctiva, not the iris. D: A scattered light reflex indicative of cataracts is incorrect as cataracts cause clouding of the lens, not scattering of light across the iris.

Question 3 of 5

During the assessment of a 20-year-old patient with a 3-day history of nausea and vomiting, the nurse notes the following: dry mucosa and deep fissures in the tongue. This finding is indicative of:

Correct Answer: A

Rationale: The dry mucosa and deep fissures in the tongue indicate dehydration in the patient. Dehydration causes decreased saliva production, leading to dry mouth and tongue fissures. This is a common symptom of dehydration. The lack of moisture in the oral cavity can result in these physical signs. The other choices are incorrect because irritation by gastric juices typically presents with other symptoms, a normal oral condition would not show these specific findings, and side effects of nausea medication would not directly cause dry mucosa and deep fissures in the tongue. Therefore, the correct answer is A: dehydration.

Question 4 of 5

A 45-year-old farmer comes in for skin evaluation and complains of hair loss. He has noticed that the hair on his head seems to be breaking off in patches and that there is some scaling on his scalp. The nurse would begin the examination suspecting:

Correct Answer: A

Rationale: The correct answer is A: tinea capitis. Tinea capitis is a fungal infection of the scalp that can cause hair loss, scaling, and breakage of hair. In this case, the patient's symptoms of hair loss, patchy hair breakage, and scaling on the scalp are consistent with tinea capitis. The nurse should suspect tinea capitis based on the presentation of these specific symptoms in the patient. Summary: - B: tinea corporis is a fungal infection of the skin, not the scalp, so it is not the most likely cause of the patient's symptoms. - C: toxic alopecia refers to hair loss due to exposure to toxins, which is unlikely in this case based on the symptoms described. - D: seborrheic dermatitis is a common skin condition that causes redness, scaly patches, and dandruff on the scalp, but it does not typically cause hair loss in the same way as tinea capitis

Question 5 of 5

While performing a mouth assessment on a patient, the nurse notices a 1-cm ulceration that is crusted and has an elevated border. It is located on the outer third of the lower lip. What other information would be most important for the nurse to obtain?

Correct Answer: B

Rationale: The correct answer is B: When the patient first noticed the lesion. This information is crucial for determining the duration of the ulceration, aiding in diagnosing potential causes like trauma or infections. Nutritional status (Choice A) may not be directly related to the specific lesion. Whether the patient has had a recent cold (Choice C) is less relevant unless there are other symptoms present. Exposure to sick animals (Choice D) is not pertinent to the mouth ulceration. Therefore, obtaining information on when the patient first noticed the lesion is the most important for proper assessment and treatment planning.

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