health assessment practice questions nursing

Correct Answer: C

Rationale: The correct answer is C because purpura is characterized by the presence of confluent and extensive patches of petechiae and ecchymoses. Petechiae are small, pinpoint hemorrhages less than 2mm in size, and ecchymoses are larger bruises. This presentation is indicative of a more severe underlying condition, such as a bleeding disorder or vasculitis. Choice A is incorrect as it describes spider veins or telangiectasias, not purpura. Choice B describes a birthmark, not purpura. Choice D is incorrect as it describes petechiae, not purpura, which involves larger areas of bleeding.

Correct Answer: A

Rationale: Visual accommodation refers to the ability of the eye to adjust focus when shifting gaze between objects at different distances. The correct answer is A, pupillary constriction when looking at a near object, as this is a key component of visual accommodation. When looking at a near object, the eye needs to adjust its focus by constricting the pupil to allow more depth of field and clearer vision. This process helps in bringing near objects into focus. Choices B, C, and D are incorrect: B: Pupillary dilation when looking at a far object is not related to visual accommodation, as the pupil dilates in low light conditions to allow more light to enter the eye. C: Changes in peripheral vision in response to light is not related to visual accommodation, as peripheral vision refers to the ability to see objects outside the direct line of sight. D: Involuntary blinking in the presence of bright light is a protective reflex to shield the eyes from excessive light and is not directly related to visual

Correct Answer: D

Rationale: The correct answer is D because it provides an accurate explanation for the frequent ear infections in the 2-year-old. The eustachian tube in children is indeed shorter and wider compared to adults, making it easier for infections to develop. This anatomical difference predisposes young children to ear infections. Choice A is incorrect because it falsely implies that frequent ear infections in small children are unusual only if something else is wrong. Choice B is incorrect as checking the immune system is not typically the first step in addressing recurrent ear infections. Choice C is incorrect as cerumen (earwax) does not directly contribute to ear infections in the middle ear.

Correct Answer: C

Rationale: The correct answer is C because testing for color vision once between the ages of 4 and 8 is appropriate to assess any potential color vision deficiencies. This age range is crucial as color vision development is mostly completed by the age of 8. Annual checks (A) are not necessary unless there are specific concerns. Asking the child to identify clothing color (B) may not be a reliable indicator of color vision deficiency. No information is provided for option D.

Correct Answer: B

Rationale: The correct answer is B: Lyme disease. The presentation of a red circular rash with central clearing, known as erythema migrans, following a hiking trip in the summer is highly indicative of Lyme disease. The specific distribution of the rash across the midriff and behind the knees aligns with typical areas where the rash appears in Lyme disease cases. This rash is a hallmark sign of early Lyme disease caused by the bacterium Borrelia burgdorferi transmitted through the bite of an infected tick. Other answer choices are incorrect because rubeola presents with a different rash pattern, an allergy to mosquito bites would not typically present in this manner, and Rocky Mountain spotted fever typically presents with a different rash appearance and distribution.