nclex practice questions 2023 health assessment

Correct Answer: D

Rationale: The presence of black and white dots on the tympanic membrane and ear canal wall during an otoscopic examination suggests a yeast or fungal infection. This is because yeast or fungal infections commonly present as white or black dots in the ear canal. Malignancy would typically manifest as abnormal growths or masses, not dots. Viral infections usually do not present as specific dots on the tympanic membrane. Blood in the middle ear would appear as red or pinkish fluid behind the eardrum, not as black and white dots. Therefore, the correct answer is D: Yeast or fungal infection.

Correct Answer: A

Rationale: The correct answer is A: parotid gland. This gland is located in the cheek in front of the ear. It is the largest salivary gland in the human body. The parotid gland secretes saliva into the mouth through Stenson's duct. The other choices are incorrect because Stenson's gland does not exist, the sublingual gland is located under the tongue, and the submandibular gland is located under the mandible. Therefore, the parotid gland is the only gland that fits the description given in the question.

Correct Answer: C

Rationale: The correct answer is C: Pull the pinna up and back before inserting the speculum. This is because pulling the pinna up and back straightens the auditory canal, allowing for easier and more accurate insertion of the speculum without causing discomfort or injury. Option A is incorrect as tilting the head forward may obstruct the view. Option B is incorrect as maintaining traction is essential for stability. Option D is incorrect as using the smallest speculum may not provide a clear view or proper insertion depth.

Correct Answer: A

Rationale: The correct answer is A: clumped. Acutely infected lymph nodes typically present as clumped due to inflammation and enlargement of multiple nodes in close proximity. This clustering is a result of the immune response to the infection. Choice B: unilateral is incorrect as lymphadenopathy in acute infection can be unilateral or bilateral. Choice C: firm but freely movable is incorrect as acutely infected lymph nodes are usually tender and may not be freely movable due to inflammation. Choice D: hard and nontender is incorrect as acutely infected lymph nodes are usually tender and may not be hard.

Correct Answer: B

Rationale: The correct answer is B: parotid gland. The parotid gland is located in front of the ear lobe, and swelling below the angle of the jaw is a common sign of parotid gland inflammation. The tenderness and increasing size of the spot also point towards a parotid gland issue. The other choices, such as thyroid gland (A), occipital lymph node (C), and submental lymph node (D), are incorrect as they are not typically associated with the specific symptoms described by the patient. It is essential to consider the location and function of each structure to arrive at the correct diagnosis.