nclex practice questions 2023 health assessment

Correct Answer: C

Rationale: The correct answer is C because the presentation of clear vesicles with an erythematous base around them at the lip-skin border is characteristic of herpes simplex virus 1 infection, commonly known as cold sores. Given the patient's recent travel to Hawaii, exposure to the virus is likely. This infection is self-limiting and typically heals in 4 to 10 days without the need for specific treatment. Choice A is incorrect because seeing a skin specialist may not be necessary for a self-limiting viral infection. Choice B is incorrect as a biopsy is not typically indicated for a clear clinical diagnosis of herpes simplex virus infection. Choice D is incorrect as riboflavin deficiency does not present with clear vesicles and erythema at the lip-skin border.

Correct Answer: C

Rationale: The correct answer is C: Erythematous scaly patch with sharp margins in the sacral area. In patients with AIDS, this presentation is most likely indicative of a common opportunistic infection called tinea corporis. This fungal infection often presents as erythematous scaly patches with well-defined borders. The location in the sacral area is also common due to the warm and moist environment. Choice A, tinea capitis, is a fungal infection of the scalp and is not typically associated with AIDS. Choice B describes a presentation more indicative of a condition like seborrheic dermatitis rather than an AIDS-related skin manifestation. Choice D describes a presentation more typical of tinea corporis, which is not commonly seen in the axilla region in patients with AIDS.

Correct Answer: A

Rationale: The correct answer is A: sternomastoid and trapezius. CN XI, also known as the spinal accessory nerve, innervates the sternomastoid and trapezius muscles. The sternomastoid muscle is responsible for neck rotation and flexion, while the trapezius muscle is responsible for shoulder movement and stability. The other choices are incorrect because the omohyoid and sternomandibular muscles are not innervated by CN XI. The spinal accessory nerve does not innervate the omohyoid muscle, and the sternomandibular muscle is not a recognized muscle in the neck. Therefore, choices B, C, and D are incorrect.

Correct Answer: B

Rationale: The correct answer is B, loss of lens elasticity. Presbyopia is the age-related loss of near vision due to the lens becoming less flexible, making it harder to focus on close objects. With aging, the lens loses its ability to change shape, affecting near vision. Other choices are incorrect because presbyopia is primarily related to changes in the lens, not the cornea (A), adaptation to darkness (C), or distance vision abilities (D).

Correct Answer: C

Rationale: The correct answer is C because shining a light across the pupil from the side allows for both direct (ipsilateral) and consensual (contralateral) pupillary constriction to be observed. This technique helps to assess the integrity of the cranial nerves involved in the pupillary light reflex (CN II and III). Direct constriction occurs in the eye exposed to the light, while consensual constriction occurs in the opposite eye. This comprehensive assessment ensures that both pupils are responding appropriately to light stimulation, providing a more accurate evaluation of the reflex. Choice A is incorrect because inspecting for pupillary constriction from directly in front may not adequately assess for consensual constriction in the opposite eye. Choice B is incorrect as asking the patient to follow the penlight in eight directions does not specifically target the pupillary light reflex. Choice D is incorrect as it focuses on accommodation rather than the pupillary light reflex.