health assessment practice questions

Correct Answer: C

Rationale: Step-by-step rationale: 1. Anisocoria is a condition where pupils are of unequal size. 2. It is typically caused by issues in the eye muscles or nerves controlling pupil size. 3. The nurse would expect to observe pupils of different sizes. 4. Dilated pupils (choice A) and excessive tearing (choice B) are not indicative of anisocoria. 5. An uneven curvature of the lens (choice D) does not directly relate to pupil size differences. Summary: Correct answer C is supported by the definition of anisocoria and its usual presentation. Choices A, B, and D are incorrect as they do not align with the characteristic feature of anisocoria.

Correct Answer: D

Rationale: The correct answer is D because floaters are a common and typically benign phenomenon caused by condensed vitreous fibers in the eye. A nurse should educate the patient that floaters are usually not significant and do not require immediate intervention. Option A is incorrect because counting the number of floaters is unnecessary. Option B is incorrect because presuming glaucoma without proper assessment is inappropriate. Option C is incorrect because seeing occasional floaters is a common and normal occurrence in many individuals.

Correct Answer: C

Rationale: The correct answer is C: bruising on the buccal mucosa or gums. This is the most relevant choice as it is a common sign of physical abuse in children. Bruising in unusual places or patterns, such as the mouth, should raise suspicion. Swollen, red tonsils (A) are more likely related to infection rather than abuse. Ulcerations on the hard palate (B) can also be due to various non-abuse related reasons. Small yellow papules along the hard palate (D) are typically harmless and not indicative of abuse. It is crucial for the nurse to recognize signs of potential abuse and take appropriate action to protect the child.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): 1. Red glow in pupils indicates a normal reflection off the inner retina known as the red reflex. 2. The red reflex helps to visualize the internal structures of the eye, including the retina. 3. This finding is expected during an ophthalmoscopic examination. 4. No abnormality is suggested by the presence of a red glow in the pupils. Summary of Other Choices: A: Incorrect. Red glow does not indicate an opacity in the lens or cornea. B: Incorrect. Checking the light source is unnecessary as red glow is a normal finding. D: Incorrect. Referral is not needed as red reflex is a normal part of an ophthalmoscopic exam.

Correct Answer: B

Rationale: The correct answer is B: This is a bifid uvula, which is a common occurrence in some Aboriginal groups. 1. A bifid uvula is a condition where the uvula is split or divided, which is a common variation seen in some Aboriginal populations. 2. Cleft palate is a different condition involving a gap in the roof of the mouth, not specifically related to Aboriginal people. 3. Uvular injury is not a common cause of a split uvula in children, so reporting to authorities is unnecessary. 4. Torus palatinus is a bony growth on the roof of the mouth and not related to a split uvula or specific to Aboriginal populations.