HEALTH ASSESSMENT FINAL - JARVIS
TEST BANK EXAM QUESTIONS WITH
CORRECT ANSWERS
During a well-baby checkup, a mother is concerned because her 2-month-old infant
cannot hold her head up when she is pulled to a sitting position. Which response by
the nurse is appropriate?
a. Head control is usually achieved by 4 months of age.
b. You shouldnt be trying to pull your baby up like that until she is older.
c. Head control should be achieved by this time.
d. This inability indicates possible nerve damage to the neck muscles. - Answer-A
During an examination of a 3-year-old child, the nurse notices a bruit over the left
temporal area. The nurse should:
a. Continue the examination because a bruit is a normal finding for this age.
b. Check for the bruit again in 1 hour.
c. Notify the parents that a bruit has been detected in their child.
d. Stop the examination, and notify the physician. - Answer-A
During an examination, the nurse finds that a patients left temporal artery is tortuous
and feels hardened and tender, compared with the right temporal artery. The nurse
suspects which condition?
a. Crepitation
b. Mastoiditis
c. Temporal arteritis
d. Bell palsy - Answer-C
The nurse is assessing a 1-month-old infant at his well-baby checkup. Which
assessment findings are appropriate for this age? Select all that apply.
a. Head circumference equal to chest circumference
b. Head circumference greater than chest circumference
c. Head circumference less than chest circumference
,d. Fontanels firm and slightly concave
e. Absent tonic neck reflex
f. Nonpalpable cervical lymph nodes - Answer-B, D, F
When examining the eye, the nurse notices that the patients eyelid margins
approximate completely. The nurse recognizes that this assessment finding:
a. Is expected.
b. May indicate a problem with extraocular muscles.
c. May result in problems with tearing.
d. Indicates increased intraocular pressure. - Answer-A
During ocular examinations, the nurse keeps in mind that movement of the
extraocular muscles is:
a. Decreased in the older adult.
b. Impaired in a patient with cataracts.
c. Stimulated by cranial nerves (CNs) I and II.
d. Stimulated by CNs III, IV, and VI. - Answer-D
The nurse is performing an external eye examination. Which statement regarding the
outer layer of the eye is true?
a. The outer layer of the eye is very sensitive to touch.
b. The outer layer of the eye is darkly pigmented to prevent light from reflecting
internally.
c. The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when
the outer surface of the eye is stimulated.
d. The visual receptive layer of the eye in which light waves are changed into nerve
impulses is located in the outer layer of the eye. - Answer-A
When examining a patients eyes, the nurse recalls that stimulation of the
sympathetic branch of the autonomic nervous system:
a. Causes pupillary constriction.
b. Adjusts the eye for near vision.
, c. Elevates the eyelid and dilates the pupil.
d. Causes contraction of the ciliary body. - Answer-C
The nurse is reviewing causes of increased intraocular pressure. Which of these
factors determines intraocular pressure?
a. Thickness or bulging of the lens
b. Posterior chamber as it accommodates increased fluid
c. Contraction of the ciliary body in response to the aqueous within the eye
d. Amount of aqueous produced and resistance to its outflow at the angle of the
anterior chamber - Answer-D
The nurse is conducting a visual examination. Which of these statements regarding
visual pathways and visual fields is true?
a. The right side of the brain interprets the vision for the right eye.
b. The image formed on the retina is upside down and reversed from its actual
appearance in the outside world.
c. Light rays are refracted through the transparent media of the eye before striking
the pupil.
d. Light impulses are conducted through the optic nerve to the temporal lobes of the
brain. - Answer-B
The nurse is testing a patients visual accommodation, which refers to which action?
a. Pupillary constriction when looking at a near object
b. Pupillary dilation when looking at a far object
c. Changes in peripheral vision in response to light
d. Involuntary blinking in the presence of bright light - Answer-A
A patient has a normal pupillary light reflex. The nurse recognizes that this reflex
indicates that:
a. The eyes converge to focus on the light.
b. Light is reflected at the same spot in both eyes.
c. The eye focuses the image in the center of the pupil.
d. Constriction of both pupils occurs in response to bright light. - Answer-D
TEST BANK EXAM QUESTIONS WITH
CORRECT ANSWERS
During a well-baby checkup, a mother is concerned because her 2-month-old infant
cannot hold her head up when she is pulled to a sitting position. Which response by
the nurse is appropriate?
a. Head control is usually achieved by 4 months of age.
b. You shouldnt be trying to pull your baby up like that until she is older.
c. Head control should be achieved by this time.
d. This inability indicates possible nerve damage to the neck muscles. - Answer-A
During an examination of a 3-year-old child, the nurse notices a bruit over the left
temporal area. The nurse should:
a. Continue the examination because a bruit is a normal finding for this age.
b. Check for the bruit again in 1 hour.
c. Notify the parents that a bruit has been detected in their child.
d. Stop the examination, and notify the physician. - Answer-A
During an examination, the nurse finds that a patients left temporal artery is tortuous
and feels hardened and tender, compared with the right temporal artery. The nurse
suspects which condition?
a. Crepitation
b. Mastoiditis
c. Temporal arteritis
d. Bell palsy - Answer-C
The nurse is assessing a 1-month-old infant at his well-baby checkup. Which
assessment findings are appropriate for this age? Select all that apply.
a. Head circumference equal to chest circumference
b. Head circumference greater than chest circumference
c. Head circumference less than chest circumference
,d. Fontanels firm and slightly concave
e. Absent tonic neck reflex
f. Nonpalpable cervical lymph nodes - Answer-B, D, F
When examining the eye, the nurse notices that the patients eyelid margins
approximate completely. The nurse recognizes that this assessment finding:
a. Is expected.
b. May indicate a problem with extraocular muscles.
c. May result in problems with tearing.
d. Indicates increased intraocular pressure. - Answer-A
During ocular examinations, the nurse keeps in mind that movement of the
extraocular muscles is:
a. Decreased in the older adult.
b. Impaired in a patient with cataracts.
c. Stimulated by cranial nerves (CNs) I and II.
d. Stimulated by CNs III, IV, and VI. - Answer-D
The nurse is performing an external eye examination. Which statement regarding the
outer layer of the eye is true?
a. The outer layer of the eye is very sensitive to touch.
b. The outer layer of the eye is darkly pigmented to prevent light from reflecting
internally.
c. The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when
the outer surface of the eye is stimulated.
d. The visual receptive layer of the eye in which light waves are changed into nerve
impulses is located in the outer layer of the eye. - Answer-A
When examining a patients eyes, the nurse recalls that stimulation of the
sympathetic branch of the autonomic nervous system:
a. Causes pupillary constriction.
b. Adjusts the eye for near vision.
, c. Elevates the eyelid and dilates the pupil.
d. Causes contraction of the ciliary body. - Answer-C
The nurse is reviewing causes of increased intraocular pressure. Which of these
factors determines intraocular pressure?
a. Thickness or bulging of the lens
b. Posterior chamber as it accommodates increased fluid
c. Contraction of the ciliary body in response to the aqueous within the eye
d. Amount of aqueous produced and resistance to its outflow at the angle of the
anterior chamber - Answer-D
The nurse is conducting a visual examination. Which of these statements regarding
visual pathways and visual fields is true?
a. The right side of the brain interprets the vision for the right eye.
b. The image formed on the retina is upside down and reversed from its actual
appearance in the outside world.
c. Light rays are refracted through the transparent media of the eye before striking
the pupil.
d. Light impulses are conducted through the optic nerve to the temporal lobes of the
brain. - Answer-B
The nurse is testing a patients visual accommodation, which refers to which action?
a. Pupillary constriction when looking at a near object
b. Pupillary dilation when looking at a far object
c. Changes in peripheral vision in response to light
d. Involuntary blinking in the presence of bright light - Answer-A
A patient has a normal pupillary light reflex. The nurse recognizes that this reflex
indicates that:
a. The eyes converge to focus on the light.
b. Light is reflected at the same spot in both eyes.
c. The eye focuses the image in the center of the pupil.
d. Constriction of both pupils occurs in response to bright light. - Answer-D