Chapter 14: Head, Face, Neck, and
Regional Lymphatics
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. A physician tells the nurse that a patients vertebra prominens is tender and asks the nurse
to reevaluate the area in 1 hour. The area of the body the nurse will assess is:
a. Just above the diaphragm.
b. Just lateral to the knee cap.
c. At the level of the C7 vertebra.
d. At the level of the T11 vertebra.
ANS: C
The C7 vertebra has a long spinous process, called the vertebra prominens, which
is palpable when the head is flexed.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
2. A mother brings her 2-month-old daughter in for an examination and says, My daughter
rolled over against the wall, and now I have noticed that she has this spot that is soft on
the top of her head. Is something terribly wrong? The nurses best response would be:
a. Perhaps that could be a result of your dietary intake during pregnancy.
b. Your baby may have craniosynostosis, a disease of the sutures of the brain.
c. That soft spot may be an indication of cretinism or congenital hypothyroidism.
d. That soft spot is normal, and actually allows for growth of the brain during the
first year of your babys life.
ANS: D
Membrane-covered soft spots allow for growth of the brain during the first year of
life. They gradually ossify; the triangular-shaped posterior fontanel is closed by 1
to 2 months, and the diamond-shaped anterior fontanel closes between 9 months
and 2 years.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
3. The nurse notices that a patients palpebral fissures are not symmetric. On examination,
the nurse may find that damage has occurred to which cranial nerve (CN)?
a. III
, b. V
c. VII
d. VIII
ANS: C
Facial muscles are mediated by CN VII; asymmetry of palpebral fissures may be
attributable to damage to CN VII (Bell palsy).
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. A patient is unable to differentiate between sharp and dull stimulation to both sides of her
face. The nurse suspects:
a. Bell palsy.
b. Damage to the trigeminal nerve.
c. Frostbite with resultant paresthesia to the cheeks.
d. Scleroderma.
ANS: B
Facial sensations of pain or touch are mediated by CN V, which is the trigeminal
nerve. Bell palsy is associated with CN VII damage. Frostbite and scleroderma are
not associated with this problem.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. When examining the face of a patient, the nurse is aware that the two pairs of salivary
glands that are accessible to examinationare the and glands.
a. Occipital; submental
b. Parotid; jugulodigastric
c. Parotid; submandibular
d. Submandibular; occipital
ANS: C
Two pairs of salivary glands accessible to examination on the face are the parotid
glands, which are in the cheeks over the mandible, anterior to and below the ear;
and the submandibular glands, which are beneath the mandible at the angle of the
jaw. The parotid glands are normally nonpalpable.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn
her head. The nurse suspects damageto CN and proceeds with the examination by
.
a. XI; palpating the anterior and posterior triangles
b. XI; asking the patient to shrug her shoulders against resistance
Regional Lymphatics
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. A physician tells the nurse that a patients vertebra prominens is tender and asks the nurse
to reevaluate the area in 1 hour. The area of the body the nurse will assess is:
a. Just above the diaphragm.
b. Just lateral to the knee cap.
c. At the level of the C7 vertebra.
d. At the level of the T11 vertebra.
ANS: C
The C7 vertebra has a long spinous process, called the vertebra prominens, which
is palpable when the head is flexed.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
2. A mother brings her 2-month-old daughter in for an examination and says, My daughter
rolled over against the wall, and now I have noticed that she has this spot that is soft on
the top of her head. Is something terribly wrong? The nurses best response would be:
a. Perhaps that could be a result of your dietary intake during pregnancy.
b. Your baby may have craniosynostosis, a disease of the sutures of the brain.
c. That soft spot may be an indication of cretinism or congenital hypothyroidism.
d. That soft spot is normal, and actually allows for growth of the brain during the
first year of your babys life.
ANS: D
Membrane-covered soft spots allow for growth of the brain during the first year of
life. They gradually ossify; the triangular-shaped posterior fontanel is closed by 1
to 2 months, and the diamond-shaped anterior fontanel closes between 9 months
and 2 years.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance
3. The nurse notices that a patients palpebral fissures are not symmetric. On examination,
the nurse may find that damage has occurred to which cranial nerve (CN)?
a. III
, b. V
c. VII
d. VIII
ANS: C
Facial muscles are mediated by CN VII; asymmetry of palpebral fissures may be
attributable to damage to CN VII (Bell palsy).
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
4. A patient is unable to differentiate between sharp and dull stimulation to both sides of her
face. The nurse suspects:
a. Bell palsy.
b. Damage to the trigeminal nerve.
c. Frostbite with resultant paresthesia to the cheeks.
d. Scleroderma.
ANS: B
Facial sensations of pain or touch are mediated by CN V, which is the trigeminal
nerve. Bell palsy is associated with CN VII damage. Frostbite and scleroderma are
not associated with this problem.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. When examining the face of a patient, the nurse is aware that the two pairs of salivary
glands that are accessible to examinationare the and glands.
a. Occipital; submental
b. Parotid; jugulodigastric
c. Parotid; submandibular
d. Submandibular; occipital
ANS: C
Two pairs of salivary glands accessible to examination on the face are the parotid
glands, which are in the cheeks over the mandible, anterior to and below the ear;
and the submandibular glands, which are beneath the mandible at the angle of the
jaw. The parotid glands are normally nonpalpable.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn
her head. The nurse suspects damageto CN and proceeds with the examination by
.
a. XI; palpating the anterior and posterior triangles
b. XI; asking the patient to shrug her shoulders against resistance
