CH 10 Head & Neck PrepU

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A client describes headaches as severe and lasting for days. Which question would be most appropriate to use to determine if these headaches are migraines? A. "When you consume alcohol, do you get a headache?" B. "Do they occur after you have been tense or anxious?" C. "Do you have any eye symptoms, such as tearing?" D. "Do you have any visual changes before the headache?"

"Do you have any visual changes before the headache?"

A nurse is palpating the head and neck of a newly referred client. Which of the following would the nurse suspect if assessment reveals that the client's skull and facial bones are larger and thicker than normal? A. Paget disease B. Acromegaly C. Brain tumor D. Parkinson disease

Acromegaly

The nurse practitioner notes that the thyroid gland is enlarged and auscultates both lobes of the thyroid. For what is the nurse practitioner listening? A. Rush B. Gurgle C. Murmur D. Bruit

Bruit

The nurse is palpating a client's cervical vertebrae. Which vertebra can be easily palpated when the neck is flexed and should help the nurse locate the other vertebrae? A. C3 B. C7 C. C5 D. C1

C7

Which vessel is the nurse assessing if the major artery of the neck is being examined? A. Jugular B. Temporal C. Radial D. Carotid

Carotid

A client presents to the health care clinic with reports of a stiff neck for the past 3 days. What objective information can the nurse obtain during the health history using inspection? A. Range of motion B. Thyroid size C. Neck tenderness D. Head position

Head position

A client presents at the clinic for a routine check-up. The nurse notes that she is dressed in warm clothing even though the temperature outside is 73°F. The nurse also notes that the patient has gained 10 pounds since her last visit 9 months ago. What might the nurse suspect? A. Effects of age-related changes B. Hypothyroidism C. Hyperthyroidism D. Brain tumor

Hypothyroidism

During your physical examination of the patient you note an enlarged tender tonsillar lymph node. What would you do? A. Look for a source such as infection in the area that it drains B. Assess for dietary changes C. Look for involvement of other regions of the body D. Assess for meningitis

Look for a source such as infection in the area that it drains

What finding upon assessment would indicate the client is experiencing shock? A. Temperature 99.5 F B. Heart rate 100 C. Systolic blood pressure 50 D. Respiratory rate 24

Systolic blood pressure 50

Which of the following would the nurse document as an abnormal finding with lymph node assessment? A. Mobile B. Discrete C. Tender D. Diameter: 0.75 cm

Tender

A client complains of a headache over both temporal areas. What type of headache should the nurse suspect the client is experiencing? A. tension B. hypertensive C. migraine D. cluster

tension

The nurse is discharging an adult client who received 18 staples for a head laceration received while mountain biking. What can the nurse focus on while doing discharge teaching? A. Teach proper posture, bending, and lifting B. Encourage the use of safety equipment C. Encourage the client to take a safety course D. Encourage proper nutrition to promote healing

Encourage the use of safety equipment

A nurse is caring for a patient admitted with neck pain. The patient is febrile. What is the most likely medical diagnosis for this patient? A. Meningitis B. Migraine C. Measles D. Cervical fracture

Meningitis

A 38-year-old accountant comes to the clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region, and is an 8 on a pain scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the-counter analgesic, which results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? Tension Migraine Analgesic rebound Cluster

Migraine

Which risk factor for traumatic brain injury (TBI) should a nurse include in a discussion about prevention for a group of adolescents? A. Females have twice the risk that males do. B. Concussions in sports and motor vehicle accidents cause the largest number of TBIs in teens. C. Falls occur more frequently in the younger population. D. Most firearm incidents are accidental.

Concussions in sports and motor vehicle accidents cause the largest number of TBIs in teens.

A client visits the clinic and tells the nurse that he is depressed because of a recent job loss. He complains of dull, aching, tight, and diffuse headaches that have lasted for several days. The nurse should recognize that these are symptoms of A. tension headaches. B. cluster headaches. C. tumor-related headaches. D. migraine headaches.

tension headaches


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