Health Assessment ch. 15

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the nurse is preparing to perform a head and neck assessment of an adult client who has immigrated to the US from cambodia. The nurse should first:

Ask if its okay to touch his head

while assessing an adult clients skul, the nurse observes that the clients skull and facial bones are larger and thicker than usual

acromegaly

the nurse is planning to assess an adult clients thyroid gland. The nurse should plan too

approach the client posteriorly

an adult client visits the clinic and tells the nurse that she has had headaches recently that are intense and stabbing and often occur late in the evening.

cluster headaches

A client visits the outpatient center with a complaint of sudden head & neck pain and stiffness. The clients oral temp is 37.7C. The nurse suspects that the client is experiencing symptoms of:

meningeal irritation (elevated temp & head stiffness)

A female client visits the clinic and tells the nurse that she frequently experiences severe recurring headaches that sometimes last for several days and are accompanied by nausea and vomiting. The nurse determines that the type of headache the client is describing

migraine

While assessing an adult client , the nurse observes asymmetry in front of the clients ear lobes. The nurse refers the client to the physician because the nurse suspects the client is experiencing:

parotid gland enlargement

The nurse assess an adult clients head and neck. While examining the carotid arteries, the nurse assess each artery individually to prevent a:

reduction of blood supply to the brain

The nurse is preparing to assess the lymph nodes of an adult client. The nuse should instruct the client to

sit in an upright position

A client visits the clinic and tells the nurse that he is depressed because of recent job loss. He complains of dull, aching, tight and diffuse headaches

tension headaches

the nurse is preparing to assess the neck of an adult client. To inspect movement of the clients thyroid gland the nurse should ask:

the client to swallow a small sip of water

While assessing an older clients neck, the nurse observes that the clients trachea is pulled to the left side

the nurse should refer the client to the physician

While assessing the head and neck of an adult client, the client tells the nurse that she has been experiencing sharp shooting facial pains that last from 10-20 seconds but are occurring more frequently. The nurse should refer the client for possible:

trigeminal neuralgia

The daughter tells the nurse that her father has been experiencing severe headaches that usually begin in the morning and become worse when he coughs. The client tells the nurse he feels dizzy when he has the headaches.

tumor-related headaches


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