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NR302 / NR 302: NURSING SKILL – HEAD-TO-CHEST
ASSESSMENT Latest | Comprehensive Expert
Strategies, Key Quiz Review & Practice Questions Chamberlain
College of Nursing – Guaranteed Success
SECTION 1: HEAD, FACE & NECK ASSESSMENT (Questions 1–20)
Question 1
When inspecting the head and face, which finding is considered ABNORMAL and
requires further investigation?
A) Symmetrical facial features
B) Asymmetry of the nasolabial folds at rest
C) Slightly raised eyebrows
D) Smooth forehead without lesions
E) Symmetrical palpebral fissures
CORRECT ANSWER : B) Asymmetry of the nasolabial folds at rest
RATIONALE:
Facial asymmetry, especially flattening of the nasolabial fold on one side, may
indicate a neurological deficit such as Bell’s palsy or a cerebrovascular accident
(stroke). Symmetrical features, smooth forehead, and symmetrical eyes are
normal findings. The nurse should assess CN VII (Facial) by asking the patient to
smile, frown, and close eyes tightly.
Question 2
The nurse is palpating a patient’s lymph nodes. Which characteristic is consistent
with an acute infection?
A) Hard, fixed, non-tender nodes
B) Soft, mobile, tender nodes
pg. 1
,2
C) Rubbery, matted nodes
D) Non-palpable nodes
E) Hard, non-tender nodes >2 cm
CORRECT ANSWER : B) Soft, mobile, tender nodes
RATIONALE:
Acutely infected lymph nodes are typically enlarged, soft or firm, mobile, and
tender due to inflammation. Hard, fixed, non-tender nodes suggest malignancy.
Rubbery, matted nodes may indicate chronic infection (e.g., tuberculosis) or
lymphoma.
Question 3
The nurse palpates a patient’s thyroid gland using a posterior approach. The gland
feels enlarged and nodular. What is the NEXT appropriate action?
A) Document as a normal variant
B) Reassure the patient that thyroid nodules are always benign
C) Notify the healthcare provider and prepare for further evaluation (e.g.,
ultrasound)
D) Apply pressure to the gland to reduce size
E) Ask the patient to cough forcefully
CORRECT ANSWER : C) Notify the healthcare provider and prepare for further
evaluation (e.g., ultrasound)
RATIONALE:
An enlarged, nodular thyroid is an abnormal finding that requires further
investigation to rule out malignancy, goiter, or thyroiditis. The nurse should notify
the provider and anticipate diagnostic tests such as ultrasound, thyroid function
tests, or biopsy. It should not be documented as normal.
Question 4
A nurse is assessing a patient with hyperthyroidism. Which finding is MOST likely
during inspection of the face and neck?
pg. 2
,3
A) Periorbital edema and puffy face
B) Exophthalmos (protruding eyes) and fine hair
C) Moon face and buffalo hump
D) Dry, coarse skin and thinning eyebrows
E) Mask-like facies with decreased blinking
CORRECT ANSWER : B) Exophthalmos (protruding eyes) and fine hair
RATIONALE:
Hyperthyroidism (Graves’ disease) presents with exophthalmos (protrusion of the
eyeballs), fine, silky hair, and a goiter (enlarged thyroid). Hypothyroidism presents
with periorbital edema, coarse hair, and loss of the outer third of the eyebrows.
Cushing’s syndrome presents with moon face and buffalo hump. Parkinson’s
disease presents with mask-like facies.
Question 5
The nurse is palpating the temporomandibular joint (TMJ). Which finding is
considered ABNORMAL?
A) Smooth, silent jaw movement with mouth opening 3–6 cm
B) Clicking, popping, or crepitus with jaw movement
C) Slight discomfort on palpation with full range of motion
D) Symmetrical jaw movement without deviation
E) Ability to move jaw laterally and protrude without pain
CORRECT ANSWER : B) Clicking, popping, or crepitus with jaw movement
RATIONALE:
Clicking, popping, or crepitus during TMJ movement suggests temporomandibular
joint dysfunction (TMD). Normal TMJ function is smooth, silent, and painless, with
an opening width of 3–6 cm (approximately three finger widths). Pain, limited
movement, and locking are also abnormal.
Question 6
A nurse is inspecting a patient’s trachea. The trachea is deviated to the left. This
finding is MOST consistent with:
pg. 3
, 4
A) A right-sided tension pneumothorax
B) Left-sided atelectasis
C) Normal tracheal position
D) Aortic aneurysm
E) Mediastinal mass
CORRECT ANSWER : B) Left-sided atelectasis
RATIONALE:
Tracheal deviation TOWARD the affected side occurs with atelectasis (lung
collapse) or fibrosis, which pull the trachea toward the affected lung. Deviation
AWAY from the affected side occurs with tension pneumothorax, large pleural
effusion, or mediastinal mass, which push the trachea away. A right-sided tension
pneumothorax would push the trachea to the LEFT, but the question asks for
trachea deviated to the LEFT; the matching condition is left-sided atelectasis
pulling the trachea toward the left.
Note: The phrasing is critical: trachea deviated to the left could be caused by left
lung collapse or right-sided tension pneumothorax. The question does not specify
which lung is affected, but left-sided atelectasis pulls the trachea left. Right
tension pneumothorax pushes trachea left. Both can cause leftward deviation. The
answer choices include left-sided atelectasis as the only left-sided pull. The answer
is Left-sided atelectasis.
Question 7
When inspecting the neck, the nurse notes the thyroid gland moves upward when
the patient swallows. This is:
A) An abnormal finding suggesting goiter
B) A normal finding because the thyroid is attached to the trachea
C) Indicative of thyroid cancer
D) A sign of hyperthyroidism
E) A sign of hypothyroidism
CORRECT ANSWER : B) A normal finding because the thyroid is attached to the
trachea
pg. 4
NR302 / NR 302: NURSING SKILL – HEAD-TO-CHEST
ASSESSMENT Latest | Comprehensive Expert
Strategies, Key Quiz Review & Practice Questions Chamberlain
College of Nursing – Guaranteed Success
SECTION 1: HEAD, FACE & NECK ASSESSMENT (Questions 1–20)
Question 1
When inspecting the head and face, which finding is considered ABNORMAL and
requires further investigation?
A) Symmetrical facial features
B) Asymmetry of the nasolabial folds at rest
C) Slightly raised eyebrows
D) Smooth forehead without lesions
E) Symmetrical palpebral fissures
CORRECT ANSWER : B) Asymmetry of the nasolabial folds at rest
RATIONALE:
Facial asymmetry, especially flattening of the nasolabial fold on one side, may
indicate a neurological deficit such as Bell’s palsy or a cerebrovascular accident
(stroke). Symmetrical features, smooth forehead, and symmetrical eyes are
normal findings. The nurse should assess CN VII (Facial) by asking the patient to
smile, frown, and close eyes tightly.
Question 2
The nurse is palpating a patient’s lymph nodes. Which characteristic is consistent
with an acute infection?
A) Hard, fixed, non-tender nodes
B) Soft, mobile, tender nodes
pg. 1
,2
C) Rubbery, matted nodes
D) Non-palpable nodes
E) Hard, non-tender nodes >2 cm
CORRECT ANSWER : B) Soft, mobile, tender nodes
RATIONALE:
Acutely infected lymph nodes are typically enlarged, soft or firm, mobile, and
tender due to inflammation. Hard, fixed, non-tender nodes suggest malignancy.
Rubbery, matted nodes may indicate chronic infection (e.g., tuberculosis) or
lymphoma.
Question 3
The nurse palpates a patient’s thyroid gland using a posterior approach. The gland
feels enlarged and nodular. What is the NEXT appropriate action?
A) Document as a normal variant
B) Reassure the patient that thyroid nodules are always benign
C) Notify the healthcare provider and prepare for further evaluation (e.g.,
ultrasound)
D) Apply pressure to the gland to reduce size
E) Ask the patient to cough forcefully
CORRECT ANSWER : C) Notify the healthcare provider and prepare for further
evaluation (e.g., ultrasound)
RATIONALE:
An enlarged, nodular thyroid is an abnormal finding that requires further
investigation to rule out malignancy, goiter, or thyroiditis. The nurse should notify
the provider and anticipate diagnostic tests such as ultrasound, thyroid function
tests, or biopsy. It should not be documented as normal.
Question 4
A nurse is assessing a patient with hyperthyroidism. Which finding is MOST likely
during inspection of the face and neck?
pg. 2
,3
A) Periorbital edema and puffy face
B) Exophthalmos (protruding eyes) and fine hair
C) Moon face and buffalo hump
D) Dry, coarse skin and thinning eyebrows
E) Mask-like facies with decreased blinking
CORRECT ANSWER : B) Exophthalmos (protruding eyes) and fine hair
RATIONALE:
Hyperthyroidism (Graves’ disease) presents with exophthalmos (protrusion of the
eyeballs), fine, silky hair, and a goiter (enlarged thyroid). Hypothyroidism presents
with periorbital edema, coarse hair, and loss of the outer third of the eyebrows.
Cushing’s syndrome presents with moon face and buffalo hump. Parkinson’s
disease presents with mask-like facies.
Question 5
The nurse is palpating the temporomandibular joint (TMJ). Which finding is
considered ABNORMAL?
A) Smooth, silent jaw movement with mouth opening 3–6 cm
B) Clicking, popping, or crepitus with jaw movement
C) Slight discomfort on palpation with full range of motion
D) Symmetrical jaw movement without deviation
E) Ability to move jaw laterally and protrude without pain
CORRECT ANSWER : B) Clicking, popping, or crepitus with jaw movement
RATIONALE:
Clicking, popping, or crepitus during TMJ movement suggests temporomandibular
joint dysfunction (TMD). Normal TMJ function is smooth, silent, and painless, with
an opening width of 3–6 cm (approximately three finger widths). Pain, limited
movement, and locking are also abnormal.
Question 6
A nurse is inspecting a patient’s trachea. The trachea is deviated to the left. This
finding is MOST consistent with:
pg. 3
, 4
A) A right-sided tension pneumothorax
B) Left-sided atelectasis
C) Normal tracheal position
D) Aortic aneurysm
E) Mediastinal mass
CORRECT ANSWER : B) Left-sided atelectasis
RATIONALE:
Tracheal deviation TOWARD the affected side occurs with atelectasis (lung
collapse) or fibrosis, which pull the trachea toward the affected lung. Deviation
AWAY from the affected side occurs with tension pneumothorax, large pleural
effusion, or mediastinal mass, which push the trachea away. A right-sided tension
pneumothorax would push the trachea to the LEFT, but the question asks for
trachea deviated to the LEFT; the matching condition is left-sided atelectasis
pulling the trachea toward the left.
Note: The phrasing is critical: trachea deviated to the left could be caused by left
lung collapse or right-sided tension pneumothorax. The question does not specify
which lung is affected, but left-sided atelectasis pulls the trachea left. Right
tension pneumothorax pushes trachea left. Both can cause leftward deviation. The
answer choices include left-sided atelectasis as the only left-sided pull. The answer
is Left-sided atelectasis.
Question 7
When inspecting the neck, the nurse notes the thyroid gland moves upward when
the patient swallows. This is:
A) An abnormal finding suggesting goiter
B) A normal finding because the thyroid is attached to the trachea
C) Indicative of thyroid cancer
D) A sign of hyperthyroidism
E) A sign of hypothyroidism
CORRECT ANSWER : B) A normal finding because the thyroid is attached to the
trachea
pg. 4
