Chapter 11: Head and Neck
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which cranial nerves innervate the face?
a. II and V
b. III and VI
c. V and VII
d. VIII and IX
ANS: C
Facial nerves are controlled by cranial nerves V and VII; cranial nerves II, III, and VI control the
eyes, cranial nerve VIII deals
with hearing, and cranial nerve IX deals with swallowing.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly
into adolescence. Which structures disproportionately enlarge in the male during adolescence?
a. Coronal sutures
b. Hyoid and cricoid cartilages
c. Mandible and maxilla bones
d. Nose and thyroid cartilages
ANS: D
In adolescent males, the nose enlarges and the thyroid cartilage becomes the largest component
of the anterior larynx, known as the Adam’s apple.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Which of the following is an expected change in the assessment of the thyroid during
pregnancy?
a. Palpation of the gland becomes difficult.
b. A bruit is auscultated.
c. Inspection reveals a goiter.
d. The gland is tender on palpation.
ANS: B
During pregnancy, the thyroid gland hypertrophies (not to the point of a goiter), palpation is
easier and, because the gland also has increased vascularity, bruits are common. It is an abnormal
finding for the thyroid to feel fibrotic, tender, or smaller.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On
examination, you noted a bruit heard over the thyroid. This is suggestive of:
a. hypothyroidism.
b. hyperthyroidism.
c. thyroid cancer.
d. thyroid cyst.
ANS: B
Because of hypermetabolic states such as hyperthyroidism, a bruit may be heard as a result of the
increased blood flow to the area.
Auscultating a bruit is not symptomatic of hypothyroidism, cancer, or a cyst. A nodule is more
indicative of cancer.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Ms. Galvan is a 22-year-old secretary who comes to the clinic with headaches of 6 weeks’
duration. She tells the office assistant
about her heavy schedule, including part-time work and evening classes. Her vital signs are
normal. Which information is most
appropriate to Ms. Galvan’s history?
a. Current medications
b. Elimination patterns
c. Immunization status
d. Previous pregnancies
ANS: A
Some current medications, such as birth control pills, nitroglycerin, antihypertensives,
antiseizure drugs, and some diabetic drugs, can be headache triggers. Withdrawal of headache
medication can also trigger headaches.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Observation during history taking is the best way to examine for:
a. head position.
b. scalp lice.
c. thyroid size.
d. tracheal alignment.
ANS: A
Head position as well as facial features is best observed when talking to the patient during the
history. Scalp lice, thyroid size, and
tracheal alignment are best assessed by palpation and closer physical observation.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. During a head and neck assessment of a neonate, it is important to screen for:
a. the presence of torticollis.
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which cranial nerves innervate the face?
a. II and V
b. III and VI
c. V and VII
d. VIII and IX
ANS: C
Facial nerves are controlled by cranial nerves V and VII; cranial nerves II, III, and VI control the
eyes, cranial nerve VIII deals
with hearing, and cranial nerve IX deals with swallowing.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly
into adolescence. Which structures disproportionately enlarge in the male during adolescence?
a. Coronal sutures
b. Hyoid and cricoid cartilages
c. Mandible and maxilla bones
d. Nose and thyroid cartilages
ANS: D
In adolescent males, the nose enlarges and the thyroid cartilage becomes the largest component
of the anterior larynx, known as the Adam’s apple.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Which of the following is an expected change in the assessment of the thyroid during
pregnancy?
a. Palpation of the gland becomes difficult.
b. A bruit is auscultated.
c. Inspection reveals a goiter.
d. The gland is tender on palpation.
ANS: B
During pregnancy, the thyroid gland hypertrophies (not to the point of a goiter), palpation is
easier and, because the gland also has increased vascularity, bruits are common. It is an abnormal
finding for the thyroid to feel fibrotic, tender, or smaller.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On
examination, you noted a bruit heard over the thyroid. This is suggestive of:
a. hypothyroidism.
b. hyperthyroidism.
c. thyroid cancer.
d. thyroid cyst.
ANS: B
Because of hypermetabolic states such as hyperthyroidism, a bruit may be heard as a result of the
increased blood flow to the area.
Auscultating a bruit is not symptomatic of hypothyroidism, cancer, or a cyst. A nodule is more
indicative of cancer.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Ms. Galvan is a 22-year-old secretary who comes to the clinic with headaches of 6 weeks’
duration. She tells the office assistant
about her heavy schedule, including part-time work and evening classes. Her vital signs are
normal. Which information is most
appropriate to Ms. Galvan’s history?
a. Current medications
b. Elimination patterns
c. Immunization status
d. Previous pregnancies
ANS: A
Some current medications, such as birth control pills, nitroglycerin, antihypertensives,
antiseizure drugs, and some diabetic drugs, can be headache triggers. Withdrawal of headache
medication can also trigger headaches.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Observation during history taking is the best way to examine for:
a. head position.
b. scalp lice.
c. thyroid size.
d. tracheal alignment.
ANS: A
Head position as well as facial features is best observed when talking to the patient during the
history. Scalp lice, thyroid size, and
tracheal alignment are best assessed by palpation and closer physical observation.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. During a head and neck assessment of a neonate, it is important to screen for:
a. the presence of torticollis.
