NSG 3160 Unit 4 Practice Questions and KEY
Multiple Choice
Identifythechoicethatbestcompletesthestatementoranswersthequestion.
____ 1. A physician tells the nurse that a patient’s vertebra prominens is tender and asks the nurse to
reevaluate the area in 1 hour. What area of the body will the nurse assess?
A. At the level of the C7 vertebra
B. At the level of the T11 vertebra
C. At the level of the L5 vertebra
D. At the level of the S3 vertebra
____ 2. A mother brings her 2-month-old daughter in for an examination and says, “My daughter rolled
against the wall, and now I have noticed that she has this spot that is soft on the top of he
something terribly wrong?” How would the nurse respond?
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 skull.”
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 baby’s life.”
____ 3. The nurse notices that a patient’s palpebral fissures are not symmetric. On examination, the nur
may find that damage has occurred to which cranial nerve (CN)?
A. V
B. VII
C. XI
D. XIII
____ 4. A patient is unable to differentiate between sharp and dull stimulation to both sides of her fac
does the nurse suspect?
A. Bell palsy
B. Scleroderma
C. Damage to the trigeminal nerve
D. Frostbite with resultant paresthesia to the cheeks
____ 5. When examining the face of a patient, what are the two pairs of salivary glands that are acce
for examination?
A. Occipital; submental
B. Parotid; submandibular
C. Submandibular; occipital
D. Sublingual; parotid
____ 6. A patient comes to the clinic reporting neck and shoulder pain and is unable to turn her head
nerve does the nurse suspect is damaged and how would the nurse proceed with the examinat
A. XII; assess for a positive Romberg sign.
B. XI; palpate the anterior and posterior triangles.
C. XI; have patient shrug their shoulders against resistance.
D. XII; percuss the sternomastoid and submandibular neck muscles.
,____ 7. When examining a patient’s CN function, what muscles would the nurse assess to assess the f
of CN XI?
A. Sternomastoid and trapezius
B. Spinal accessory and omohyoid
C. Trapezius and sternomandibular
D. Sternomandibular and spinal accessory
____ 8. A patient’s laboratory data reveal an elevated thyroxine (T4) level. What gland would the nurse
assess?
A. Thyroid
B. Parotid
C. Adrenal
D. Parathyroid
____ 9. A patient says that she has recently noticed a lump in the front of her neck below her “Ada
apple” that seems to be getting bigger. During the assessment, what finding would lead the nu
suspect that this may not be a cancerous thyroid nodule?
A. It is tender.
B. It is mobile and soft.
C. It disappears when the patient smiles.
D. It is hard and fixed to the surrounding structures.
____ 10. The nurse notices that a patient’s submental lymph nodes are enlarged. In an effort to identify
cause of the node enlargement, what would the nurse assess?
A. Infraclavicular area
B. Supraclavicular area
C. Area distal to the enlarged node
D. Area proximal to the enlarged node
____ 11. The nurse is explaining to a student nurse the four areas in the body where lymph nodes are
accessible. Which areas would the nurse include in the explanation to the student?
A. Head, breasts, groin, and abdomen
B. Arms, breasts, inguinal area, and legs
C. Head and neck, arms, breasts, and axillae
D. Head and neck, arms, inguinal area, and axillae
____ 12. A mother brings her newborn in for an assessment and asks, “Is there something wrong with
baby? His head seems so big.” Which statement is true regarding the relative proportions of th
and trunk of the newborn?
A. At birth, the head is one fifth the total length.
B. Head circumference should be greater than chest circumference at birth.
C. The head size reaches 90% of its final size when the child is 3 years old.
D. When the anterior fontanel closes at 2 months, the head will be more proportioned
to the body.
____ 13. An 85-year-old patient, is reporting that the bones in their face have become more noticeable.
explanation should the nurse give the patient?
A. Diets low in protein and high in carbohydrates may cause enhanced facial bones.
, B. Bones can become more noticeable if the person does not use a dermatologically
approved moisturizer.
C. More noticeable facial bones are probably due to a combination of factors related
to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin.
D. Facial skin becomes more elastic with age. This increased elasticity causes the skin
to be more taught, drawing attention to the facial bones.
____ 14. A patient reports excruciating headache pain on one side of their head, especially around the e
forehead, and cheek that has lasted approximately to 2 hours, occurring once or twice each
What would the nurse suspect?
A. Hypertension
B. Cluster headaches
C. Tension headaches
D. Migraine headaches
____ 15. A patient reports that while studying for an examination they began to notice a severe headach
the frontotemporal area of their head that is throbbing and is somewhat relieved when they lie
down. The patient tells the nurse that their mother also had these headaches. What would the
suspect?
A. Hypertension
B. Cluster headaches
C. Tension headaches
D. Migraine headaches
____ 16. A 19-year-old college student is brought to the emergency department with a severe headache t
he describes as, “Like nothing I’ve ever had before.” His temperature is 40°C, and he has a
neck. The nurse looks for other signs and symptoms of which problem?
A. Head injury
B. Cluster headache
C. Migraine headache
D. Meningeal inflammation
____ 17. During a well-baby checkup, the nurse notices that a 1-week-old infant’s face looks small comp
with the cranium, which seems enlarged. On further examination, the nurse also notices dilated
veins and downcast or “sunsetting” eyes. The nurse suspects which condition?
A. Craniotabes
B. Microcephaly
C. Hydrocephalus
D. Caput succedaneum
____ 18. The nurse needs to palpate the temporomandibular joint for crepitation. Where is this joint loca
A. Just below the hyoid bone and posterior to the tragus
B. Just below the vagus nerve and posterior to the mandible
C. Just below the temporal artery and anterior to the tragus
D. Just below the temporal artery and anterior to the mandible
, ____ 19. A patient has come in for an examination and states, “I have this tender area on my cheek i
my ear lobe that seems to be getting bigger. What do you think it is?” The nurse notes swe
below the angle of the jaw. What does the nurse suspect?
A. Inflammation of the thyroid gland
B. Inflammation of the parotid gland
C. Infection in the occipital lymph node
D. Infection in the submental lymph node
____ 20. A patient with a history of acquired immunodeficiency syndrome (AIDS) has come in for an
examination and states, “I think that I have the mumps.” What would the nurse examine first?
A. Thyroid gland
B. Parotid gland
C. Cervical lymph nodes
D. Mouth and skin for lesions
____ 21. The nurse suspects that a patient has hyperthyroidism, and the laboratory data indicate that the
patient’s T4 and T3 hormone levels are elevated. Which of these findings would the nurse mo
likely find on examination?
A. Dyspnea
B. Tachycardia
C. Constipation
D. Atrophied nodular thyroid gland
____ 22. A patient’s thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid gland
the presence of a bruit. What technique would the nurse use to assess for a bruit.
A. Palpate the thyroid while the patient is swallowing.
B. Auscultate the thyroid with the bell of the stethoscope.
C. Palpate the thyroid while the patient holds their breath.
D. Auscultate the thyroid with the diaphragm of the stethoscope.
____ 23. The nurse notices that an infant has a large, soft lump on the side of his head and his moth
concerned. The mother tells the nurse that she noticed the lump approximately 8 hours after h
baby’s birth and that it seems to be getting bigger. What is a possible explanation for this?
A. Hydrocephalus
B. Craniosynostosis
C. Cephalhematoma
D. Caput succedaneum
____ 24. During an admission assessment, the nurse notices that a patient has an enlarged and rather th
skull. The nurse suspects acromegaly. What additional finding would the nurse assess for to co
this suspicion?
A. Exophthalmos
B. Bowed long bones
C. Acorn-shaped cranium
D. Coarse facial features
____ 25. When examining children affected with Down syndrome (trisomy 21), what would the nurse loo
for related to this disorder?
Multiple Choice
Identifythechoicethatbestcompletesthestatementoranswersthequestion.
____ 1. A physician tells the nurse that a patient’s vertebra prominens is tender and asks the nurse to
reevaluate the area in 1 hour. What area of the body will the nurse assess?
A. At the level of the C7 vertebra
B. At the level of the T11 vertebra
C. At the level of the L5 vertebra
D. At the level of the S3 vertebra
____ 2. A mother brings her 2-month-old daughter in for an examination and says, “My daughter rolled
against the wall, and now I have noticed that she has this spot that is soft on the top of he
something terribly wrong?” How would the nurse respond?
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 skull.”
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 baby’s life.”
____ 3. The nurse notices that a patient’s palpebral fissures are not symmetric. On examination, the nur
may find that damage has occurred to which cranial nerve (CN)?
A. V
B. VII
C. XI
D. XIII
____ 4. A patient is unable to differentiate between sharp and dull stimulation to both sides of her fac
does the nurse suspect?
A. Bell palsy
B. Scleroderma
C. Damage to the trigeminal nerve
D. Frostbite with resultant paresthesia to the cheeks
____ 5. When examining the face of a patient, what are the two pairs of salivary glands that are acce
for examination?
A. Occipital; submental
B. Parotid; submandibular
C. Submandibular; occipital
D. Sublingual; parotid
____ 6. A patient comes to the clinic reporting neck and shoulder pain and is unable to turn her head
nerve does the nurse suspect is damaged and how would the nurse proceed with the examinat
A. XII; assess for a positive Romberg sign.
B. XI; palpate the anterior and posterior triangles.
C. XI; have patient shrug their shoulders against resistance.
D. XII; percuss the sternomastoid and submandibular neck muscles.
,____ 7. When examining a patient’s CN function, what muscles would the nurse assess to assess the f
of CN XI?
A. Sternomastoid and trapezius
B. Spinal accessory and omohyoid
C. Trapezius and sternomandibular
D. Sternomandibular and spinal accessory
____ 8. A patient’s laboratory data reveal an elevated thyroxine (T4) level. What gland would the nurse
assess?
A. Thyroid
B. Parotid
C. Adrenal
D. Parathyroid
____ 9. A patient says that she has recently noticed a lump in the front of her neck below her “Ada
apple” that seems to be getting bigger. During the assessment, what finding would lead the nu
suspect that this may not be a cancerous thyroid nodule?
A. It is tender.
B. It is mobile and soft.
C. It disappears when the patient smiles.
D. It is hard and fixed to the surrounding structures.
____ 10. The nurse notices that a patient’s submental lymph nodes are enlarged. In an effort to identify
cause of the node enlargement, what would the nurse assess?
A. Infraclavicular area
B. Supraclavicular area
C. Area distal to the enlarged node
D. Area proximal to the enlarged node
____ 11. The nurse is explaining to a student nurse the four areas in the body where lymph nodes are
accessible. Which areas would the nurse include in the explanation to the student?
A. Head, breasts, groin, and abdomen
B. Arms, breasts, inguinal area, and legs
C. Head and neck, arms, breasts, and axillae
D. Head and neck, arms, inguinal area, and axillae
____ 12. A mother brings her newborn in for an assessment and asks, “Is there something wrong with
baby? His head seems so big.” Which statement is true regarding the relative proportions of th
and trunk of the newborn?
A. At birth, the head is one fifth the total length.
B. Head circumference should be greater than chest circumference at birth.
C. The head size reaches 90% of its final size when the child is 3 years old.
D. When the anterior fontanel closes at 2 months, the head will be more proportioned
to the body.
____ 13. An 85-year-old patient, is reporting that the bones in their face have become more noticeable.
explanation should the nurse give the patient?
A. Diets low in protein and high in carbohydrates may cause enhanced facial bones.
, B. Bones can become more noticeable if the person does not use a dermatologically
approved moisturizer.
C. More noticeable facial bones are probably due to a combination of factors related
to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin.
D. Facial skin becomes more elastic with age. This increased elasticity causes the skin
to be more taught, drawing attention to the facial bones.
____ 14. A patient reports excruciating headache pain on one side of their head, especially around the e
forehead, and cheek that has lasted approximately to 2 hours, occurring once or twice each
What would the nurse suspect?
A. Hypertension
B. Cluster headaches
C. Tension headaches
D. Migraine headaches
____ 15. A patient reports that while studying for an examination they began to notice a severe headach
the frontotemporal area of their head that is throbbing and is somewhat relieved when they lie
down. The patient tells the nurse that their mother also had these headaches. What would the
suspect?
A. Hypertension
B. Cluster headaches
C. Tension headaches
D. Migraine headaches
____ 16. A 19-year-old college student is brought to the emergency department with a severe headache t
he describes as, “Like nothing I’ve ever had before.” His temperature is 40°C, and he has a
neck. The nurse looks for other signs and symptoms of which problem?
A. Head injury
B. Cluster headache
C. Migraine headache
D. Meningeal inflammation
____ 17. During a well-baby checkup, the nurse notices that a 1-week-old infant’s face looks small comp
with the cranium, which seems enlarged. On further examination, the nurse also notices dilated
veins and downcast or “sunsetting” eyes. The nurse suspects which condition?
A. Craniotabes
B. Microcephaly
C. Hydrocephalus
D. Caput succedaneum
____ 18. The nurse needs to palpate the temporomandibular joint for crepitation. Where is this joint loca
A. Just below the hyoid bone and posterior to the tragus
B. Just below the vagus nerve and posterior to the mandible
C. Just below the temporal artery and anterior to the tragus
D. Just below the temporal artery and anterior to the mandible
, ____ 19. A patient has come in for an examination and states, “I have this tender area on my cheek i
my ear lobe that seems to be getting bigger. What do you think it is?” The nurse notes swe
below the angle of the jaw. What does the nurse suspect?
A. Inflammation of the thyroid gland
B. Inflammation of the parotid gland
C. Infection in the occipital lymph node
D. Infection in the submental lymph node
____ 20. A patient with a history of acquired immunodeficiency syndrome (AIDS) has come in for an
examination and states, “I think that I have the mumps.” What would the nurse examine first?
A. Thyroid gland
B. Parotid gland
C. Cervical lymph nodes
D. Mouth and skin for lesions
____ 21. The nurse suspects that a patient has hyperthyroidism, and the laboratory data indicate that the
patient’s T4 and T3 hormone levels are elevated. Which of these findings would the nurse mo
likely find on examination?
A. Dyspnea
B. Tachycardia
C. Constipation
D. Atrophied nodular thyroid gland
____ 22. A patient’s thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid gland
the presence of a bruit. What technique would the nurse use to assess for a bruit.
A. Palpate the thyroid while the patient is swallowing.
B. Auscultate the thyroid with the bell of the stethoscope.
C. Palpate the thyroid while the patient holds their breath.
D. Auscultate the thyroid with the diaphragm of the stethoscope.
____ 23. The nurse notices that an infant has a large, soft lump on the side of his head and his moth
concerned. The mother tells the nurse that she noticed the lump approximately 8 hours after h
baby’s birth and that it seems to be getting bigger. What is a possible explanation for this?
A. Hydrocephalus
B. Craniosynostosis
C. Cephalhematoma
D. Caput succedaneum
____ 24. During an admission assessment, the nurse notices that a patient has an enlarged and rather th
skull. The nurse suspects acromegaly. What additional finding would the nurse assess for to co
this suspicion?
A. Exophthalmos
B. Bowed long bones
C. Acorn-shaped cranium
D. Coarse facial features
____ 25. When examining children affected with Down syndrome (trisomy 21), what would the nurse loo
for related to this disorder?