A 45-year-old farmer comes in for skin evaluation and complains of hair loss. He has noticed that the hair on his head seems to be breaking off in patches and that there is some scaling on his scalp. The nurse would begin the examination suspecting:

Correct Answer: A

Rationale: The correct answer is A: tinea capitis. Tinea capitis is a fungal infection of the scalp that can cause hair loss, scaling, and breakage of hair. In this case, the patient's symptoms of hair loss, patchy hair breakage, and scaling on the scalp are consistent with tinea capitis. The nurse should suspect tinea capitis based on the presentation of these specific symptoms in the patient. Summary: - B: tinea corporis is a fungal infection of the skin, not the scalp, so it is not the most likely cause of the patient's symptoms. - C: toxic alopecia refers to hair loss due to exposure to toxins, which is unlikely in this case based on the symptoms described. - D: seborrheic dermatitis is a common skin condition that causes redness, scaly patches, and dandruff on the scalp, but it does not typically cause hair loss in the same way as tinea capitis

Correct Answer: D

Rationale: The correct answer is D: Enlarged regional lymph nodes. In otitis externa, there may be regional lymphadenopathy due to inflammation and infection. Rhinorrhea (A) is associated with upper respiratory infections, not otitis externa. Periorbital edema (B) is seen in conditions like periorbital cellulitis. Pain over the maxillary sinuses (C) is indicative of sinusitis, not otitis externa.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): 1. Immediate intervention is crucial as the newborn needs clear airways for breathing. 2. Inability to suction the nares can lead to respiratory distress and compromise the infant's oxygenation. 3. Waiting or attempting again may delay necessary actions, risking the baby's health. 4. Physician's assistance may be needed, but recognizing the urgency is the nurse's responsibility to ensure timely care. Summary of Incorrect Choices: A. Attempting to suction again with a bulb syringe may not resolve the issue and delay necessary intervention. B. Waiting for the infant to stop crying is not ideal as it may prolong the risk of respiratory distress. D. While physician assistance may be necessary, immediate recognition of the critical situation is the nurse's primary responsibility.

Correct Answer: B

Rationale: The correct answer is B: pearly grey and slightly concave. This is because a healthy tympanic membrane should appear pearly grey in color and slightly concave in shape. The pearly grey color indicates normal transparency and reflection of light, while the slightly concave shape is indicative of a normal eardrum. Choice A is incorrect as a light pink color and slight bulge are not characteristic of a healthy tympanic membrane. Choice C is incorrect because a pulled-in appearance at the base of the cone of light suggests retraction, which is abnormal. Choice D is incorrect as a whitish color with a small fleck of light is not a typical presentation of a healthy tympanic membrane.

Correct Answer: A

Rationale: The correct answer is A. Referring the patient to an ophthalmologist or optometrist is the appropriate action because the patient's inability to read the 20/100 line on the Snellen chart suggests significant visual impairment that requires professional evaluation. Options B and C are incorrect as they do not address the underlying cause of the vision issue. Option B focuses on a different method of assessment and does not provide a solution for the patient's visual acuity problem. Option C assumes the patient's vision issue can be corrected by reading glasses, which may not be the case for a 20/100 visual acuity. Option D is also incorrect as it only adjusts the testing distance and does not address the need for a comprehensive evaluation by an eye care specialist.

Correct Answer: A

Rationale: The dry mucosa and deep fissures in the tongue indicate dehydration in the patient. Dehydration causes decreased saliva production, leading to dry mouth and tongue fissures. This is a common symptom of dehydration. The lack of moisture in the oral cavity can result in these physical signs. The other choices are incorrect because irritation by gastric juices typically presents with other symptoms, a normal oral condition would not show these specific findings, and side effects of nausea medication would not directly cause dry mucosa and deep fissures in the tongue. Therefore, the correct answer is A: dehydration.

Correct Answer: D

Rationale: The correct answer is D: convergence of the axes of the eyes. During the accommodation response, the eyes converge to focus on a near object. This is necessary to maintain clear vision when looking at close objects. Dilation of the pupils (A) is not part of the accommodation response. A consensual light reflex (B) refers to both pupils constricting simultaneously in response to light, not specific to accommodation. Conjugate movement of the eyes (C) refers to both eyes moving together in the same direction, which is not the primary action during accommodation.

Correct Answer: C

Rationale: The correct answer is C because the trigeminal (CN V) and the trochlear (CN IV) nerves are indeed stimulated when the outer surface of the eye is stimulated. The trigeminal nerve is responsible for the sensation of touch in the face and controls the muscles involved in chewing. The trochlear nerve controls the superior oblique muscle of the eye, which helps with downward and inward eye movements. Therefore, when the outer layer of the eye is touched or stimulated, these nerves are activated to convey the sensation to the brain. Choices A, B, and D are incorrect: A: The outer layer of the eye is not particularly sensitive to touch compared to other areas like the cornea or conjunctiva. B: The outer layer of the eye is not darkly pigmented; the pigmented layer is actually the uvea inside the eye. D: The visual receptive layer of the eye, known as the retina, is located deeper within the eye, not

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Bloody or clear watery drainage can indicate a basal skull fracture. 2. Basal skull fractures can cause cerebrospinal fluid leakage, leading to clear watery drainage. 3. Blood in the ear canal can suggest a temporal bone fracture. 4. Assessing for drainage helps identify potential serious head injuries. Summary: A. Incorrect. Purulent drainage indicates infection, not related to head injuries. C. Incorrect. Increased cerumen is not the priority in assessing head injuries. D. Incorrect. Foreign bodies in the canal are not the primary concern in this scenario.