A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. These findings suggest that:

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Question 1 of 9

A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. These findings suggest that:

Correct Answer: A

Rationale: The correct answer is A: she may have macular degeneration. Macular degeneration is characterized by loss of central vision while peripheral vision remains intact. In this case, the woman's difficulty with tasks that require central vision, such as reading and recognizing faces, points towards macular degeneration. The other choices are incorrect because: B: Her symptoms indicate a specific vision problem, not just age-related changes. C: Cataracts typically cause blurred vision, not loss of central vision. D: Glaucoma typically affects peripheral vision first before progressing to central vision loss.

Question 2 of 9

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

Question 3 of 9

A patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The nurse suspects:

Correct Answer: B

Rationale: The correct answer is B: damage to the trigeminal nerve. Trigeminal nerve damage can result in the inability to differentiate between sharp and dull sensations on the face. The trigeminal nerve is responsible for transmitting sensory information from the face to the brain. Bell's palsy (choice A) affects facial muscles, not sensory perception. Frostbite (choice C) typically causes numbness rather than loss of sensation discrimination. Scleroderma (choice D) is a connective tissue disorder that does not directly affect sensory perception on the face.

Question 4 of 9

Which of the following would the nurse expect to find when examining the eyes of a patient of African descent?

Correct Answer: B

Rationale: The correct answer is B: A dark retinal background. This is because individuals of African descent typically have a higher concentration of melanin in their eyes, resulting in a darker retinal background. This can affect the appearance of the fundus during eye examinations. Incorrect choices: A: Increased night vision - Night vision is not directly influenced by melanin levels in the eyes and is more related to the function of rods and cones in the retina. C: Increased photosensitivity - Melanin provides some protection against UV light, so individuals with darker retinas may have lower photosensitivity. D: Narrowed palpebral fissures - Palpebral fissures refer to the opening between the eyelids and are not typically influenced by melanin levels in the eyes.

Question 5 of 9

The physician has diagnosed a tracheal shift in a patient. The nurse is aware that this means that the patient's trachea is:

Correct Answer: D

Rationale: The correct answer is D because tracheal shift due to thyroid enlargement occurs when the thyroid gland enlarges and displaces the trachea to the opposite side. This is a common clinical finding in conditions like a goiter. Other choices are incorrect because: A is incorrect as tracheal shift is not related to systole; B is incorrect as tracheal shift is typically caused by a mass pushing the trachea; C is incorrect as pleural adhesions don't typically cause tracheal shift.

Question 6 of 9

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and the light reflex is not visible. The most likely cause is:

Correct Answer: B

Rationale: The correct answer is B: acute otitis media. In this case, the presentation of a bright red tympanic membrane and absence of the light reflex are indicative of inflammation and fluid accumulation in the middle ear, which are classic signs of acute otitis media. This condition commonly occurs in young children, especially after a recent upper respiratory infection. Incorrect choices: A: Fungal infection is less likely in this case as the symptoms are more consistent with acute bacterial infection seen in otitis media. C: Rupture of the drum would typically present with sudden relief of pain and discharge from the ear, which is not described in the scenario. D: Blood behind the drum (hemotympanum) is uncommon in children with acute otitis media and would usually be associated with trauma or barotrauma.

Question 7 of 9

A male patient with acquired immunodeficiency syndrome (AIDS) has come in for an examination and says,"I think that I have the mumps." The nurse would begin by examining the:

Correct Answer: B

Rationale: The correct answer is B: parotid gland. This is because mumps typically presents with swelling and tenderness of the parotid glands. The nurse should examine the parotid gland first to assess for these characteristic signs of mumps. Examining the thyroid gland (choice A) is not relevant to mumps. Cervical lymph nodes (choice C) may be swollen in various conditions but are not specific to mumps. Lastly, examining the mouth and skin for lesions (choice D) is not the initial priority when suspecting mumps.

Question 8 of 9

When examining the nares of a 45-year-old patient who complains of rhinorrhea, itching of the nose and eyes, and sneezing, the nurse notes the following: pale, swollen turbinates and clear rhinorrhea. Which of the following is most likely the cause?

Correct Answer: C

Rationale: The correct answer is C: Allergic rhinitis. The patient's symptoms of rhinorrhea, itching, and sneezing, along with pale, swollen turbinates and clear rhinorrhea, are indicative of allergic rhinitis. Allergic rhinitis is characterized by an allergic response to allergens, leading to inflammation of the nasal passages and increased mucus production. Nasal polyps (choice A) typically present with nasal congestion and reduced sense of smell. Acute sinusitis (choice B) would likely present with purulent nasal discharge and facial pain/pressure. Nasal carcinoma (choice D) is unlikely in this case due to the patient's symptoms and age.

Question 9 of 9

A very concerned mother is at the clinic with her infant who has a large, soft lump on the side of his head. She tells the nurse that she noticed the lump about 8 hours after her baby's birth and that it seems to be getting bigger. One possible explanation for this is:

Correct Answer: C

Rationale: The correct answer is C: cephalhematoma. A cephalhematoma is a collection of blood between a baby's skull and the periosteum, typically occurring due to trauma during birth. In this case, the lump appeared 8 hours after birth, which aligns with the timeline for cephalhematoma development. It is soft because it consists of blood, and it can increase in size as the blood accumulates. Incorrect Choices: A: Hydrocephalus is an abnormal accumulation of cerebrospinal fluid within the brain, not a collection of blood. B: Craniosynostosis is the premature fusion of skull bones, leading to an abnormal head shape, not a collection of blood. D: Caput succedaneum is swelling of the soft tissues of a newborn's scalp due to pressure during delivery, not a collection of blood.

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