An ophthalmic examination reveals papilledema. The nurse is aware that this finding indicates:

Questions 46

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nclex physical and health assessment questions Questions

Question 1 of 9

An ophthalmic examination reveals papilledema. The nurse is aware that this finding indicates:

Correct Answer: D

Rationale: The correct answer is D: increased intracranial pressure. Papilledema is swelling of the optic disc due to increased pressure in the brain. It is a sign of serious conditions like brain tumors, head trauma, or hydrocephalus. The other choices are incorrect because retinal detachment presents with visual disturbances and floaters (A), diabetic retinopathy with retinal damage due to diabetes (B), and acute-angle glaucoma with sudden eye pain and blurred vision (C). Papilledema specifically indicates increased intracranial pressure, making choice D the correct answer.

Question 2 of 9

A 70-year-old patient reports to the nurse that he is having trouble hearing, especially when he is in large groups. He says he"can't always tell where the sound is coming from" and the words often sound"mixed up." What might the nurse suspect as the cause for this?

Correct Answer: C

Rationale: The correct answer is C: Degeneration of nerves in the inner ear. This is likely the cause of the patient's hearing difficulties, as age-related degeneration of nerves in the inner ear can lead to difficulty distinguishing sounds and determining their direction. Atrophy of the apocrine glands (Choice A) and cilia becoming coarse and stiff (Choice B) are not related to hearing loss. Scarring of the tympanic membrane (Choice D) would affect sound conduction but not the perception of sound direction and clarity.

Question 3 of 9

Which of the following is a risk factor for ear infections in young children?

Correct Answer: D

Rationale: The correct answer is D: Second-hand cigarette smoke. Exposure to second-hand smoke can irritate and inflame the lining of the Eustachian tube, making young children more susceptible to ear infections. This is supported by research showing a clear link between exposure to cigarette smoke and increased rates of ear infections in children. Family history (A) may contribute to genetic predisposition but is not a direct risk factor. Air conditioning (B) does not directly cause ear infections. Excessive cerumen (C) can lead to blockages but is not a primary risk factor for infections.

Question 4 of 9

Which of the following best describes the test to assess the function of cranial nerve (CN) X?

Correct Answer: D

Rationale: The correct answer is D because cranial nerve X, also known as the vagus nerve, controls the movement of the soft palate and uvula. Asking the patient to say "ahhh" assesses the function of CN X as the soft palate and uvula should elevate symmetrically. A: Observing the patient's ability to articulate specific words does not specifically test CN X function. B: Assessing movement of the hard palate and uvula with the gag reflex primarily tests CN IX (glossopharyngeal nerve). C: Having the patient stick out the tongue and observing for tremors or pulling to one side primarily tests CN XII (hypoglossal nerve).

Question 5 of 9

A 40-year-old patient who has just finished chemotherapy for breast cancer tells the nurse that she is concerned about her mouth. During assessment, the nurse finds the following: areas of buccal mucosa that are raw and red with some bleeding, as well as other areas that have a white, cheesy coating. The nurse recognizes that this abnormality is:

Correct Answer: B

Rationale: The correct answer is B: candidiasis. Candidiasis is a fungal infection caused by Candida albicans, commonly seen in immunocompromised individuals like cancer patients post-chemotherapy. The raw, red, and bleeding areas indicate mucosal irritation, while the white, cheesy coating represents fungal overgrowth. Carcinoma (choice A) refers to cancerous growths, which typically present differently. Leukoplakia (choice C) is a precancerous lesion characterized by white patches, not raw areas with bleeding. Koplik's spots (choice D) are small, white spots seen in the mouth in measles, not indicative of the described findings.

Question 6 of 9

While discussing the history of a 6-month-old infant, the mother tells the nurse that she took a great deal of aspirin while she was pregnant. What question would the nurse want to include in the history?

Correct Answer: D

Rationale: The correct answer is D. The nurse would want to ask about the number of ear infections the baby has had since birth because aspirin exposure during pregnancy is associated with an increased risk of developing Reye's syndrome, which can lead to recurrent ear infections. This question helps assess the baby's risk for complications related to aspirin exposure. Choices A, B, and C are incorrect as they are not directly related to the potential complications associated with aspirin exposure during pregnancy.

Question 7 of 9

Which of the following is the best way to palpate the lymph nodes in the neck?

Correct Answer: D

Rationale: The correct answer is D because using the index and middle fingers to palpate with gentle pressure in a rotating pattern allows for a thorough examination of the lymph nodes without causing discomfort or injury. This method helps to assess the size, shape, consistency, and tenderness of the nodes accurately. It also enables the examiner to detect any abnormalities such as enlargement or tenderness. A is incorrect as using strong pressure can be painful and lead to inaccurate assessment. B is incorrect as strong pressure can be harmful and may not provide the necessary sensitivity to detect abnormalities. C is incorrect as pinching each node can be uncomfortable and may not allow for a systematic examination of the lymph nodes.

Question 8 of 9

During the ear examination of an 80-year-old patient, which of the following would be a normal finding?

Correct Answer: C

Rationale: The correct answer is C: A thin, translucent membrane. In elderly patients, the tympanic membrane tends to become thinner and more translucent due to age-related changes. This is considered a normal finding as it is a common occurrence in older individuals. The other choices are incorrect because: A) Loss of high-tone frequency hearing is not a normal finding in an ear examination of an elderly patient, as age-related hearing loss typically affects high frequencies. B) Increased elasticity of the pinna is not a common age-related change and may indicate a different issue. D) A shiny pink tympanic membrane is not a typical finding in an elderly patient and could suggest inflammation or infection instead of a normal age-related change.

Question 9 of 9

The nurse is performing an eye assessment on an 80-year-old patient. Which of the following findings is considered abnormal?

Correct Answer: B

Rationale: The correct answer is B because unequal pupillary constriction in response to light is abnormal and may indicate nerve damage or neurological issues. A: Decrease in tear production is common with age. C: Arcus senilis is a normal age-related change. D: Loss of hair at the outer line of the eyebrows is also a common age-related change.

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