Which of the following statements about otoscopic examination of a newborn would be true?

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Question 1 of 9

Which of the following statements about otoscopic examination of a newborn would be true?

Correct Answer: C

Rationale: The correct answer is C because the normal eardrum of a newborn can appear thick and opaque due to the presence of vernix or desquamated epithelium. Immobility of the drum (Choice A) is not a normal finding in a newborn and could indicate a problem. An "injected" membrane (Choice B) would suggest inflammation or infection, not necessarily infection. The appearance of the membrane in a newborn is not identical to that of an adult (Choice D) as it may have a different color, thickness, or opacity due to developmental differences.

Question 2 of 9

Which of the following signs would the nurse expect to find on assessment of an individual with otitis externa?

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.

Question 3 of 9

A mother brings her newborn in for an assessment and asks,"Is there something wrong with my baby? His head seems so big." Which of the following does the nurse know about the relative proportions of the head and trunk in the newborn?

Correct Answer: A

Rationale: The correct answer is A: At birth, the head is one fifth the total length. This is because newborns have relatively larger heads compared to their body size. This is known as cephalocaudal growth, where development starts from the head and progresses down the body. The head being one-fifth of the total length is a normal proportion in newborns. Choice B is incorrect because at birth, the chest circumference is usually greater than the head circumference. Choice C is incorrect as the head size reaches about 80% of its final size by age 2, not 3 years old. Choice D is incorrect because the closure of the anterior fontanelle at 2 months does not necessarily mean the head will appear proportionate to the body; it continues to grow in proportion to the body size.

Question 4 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 5 of 9

The nurse is assessing a patient with a history of intravenous drug abuse. While assessing his mouth, the nurse notices a dark red confluent macule on the hard palate. This could be an early sign of:

Correct Answer: A

Rationale: The correct answer is A: acquired immunodeficiency syndrome (AIDS). The dark red confluent macule on the hard palate is known as Kaposi's sarcoma, a common manifestation of AIDS. This lesion is caused by Human Herpesvirus 8 and is often seen in patients with compromised immune systems. Measles (B) typically presents with a rash, not a dark red macule. Leukemia (C) does not typically manifest as a dark red macule in the mouth. Carcinoma (D) refers to cancer and would present differently than Kaposi's sarcoma. In summary, the presence of a dark red confluent macule on the hard palate in a patient with a history of intravenous drug abuse is highly suggestive of AIDS, specifically Kaposi's sarcoma.

Question 6 of 9

A few days after a summer hiking trip, a 25-year-old man comes to the clinic with a rash. On examination, the nurse notes that the rash is red and circular with central clearing, and is located across his midriff and behind his knees. The nurse suspects:

Correct Answer: B

Rationale: The correct answer is B: Lyme disease. The presentation of a red circular rash with central clearing, known as erythema migrans, following a hiking trip in the summer is highly indicative of Lyme disease. The specific distribution of the rash across the midriff and behind the knees aligns with typical areas where the rash appears in Lyme disease cases. This rash is a hallmark sign of early Lyme disease caused by the bacterium Borrelia burgdorferi transmitted through the bite of an infected tick. Other answer choices are incorrect because rubeola presents with a different rash pattern, an allergy to mosquito bites would not typically present in this manner, and Rocky Mountain spotted fever typically presents with a different rash appearance and distribution.

Question 7 of 9

A patient's laboratory data reveal an elevated thyroxine level. The nurse would examine the:

Correct Answer: A

Rationale: The correct answer is A: thyroid gland. Thyroxine is a hormone produced by the thyroid gland. An elevated thyroxine level indicates a potential thyroid gland dysfunction. The nurse would examine the thyroid gland to assess its size, texture, and any signs of abnormalities. Incorrect choices: B: Parotid gland - This gland is responsible for producing saliva, not thyroxine. C: Adrenal gland - Responsible for producing hormones like cortisol and adrenaline, not thyroxine. D: Thyroxine gland - There is no such thing as a "thyroxine gland." Thyroxine is a hormone produced by the thyroid gland.

Question 8 of 9

A patient has been admitted for severe iron-deficiency anemia. What can the nurse expect to find in the patient's fingernails?

Correct Answer: C

Rationale: The correct answer is C: Spoon nails. In iron-deficiency anemia, the nails may develop a concave or spoon-like shape (koilonychia). This is due to the decreased oxygen supply to the nail bed. The characteristic spoon nails are indicative of severe iron deficiency. Splinter hemorrhages (choice A) are small areas of bleeding under the nails and are more commonly associated with conditions like endocarditis. Paronychia (choice B) is an infection around the nail, not specific to anemia. Beau's lines (choice D) are horizontal depressions in the nails, typically seen after a period of severe illness or stress, rather than specifically in iron-deficiency anemia.

Question 9 of 9

During a physical education class, a student is hit in the eye with the end of a baseball bat. When examined in the emergency department, the nurse notes the presence of blood in the anterior chamber of the eye. This finding indicates the presence of:

Correct Answer: B

Rationale: The correct answer is B: hyphema. Hyphema is the presence of blood in the anterior chamber of the eye, which can occur due to trauma like being hit with a baseball bat. This indicates bleeding inside the eye, specifically in the space between the cornea and iris. Hypopyon (A) is the accumulation of white blood cells in the anterior chamber. Corneal abrasion (C) is a scratch on the cornea, not related to blood in the anterior chamber. Iritis (D) is inflammation of the iris, which does not necessarily involve blood in the anterior chamber.

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