Chapter 14, Head, Face, Neck, and Regional LymphaticsHead and Neck

Question 1 of 25

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Which face bone is movable?

• • MaxillaThe maxilla is not a movable face bone.
• Correct
  • MandibleThe mandible is a movable face bone.
• • HyoidThe hyoid is not a face bone.
• • Occipital boneThe occipital bone is not a face bone.

Question 2 of 25

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Label the skull bones at their locations on the diagram.

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Submitted Answers:

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1 Frontal bone

Correct

2 Parietal bone

Correct

3 Occipital bone

Correct

4 Zygomatic bone

Question 3 of 25

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Identify the indicated sutures of the adult skull.

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1 Coronal

Correct

2 Lambdoid

Correct

3 Squamous

Question 4 of 25

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Which sutures separate the cranial bones in infants?

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  • SagittalThe sagittal suture separates the cranial bones in infants.
• • ZygomaticThe zygomatic suture does not separate the cranial bones in infants.
• Correct
  • CoronalThe coronal suture separates the cranial bones in infants.
• Correct
  • LambdoidThe lambdoid suture separates the cranial bones in infants.
• • FrontalThe frontal suture does not separate the cranial bones in infants

Question 5 of 25

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Label the indicated structures of the infant skull.

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Correct Answers:

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Submitted Answers:

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1 Posterior fontanel

Correct

2 Coronal suture

Correct

3 Sagittal suture

Correct

4 Lambdoid suture

Correct

5 Anterior fontanel

Question 6 of 25

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What questions related to the history of present illness should a nurse ask a patient who complains of anterior neck swelling?

• • “Have you been experiencing stress at work or home?”Stress at work or home is part of personal/social history, not history of present illness.
• Correct
  • “How long have you had this?”Asking about onset and duration of the problem is part of the history of present illness.
• • “Have you had radiation to the head and neck?”Although radiation exposure is important to ask about, it is part of past medical history, not history of present illness.
• Correct
  • “Do you have any difficulty swallowing?”It is appropriate to ask about associated symptoms as part of the history of present illness.
• • “Does anyone in your family have thyroid problems?”Although it is appropriate to ask about family members with a thyroid problem, that is part of family history, not history of present illness.

Question 7 of 25

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The nurse should choose which question to ask a patient who reports riding their bicycle to work every day as part of social and personal history assessment of the head and neck?

• • “Do you have issues with balance while riding your bike?”Because the patient reports riding a bicycle to work every day it is important to assess issues with balance as part of the history of present illness, not the personal and social history assessment of the head and neck.
• Correct
  • “Do you wear a helmet?”Because the patient reports riding a bicycle to work every day it is important to assess the use of helmet as part of the personal and social history assessment of the head and neck.
• • “Do you wear sunglasses and sunblock?”Although it is important to ask about use of sunglasses and sunblock because the patient reports riding a bicycle to work every day, this question pertains more to the personal and social history of the eyes and skin, not the head and neck.
• • “Have you ever had a bicycle accident where you injured your head or neck?”Because the patient reports riding a bicycle to work every day it is important to assess previous accidents as part of a past medical history assessment of the head and neck, not personal and social history.

Question 8 of 25

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What questions should a nurse ask a patient complaining of headache when assessing history of present illness?

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  • “Can you describe the pain to me?”It is important to assess the quality or character of pain when assessing history of present illness of a headache.
• • “Are you under a lot of stress either at home or work?”Asking about stress at home or work addresses personal and social history related to the headaches, not history of present illness.
• Correct
  • “On a scale of 1 to 10 how severe is the pain?”It is important to assess the severity of pain when assessing history of present illness of a headache.
• Correct
  • “Is the pain worse in the morning?”It is important to assess if there is a pattern to the pain when assessing history of present illness of a headache.
• Correct
  • “Where specifically is the pain?”It is important to assess the location of pain when assessing history of present illness of a headache.
• • “Does anyone in your family have similar headaches?”Asking about family members with similar headaches addresses family history related to the headaches, not history of present illness.

Question 9 of 25

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During the head and face assessments, which features would be assessed by inspection?

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  • Head positionThe nurse should inspect the head position during the head and face assessment.
• Correct
  • Facial featuresThe nurse should inspect the facial features during the head and face assessment.
• Correct
  • Tics and spasmsThe nurse should inspect for tics and spasms during the head and face assessment.
• Correct
  • Facial symmetryThe nurse should inspect facial symmetry during the head and face assessment.
• • Facial skin thicknessAssessment of the facial skin thickness is determined by palpation, not inspection.
• Correct
  • Skull size and shapeThe nurse should inspect the skull size and shape during the head and face assessment.

Question 10 of 25

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Which features of the neck should the nurse inspect as part of a thorough assessment?

• Correct
  • FullnessThe nurse should inspect for fullness of the neck during a thorough neck assessment.
• Correct
  • SymmetryThe nurse should inspect for symmetry of the neck during a thorough neck assessment.
• • Lymph nodesThe nurse should assess lymph nodes during palpation, not inspection, of the neck.
• Correct
  • Alignment of tracheaThe nurse should inspect for alignment of the trachea during a thorough neck assessment.
• Correct
  • Masses, webbing, and skinfoldsThe nurse should inspect for masses, webbing, and skinfolds during a thorough neck assessment.

Question 11 of 25

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Which features would the nurse assess by palpation during a head and neck assessment?

• Correct
  • Hair distributionHair distribution is assessed by both inspection and palpation.
• • Facial expressionFacial expression and its appropriateness to behavior or reported mood would be assessed through inspection, not palpation.
• Correct
  • Temporomandibular joint spaceThe nurse would assess the temporomandibular joint space by palpation during the head and neck assessment.
• Correct
  • Size and shape of the thyroid glandThe nurse would assess the size and shape of the thyroid gland by palpation during the head and neck assessment.
• Correct
  • Symmetry and smoothness of the skullThe nurse would assess the symmetry and smoothness of the skull by palpation during the head and neck assessment.

Question 12 of 25

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Which aspects of the scalp should the nurse inspect as part of a thorough infant head and neck assessment?

• Correct
  • ScalingThe nurse should inspect the scalp for scaling or crusting during the infant head and neck assessment.
• Correct
  • ShapeThe nurse should inspect the shape of the scalp and skull during the infant head and neck assessment.
• • MovementThe nurse should assess for scalp movement by palpation, not inspection.
• • SmoothnessThe nurse should assess for scalp smoothness by palpation, not inspection.
• • TemperatureThe nurse should assess for scalp temperature by palpation, not inspection.

Question 13 of 25

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As part of a thorough head and neck assessment, the nurse should assess which features of the infant head by palpation?

• • Skin colorThe nurse should assess the color of the face and neck by inspection, not palpation.
• Correct
  • Suture linesThe nurse should assess the suture lines by palpation during the infant head and neck assessment.
• Correct
  • FontanelsThe nurse should assess the fontanels by palpation during the infant head and neck assessment.
• • Neck muscle toneThe nurse should assess neck muscle tone by palpation during the infant neck assessment.
• Correct
  • Skull depressionsThe nurse should assess for skull depressions by palpation during the infant head and neck assessment.

Question 14 of 25

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Transillumination is a technique used to assess the head of infants under which circumstances?

• • The infant has a neck mass.Transillumination is not required to assess the head of an infant with a neck mass.
• • The infant’s oral mucosa appears dry.Transillumination is not required to assess the head of an infant with dry mucous membranes.
• Correct
  • The infant has suspected intracranial lesions.Transillumination is used to assess the head of an infant with suspected intracranial lesions.
• • The infant has suspected respiratory compromise.Transillumination is not required to assess the head of an infant with suspected respiratory compromise.
• Correct
  • The infant has a rapidly increasing head circumference.Transillumination is used to assess the head of an infant with a rapidly increasing head circumference.

Question 15 of 25

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Which finding should the nurse note as normal on inspection of the head?

• • Head tilted to sideThe head should be upright and midline on inspection.
• • Balding pattern in femalesBalding in male patients may be a common finding, but balding in females is abnormal and unexpected.
• • Slight asymmetry in skull sizeSkull size should be symmetrical, not asymmetrical, when inspecting the head.
• Correct
  • Slight asymmetry in facial featuresSlight asymmetry of facial features is a normal finding when inspecting the head.

Question 16 of 25

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Which findings would be considered normal on palpation of the neck?

• • Palpable lymph nodesLymph nodes of the neck should not be palpable. This would be an abnormal finding that may suggest infection or malignancy.
• Correct
  • Firm thyroid gland tissueThe thyroid gland would be expected to be firm and pliable.
• Correct
  • Right thyroid lobe slightly larger than leftThe right lobe of the thyroid gland may be up to 25% larger than the left. This would be considered a normal finding.
• Correct
  • Movement of cricoid cartilage on swallowingThe hyoid, thyroid, and cricoid cartilage should move during swallowing. This would be considered a normal finding.
• • A palpable thrill over the carotid arteriesThere should not be a palpable thrill over the carotid arteries. This is an abnormal finding that indicates disruption of the arterial flow.

Question 17 of 25

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Which finding should the nurse note as normal when assessing the face?

• • Rough textureThe face should have a smooth, not rough, texture on palpation. Rough texture would be noted as an abnormal, not normal, finding.
• Correct
  • Variations in shapeVariations in facial shape are normal and based on race, gender, age, and build.
• • Palpable skin lesionA palpable skin lesion is considered an abnormal finding and may require further evaluation.
• • Heterogeneous skin colorSkin color should be uniform throughout the face. Heterogeneous skin color would be considered an abnormal, not normal, finding.

Question 18 of 25

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Which finding should the nurse note as abnormal when palpating the thyroid?

• • Right lobe may be larger than the leftThe right lobe of the thyroid gland may be up to 25% larger than the left.
• • Tissue firm and pliableThe thyroid gland tissue is firm and pliable.
• Correct
  • Palpable noduleA palpable nodule on the thyroid gland is considered an abnormal finding and may require further evaluation.
• • Gland rises freely with swallowingThe thyroid gland should rise freely with swallowing.
• Correct
  • Left lobe may be larger than the rightThe right lobe of the thyroid gland may be up to 25% larger than the left.

Question 19 of 25

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Which finding should the nurse consider normal on assessment of the thyroid gland?

• • Large lobesThyroid gland nodes are expected to be small. Large lobes would be considered an abnormal, not normal, finding.
• • NodulesThyroid nodules are an abnormal, not normal, finding and should be further evaluated.
• • Fixed lobesThe thyroid gland should rise freely with swallowing. Fixed lobes’ would be considered an abnormal, not normal, finding and may indicate malignancy.
• Correct
  • Firm and pliableThe thyroid gland tissue should be firm and pliable.

Question 20 of 25

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Which head assessment findings would be considered abnormal?

• Correct
  • TicsTics are an abnormal finding on assessment of the head.
• Correct
  • PallorPallor, or an unhealthy pale appearance, is an abnormal finding on assessment of the head.
• Correct
  • AlopeciaAlopecia is an abnormal finding on assessment of the head.
• • Symmetry of the headThe head is expected to be symmetrical.
• • Slight asymmetry of the facial featuresSlight asymmetry of facial features is common on inspection of the head and face.

Question 21 of 25

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Match the condition with the abnormal neck assessment finding.

• Torticollis
• Thyroglossal duct cyst
• Branchial cleft cyst

Question 22 of 25

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Match the abnormal finding with the relevant element of the head.

• Hair
• Facial nerve
• Temporal arteries

Question 23 of 25

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An 82-year-old patient complains of sudden headache, difficulty opening the mouth, and pain in the neck. The nurse notes pinpoint pupils, increased ocular pressure, and green drainage from the eye. Which findings should the nurse document as history of present illness related to the head assessment?

• Correct
  • HeadacheA headache is part of the history of present illness related to the head assessment.
• • Pinpoint pupilsPinpoint pupils, as identified by the nurse, are objective data, not part of the history of present illness.
• Correct
  • Tenderness of the neckTenderness of the neck is part of the history of present illness related to the head assessment.
• • Green drainage from eyeGreen drainage from the eye, as identified by the nurse, is objective data, not part of the history of present illness.
• • Increased ocular pressureIncreased ocular pressure, as identified by the nurse, is objective data, not part of the history of present illness.
• Correct
  • Difficulty opening the mouthDifficulty opening the mouth is part of the history of present illness related to the head assessment.

Question 24 of 25

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A patient complains of hoarseness, throat pain, and difficulty swallowing. The nurse notes a bruit over the thyroid and neck swelling. Which information should the nurse document as objective data?

• • HoarsenessThe patient’s hoarseness is part of the history of present illness, not objective data.
• • Throat painThe patient’s throat pain is part of the history of present illness, not objective data.
• Correct
  • Neck swellingThe nurse’s observation of neck swelling is objective data suggestive of thyroid disease.
• • Difficulty swallowingThe patient’s difficulty swallowing is part of the history of present illness, not objective data.
• Correct
  • Bruit over the thyroidThe nurse’s observation of a bruit is objective data suggestive of thyroid disease.

Question 25 of 25

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A 54-year-old female patient presents to the clinic concerned that she might be having a stroke. She reports symptoms started this morning and she sought help immediately. Her speech and cognition are intact, but she is complaining of a headache. The nurse notices upon inspection that her face is asymmetrical, with the right eyelid not closing completely, a drooping eyelid and corner of mouth, and a loss of the nasolabial fold on the affected side. What should the nurse document as objective data for the head and neck assessment?

• Correct
  • Loss of nasolabial fold on affected sideLoss of nasolabial fold on affected side should be documented as objective data.
• • Rapid onset of symptomsRapid onset of symptoms should be documented as subjective data.
• • HeadacheHeadache should be documented as subjective data.
• Correct
  • Asymmetrical faceAsymmetrical face should be documented as objective data.
• Correct
  • Right eyelid not closing completelyRight eyelid not closing completely should be documented as objective data.
• Correct
  • Drooping eyelid and corner of mouth on affected sideDrooping eyelid and corner of mouth on the affected side should be documented as objective data.