Jarvis Chapter 14: Head, Face, and Neck Flashcards

Questions and Answers

A physician tells the nurse that a patient's vertebra prominens is tender. The area of the body the nurse will assess is:

Just above the diaphragm

At the level of the C7 vertebra (correct)

At the level of the T11 vertebra

Just lateral to the knee cap

The nurse's best response to a mother who is concerned about her 2-month-old daughter's soft spot on her head is:

Perhaps that could be a result of your dietary intake during pregnancy

That soft spot is normal, and actually allows for growth of the brain during the first year of your baby's life (correct)

Your baby may have craniosynostosis, a disease of the sutures of the brain

That soft spot may be an indication of cretinism or congenital hypothyroidism

If a patient's palpebral fissures are not symmetric, damage may have occurred to which cranial nerve?

VII (correct)

III

VIII

If a patient is unable to differentiate between sharp and dull stimulation to both sides of her face, the nurse suspects:

Damage to the trigeminal nerve Signup and view all the answers

When examining the face of a patient, the two pairs of salivary glands that are accessible to examination are the _ and _ glands.

Parotid; submandibular Signup and view all the answers

If a patient is having neck and shoulder pain and cannot turn her head, the nurse suspects damage to CN and proceeds with the examination by ____.

XI; asking the patient to shrug her shoulders against resistance Signup and view all the answers

The muscles in the neck that are innervated by CN XI are the:

Sternomastoid and trapezius Signup and view all the answers

A patient's laboratory data reveal an elevated thyroxine (T4) level. The nurse would proceed with an examination of the _____ gland.

Thyroid Signup and view all the answers

A finding that leads the nurse to suspect a lump in the neck is not cancerous is if the nodule:

Is mobile and not hard Signup and view all the answers

To identify the cause of enlarged submental lymph nodes, the nurse would assess the patient's:

Area proximal to the enlarged node Signup and view all the answers

The four areas in the body where lymph nodes are accessible are the:

Head and neck, arms, inguinal area, and axillae Signup and view all the answers

Which statement is true regarding the relative proportions of the head and trunk of the newborn?

Head circumference should be greater than chest circumference at birth Signup and view all the answers

More noticeable facial bones in an 85-year-old woman are probably due to:

More noticeable facial bones are probably due to a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin Signup and view all the answers

A patient reports excruciating headache pain around his eye, forehead, and cheek that has lasted approximately 2 hours. The nurse should suspect:

Cluster headaches Signup and view all the answers

A patient describes a throbbing headache in the frontotemporal area that is somewhat relieved when lying down. The nurse suspects:

Migraine headaches Signup and view all the answers

A 19-year-old college student has a severe headache, temperature of 40 C, and stiff neck. The nurse should look for signs of which problem?

Meningeal inflammation Signup and view all the answers

During a well-baby checkup, the nurse notices a 1-week-old infant has a small face compared to his enlarged cranium. The findings suggest which condition?

Hydrocephalus Signup and view all the answers

To palpate for crepitation, the temporomandibular joint is located just below the temporal artery and anterior to the:

Tragus Signup and view all the answers

A patient has swelling below the angle of the jaw and the nurse suspects inflammation of which gland?

Parotid gland Signup and view all the answers

A male patient with a history of AIDS thinks he has the mumps. The nurse would begin by examining the:

Parotid gland Signup and view all the answers

If a patient has elevated T4 and T3 hormone levels, which finding would the nurse most likely find on examination?

Tachycardia Signup and view all the answers

If a visitor from Poland is apprehensive about neck examination, he would probably be more comfortable with the nurse examining his thyroid gland from:

The front with the nurse's thumbs on either side of his trachea and his head tilted forward Signup and view all the answers

A bruit is a sound that is heard best with the of the stethoscope.

Soft, whooshing, pulsatile; bell Signup and view all the answers

An infant has a large lump on the side of his head noticed approximately 8 hours after birth. One possible explanation for this is:

Cephalhematoma Signup and view all the answers

A mother brings in her newborn for assessment and notices that whenever her newborn's head is turned to the right side, she straightens the arm and leg on the same side. This reflex is:

Normal and is called the tonic neck reflex, which should disappear between 3 and 4 months of age Signup and view all the answers

During an admission assessment, the nurse notices that a male patient has an enlarged and thick skull. The nurse suspects acromegaly and would further assess for:

Coarse facial features Signup and view all the answers

When examining children with Down syndrome (trisomy 21), the nurse looks for the possible presence of:

Ear dysplasia Signup and view all the answers

A patient who has recently noticed paralysis on the left side of his mouth likely has:

Cerebrovascular accident (CVA) or stroke Signup and view all the answers

A woman feels sick and describes her eyes as puffy while her eyebrows and hair are coarse and dry. The nurse will assess for signs of:

Myxedema Signup and view all the answers

During an examination of a female patient with lymphadenopathy, the nurse suspects an acute infection. Acutely infected lymph nodes would be:

Firm but freely movable Signup and view all the answers

A physician reports that a patient with a neck tumor has a tracheal shift. The nurse is aware that this means the patient's trachea is:

Pushed to the unaffected side Signup and view all the answers

During an assessment of an infant, depressed and sunken fontanels may suggest which condition?

Dehydration Signup and view all the answers

During an assessment of a child with chronic watery eyes and sneezing, the findings are characteristic of:

Allergies Signup and view all the answers

While performing a well-child assessment on a 5-year-old, the nurse finds palpable, bilateral, cervical, and inguinal lymph nodes. The nurse suspects that this child:

Is exhibiting a normal finding for a well child of this age Signup and view all the answers

The nurse knows that most lymph nodes in healthy adults are normally:

Nonpalpable Signup and view all the answers

During examination, the best way to palpate the lymph nodes in the neck is by:

Using gentle pressure, palpate with both hands to compare the two sides Signup and view all the answers

During a well-baby checkup, a mother is concerned because her 2-month-old infant cannot hold her head up when pulled to a sitting position. The nurse responds:

Head control is usually achieved by 4 months of age Signup and view all the answers

During examination of a 3-year-old child, the nurse notices a bruit over the left temporal area. The nurse should:

Continue the examination because a bruit is a normal finding for this age Signup and view all the answers

During examination, a patient's left temporal artery feels hardened and tender compared with the right. The nurse suspects which condition?

Temporal arteritis Signup and view all the answers

During a well-baby checkup, the nurse assesses an infant's age-appropriate findings. Which assessment findings are appropriate for a 1-month-old infant? Select all that apply.

Nonpalpable cervical lymph nodes Signup and view all the answers

Study Notes

Head, Face, and Neck Assessment Notes

Vertebra Prominens: Tenderness found at the level of the C7 vertebra indicates potential issues that require further evaluation.
Infant Soft Spot: A soft spot (fontanel) in a 2-month-old is normal and allows for brain growth during the first year.
Palpebral Fissures Asymmetry: Asymmetry may indicate damage to cranial nerve VII (facial nerve).
Trigeminal Nerve Damage: Inability to differentiate between sharp and dull sensations on the face suggests damage to cranial nerve V (trigeminal nerve).
Salivary Glands Examination: The parotid and submandibular glands are significant accessible salivary glands during examination.
CN XI Damage Indicators: Suspected damage to cranial nerve XI if a patient has neck/shoulder pain and difficulty turning the head; confirmed by shoulder shrug against resistance.
Neck Muscles Innervated by CN XI: Sternomastoid and trapezius muscles are innervated by cranial nerve XI.
Thyroxine (T4) Examination: Elevated T4 levels necessitate an examination of the thyroid gland.
Thyroid Nodule Characteristics: A mobile, non-hard nodule in the neck is less likely to be cancerous compared to a hard, fixed one.
Enlarged Submental Lymph Nodes: Enlarged nodes prompt examination of the area proximal to them.
Accessible Lymph Node Areas: Major lymph node areas include head and neck, arms, inguinal area, and axillae.
Newborn Head Proportion: At birth, head circumference exceeds chest circumference; should equal by 1 year.
Facial Visibility with Age: Enhanced visibility of facial bones in elderly patients relates to decreased skin elasticity and fat.
Cluster Headaches Signs: Patients report excruciating, unilateral headaches particularly around the eye area.
Migraine Symptoms: Characterized by throbbing pain, often relieved by lying down, with a familial history common.
Suspected Meningeal Inflammation: Severe headaches and stiff neck in a feverish patient may indicate meningitis.
Hydrocephalus Symptoms: Enlarged cranium, dilated scalp veins, and "setting sun" eyes in infants suggest hydrocephalus.
Temporomandibular Joint Location: Located anterior to the tragus of the ear, just below the temporal artery
Parotid Gland Inflammation Indications: Swelling in front of the ear, especially with tenderness, indicates possible parotid gland inflammation.
Hyperthyroidism Signs: Elevated T4/T3 levels often correlate with symptoms like tachycardia.
Thyroid Gland Examination Comfort: Patients may be more comfortable with the cervical examination from the front.
Auscultation of Thyroid Gland: A bruit indicates increased blood flow, best detected using the bell of a stethoscope.
Cephalhematoma in Infants: Large soft lumps appearing post-birth likely indicate cephalhematoma.
Tonic Neck Reflex: Present in newborns and should disappear by 3 to 4 months of age.
Symptoms of Acromegaly: Notable thickening of the skull and coarse facial features are indicative of acromegaly.
Down Syndrome Indicators: Look for ear dysplasia and other distinguishing physical characteristics during examination.
CVA vs. Bell’s Palsy: Unilateral facial paralysis suggests either a cerebrovascular accident or Bell's palsy, requiring differential assessment.
Myxedema Features: Puffy eyes and coarse hair suggest hypothyroid conditions like myxedema.
Lymphadenopathy in Infections: Infected nodes appear firm but remain movable; a common finding during acute infections.
Tracheal Shift Implications: Shift towards the unaffected side in neck tumors indicates possible compression or mass effect.
Signs of Dehydration in Infants: Depressed and sunken fontanels often suggest dehydration.
Allergy Indicators: Symptoms in children, including sneezing and dark circles under the eyes, often indicate allergic reactions.
Normal Lymph Node Findings: In healthy adults, the majority of lymph nodes are typically nonpalpable, indicating no infection.
Pregnancy-Induced Thyroid Enlargement: Slight thyroid enlargement during pregnancy is usually normal due to hormonal changes.
Lymph Node Palpation Technique: Gentle pressure with both hands is the best technique for comparing lymph node size and feel.
Head Control Milestones: Infants typically achieve head control by around 4 months of age.
Bruit Over Temporal Area: Generally considered a normal finding in younger children and requires re-evaluation rather than immediate intervention.
Temporal Artery Conditions: Hardened, tender temporal arteries in a patient may indicate temporal arteritis, requiring further investigation.

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This quiz focuses on Chapter 14 of the Jarvis textbook, covering the anatomy and assessment of the head, face, and neck. Through a series of flashcards, users will test their knowledge on key concepts and terminology relevant to this chapter. Ideal for nursing students and healthcare professionals.