chapter 13: hair, skin, and nails
While assessing a patient’s skin, you note an erythematous area that does not blanch when pressure is applied. What stage of pressure injury is this?
What is Stage I pressure injury.
During assessment, you palpate the thyroid gland and find no enlargement. What is the term for this normal finding?
What is The thyroid gland is non-palpable or “not enlarged.”
What is the expected response when you shine a light into a patient’s eyes to assess the pupillary light reflex?
What is Both pupils should constrict (direct and consensual light reflex).
What does a normal tympanic membrane look like upon otoscopic examination?
What is The tympanic membrane should appear pearly gray, translucent, and intact
A patient reports a nosebleed. You assess and find bleeding coming from the anterior portion of the nasal septum. What is the likely cause?
What is Epistaxis from Kiesselbach’s plexus.
During a skin assessment, you observe a lesion that is asymmetrical, has irregular borders, and varies in color. What is your priority action?
What is Refer the patient for further evaluation for potential malignant melanoma using the ABCDEF rule.
A patient presents with swollen, tender, and palpable lymph nodes in the submandibular region. What should you suspect and assess further for?
What is Suspect infection or inflammation, possibly an upper respiratory or dental infection. Assess for fever, pain, and other signs of infection.
A patient presents with clouding of the lens, causing blurry vision. What condition does this describe, and what is a common cause?
What is This describes cataracts, often caused by aging.
A 75-year-old patient reports difficulty hearing high-pitched sounds. What condition might this suggest?
What is , age-related hearing loss.
During an oral examination, you note white patches on the patient’s tongue that cannot be scraped off. What condition does this indicate?
What is This indicates oral candidiasis (thrush).
A patient presents with an area of skin loss involving the epidermis and dermis. What stage of pressure injury does this represent, and what interventions would you consider?
What is Stage II pressure injury. Implement pressure-relief strategies, apply wound dressings, and monitor for infection
When testing cranial nerve XI (accessory nerve), what muscle movements should the patient perform?
The patient should shrug their shoulders against resistance and turn their head side to side against resistance.
You are performing a Snellen chart test. The patient has 20/40 vision. What does this mean?
What is The patient can see at 20 feet what a person with normal vision can see at 40 feet.
You are performing a Rinne test and find that air conduction is greater than bone conduction. What does this indicate?
What is This is a normal finding, indicating no conductive hearing loss.
A patient has 3+ tonsils that are touching the uvula. What is the most likely diagnosis?
What is The patient likely has tonsillitis.
A 65-year-old patient reports thinning skin and hair loss. What is the most likely cause, and what normal aging process does this indicate?
What is Decreased collagen production and loss of elasticity in aging adults. This is a normal age-related change in the integumentary system.
A patient presents with an enlarged thyroid gland and reports feeling fatigued, cold, and experiencing weight gain.
What is Hypothyroidism. Consider assessing T3, T4, and TSH levels.
A patient reports difficulty seeing objects in their peripheral vision. What test would you perform, and what could this finding indicate?
What is Perform the confrontation test. Loss of peripheral vision could indicate glaucoma.
A child presents with ear pain, fever, and a bulging, red tympanic membrane. What is the likely diagnosis, and what is the first-line treatment?
What is Acute otitis media. First-line treatment is antibiotics.
You are assessing the sense of smell in a patient. Which cranial nerve are you testing, and how would you test it?
You are testing cranial nerve I (olfactory nerve). Have the patient identify familiar scents with their eyes closed.
When performing a head-to-toe skin assessment, you notice a patient’s skin is cold, clammy, and pale. What are your immediate concerns and actions?
What is This may indicate poor perfusion or shock. Immediate interventions include assessing vital signs, checking for signs of cyanosis, and notifying the provider.
During an examination, you observe that a patient’s facial features are asymmetrical. They are unable to raise their eyebrows or smile symmetrically. Which cranial nerve is affected, and what condition could this indicate?
Cranial nerve VII (facial nerve) is affected. This could indicate Bell’s palsy.
During an ophthalmoscopic exam, you observe increased cupping of the optic disc. What condition should you consider, and what further tests might be necessary?
What is Consider glaucoma. Further testing should include measuring intraocular pressure and assessing visual fields.
A patient presents with vertigo, tinnitus, and hearing loss. What condition should you suspect, and how would you confirm this diagnosis?
What is Suspect Meniere’s disease. Confirmation may require audiometry and vestibular testing.
A patient presents with difficulty swallowing, and you suspect a cranial nerve deficit. Which cranial nerves should you assess, and how?
Assess cranial nerves IX (glossopharyngeal) and X (vagus) by checking the gag reflex and asking the patient to say “ah” while observing the uvula’s movement.