A nurse is preforming a focus physical assessment of the head and neck of a 20 year old male client. In assessing the lymph nodes what part of the head and neck should the nurse perform gentle circular motion to assess the occipital lymph nodes?

A) Bacterial: Bacterial infections in the mouth typically result in symptoms like foul odor, swelling, or pus, but they do not generally cause a black, hairy appearance on the tongue. A black, hairy tongue is more commonly associated with fungal overgrowth or other non-bacterial factors.

B) Fungal: A black, hairy tongue is often caused by an overgrowth of yeast or fungi, particularly Candida. This condition occurs when the normal balance of microorganisms in the mouth is disrupted, leading to the growth of fungi on the tongue’s papillae. These elongated, discolored papillae can trap food, bacteria, and dead cells, leading to a dark, furry appearance.

C) Parasite: Parasitic infections in the mouth are rare and usually cause symptoms such as sores, swelling, or difficulty swallowing, but they do not typically result in a black, hairy tongue. A parasitic infection would have a different set of symptoms and appearance.

D) Viral: Viral infections, such as those caused by the herpes simplex virus, can cause sores or ulcers in the mouth but do not typically cause a black, hairy appearance of the tongue. Viral infections might also cause symptoms like fever, pain, or swelling, but not this specific characteristic.

A) Rosenbaum test: The Rosenbaum test is used to assess near vision and is typically performed with a handheld card to check for presbyopia, which is the difficulty seeing up close. It is not appropriate for testing peripheral vision, which is the focus of the current assessment.

B) Consensual constriction: Consensual constriction refers to the reaction of the pupil in the opposite eye when light is shined into one eye. This test assesses the pupillary light reflex, which evaluates how well the pupils constrict in response to light. It is not used to assess peripheral vision and focuses more on the function of the optic nerve and pupil reaction.

C) Corneal Light Reflex: The corneal light reflex is a test used to assess for strabismus (misalignment of the eyes) by checking the symmetry of the light reflection on the cornea. This test helps in diagnosing eye alignment issues, but it does not evaluate peripheral vision.

D) Confrontation test: The confrontation test is a straightforward and effective method used to assess peripheral vision. The nurse and patient sit facing each other, and the patient covers one eye while the nurse tests the other eye’s visual fields by moving their fingers in from the periphery. This test evaluates the patient's ability to detect objects in their peripheral vision and is specifically designed for this purpose.