The nurse is palpating the sinus areas. If they are normal, which of the following would the patient report?
No sensation
Pain sensation behind eyes
Firm pressure
Pain during palpation
The Correct Answer is C
A. No sensation: Complete absence of sensation would not be expected during sinus palpation, as light pressure typically produces some awareness of touch. A normal response is mild firmness rather than no feeling at all.
B. Pain sensation behind eyes: Pain behind the eyes may indicate sinus inflammation or infection, particularly of the ethmoid sinuses. This is not a normal finding during sinus palpation.
C. Firm pressure: During a normal palpation of the frontal and maxillary sinus areas, a patient should feel firm pressure but no tenderness or pain. This indicates that the sinus cavities are clear and not inflamed or infected.
D. Pain during palpation: Pain elicited during palpation suggests sinus tenderness, which is usually associated with sinusitis or other pathology. This finding would not be considered normal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Flatness in the RUQ: Flatness is normally heard over solid structures such as bone or muscle. In the RUQ, flatness would not be expected, even with ascites, since fluid accumulation produces dullness rather than flatness.
B. Hyper-resonance in the LUQ: Hyper-resonance is associated with excessive air, such as in conditions like pneumothorax or emphysema. In the abdomen, it may indicate gaseous distension, but it is not a finding typically associated with fluid accumulation from ascites.
C. Dullness across the abdomen: Ascites involves fluid accumulation in the peritoneal cavity, and fluid transmits sound poorly, resulting in dullness on percussion. Widespread dullness is a key finding when assessing for significant ascites.
D. Tympany in the RLQ and LLQ: Tympany is usually heard over air-filled areas such as the stomach or intestines. In ascites, tympany may be heard superiorly where bowel loops float on top of the fluid, but the dominant and defining finding would be diffuse dullness.
Correct Answer is C
Explanation
A. Motor component of CN X and sensory component of CN VII: CN X (vagus) controls muscles of the pharynx and larynx, and CN VII (facial) has both motor and sensory components. However, loss of facial movement and absence of blink specifically indicate a problem with the motor function of CN VII rather than CN X.
B. Motor and sensory component of CN XI: CN XI (accessory nerve) controls the sternocleidomastoid and trapezius muscles. Dysfunction would present as difficulty with shoulder shrug or head rotation, not facial movement or blinking.
C. Motor component of CN VII: CN VII (facial nerve) controls muscles of facial expression, including blinking and movement of facial features. The findings of absent blink, intact sensation, and facial muscle weakness on one side indicate a motor deficit of CN VII.
D. Motor component of CN IV: CN IV (trochlear nerve) controls the superior oblique muscle of the eye. Dysfunction would affect eye movement, specifically downward and inward gaze, rather than facial expression or blink reflex.
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