Chapter 11: Head and Neck

Question 1

1. Which cranial nerves innervate the face?
   a. II and V
   b. III and VI
   c. V and VII
   d. VIII and IX

Answer 1

c. V and VII

Question 2

2. Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?
   a. Coronal sutures
   b. Hyoid and cricoid cartilages
   c. Mandible and maxilla bones
   d. Nose and thyroid cartilages

Answer 2

d. Nose and thyroid cartilages

Question 3

3. Which of the following is an expected change in the assessment of the thyroid during pregnancy?
   a. Palpation of the gland becomes difficult.
   b. A bruit is auscultated.
   c. Inspection reveals a goiter.
   d. The gland is tender on palpation.

Answer 3

b. A bruit is auscultated.

Question 4

. Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On examination, you noted a bruit heard over the thyroid. This is suggestive of
a. hypothyroidism.
b. hyperthyroidism.
c. thyroid cancer.
d. thyroid cyst.

Answer 4

b. hyperthyroidism.

Question 5

5. Ms. Galvan is a 22-year-old secretary who comes to the clinic with headaches of 6 weeks’ duration. She tells the office assistant about her heavy schedule, including part-time work and evening classes. Her vital signs are normal. Which information is most appropriate to Ms. Galvan’s history?
   a. Current medications
   b. Elimination patterns
   c. Immunization status
   d. Previous pregnancies

Answer 5

a. Current medications

Question 6

6. Observation during history taking is the best way to examine for
   a. head position.
   b. scalp lice.
   c. thyroid size.
   d. tracheal alignment.

Answer 6

a. head position.

Question 7

7. During a head and neck assessment of a neonate, it is important to screen for
   a. the presence of torticollis.
   b. signs and symptoms of cerebral palsy.
   c. uneven movement of the eyes.
   d. unilateral movement of the tongue.

Answer 7

a. the presence of torticollis.

Question 8

8. During a physical examination of a 30-year-old Chinese man, you notice a slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to
   a. ask the patient if this characteristic runs in his family.
   b. perform monofilament testing on the face.
   c. consult with the clinician regarding the laboratory tests needed.
   d. record the finding in the patient’s chart.

Answer 8

d. record the finding in the patient’s chart.

Question 9

9. Which is the best way to position a patient’s neck for palpation of the thyroid?
   a. Flexed away from the side being examined
   b. Flexed directly forward
   c. Flexed toward the side being examined
   d. Hyperextended directly backward

Answer 9

c. Flexed toward the side being examined

Question 10

10. The thyroid gland should
    a. be slightly left of midline.
    b. have a clear vascular sound.
    c. move when the patient swallows.
    d. tug with each heartbeat.

Answer 10

c. move when the patient swallows.

Question 11

11. You are palpating a patient’s thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate
    a. a congenital anomaly.
    b. a multinodular goiter.
    c. a normal thyroid gland.
    d. thyroiditis.

Answer 11

c. a normal thyroid gland.

Question 12

12. The correct way to transilluminate an infant’s skull is to
    a. hold the light 18 inches from the skull.
    b. move the light toward and then away from the head
    c. place the light firmly against the skull.
    d. shine the light inside the infant’s mouth.

Answer 12

c. place the light firmly against the skull

Question 13

13. Which of the following is true regarding a cephalohematoma?
    a. It is bound by suture lines.
    b. The affected part feels soft.
    c. It is obvious at birth.
    d. The margins are poorly defined.

Answer 13

a. It is bound by suture lines.

Question 14

14. Nuchal rigidity is most commonly associated with
    a. thyroiditis.
    b. meningeal irritation.
    c. Down syndrome.
    d. cranial nerve V damage.

Answer 14

b. meningeal irritation.

Question 15

15. When noting a bulging fontanel with marked pulsations in a 6-month-old, you suspect
    a. normal development.
    b. congenital anomaly.
    c. increased intracranial pressure.
    d. fever response to a viral infection.

Answer 15

c. increased intracranial pressure.

Question 16

16. Which type of headache usually occurs at night, is precipitated by alcohol consumption, and occurs more often in men than in women?
    a. Classic migraine
    b. Temporal arteritis
    c. Cluster
    d. Hypertensive

Answer 16

c. Cluster

Question 17

17. Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region, at the base of the tongue. This is most likely a
    a. parotid gland tumor.
    b. branchial cleft cyst.
    c. Stensen duct stone.
    d. thyroglossal duct cyst.

Answer 17

d. thyroglossal duct cyst.

Question 18

18. The premature union of cranial sutures that involves the shape of the head without mental retardation is
    a. craniosynostosis.
    b. encephalocele.
    c. microcephaly.
    d. myxedema.

Answer 18

a. craniosynostosis.

Question 19

19. Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the examiner, you are palpating his head during your physical examination. Which of the following would be your first step?
    a. Palpate the patient’s hair, noting texture, color, and distribution.
    b. Palpate the temporomandibular joint.
    c. Palpate the skull from front to back.
    d. Palpate the temporal artery.

Answer 19

c. Palpate the skull from front to back.