The nurse assesses a client's submental lymph nodes. In which area of the client's head should the nurse palpate these lymph nodes?

In front of the ear.

In the midline, a few centimeters behind the tip of the mandible.

Superficial to the sternomastoid.

At the angle of the mandible.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Palpating in front of the ear would assess the preauricular lymph nodes, not the submental lymph nodes. The preauricular nodes are located just in front of the ears and are typically examined when there is an infection or inflammation in the eyes, ears, or scalp.

Choice B reason:

The submental lymph nodes are located in the midline, just under the chin, behind the bony prominence of the mandible. This is the correct area for palpation when assessing the submental lymph nodes. These nodes drain the lower lip, the floor of the mouth, the tip of the tongue, and the incisors, and they can become enlarged due to infections or malignancies in these areas.

Choice C reason:

Palpating superficial to the sternomastoid would assess the cervical lymph nodes, specifically the anterior cervical nodes, which are not the submental lymph nodes. The sternomastoid muscle is a landmark for several lymph node groups in the neck, but not for the submental group.

Choice D reason:

Palpating at the angle of the mandible would assess the submandibular lymph nodes, not the submental lymph nodes. The submandibular nodes are located beneath the jawline and can become enlarged due to infections or malignancies in the mouth, throat, and salivary glands.

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Correct Answer is B

Explanation

Choice A Reason:
An ophthalmoscope is primarily used for examining the interior structures of the eye, such as the retina, and is not typically used for assessing near vision. It provides a view of the fundus of the eye, which is essential for diagnosing various eye conditions but does not directly assess a patient's reading or close-up vision.

Choice B Reason:
The Snellen Chart is traditionally used to measure distance visual acuity and would not be the first choice for assessing near vision. However, there are versions of the Snellen Chart or similar charts designed for near vision assessment, typically held at a reading distance of about 14 inches from the patient. These charts have rows of letters or symbols that decrease in size and are used to determine the smallest print size a person can read.

Choice C Reason:
A magazine can be a practical tool for assessing near vision informally, as it contains various sizes of print and is a good representation of everyday reading material. The nurse can ask the patient to read a specific paragraph to observe their ability to see and comprehend text at a close distance.

Choice D Reason:
A penlight is not used for assessing near vision. It is typically used to assess the pupillary light reflex or to illuminate specific areas of the eye during an examination. The penlight helps to evaluate the response of the pupils to light but does not measure the patient's ability to read or see objects up close.

A. "I should get a longer cord for my telephone." B. "I should place a throw rug over electrical cords." C. "It is a good idea to use the handrails in the bathroom." D. "I should use chairs without armrests."

Correct Answer is C

Explanation

Choice a reason:
Getting a longer cord for the telephone may reduce the risk of tripping over a short cord but could potentially introduce new tripping hazards if not managed properly. It's important to keep cords secured and out of walkways to prevent falls.

Choice b reason:
Placing a throw rug over electrical cords is not advisable as it can create a tripping hazard. Rugs should be secured with non-slip backing and kept away from high-traffic areas to prevent falls.

Choice c reason:
Using handrails in the bathroom is a recommended safety measure to prevent falls. Bathrooms can be slippery, and handrails provide support and stability for residents when moving around in this area.

Choice d reason:
Using chairs without armrests is not a recommended practice for fall prevention. Chairs with armrests can aid residents in safely sitting down and standing up, providing support and reducing the risk of falls.

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The nurse assesses a client's submental lymph nodes. In which area of the client's head should the nurse palpate these lymph nodes?

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