What type of clinical finding are cotton wool spots in the eye with an ophthalmoscope?
expected finding
unexpected finding
expected variation
irrelevant
The Correct Answer is B
A) Expected finding: Cotton wool spots are not considered an expected finding during a routine eye exam. These spots are indicative of underlying pathology, and their presence typically suggests an abnormality that warrants further investigation. They are not part of normal eye anatomy or typical health.
B) Unexpected finding: Cotton wool spots are small, white, fluffy lesions in the retina that occur due to microinfarctions of retinal nerve fibers. Their presence is considered an unexpected or abnormal finding during an ophthalmoscopic exam and can be associated with several conditions, including diabetes, hypertension, and other systemic diseases that affect blood flow to the retina. Their appearance is a signal of potential underlying health issues that require attention.
C) Expected variation: Cotton wool spots are not a variation of normal anatomy or function. They are pathological and should not be regarded as a normal variation of retinal appearance during an eye exam.
D) Irrelevant: The term "irrelevant" is not applicable in this context, as the presence of cotton wool spots is highly relevant to the clinical assessment. Their discovery suggests a need for further investigation into the patient's overall health, particularly cardiovascular or systemic conditions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Oral Candidiasis: Oral candidiasis, also known as a yeast infection or thrush, typically presents as white patches or plaques on the mucosa, especially on the tongue, inner cheeks, and roof of the mouth. These lesions are not usually painful unless they become irritated or infected. They are different from aphthous ulcers, which are small, round, and painful sores that occur on the mucous membranes of the mouth.
B) Thrush: Thrush is another term for oral candidiasis, caused by the overgrowth of Candida albicans. As with oral candidiasis, thrush typically presents as white lesions or patches rather than painful, round, white lesions like those seen in aphthous ulcers. These lesions can often be scraped off, which distinguishes them from the painful lesions associated with aphthous ulcers.
C) Hepatic Disease: Hepatic disease can cause various symptoms such as jaundice (yellowing of the skin and eyes), dark urine, and abdominal discomfort, but it does not specifically lead to small, round, white painful lesions in the mouth. The lesions described in the question are more characteristic of aphthous ulcers rather than a systemic condition like hepatic disease.
D) Aphthous Ulcers: Aphthous ulcers, also known as canker sores, are small, round, painful lesions that commonly appear on the oral mucosa. These sores are typically white or yellow with a red border and are known to be painful, particularly when eating or talking. This condition is the most consistent with the symptoms described in the question, including the size, shape, and pain associated with the lesions.
Correct Answer is A
Explanation
A) At the base of the skull: The occipital lymph nodes are located at the base of the skull, just above the nape of the neck. The nurse should use a gentle circular motion to palpate the area where these lymph nodes are found. This is the correct location to assess for tenderness, swelling, or abnormalities in the occipital lymph nodes.
B) In front of the ears: The lymph nodes located in front of the ears are known as the preauricular lymph nodes. These are not the occipital lymph nodes. The preauricular nodes are assessed by palpating just in front of the ear, not at the base of the skull.
C) Under the mandible: The submandibular lymph nodes are located under the mandible (lower jaw). These nodes are not the occipital lymph nodes. The nurse would need to palpate under the jawline to assess the submandibular area.
D) Above the clavicles: The supraclavicular lymph nodes are located above the clavicles (collarbones), and they are not the occipital lymph nodes. This area is assessed separately to check for lymph node enlargement or abnormal findings.
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