During an admission assessment, the nurse notices that a male ...

[abarnes]

During an admission assessment, the nurse notices that a male patient has an enlarged and rather thick skull. The nurse suspects acromegaly and would further assess for:
 
  a. Exophthalmos.
  b. Bowed long bones.
  c. Coarse facial features.
  d. Acorn-shaped cranium.

Question 2

A mother brings in her newborn infant for an assessment and tells the nurse that she has noticed that whenever her newborn's head is turned to the right side, she straightens out the arm and leg on the same side and flexes the opposite arm and leg.
 
  After observing this on examination, the nurse tells her that this reflex is:
  a.
  Abnormal and is called the atonic neck reflex.
  b.
  Normal and should disappear by the first year of life.
  c.
  Normal and is called the tonic neck reflex, which should disappear between 3 and 4 months of age.
  d.
  Abnormal. The baby should be flexing the arm and leg on the right side of his body when the head is turned to the right.

[yuyiding]

Answer to Question 1

ANS: C
Acromegaly is excessive secretion of growth hormone that creates an enlarged skull and thickened cranial bones. Patients will have elongated heads, massive faces, prominent noses and lower jaws, heavy eyebrow ridges, and coarse facial features. Exophthalmos is associated with hyperthyroidism. Bowed long bones and an acorn-shaped cranium result from Paget disease.

Answer to Question 2

ANS: C
By 2 weeks, the infant shows the tonic neck reflex when supine and the head is turned to one side (extension of same arm and leg, flexion of opposite arm and leg). The tonic neck reflex disappears between 3 and 4 months of age.

[abarnes]

Excellent

[kjohnson]

TYSM