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Exam 2
Med Surg Exam 2
| Question | Answer |
|---|---|
| A nurse reads in a patient’s history that the patient has experienced otalgia. Which interpretation of this term is correct? | Ear pain |
| A nurse is assisting with a caloric test and notes that the specific patient response that indicates a hearing disorder is a problem in the labyrinth. Which response did the nurse witness? | Nystagmus |
| A 75-year-old patient has normal age-related changes in his ear. Which should not be considered a normal change in the aging patient? | Otitis externa |
| A patient reports that her hearing loss has become more severe over the past 3 months. The clinic nurse makes arrangements for an evaluation for a hearing aid. Which health care provider should provide this service? | Audiologist |
| When a patient has a suspected vestibular disorder, the physician orders an electronystagmography test. Which instruction should the nurse include when educating the patient about this test? | The patient should have nothing to eat or drink (NPO) 3 hours before the test. |
| A nurse assessing the results of a Rinne test sees the notation of BC > AC. Which translation of this result is correct? | Conductive hearing loss |
| A patient undergoing a Weber test says that the sound is louder in her left ear. Which interpretation of this result is correct? | Conductive hearing loss in the left ear |
| Which instruction should a nurse include when providing patient teaching information for a patient who will be self-administering ear drops for an ear infection? | Tip the affected ear up and keep it in that position for several minutes after instilling the medication. |
| Which nursing action should be implemented when irrigating a patient’s ear? | Use a body temperature solution and have the patient hold a basin under the ear while directing the solution toward the top of the canal. |
| A nursing report on a newly admitted patient who is profoundly deaf says that the patient is confused and difficult to assess because she does not appropriately respond to questions or sometimes fails to respond at all. | Assess the patient to determine whether her hearing aids are in. |
| Which patient problem would the nurse prioritize for a patient having ear surgery? | Potential injury |
| Which significant instruction should a nurse include to a patient being discharged after ear surgery? | Avoid blowing your nose. |
| A patient with diabetes says that he needs a hearing aid because he cannot hear well, and everything sounds garbled and distant. Which type of hearing loss should the nurse suspect? | Sensorineural hearing loss |
| Which is the most appropriate concern when considering the impact of a hearing deficit when planning care for a child who has been diagnosed with a hearing impairment? | Decreased socialization |
| An 85-year-old patient has had age-related changes in the cochlea. Which is the most appropriate nursing action for the nurse to implement? | Provide assistance with ambulation. |
| A patient who has been taking opioid medication for postoperative pain exhibits pinpoint pupils. Which anatomic portion of the eye has been affected by the medication? | Choroid |
| Which portion of the eye makes it possible for a person to see in a darkened environment? | Rods |
| When being interviewed, a 50-year-old patient says that he cannot see the newspaper as well as he used to. Which reason explains why this patient’s vision has changed from near to far? | The lens of the eye changes shape as the ciliary muscle contracts and relaxes. |
| During the initial assessment of a very thin patient at the eye clinic, a nurse notes that the patient has very prominent eyes. Which medical diagnosis might the nurse find in this patient’s history? | Graves disease |
| When asked about his vision, a patient says that the last time he had it tested, his vision was recorded as 20/50. Which information does this result provide? | He can read at 20 feet what a person with normal vision can read at 50 feet. |
| Which intraocular pressure reading obtained by tonometry indicates a patient being evaluated for a visual impairment does not have glaucoma? | 18 mm Hg |
| Which intervention does a pneumatonometric study of the eye require? | A puff of air directed at the surface of the eye |
| Which of the following is an appropriate nursing action to implement when performing eye irrigation? | Direct the irrigating fluid from the inner canthus to the outer canthus. |
| Which information should a nurse include when providing information to a patient using topical eye medications? | Pull the lower eyelid down and drop the medication into the conjunctival sac. |
| Which measurement does electroretinography provide? | A contact lens electrode is placed on the eye and exposed to flashes of light to evaluate the retinal response. |
| Which information should a nurse relay to a patient when providing education about protecting vision? | After 40 years of age, eye examinations should be performed every 2 years. |
| Which techniques will allow a nurse to assist a visually impaired patient to ambulate? | Allow the visually impaired person to hold the helper’s arm, with the helper slightly ahead. |
| A newly diagnosed patient with macular degeneration flings her book at the television set and furiously says, “I can’t read this blasted book, and I can’t see what is on the stupid TV!” Which definition of this behavior is correct? | Anger stage of grieving |
| Which term is correct to use for a patient with a vision disorder? | Visually impaired |
| Which implementation is appropriate in the care plan for a visually impaired person? | Announcing your presence when you enter and leave the room |
| Which patient behaviors should alert a nurse to a possible hearing deficit? (Select all that apply.) | Watches the speaker’s mouth. Gives inappropriate answers to questions. Fails to respond when spoken to. Turns the good ear to the speaker. |
| Which common characteristics might a patient with conductive hearing loss display? (Select all that apply.) | Hears adequately in noisy settings. Has improved hearing with hearing aids. Speaks in a normal volume. |
| A patient complains that his hearing aid is not working. Which actions should a nurse implement to assess the device? (Select all that apply.) | Check to see if the device is turned on. Clean the earpiece and remove cerumen clogged in the vent. Examine the interior of the earpiece for water. |
| A nurse assesses an 80-year-old patient for age-related changes to the eye. Which potential changes should the nurse anticipate? (Select all that apply.) | Decreased tear production Eyeball sunk deep in orbit Hyperopia |
| Which terms identify what make up the refractive media of the eye? (Select all that apply.) | Aqueous humor Vitreous humor Cornea Lens |
| Which actions should a nurse implement when assessing a patient’s accommodation? (Select all that apply.) | Hold his or her finger approximately 20 inches in front of the patient’s eyes. Observe for pupillary constriction. Assess for convergence. Move his or her finger slowly toward the patient’s nose. |
| A 60-year-old patient who has had an enucleation asks when he can get his prosthesis fitted. Which number indicates in approximately how many weeks this patient should expect to be fitted? | 4 |
| A patient with glaucoma is taking a beta-adrenergic blocking agent, timolol (Timoptic). Which potential side effect should the nurse assess for in the patient? | Wheezing |
| A 52-year-old patient reports that he must hold his paper farther and farther away from his face to read it. Which is the nurse’s most informative response? | “You have presbyopia. Nonprescription reading glasses will help you.” |
| A nurse explains that laser-assisted in situ keratomileusis (Lasik) and photorefractive keratectomy (PRK) are methods to correct refractive errors surgically. Which eye structure do these procedures reshape? | Cornea |
| A patient reports to a home health care nurse of having cloudy vision and seeing spots and halos around lights. Which disorder should the nurse suspect based on these patient symptoms? | Cataracts |
| Which statement correctly identifies how closed-angle glaucoma differs from open-angle glaucoma? | The onset is acute. |
| Which cause applies to glaucoma? | Increase in intraocular pressure |
| A patient in the emergency department complains of severe pain in his eye and is seeing halos around lights and feeling nauseous. Which diagnosis should the nurse suspect? | Angle-closure glaucoma |
| Which surgical implementation is most effective with retinal detachment? | Scleral buckling |
| A patient who has had surgery this morning for cataracts is now going home. Which information should the nurse include when providing discharge instructions? (Select all that apply.) | Use stool softeners. Avoid bending over. Avoid lifting anything heavier than 5 lb. |
| When making an initial assessment on a patient with a hearing deficit, the patient reports that he often feels off balance and is dizzy when he stands up. Which diagnosis might explain these symptoms? | Sinus infection |
| A 94-year-old patient is receiving gentamicin sulfate (Garamycin) in a continuous intravenous (IV) infusion. The nurse adds to the nursing care plan the patient problem “Potential injury.” Which nursing action should be implemented? | Measure intake and output. |
| A 75-year-old patient reports to a nurse that although she has cleaned her ears with cotton-tipped applicators for weeks, she still cannot hear her television unless the volume is loud, and she misses a great deal of conversations. | Dry cerumen across the canal |
| Which patient problem should take priority in planning care for a patient with Ménière disease? | Potential injury |
| Which information should a nurse stress when teaching a patient with Ménière disease about managing the disorder? | Avoiding the use of alcohol and tobacco |
| A patient comes to the primary care clinic complaining of a head cold and ear pain with drainage. Which disorder should the nurse suspect this patient is experiencing? | Acute otitis media |
| A young woman being admitted to the clinic service states that all the members of her family have been hard of hearing. She says her hearing loss became more pronounced when she was pregnant. Which term explains this type of hearing loss? | Otosclerosis |
| Which information should a nurse include when educating a patient with Ménière disease? | “Decrease your sodium intake and take your diuretic medication between attacks.” |
| A 75-year-old patient reports having difficulty hearing in crowds but can hear just fine at home with his wife. Which hearing disorder should the nurse suspect? | Presbycusis |
| During an intake physical examination, a patient reports that he has been taking 10 aspirin tablets a day for his arthritis. Which question should the nurse ask based on this information? | “Do you have ringing in your ears?” |
Created by:
DrFeelgood
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