Deck 58: Special Senses Introduction

Question 1

When asked about his vision, a patient says that the last time he had it tested, his vision was recorded as 20/50.What does this mean?

A) He can read at 20 feet what a person with normal vision can read at 50 feet.
B) He can read at 50 feet what a person with normal vision can read at 20 feet.
C) He needs to be 50 feet from objects to see them.
D) He can see objects the best between 20 and 50 feet.

Answer 1

He can read at 20 feet what a person with normal vision can read at 50 feet.

Question 2

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?

A) Use tea or coffee on the morning of test.
B) Electrodes will be placed on the scalp.
C) Air will be blown into the external ear.
D) The patient should have nothing to eat or drink (NPO)3 hours before the test.

Answer 2

The patient should have nothing to eat or drink (NPO)3 hours before the test.

Question 3

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?

A) Blinking
B) Grimacing
C) Headache
D) Nystagmus

Answer 3

Nystagmus

Question 4

A nurse assessing the results of a Rinne test sees the notation of BC > AC.How should the nurse translate this result?

A) Conductive hearing loss
B) Sensorineural hearing loss
C) Normal hearing
D) Cochlear defect

Question 5

A patient with diabetes says that he needs a hearing aid because he cannot hear well, and everything sounds garbled and distant.What type of hearing loss should the nurse suspect?

A) Mixed hearing loss
B) Conductive hearing loss
C) Central hearing loss
D) Sensorineural hearing loss

Question 6

A patient undergoing a Weber test says that the sound is louder in her left ear.What should this result indicate?

A) Normal hearing
B) Nerve damage from listening to loud music
C) Blocked ear canal in the right ear
D) Conductive hearing loss in the left ear

Question 7

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.What health care provider should provide this service?

A) Otologist
B) Otolaryngologist
C) Audiometrist
D) Audiologist

Question 8

A nurse reads in a patient's history that the patient has experienced otalgia.How should the nurse interpret this term?

A) Difficulty hearing
B) Buildup of cerumen
C) Ear pain
D) Ringing in the ears

Question 9

During the initial assessment of a very thin patient at the eye clinic, a nurse notes that the patient has very prominent eyes.What medical diagnosis might the nurse find in this patient's history?

A) Diabetes
B) Glomerulonephritis
C) Hyperthyroidism
D) Hypertension

Question 10

Which patient problem would the nurse prioritize for a patient having ear surgery?

A) Altered self-concept
B) Potential injury
C) Knowledge deficit
D) Inability to communicate effectively

Question 11

When being interviewed, a 50-year-old patient says that he cannot see the newspaper as well as he used to.What is the reason this patient vision has changed from near to far?

A) The ciliary muscle changes the pupil size.
B) The lens of the eye changes shape as the ciliary muscle contracts and relaxes.
C) Nearsightedness has set in.
D) Clouding of the vitreous humor has occurred.

Question 12

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.What should be the first action of the oncoming nurse?

A) Consider asking the physician to assess the patient for dementia.
B) Assess the patient to determine whether her hearing aids are in.
C) Report to the physician that the patient is exhibiting signs of the sundown syndrome.
D) Assess the patient's medications to check for an overdose.

Question 13

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?

A) Tip the affected ear up and keep it in that position for several minutes after instilling the medication.
B) Keep the medication in the refrigerator to preserve it.Instill the medication with the affected ear tilted upward.
C) Touch the dropper to the opening of the ear canal to ensure that the drops are correctly instilled.
D) Warm the ear drops and then tilt the head downward.

Question 14

What nursing action should be implemented when irrigating a patient's ear?

A) Straighten the ear canal and irrigate with a large-tipped bulb syringe.
B) Direct the solution to the middle of the canal to avoid damaging the ear.
C) 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.
D) Repeat the irrigation with hotter water.

Question 15

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?

A) Potential injury
B) Decreased socialization
C) Knowledge deficit
D) Anxiety

Question 16

A 75-year-old patient has normal age-related changes in his ear.What change should not be considered a normal change in the aging patient?

A) Dry and wrinkled skin on the auricle
B) Otitis externa
C) Dry cerumen
D) Hair in the ear canal

Question 17

What significant instruction should a nurse include to a patient being discharged after ear surgery?

A) Use stool softeners with caution.
B) Assume your usual activities.
C) Avoid blowing your nose.
D) Shampoo your hair with baby shampoo.

Question 18

An 85-year-old patient has had age-related changes in the cochlea.What is the most appropriate nursing action for the nurse to implement?

A) Speak slowly.
B) Provide assistance with ambulation.
C) Speak in a lower tone.
D) Communicate with the patient in writing.

Question 19

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?

A) Sclera
B) Retina
C) Choroid
D) Bulbar conjunctiva

Question 20

Which portion of the eye makes it possible for a person to see in a darkened environment?

A) Macula
B) Rods
C) Cones
D) Optic nerve

Question 21

What actions should a nurse implement when assessing a patient's accommodation? (Select all that apply.)

A) Hold his or her finger approximately 20 inches in front of the patient's eyes.
B) Observe for pupillary constriction.
C) Assess for convergence.
D) Note blinking.
E) Move his or her finger slowly toward the patient's nose.

Question 22

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!" How should the nurse define this behavior?

A) Anger stage of grieving
B) Poor impulse control
C) Ineffective management of a therapeutic regimen
D) Psychotic reaction to loss

Question 23

A nurse uses a diagram to show the physiologic sequence of hearing.After entering the external ear, the sound is then conducted through the: ______ (Arrange the options in sequence.Do not separate answers with a space or punctuation.Example: ABCD.)

A)tympanic membrane
B)sensory receptors
C)oval window
D)acoustic nerve to the brain
E)malleus, incus, and stapes

Question 24

Which patient behaviors should alert a nurse to a possible hearing deficit? (Select all that apply.)

A) Watches the speaker's mouth.
B) Gives inappropriate answers to questions.
C) Pulls at the ears.
D) Fails to respond when spoken to.
E) Turns the good ear to the speaker.

Question 25

How should a nurse assist a visually impaired patient to ambulate?

A) Hold the visually impaired person by his or her nondominant arm and walk side by side.
B) Hold the nondominant hand, wrap the arm around his or her waist, and walk side by side.
C) Allow the visually impaired person to hold the helper's arm, with the helper slightly ahead.
D) Allow the visually impaired person to hold the shoulder of the helper and walk slightly behind the helper.

Question 26

What information should a nurse relay to a patient when providing education about protecting vision?

A) After 40 years of age, eye examinations should be performed every 2 years.
B) Crusted eyelids on awakening are caused by decreased tear production.
C) Floaters are a sign of eye infection.
D) Blurred vision without pain is temporary eye strain.

Question 27

What information should a nurse include when providing information to a patient using topical eye medications?

A) Look upward and drop the medication into the inner canthus.
B) Pull the lower eyelid down and drop the medication into the conjunctival sac.
C) Hold both eyelids open and drop the medication onto the sclera.
D) Tilt the head to the side and drop the medication into the outer canthus.

Question 28

What does a pneumatonometric study of the eye require?

A) Regional anesthesia
B) A pneumotonometer to be placed into the eye
C) A puff of air directed at the surface of the eye
D) An applanation performed with a slit-lamp microscope

Question 29

What is the correct term to use for a patient with a vision disorder?

A) Blind
B) Handicapped
C) Partially blind
D) Visually impaired

Question 30

When planning care for a patient who cannot perceive or interpret sounds, a nurse takes into consideration that the patient may have a(n)______ hearing loss.

Question 31

Which common characteristics might a patient with conductive hearing loss display? (Select all that apply.)

A) Hears adequately in noisy settings.
B) Hears sounds but has difficulty understanding speech.
C) Has improved hearing with hearing aids.
D) Has a history of diabetes mellitus.
E) Speaks in a normal volume.

Question 32

A nurse assesses an 80-year-old patient for age-related changes to the eye.What potential changes should the nurse anticipate? (Select all that apply.)

A) Decreased tear production
B) Eyeball sunk deep in orbit
C) Hyperopia
D) Eyelashes diminished
E) Arcus senilis

Question 33

What does electroretinography measure?

A) A fluorescein dye is injected intravenously (IV)into a vein in the arm, and the retina is observed as the dye circulates.
B) Electrodes are placed on the scalp, each eye is stimulated, and retinal activity is assessed.
C) A small plunger is used to apply pressure on the sclera while the retinal vessels are evaluated.
D) A contact lens electrode is placed on the eye and exposed to flashes of light to evaluate the retinal response.

Question 34

Which intraocular pressure reading obtained by tonometry indicates a patient being evaluated for a visual impairment does not have glaucoma?

A) 18 mm Hg
B) 28 mm Hg
C) 45 mm Hg
D) 52 mm Hg

Question 35

Which implementation is appropriate in the care plan for a visually impaired person?

A) Leaving the bed in the highest position
B) Keeping the door closed
C) Announcing your presence when you enter and leave the room
D) Leaving the radio on all the time to help the patient know the time of day

Question 36

What is an appropriate nursing action to implement when performing eye irrigation?

A) Ask the patient to tip up her head and run the irrigation fluid over her open eye.
B) Direct the irrigating fluid from the inner canthus to the outer canthus.
C) Not allow the patient to blink.
D) Place the irrigating syringe directly onto the corner of the eye and allow the fluid to move across the eye.

Question 37

What makes up the refractive media of the eye? (Select all that apply.)

A) Aqueous humor
B) Retina
C) Vitreous humor
D) Cornea
E) Lens

Question 38

A patient complains that his hearing aid is not working.What actions should a nurse implement to assess the device? (Select all that apply.)

A) Check to see if the device is turned on.
B) Clean the earpiece and remove cerumen clogged in the vent.
C) Open the earpiece to see if the microphone wire is connected.
D) Examine the interior of the earpiece for water.
E) Validate that the battery is correctly placed.