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Introduction to critical care nursing NSG 400.
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Introduction to critical care nursing NSG 400.
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Chapter 63 Management of Patients With NeurologicDysfunction - ANS-
1. The clinic nurse is assessing a child who has been brought to the clinic with signs
and
symptoms that are suggestive of otitis externa. What assessment finding is
characteristic
of otitis externa?
A) Tophi on the pinna and ear lobe
B) Dark yellow cerumen in the external auditory canal
C) Pain on manipulation of the auricle
D) Air bubbles visible in the middle ear - ANS-C
2. While reviewing the health history of an older adult experiencing hearing loss the
nurse
notes the patient has had no trauma or loss of balance. What aspect of this patients
health
history is most likely to be linked to the patients hearing deficit?
A) Recent completion of radiation therapy for treatment of thyroid cancer
B) Routine use of quinine for management of leg cramps
C) Allergy to hair coloring and hair spray
D) Previous perforation of the eardrum - ANS-B
3. A nurse is planning preoperative teaching for a patient with hearing loss due to
otosclerosis. The patient is scheduled for a stapedectomy with insertion of a prosthesis.
What information is most crucial to include in the patients preoperative teaching?
A) The procedure is an effective, time-tested treatment for sensory hearing loss.
B) The patient is likely to experience resolution of conductive hearing loss after the
procedure.
C) Several months of post-procedure rehabilitation will be needed to maximize
benefits.
D) The procedure is experimental, but early indications suggest great therapeutic
benefits. - ANS-B
4. Which of the following nursing interventions would most likely facilitate effective
communication with a hearing-impaired patient?
A) Ask the patient to repeat what was said in order to evaluate understanding.
B) Stand directly in front of the patient to facilitate lip reading.
C) Reduce environmental noise and distractions before communicating.
D) Raise the voice to project sound at a higher frequency. - ANS-C
,5. The nurse is providing discharge education for a patient with a new diagnosis of
Mnires
disease. What food should the patient be instructed to limit or avoid?
A) Sweet pickles
B) Frozen yogurt
C) Shellfish
D) Red meat - ANS-A
6. Following a motorcycle accident, a 17-year-old man is brought to the ED. What
physical
assessment findings related to the ear should be reported by the nurse immediately?
A) The malleus can be visualized during otoscopic examination.
B) The tympanic membrane is pearly gray.
C) Tenderness is reported by the patient when the mastoid area is palpated.
D) Clear, watery fluid is draining from the patients ear. - ANS-D
7. A patient has been diagnosed with hearing loss related to damage of the end organ
for
hearing or cranial nerve VIII. What term is used to describe this condition?
A) Exostoses
B) Otalgia
C) Sensorineural hearing loss
D) Presbycusis - ANS-C
8. A group of high school students is attending a concert, which will be at a volume of
80 to
90 dB. What is a health consequence of this sound level?
A) Hearing will not be affected by a decibel level in this range.
B) Hearing loss may occur with a decibel level in this range.
C) Sounds in this decibel level are not perceived to be harsh to the ear.
D) Ear plugs will have no effect on these decibel levels. - ANS-B
9. A patient has undergone diagnostic testing and has been diagnosed with
otosclerosis?
What ear structure is primarily affected by this diagnosis?
A) Malleus
B) Stapes
C) Incus
D) Tympanic membrane - ANS-B
,10. A patient with otosclerosis has significant hearing loss. What should the nurse do to
best
facilitate communication with the patient?
A) Sit or stand in front of the patient when speaking.
B) Use exaggerated lip and mouth movements when talking.
C) Stand in front of a light or window when speaking.
D) Say the patients name loudly before starting to talk. - ANS-A
11. The nurse in the ED is caring for a 4 year-old brought in by his parents who state
that the
child will not stop crying and pulling at his ear. Based on information collected by the
nurse, which of the following statements applies to a diagnosis of external otitis?
A) External otitis is characterized by aural tenderness.
B) External otitis is usually accompanied by a high fever.
C) External otitis is usually related to an upper respiratory infection.
D) External otitis can be prevented by using cotton-tipped applicators to clean the ear. -
ANS-A
12. A patient diagnosed with arthritis has been taking aspirin and now reports
experiencing
tinnitus and hearing loss. What should the nurse teach this patient?
A) The hearing loss will likely resolve with time after the drug is discontinued.
B) The patients hearing loss and tinnitus are irreversible at this point.
C) The patients tinnitus is likely multifactorial, and not directly related to aspirin use.
D) The patients tinnitus will abate as tolerance to aspirin develops. - ANS-A
13. A patient is postoperative day 6 following tympanoplasty and mastoidectomy. The
patient has phoned the surgical unit and states that she is experiencing occasional
sharp,
shooting pains in her affected ear. How should the nurse best interpret this patients
complaint?
A) These pains are an expected finding during the first few weeks of recovery.
B) The patients complaints are suggestive of a postoperative infection.
C) The patient may have experienced a spontaneous rupture of the tympanic
membrane.
D) The patients surgery may have been unsuccessful. - ANS-A
14. The nurse is discussing the results of a patients diagnostic testing with the nurse
, practitioner. What Weber test result would indicate the presence of a sensorineural
loss?
A) The sound is heard better in the ear in which hearing is better.
B) The sound is heard equally in both ears.
C) The sound is heard better in the ear in which hearing is poorer.
D) The sound is heard longer in the ear in which hearing is better. - ANS-A
15. The advanced practice nurse is attempting to examine the patients ear with an
otoscope.
Because of impacted cerumen, the tympanic membrane cannot be visualized. The
nurse
irrigates the patients ear with a solution of hydrogen peroxide and water to remove the
impacted cerumen. What nursing intervention is most important to minimize nausea and
vertigo during the procedure?
A) Maintain the irrigation fluid at a warm temperature.
B) Instill short, sharp bursts of fluid into the ear canal.
C) Follow the procedure with insertion of a cerumen curette to extract missed ear
wax.
D) Have the patient stand during the procedure. - ANS-A
16. A patient is scheduled to have an electronystagmography as part of a diagnostic
workup
for Mnires disease. What question is it most important for the nurse to ask the patient in
preparation for this test?
A) Have you ever experienced claustrophobia or feelings of anxiety while in enclosed
spaces?
B) Do you currently take any tranquilizers or stimulants on a regular basis?
C) Do you have a history of falls or problems with loss of balance?
D) Do you have a history of either high or low blood pressure? - ANS-B
17. The nurse is planning the care of a patient who is adapting to the use of a hearing
aid for
the first time. What is the most significant challenge experienced by a patient with
hearing loss who is adapting to using a hearing aid for the first time?
A) Regulating the tone and volume
B) Learning to cope with amplification of background noise
C) Constant irritation of the external auditory canal
D) Challenges in keeping the hearing aid clean while minimizing exposure to
moisture - ANS-B
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