Chapter 38 Disorders of Special Sensory Function: Mastery PrepU

Which of the following nursing interventions is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo implement?

Fall precautions

Acute otitis media (AOM) is the disorder in children for which antibiotics are most prescribed. What are the risk factors for AOM? Select all that apply.

• Ethnicity • Premature birth • Genetic syndromes

Vision is a special sensory function that incorporates the visual receptors functions of which parts of the eye? Select all that apply.

• Eyeball • Optic nerve • Retina

The nurse is performing a health history for a seventy-two-year-old client. When reviewing the client's medications, the client states, "I take a baby aspirin every day, but I'm worried. I heard that aspirin can cause hearing problems!" Which of the following is an appropriate response by the nurse?

"A baby aspirin is a low dose that is considered to be safe."

The nurse is teaching a client who has tinnitus about suggested dietary modifications. The most important information for the nurse to include would be:

"Cut down on takeout meals because of high amounts of monosodium glutamate."

The nurse is teaching a teenaged client strategies to avoid recurrent ear infections. The nurse understands that further teaching is required when the client states which of the following?

"I will dry the inside of my ears thoroughly with cotton-tipped applicators after swimming."

A female client with rheumatoid arthritis has taken high doses of aspirin for several years to control inflammatory pain. Which of the following statements leads the health care provider to suspect the client has developed ototoxicity?

"I've been getting dizzy and light-headed. I seem to have a constant ringing in my ear."

The father of a third grade girl has brought his daughter to a walk-in clinic because he believes the girl has pink eye, which has been going around the students in her class. The nurse at the clinic concurs with the father's suspicion of conjunctivitis. Which follow-up explanation by the nurse is most accurate?

"The surfaces of her eyes have bacteria or a virus established, and it's important to maintain good hand hygiene until it goes away."

What are the symptoms of Ménière disease? Select all that apply.

• Severe ringing in the ear(s) • Feeling of fullness in the ear(s) • Episodes of disabling vertigo

Distraught at the persistent ringing in his ears and his inability to alleviate it, a 50 year-old man has visited his healthcare provider. After diagnostic testing, no objective cause (like impacted cerumen or vascular abnormality) was found. Given these testing results, which of the following teaching points by the care provider is most appropriate?

"There are some treatments like tinnitus retraining therapy, which includes the extended use of low-noise generators, which has shown good success."

A patient has shingles. What is the best time frame for the initiation of oral and intravenous antiviral drugs after the appearance of a rash to reduce the incidence of ocular complication?

3 days

Which of the following individuals is most likely to be diagnosed with a central vestibular disorder?

A woman who has ongoing difficulty balancing herself when walking.

A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe:

Antiviral medication for herpes zoster ophthalmicus

The nurse is caring for a client who reports, "My ears are constantly ringing!" The nurse will evaluate the client further for the use of which of the following medications?

Acetylsalicylic acid (aspirin)

The nurse understands that an antimicrobial drug is most likely to be prescribed for which of the following conditions?

Acute otitis media

The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be:

Administration of topical beta-adrenergic antagonists to lower the pressure.

A 46 year-old male has presented to the emergency department because of the eye pain, severe headache and blurred vision that has followed an eye exam at an optometrist's office earlier in the day. The client tells the triage nurse that he received eye drops during the exam "to keep my pupils wide open." What differential diagnosis will the care team first suspect?

Angle-closure glaucoma

The students are reviewing the anatomy of the eye and where the eye structures are located. Where is the anterior chamber located?

Anterior segment of the globe

The nurse is performing a Romberg test on a client. Select the statement that best describes purpose of the test.

Assess for static vestibular function

A young child has been diagnosed with amblyopia. The parents ask the nurse when treatment should be considered. At what age should treatment of children with the potential for development of amblyopia be instituted?

Before 6 years

The nurse is working at a first aid station in an amusement park. A 45-year-old client arrives reporting severe dizziness after a ride on the roller coaster. The nurse understands that a common cause of this sensation is which of the following?

Benign paroxysmal positional vertigo

The nurse is assessing a patient's risk for sensorineural hearing loss. Which of the following places the patient at greatest risk?

Chronic noise exposure

The nurse is assisting a client who is undergoing the Romberg test. The nurse understands that the client will be asked to do which of the following?

Close the eyes.

The nurse is caring for a client whose hearing is impaired due to impacted earwax. The nurse understands that the associated deafness is due to which of the following?

Conduction disorder

A patient's chart documents the finding of cholesteatoma. The nurse interprets this to mean that the patient has which of the following?

Cystlike mass in the middle ear

The nurse is educating a patient diagnosed with Meniere's disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include?

Decrease dietary intake of sodium

During a physical exam, the nurse practitioner notes that the patients' optic disk is very pale with a larger size/depth of the optic cup. At this point, they are thinking the patient may have:

Glaucoma

The nurse is assisting with a client who is undergoing caloric testing. The nurse expects which of the following actions will be needed to complete the test?

Have ice water available.

The ophthalmologist is performing a client's annual eye exam and notes an increase in intraocular pressure. The condition most likely is the result of:

Imbalance between aqueous production and outflow

The nurse is conducting a community education class on amblyopia. The nurse determines that the participants are understanding the concepts when they identify which of the following as the time when amblyopia is generally diagnosed?

Infancy

The nurse documents the presence of nystagmus when assessing a client. This can be interpreted as:

Involuntary eye movements that preserve eye fixation on stable objects in the visual field

The nurse is conducting a community education class on acute otitis media. Which statement by the participants indicates to the nurse that they are understanding the education?

It can be caused by a bacterial infection.

During an eye assessment the nurse notes inflammation of the client's cornea. The nurse should document this as which of the following?

Keratitis

A patient has been diagnosed with hemianopia. The patient asks the nurse what this is describing concerning the eye?

Loss of half of the visual field in one eye

Conductive hearing loss can occur for a variety of reasons, including foreign bodies in the ear canal, damage to the ear drum, or disease. What disease is associated with conductive hearing loss?

Paget disease

Which type of receptor is mediated through vision in dim light?

Photoreceptors

What is the nursing focus when the nurse performs a hearing test on a newborn infant?

Preventing developmental delays

The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse expects which of the following medications will be prescribed to manage the symptoms?

Promethazine (Phenergan)

A client seeks medical care when he wrecks his car because of poor eyesight. At the time of admission, his blood glucose level was 390 mg/dL. The client is diagnosed with diabetes (type 2). The ophthalmologist must perform an urgent intravitreal injection. The nurse explains this to the client by stating the doctor will:

Put a needle with syringe into your eyeball and inject some medication to decrease active bleeding.

The spouse of a client with a history of chronic alcohol abuse tells the nurse that her spouse has no difficulty speaking and responds when spoken to but is having difficulty understanding what is being said. The spouse asks if the nurse believes the client needs a hearing aid. The nurse explains to the spouse that the client probably does not require a hearing aid but may be suffering from which of the following?

Receptive aphasia

Presbycusis is degenerative hearing loss associated with aging. What is the first symptom of this disorder?

Reduction in ability to understand speech

The nurse is assessing a steel mill worker who suffers from hearing loss related to exposure to loud, occupational noise. The nurse understands that this type of hearing loss is classified as which of the following?

Sensorineural hearing loss

The nurse conducting a class on treatment of eye disorders may include that Botox injections may sometimes be used to treat which of the following eye disorders?

Stabismus

When a client reports that he feels like he is spinning but the room is stable, the nurse should document the finding as which of the following?

Subjective vertigto

The nurse observes nystagmus in a client sitting quietly without head movement. The nurse interprets this finding in which of the following way?

This is a pathological finding.

Binocular vision depends on the coordination of how many pairs of extraocular nerves that provide for the conjugate eye movements?

Three

It is important to differentiate between the kinds of hearing loss so they can be appropriately treated. What is used to test between conductive and sensorineural hearing loss?

Tuning fork

Which of the following is a risk factor for the development of acute otitis media in a child?

Upper respiratory infection

The nurse is preparing a client for a surgical procedure to create an endolymphatic shunt. The nurse understands that this procedure aims to relieve which of the following symptoms?

Vertigo

While on a cruise to the Caribbean, a person develops "motion sickness" with associated malaise, and nausea/vomiting. The nurse notes the client's BP is 88/52; pulse is 110; and skin moist with perspiration. The client diagnosis related to the clinical manifestations would most likely be:

Vertigo

A patient is having difficulty with balance. The nurse understands that the area of the ear that impacts balance is which one of the following?

Vestibular apparatus

A young patient is brought to the clinic with symptoms of a runny nose, small amount of drainage from both eyes, fever, and malaise. The mother states to the nurse, "I knew she was going to be sick. That swimming pool she played in 2 days ago was filthy." What disease should the nurse suspect this child is experiencing?

Viral conjunctivitis

A client presents to the emergency department complaining of loss of part of his vision. An MRI with contrast reveals multiple aneurysms of the circle of Willis. The client is diagnosed with "bitemporal heteronymous anopia." For this client, what effect will this have on his vision?

With both eyes open, the client has full binocular visual fields

The nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor which fills the anterior and posterior chambers of the eye as which disease?

glaucoma

The nurse is performing her morning assessment on a 69 year old patient on a medical-surgical unit. Upon assessing her pupils the nurse notices that they are equal and responsive to light but not to accommodation.The nurse is aware that with aging the lens becomes thicker and its capsule less elastic so she believes this to be the case. When accommodation is diminished in an older person as a result of aging this is referred to as what?

presbyopia

A mother brings her toddler to the clinic and tells the nurse that she thinks something is wrong with the baby's eyes. Upon further assessment the nurse notices that the child has upper deviation in movement in only one eye.What should the nurse suspect is wrong with the child?

strabismus

The nurse is a conducting discharge teaching to a patient prescribed an ototoxic medication. Which cochlear signs and/or symptoms will the nurse ask the client to report? Select all that apply.

• Tinnitus • Hearing loss

The eustachian tube connects the nasopharynx and the middle ear. In infants and children with abnormally patent tubes, what enters the eustachian tube when the infant or child cries or blows their nose?

Air and secretions

What is ocular muscle imbalance resulting in "lazy eye" called?

Amblyopia

A client tells the doctor he has noticed a recent change in his vision: he can bring distant images into focus, but near images become blurred. The client has most likely developed:

Hyperopia

A patient tells the nurse of being able to see everything in the distance very clearly. The patient has difficulty seeing clearly close up. The nurse has to document in the electronic medical record what condition for this patient?

Hyperopia

The nurse has received a prescription to administer a ceruminolytic agent twice daily to an elderly client. The nurse understands that the rationale for use of this agent is to remove which of the following?

Impacted ear wax

Causes of eyelid weakness include neurologic causes. There can be damage to the cranial nerves that innervate the eyelids, or there can be damage to the central nuclei of the cranial nerves. Where are the central nuclei of cranial nerve (CN) III (oculomotor nerve) and CN VII (facial nerve)?

Midbrain and caudal pons

A young teenager is brought to the clinic for an eye exam. She has been complaining that she is having difficulty in school as she cannot see the blackboard as clearly as she used to. She tells the nurse that it is blurry. What should the nurse suspect is wrong with this child?

Myopia

A college junior calls his mother, a nurse, complaining of, "not being able to see." When questioned further, he describes, "A gray curtain just went down my right visual field. I don't know what to do." The nurse should recognize this symptom as which of the following conditions and have their teenager go to the emergency department immediately.

Retinal detachment.

Age-related cataracts are characterized by what?

Visual distortion

The nursing instructor is teaching a class on diabetes and discusses complications of the disease. She further states that diabetic retinopathy is one of the leading causes of blindness. What does she tell the students are major risk factors for developing diabetic retinopathy? Select all that apply.

• Chronic hyperglycemia • Hypertension • Smoking

An 83-year-old client presents to the outpatient clinic with complaint of external ear pain. The ear is red, swollen, and tender to touch. What factors are likely contributors to this condition? Select all that apply.

• Hearing aid • Glasses

A nurse is conducting a "Living Well with Diabetes" seminar for the community outreach center. The nurse is discussing diabetic retinopathy and its overwhelming effect on people living with diabetes. Which of the following modifiable risk factors would the nurse discuss? Select all that apply.

• Hyperglycemia • Hypercholesteremia • Hypertension

As part of the community health department, a nurse is educating a group of diabetic clients about prevention of blindness. Which of the following topics should be covered during this class? Select all that apply.

• Importance of yearly eye exams • Tight control of blood glucose levels • Keep BP below 130.85 (Am. Heart Assoc. Guidelines)

The nurse is conducting hearing evaluation of a group of pre-school children. The nurse understands that failure to recognize hearing loss in children can result in impairment of which of the following? Select all that apply.

• Language development • Emotional development • Cognitive development

Stepping out of a mall and into the sunshine has caused a man's pupils to constrict. Place the following anatomical components of the man's pupillary reflex in the ascending chronological order that they responded to the light. Use all the options.

• Retinal ganglionic cells • Preganglionic neurons • Oculomotor nuclei • Pretectal nuclei