Lab Manual Ch. 17 (Ears) & 18 (Mouth, Nose, Sinuses, Throat)

by age 90, renal blood flow has usually decreased by approximately

50%

decreased ventricular compliance

S4

while assessing an adult client's jaw, the nurse hears a clicking popping sound, and the client expresses pain in the joint. the nurse should further assess the client for

TMJ dysfunction

a neurologic change associated with normal aging is

a decrease in reaction time

a risk factor for sinusitis in the frail elderly is

a nasogastric feeding tube

when the nurse moves the client's arm away from the midline of the body, the nurse is performing

abduction

the functional reflex that allows the eyes to focus on near objects is termed

accomodation

the physical declines of aging often first become noticeable when

acute or chronic illness places excessive demands on the body

after examining the client's tympanic membranes, the nurse documents "right tympanic membrane red and bulging with no light reflex." the nurse recognizes that these are signs of

acute otitis media

moving limbs toward median plane of the body

adduction

the meibomian glands secrete

an oily substance to lubricate the eyes

the nurse has assessed the nose of an adult client and has explained to the client about her thick yellowish nasal discharge. the nurse determines that the client understand the instruction when the client says that the yellowish discharge is most likely due to

an upper respiratory infection

constipation is a possible adverse side effect of

anticholinergics, oral corticosteroids

orthostatic hypotension is a possible adverse side effect of

anticholinergics, oral corticosteroids, steroidal inhalant

erectile dysfunction is a possible adverse side effect of

anticholinergics, steroidal inhalants

whitish or yellow-tinged patched in mouth are possible adverse side effects of

antidepressants, anticoagulants

GI bleeding is a possible adverse side effect of

antihypertensives

an adult client visits the clinic complaining of recurrent ulcers in the mouth. the nurse assess the client's mouth and observes a painful ulcer. the nurse should document the presence of

aphthous stomatitis

the nurse is assessing an adult client's oral cavity for possible oral cancer. the nurse should explain to the client that the most common site of oral cancer is the

area underneath the tongue

a client visits the clinic and tells the nurse that she has joint pain in her hands, especially in the morning. the nurse should assess the client further for signs and symptoms of

arthritis

while assessing the elbow of an adult client, the client complains of pain and swelling. the nurse should further assess the client for

arthritis

the nurse is assessing the mouth of an older adult and observes that the client appears to have poorly fitting dentures. the nurse should instruct the client that she may be at greater risk for

aspiration

while assessing muscle strength in an older adult client, the nurse determines that the client's knee joint has a rating of 3 and exhibits active motion against gravity. the nurse should document the client's muscle strength as being/having

average weakness

the conjunctiva of the eye is divided into the palpebral portion and the

bulbar portion

inflammation of the bursa

bursitis

while assessing an older adult client, the client complains of chronic pain and severe limitation of all should movements. the nurse should refer the client to a physician for possible

calcified tendinitis

the nurse is assessing a client who has been taking antibiotics for an infection for 10 days. the nurse observes whitish curd-like patches in the client's mouth. the nurse should explain to the client that these spots are most likely

candida albicans infection

significant decrease in central vision

cataract

the middle layer of the eye is known as the

choroid layer

the chambers of the eye contain aqueous humor, which helps to maintain intraocular pressure and

cleanse the cornea and the lens

type of rigidity characterized by jerky movements with passive stretching

cogwheel

the transmission of sound waves through the external ear and the middle ear is known as

conductive hearing

the nurse has performed the rinne test on an older adult client. after the test, the client reports that her bone conduction sound was heard longer than the air conduction sound. the nurse determines that the client is most likely experiencing

conductive hearing loss

a sign of infection in the elder that is more common than fever is

confusion

crackling sound or sensation heard or felt with joint movement

crepitus

the nurse is planning to inspect an adult client's mouth, using a tongue depressor. the nurse should plan to

depress the tongue blade slightly off center

noticeable loss of vision and distortion of familiar objects and occasional floaters

diabetic retinopathy

the nurse is planning a presentation to a group of high school students about the risk factors for oral caner. which of the following should be included in the nurse's plan

diets low in fruits and vegetables are a possible risk factor for oral cancer

before examining the mouth of an adult client, the nurse should first

don clean gloves for the procedure

backward bending or flexion of a joint

dorsiflexion

movement bringing a limb into or toward a straight condition

extension

the cone of light is located in the

external ear

bones contain yellow marrow that is composed mainly of

fat

joints may be classified as cartilaginous, synovial, or

fibrous

the nurse is preparing the examine the ears of an adult client with an otoscope. the nurse should plan to

firmly pull the auricl, out, up, and back

a client visits the clinic and tells the nurse that after playing softball yesterday, he thinks his knee is 'locking up'. the nurse should perform McMurray test by asking the client to

flex the knee and hip while in a supine position

movement that brings a limb into or toward a bent condition

flexion

in the hearing pathway, hair cells of the spiral organ of corti are stimulated by movement of

fluid

an adult client tells the nurse that he eats sardines every day. the nurse should instruct the client that a diet high in purines can contribute to

gouty arthritis

while examining the spine of an adult client, the nurse notes that the client has a flattened lumbar curvature. the nurse should refer the client to a physician for possible

herniated disc

an older adult client visits the clinic and tells the nurse that she has had shooting pain for the past several days. the nurse should assess the client for signs and symptoms of

herniated intervertebral disc

articulation between the head of the femur and the acetabulum is in the

hip joint

while reviewing a client's charts before seeing the client for the first time, the nurse notes that the client has a diagnosis of dupuytren contracture. the nurse anticipates that the client will exhibit

inability to extend the ring and little finger

while assessing the ears of an adult client, the nurse observes that the tympanic membrane is completely immobile. the nurse should further assess the client for signs and symptoms of

infection

an adult client tells the nurse that his 80-year-old father is almost completely deaf. after an explanation to the client about risk factors for hearing loss, the nurse determines the client needs further instruction when the client says

it is difficult to prevent hearing loss or worsening hearing

abnormal convexity of the posterior curve of spine

kyphosis

a benign skin lesion commonly seen in the aged is

lentigines

a client visits the clinic and tells the nurse that he has had lower back pain for the past several days. to perform lasegue test, the nurse should ask the client to

lie flat and raise his legs to the point of pain

bones in synovial joints are joined together by

ligaments

blurriness of words in center of the page

macular degeneration

the nurse is preparing to examine the sinuses of an adult client. after examining the frontal sinuses, the nurse should proceed to examine the

maxillary sinuses

the tarsal plates of the upper eyelid contain

meibomian glands

the nurse is planning a presentation on osteoporosis to a group of high school students. which of the following should the nurse plan to include in the presentation?

moderate strenuous exercise tends to increase bone density

tenderness or pain in the muscle

myalgia

the nurse is planning to perform an ear examination on an adult client. after explaining the procedures to the client, the nurse should

observe the client's response to the explanations

the optic nerves from each eyeball cross as the

optic chiasma

decreased baroreceptor sensitivity

orthostatic hypotension

while assessing the musculoskeletal system of an adult client, the nurse observes hard painless nodules over the distal interphalanged joints. the nurse should document the presense of

osteoarthritis

a client with insulin-dependent diabetes visits the clinic and complains of painful hip joints. the nurse should asses the client carefully for signs and symptoms of

osteomyelitis

a female client visits the clinic and tells the nurse that she began menarche at the age of 16 years. the nurse should instruct the client that she is at a higher risk for

osteoporosis

transmission of sound waves in the inner ear is known as

perceptive hearing

the external covering of the bone that contains osteoblasts and blood vessels is termed the

periosteum

type of flexion associate with foot extension

plantar

the nurse is preparing to inspect the nose of an adult client with an otoscope. the nurse plans to

position the handle of the otoscope to one side

diminished vibratory sensations and slowed motor responses in advanced age result in

postural instability

one of the functions of a bone is to

produce blood cells

the bony orbit and fat cushion of the eye serves as a

protector

straight movements of the eye are controlled by the

rectus muscles

a nurse assesses the mouth of an adult male client and observes a rough, crusty, eroded area. the nurse should

refer the client for further evaluation

an adult client visits the clinic and tells the nurse that she has been experiencing frequent nosebleeds for the past month. the nurse should

refer the client for further evaluation

while assessing the ears of an adult client. the nurse observes bloody drainage in the client's ear. the nurse should

refer the client to a physician

photoreceptors of the eye are located in the eye's

retina

floaters associated with flashes of light

retinal detachment

a client visits the clinic and tells the nurse that she has painful cracking in the corners of her lips. the nurse should assess the client's diet for a deficiency of

riboflavin

loss of elasticity in aorta and arteries

rise in systolic blood pressure

while assessing the range of motion in an adult client's shoulders, the client expresses pain and exhibits limited abduction and muscle weakness. the nurse plans to refer the client to a physician for possible

rotator cuff tear

the nurse is assessing the spine of an adult client and detects lateral curvature of the thoracic spine with an increase in convexity on the left curved side. the nurse suspects that the client is experiencing

scoliosis

the subacromial bursae are contained in the

shoulder joint

calcification, stiffening, and dilation of the aortic valve

soft systolic murmur at base of heart

the ossicles contained in the middle ear include the malleus, the incus, and the

stapes

an adolescent client tells the nurse that her mother says she grinds her teeth when she sleeps. the nurse should explain to the client that grinding the teeth may be a sign of

stress and anxiety

the nurse is planning to conduct the weber test on an adult male client. to perform this test, the nurse should plan to

strike a tuning fork and place it on the center of the client's head or forehead

when the nurse moves a client's leg upward, the nurse is performing

supination

an adult client visits the clinic and complains of tinnitus. the nurse should ask the client if she has been

taking antibiotics

skeletal muscles are attached to bones by

tendons

an adult client visits the clinic complaining of a sore throat. after assessing the throat, the nurse documents the client's tonsils as 4+. the nurse should explain to the client that 4+ tonsils are present when the nurse observes tonsils that are

touching each other

sensory receptors in the ear that help to maintain both static and dynamic equilibrium are located in the semicircular canals and the

vestibule

the nurse is caring for an adult client who is in a cast because of a fractured arm. to promote healing of the bone and tissue, the nurse should instruct the client to eat a diet that is high in

vitamin C

a client tells the nurse that his grandmother has a diagnosis of osteomalacia. the nurse should instruct the client that to decrease the risk factors for osteomalacia, the clients should have adequate amounts of

vitamin D

the nurse is preparing to perform a musculoskeletal examination on an adult client. the nurse has explained the examination procedure to the client. the nurse determines that the client needs further instructions when the client says

you'll continue with range of motion even if i have discomfort