Clin Path Chapter 12

In contrast to acute pain, persistent chronic pain indicates which purpose?

Imposes physiologic stresses

Which clinical manifestation is commonly seen in clients with systemic problems such as diabetes and/or hypertension?

Intraretinal hemorrhages

While performing a Romberg test on a client, the client asks, "What is the purpose of this test?" Which response by the nurse is most accurate?

It assesses for static vestibular function

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids?

Periaqueductal gray (PAG) region

Which pain disorder is a manifestation of a disruption of cranial nerve function?

Trigeminal neuralgia

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."

Which of these clients' statements would be most suggestive of retinal detachment?

"I feel like there's a shadow that's blocking my vision."

A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing:

Acute angle-closure glaucoma

An older adult client is scheduled for outpatient cataract surgery. While taking a presurgery history, which statement by the client correlates to the manifestations of cataracts, thereby verifying the client has received information about the condition?

"I have blurred vision in both my eyes and my vision is distorted."

An older adult client has been diagnosed with macular degeneration. Which statement by the client best demonstrates an accurate understanding of the new diagnosis?

"I suppose that this may be one of the things that happens when you get older."

The nurse is working with a client who has been diagnosed with recurring migraine headaches. Which advice by the nurse is most appropriate?

"Many people find that maintaining regular eating and sleeping habits is beneficial."

A client asks if pain threshold and pain tolerance are the same. The best response by the health care provider would be:

"Pain threshold is the point at which a stimulus is perceived as painful."

A client tells the health care provider that he developed an acute onset (hours) of vertigo, nausea, and vomiting lasting several days, but he has not had auditory or other neurologic manifestations. Which possible diagnosis is responsible for this client's manifestations?

Acute vestibular neuronitis

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

Amblyopia

For which older adult client would pain assessment likely be most challenging for the nurse?

An 87-year-old client with vascular dementia and numerous other health problems, such as heart failure

The nurse is explaining the role of aqueous humor in the development of glaucoma to a client who has just been diagnosed with the condition. How should the nurse describe the role of aqueous humor in the pathogenesis of glaucoma?

Aqueous humor is continually produced and drained to maintain the appropriate pressure. In glaucoma, the normal drainage is impeded and the increased pressure can damage the optic nerve.

A client presents with copious amounts of yellow-green drainage, conjunctival redness, and chemosis to the right eye. A culture of the eye drainage reveals S. pneumoniae. The client most likely developed:

Bacterial conjunctivitis

Which principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?

Dosing and timing should aim for a steady serum level of the prescribed drug.

Which pain assessment tool is best to utilize when caring for children between ages 3 to 8 years?

FACES pain scale

The nurse is conducting a health promotion class on the prevention of blindness and vision impairment. The nurse determines that participants understand the information when they identify which vision disorder as most likely to have an infectious etiology?

Keratitis

Select the statement that best describes Meniere disease.

Meniere disease is a disorder of the inner ear due to distention of the endolymphatic compartment of the inner ear, causing hearing loss, vertigo, and tinnitus.

While on an ocean cruise, a person develops malaise and nausea/vomiting. The nurse notes the client's blood pressure is 88/52 mm Hg; pulse is 110 bpm; and skin is moist with perspiration. Which diagnosis is associated with these clinical manifestations?

Motion sickness

The nurse is caring for a client with visual impairment due to lens thickening. Which condition does the nurse suspect?

Myopia

Which intervention is usually the first line of therapy when treating moderate pain in the older adult population?

Nonopioids such as acetaminophen

To maintain fixation on stable objects during head rotation, the eyes slowly drift in the opposite direction and then jump rapidly back toward the direction of rotation. This process is known by what term?

Nystagmus

A client is experiencing chest pain that radiates to the left arm and neck. The nurse would interpret this pain as:

Referred

A client expresses concern about feeling fullness in the ear. Which additional manifestation leads the health care provider to suspect Menière disease?

Rotary vertigo and tinnitus

The nurse is caring for an older adult client with a suspected diagnosis of presbycusis. Select the most likely manifestation.

Sensorineural hearing loss caused by natural aging

Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by which region of the brain?

Somatosensory cortex

If a client is experiencing acute pain, which clinical manifestation will the nurse assess?

Tachycardia

The nurse is performing an eye assessment on a client who presents with a red eye. The nurse determines that the redness is related to bacterial conjunctivitis based on which additional symptom(s)?

Tearing, itching, and burning

A client with a history of migraine headaches tells the physician that he or she usually experiences an aura before the onset of the headache. The client is most likely experiencing:

Visual disturbances

Which characteristic differentiates a migraine with aura from a migraine without aura?

Visual symptoms such as flickering lights precede the headache

The nurse is caring for a client with visual impairment who states recent difficulty seeing clearly at night. Which condition does the nurse suspect the client may suffer from?

Vitamin A deficiency

Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:

an illusion of motion.

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 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.

A client has been diagnosed with open-angle glaucoma during a routine eye exam. The client has been prescribed a topical β-adrenergic antagonist. Client teaching about how this drug works should include which of the following statements? β-adrenergic antagonists:

lower intraocular pressure by decreasing aqueous humor production

Which hearing test would be prescribed to help differentiate conductive from sensorineural hearing loss?

A Weber (tuning fork) test

Which client may be experiencing the effects of neuropathic pain?

A man with pain secondary to his poorly controlled diabetes

When pupillary dilation partially compensates for the reduced size of the retinal image by increasing the light entering the pupil, this is a component of which eye adjustment?

Accommodation

A client reveals that, when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client most likely experiencing?

Benign paroxysmal positional vertigo

Place the pain pathway steps in correct order, according to the specificity theory of pain. Spinal cord Medulla oblongata Spinothalamic tract Specific pain pathway Periphery

Periphery Spinal cord Medulla oblongata Spinothalamic tract Specific pain pathway

Which visual deficit is a clinician justified in attributing to the normal aging process?

Presbyopia

A nurse working in an outpatient pediatric clinic notes a large number of ear infections among children. What is the nurse's understanding of this increased rate?

The eustachian tube is narrower in children.

The nurse is assessing a client's hearing and wants to determine if the client has hearing loss of certain frequencies. Which audiometry test will the nurse perform?

Pure-tone audiometry

A client experiencing deep somatic pain would manifest which clinical symptoms? Select all that apply.

Radiation of pain Pain reproduced by stimuli

A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which assessment components should the nurse prioritize when assessing the client's pain?

The client's subjective report of the character and severity of pain

The nurse is caring for a client with impaired vision. When reviewing the client's recent diagnostic test results, the nurse notes the client's intraocular pressure is 12 mmHg. How does the nurse interpret these results?

The intraocular pressure is normal.

A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items?

The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron

A 2-year-old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be:

Tympanostomy tube insertion

A client who experiences constant cloudiness of vision, sees floaters, and has an opaque lens is diagnosed with a cataract. The most appropriate treatment would be:

surgical lens replacement to correct vision.

Which stimulus would be used to elicit the withdrawal reflex when testing response to nociceptive stimuli?

pressure from a sharp object

A client is experiencing a cluster headache. The client would most likely manifest:

severe pain behind the eye.