ATI questions - Sensory Perception

A nurse is assessing a client who has delirium. Which of the following manifestation should the nurse expect? (Select all that apply.)

Difficulty maintaining attention. Agitation. Hallucinations. Rambling speech.

A nurse is preparing to administer medication's to a client. Which of the following classifications of medication should the nurse identify as being ototoxic (hearing or balance problems) ? Select all that apply.

Loop diuretics. NSAIDs. Aminoglycoside antibiotics.

A nurse is caring for a client who states, "my doctor said I should have EMG. What is that?" Which of the following responses should the nurse meet?

"It is a test that determines if there is nerve damage affecting a muscle."

Hey chargers discussing sensory processing disorder with a newly licensed nurse. Which of the following statements at the charge nurse make?

"SPD Causes clients to be overly sensitive to stimuli, such as the feel of fabric on their skin."

A nurse is caring for a client who is scheduled for an auto acoustic omissions (OAE) test. The client asks what to expect during the test. Which of the following responses should the nurse make?

"You will have a small probe placed in your ear canal during the test."

A charge nurse is discussing hearing test with a newly licensed nurse. Which of the following information should the charge nurse include?

A tuning fork is placed against the clients mastoid bone during the Rinne test.

A nurse is providing teaching about safe ambulation to a client who has vision loss. Which of the following items should the nurse include in the teaching?

A walking cane. A walker.

A nurse is reviewing the medical record of a client who reports recent anosmia. The nurse should identify which of the following conditions as a risk factor for developing anosmia.

Alzheimer's disease.

A nurse is assessing a client whose family is concerned that the client has developed dementia. Which of the following findings should the nurse identify as a manifestation of dementia?

Difficulty problem-solving.

A nurse is assessing a client for hearing loss. Which of the following findings should the nurse identify as an indication of a possible hearing loss?

Ask for questions to be repeated. Withdraws from social activities. Describe sounds as being muffled.

A nurse is reviewing discharge instructions with a client who has macular degeneration. Which of the following information should the nurse include in the instructions?

Availability of age to enhance vision.

A nurse is preparing to perform a cranial nerve assessment on a client. Which of the following action should the nurse take to assess cranial nerve II?

Check the clients visual acuity using a Snellen chart. (Optic nerve)

A nurse is caring for a client who has hearing loss. Which of the following action should the nurse use to enhance communication with the client? (Select all that apply.)

Ensure the client wears their hearing aids. Use a sign language interpreter. Communicate using paper and pen. Face the client when speaking.

A nurse is caring for a client who reports decreased peripheral vision. The nurse should identify this is a manifestation of which of the following visual impairments?

Glaucoma

A nurse is teaching a group of older adult client about the sensory system. The nurse should include that the aging process is most likely to cause which of the following changes?

Hearing loss

A nurse is providing discharge teaching to a client who has diabetic neuropathy. Which of the following information should the nurse include?

Inspect the feet every day. Wear close toed shoes. Manage glucose levels.

A nurse is providing care for a client who has a sensory deficit. Which of the following actions is the nurses priority for the client?

Keep the clients environment free from clutter.

A nurse is preparing an in-service for a group of staff members about types of test used to diagnose sensory impairment. Which of the following information should the nurse include?

Phone osculate her test measures how efficiently sound waves are transmitted through the ossicles.

A nurse is caring for a middle adult client who asks about expected age related changes. Which of the following century changes to the nurse include as an age related change?

Presbyopia (Decreased in the ability to focus clearly on objects that are up close. )

A nurse is preparing a poster presentation about sensory alterations. Which of the following information should the nurse include about sensory deprivation?

Race factors for sensory deprivation include it experiencing total vision or hearing loss.

A nurse is caring for an older adult client who reports unintended weight loss. The client reports that their food Does not taste right. The nurse should inform the client the ability to taste which of the following can decrease with age? (Select all that apply.)

Sour, Salty, bitter

A nurse is reviewing the process of how a refraction assessment is perform with the client. Which of the following statements should the nurse made?

This test is performed using lenses are various prescription strength.

A nurse is reviewing the medical history of a client who has conductive hearing loss. The nurse should identify which of the following factors as a potential cause of conductive hearing loss? (Select all that apply.)

Trauma to the outer ear. Inflammation. Cerumen buildup. Otis media.

A nurse is preparing to perform a cranial nerve assessment on a client. Which of the following actions should the nurse take to assess cranial nerve VIII

Whisper something in one ear while occluding the other ear.