Patho PrepU Chp 38

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

The nurse is caring for an elderly client with a suspected diagnosis of presbycusis. Select the most likely manifestation that the nurse would note.

Inability to understand words during a conversation

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.

The nurse is assessing the hearing of a twenty-five-year-old client who reports chronic painless tinnitus and difficulty hearing. The nurse suspects the client suffers from which of the following?

Otosclerosis

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

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

Preventing developmental delays

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."

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

A 2-year-old child has been diagnosed with uncomplicated acute otitis media by a nurse practitioner. When explaining the plan of care, which description is most appropriate?

"Let's keep a close eye on his condition for a couple of days before starting antibiotics."

A client with a diagnosis of benign paroxysmal positional vertigo (BPPV) is receiving teaching from her physician about her diagnosis. The client is eager to avoid future episodes of vertigo and has asked the physician what she can do to prevent future episodes. How can the physician best respond?

"There are some exercises that I'll teach you to help reorient your inner ear and prevent vertigo."

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. The health care provider interprets this as:

Acute vestibular neuronitis

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.

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 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

A client tells the nurse that when she is in bed, changes position of her head, and rolls into a lateral position, she experiences brief periods of vertigo, usually lasting less than 1 minute. The client is most likely experiencing:

Benign paroxysmal positional vertigo

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

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

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

The nurse is caring for a client who has been diagnosed with presbycusis. The nurse understands that with this disorder, the client experiences which of the following?

Difficulty hearing high-pitched frequencies

Impaired function of which eye structure is responsible for blurred vision and loss of fine tuning of focus?

Lens

The nurse who works at a clinic for pediatric clients observes that a frequent reason for client visits is acute otitis media (AOM). The nurse understands which of the following structural characteristics of the ear in infants and children increase the potential for AOM?

Less efficient tensor muscle to open the eustachian tube

The nurse is assessing a client who has been diagnosed with esotropia. The nurse would expect the assessment findings to include:

Medial deviation

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

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.

For complete function of the eyes, it is necessary that the two eyes point toward the same fixation point and that the retinal and central nervous system visual acuity mechanisms function. How many pairs of extraocular muscles does binocular vision depend on?

Three

A 60-year-old client with a medical history of diabetes and hypertension is having a yearly physical exam, and the practitioner instructs the client to make an appointment with an ophthalmologist. The client states that there is nothing wrong with her vision. What is the best response from the practitioner to explain the purpose of a checkup by an opthamologist?

To rule out the presence of open-angle glaucoma, which often has no signs or symptoms

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

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

The parent of a 10-year-old child who has developed severe inflammation, excessive tearing, fever, clear discharge from his eyes, and is very listless arrives at the medical care unit. The parent tells the receiving nurse that the child started swimming lessons at the community pool last week. The nurse would suspect which of the following?

Viral conjunctivitis

A patient has been diagnosed with bacterial conjunctivitis. This type of infection is usually characterized by large amounts of what color drainage?

Yellow-green

A 42-year-old client has sought care because he reports increasing difficulty reading the labels on packages and other small fonts. He states that he has to continually hold it further and further away from his face in order to see the type clearly. The client is most likely experiencing:

an age-related change in accommodation.

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."

A 69-year-old patient comes to the clinic for a routine checkup. Upon examination the nurse practitioner informs the patient that she has cataracts. The patient then tells the nurse that she already knew that and her physician told her that she could use bifocals and that would take care of the problem. What would be the best response by the nurse practitioner?

"Surgery is the only effective treatment for cataracts."

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.

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 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

A patient tells the nurse that he has hearing loss due to otosclerosis. The nurse realizes that the patient has which of the following?

Conductive hearing loss

As the eyes rotate upward, the upper eyelid reflexively retracts. Which cranial nerve is primarily responsible for this response?

Cranial nerve III.

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

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

The nurse understands that vestibular rehabilitation includes which of the following?

Exercises in balance retraining

A group of student nurses is reviewing the anatomy of the eye for an upcoming exam. One of the student nurses asks where the tarsal plate is located. What is the response?

Eyelid

The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse understands which of the following medications may be prescribed for diagnostic purposes? Select all that apply.

Furosemide (Lasix) Urea Glycerin

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

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.

Oculomotor nuclei Retinal ganglionic cells Preganglionic neurons Pretectal nuclei

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.

Otitis media (OM), which can occur is any age group, is the most common diagnosis made by health care providers who care for children. Which bacterial pathogen causes the largest proportion of cases that result in sensorineural hearing loss?

Streptococcus pneumoniae

A young child is flying on a plane for the first time. As the plane begins its decent for landing, his ears begin to hurt. The flight attendant sees that he is in pain and tells him to swallow until the pain goes away. Which structure is the child using to equalize the pressure and relieve the pain?

Swallowing pulls air through the eustachian tubes, allowing the air pressure to equalize in the inner ear.

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

The nurse understands that movement of otoliths may result in which of the following?

Vertigo and nystagmus

A client is distraught because she has suddenly lost vision in the right half of both of her eyes. The care team's subsequent diagnostic testing will address the likelihood of:

an optic nerve lesion.

An elderly woman comes to the clinic complaining of seeing flashing lights and small spots. She tells the nurse that this has been going on for over 24 hours but now it is as if she sees a dark curtain whenever she opens her eyes. She asks the nurse if this means she is going to be blind.What diagnosis should the nurse suspect ?

retinal detachment

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

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

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."

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

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 is explaining to the parent of a 5-year-old that the child has otitis media with effusion (OME), noted by otoscopic exam, following an upper respiratory infection. Unlike acute otitis media (AOM), OME does not require treatment with antibiotics because it is usually which of the following?

Asymptomatic and often self-limiting

The nurse suggests which of the following to a mother who is taking her two-month-old infant on an airplane ride?

Breast feed or bottle feed the infant during the airplane's ascent or descent.

The parents of a 1-month-old child tell the nurse at the pediatrician's office that their child doesn't seem right; the child doesn't always look toward them when they speak. What assessment does the nurse expect the physician to conduct?

Hearing screening

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 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

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 is discussing measures that a client may take to prevent barotrauma related to airplane travel. Which of the following measures will the nurse recommend during changes in air pressure?

Swallowing

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

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

Upper respiratory infection

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

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