Sensory Perception PrepU's

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The pain of labor is influenced by many factors. What is one of these factors?

the woman is prepared for labor and birth

The nurse understands that movement of otoliths may result in:

vertigo and nystagmus

Which question is most likely to be clinically useful in the differential diagnosis of sensorineural versus conductive hearing loss?

"What medications do you currently take?"

An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which teaching point about the client's future health risks is most accurate?

"When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

The school nurse is preparing a teaching plan for young school-aged children on ways to maintain eye health and prevent eye damage. What information would the nurse include in the plan? Select all that apply.

"Do not look directly at the sun on sunny, bright days." "If you have difficulty seeing objects, report this to your parents or teacher." "Do not rub your eyes."

The nurse in the emergency department is caring for a child who has a simple contusion of the right eye following a motor vehicle accident. Upon discharge to home, which response by the parents requires further clarification?

"I will need to apply heat to the eye four times a day."

A primigravida client at 38 weeks' gestation calls the clinic and reports, "My baby is lower and it is more difficult to walk." Which response should the nurse prioritize?

"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks."

The nurse is supervising a family member who instilling ear drops into the client's ear. Which of the following statements, made by the family member, would require further nursing instruction?

"These drops are cold from being on the window sill."

Which clients would be considered high risk for developing papilledema? Select all that apply.

43-year-old male with diabetes, renal insufficiency and BP 200/107 mm Hg. 25-year-old motorcyclist who was in an accident and has a potential subdural hematoma. 2-year-old client who has a shunt placed following a diagnosis of hydrocephalus.

Which situation demonstrates sensory adaptation?

A client has learned to sleep through the frequent beeping of the intravenous pump.

There are 12 pairs of cranial nerves. Only three are sensory. Select the cranial nerve that is affected with decreased visual fields.

Cranial nerve II

Which cranial nerve is designated as the vestibulocochlear nerve?

Cranial nerve VIII

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 client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:

demonstrate eyedrop instillation.

Health teaching for a patient who suffers from motion sickness would include recommending the use of which one of the following over-the-counter drugs?

dramamine

The nurse is assessing a client who has experienced a seizure. The client describes having a feeling or warning that the seizure would occur. Which term does the nurse use when documenting about this perceived warning?

prodrome

A client has been involved in a motor vehicle accident and has sustained spinal cord damage. The client has voluntary motor function loss on one side and a loss of pain and temperature sensation from the contralateral side below the level of the lesion. What type of cord syndrome does the nurse recognize the client has sustained?

Brown-Sequard syndrome

Which action(s) is appropriate to safely bathe an older adult client? Select all that apply.

Carefully monitor water temperature. Provide the client a long-handled shower brush or attachment if experiencing limited mobility. Use a tub/shower seat if balance problems are present.

The nurse is caring for an 88-year-old male admitted 2 days ago for dehydration. The nurse brings the client his breakfast tray and notes that the client appears to be having difficulty understanding what she is saying to him today. Which nursing action is most appropriate?

Check the client's ear canals for cerumen.

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure?

Clitoris

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.

Dementia Blindness Ataxia

The nurse is evaluating the hearing of a newborn with the understanding that an infant may be born with hearing deficits related to which family history? Select all that apply.

Developmental malformation of the inner ear Maternal rubella Genetic causes

Which statement best explains why digital removal of stool is considered a last resort after other methods of bowel evacuation have been unsuccessful?

Digital removal of stool may cause parasympathetic stimulation.

How does a woman who feels in control of the situation during labor influence her pain?

Feelings of control are inversely related to the client's report of pain.

A client's family member asks the nurse, "What is a conversion disorder?" Which is the best response by the nurse?

It involves unexplained, usually sudden, deficits in sensory or motor function.

Spinal nerves that form complex nerve networks are called which of the following?

Plexuses

A patient with Bell's palsy says to the nurse, "It doesn't hurt anymore to touch my face. How am I going to get muscle tone back so I don't look like this anymore?" What interventions can the nurse suggest to the patient?

Suggest massaging the face several times daily, using a gentle upward motion, to maintain muscle tone.

Which lobe of the brain performs functions of perception, long-term memory, and recognition of auditory stimuli?

Temporal lobe

The nurse is performing a test to determine a client's neurologic function related to a suspected lesion in the parietal lobe. What would the nurse determine is a normal finding after assessment?

The client is able to determine correctly that the item placed in his hand is a paper clip.

The diagnosis of delirium is supported when the nurse notes what about the client?

The client reports seeing "hundreds of bugs" and is not always oriented to time and place

The nurse is conducting a physical examination of an 8-month-old infant. Which observation may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex).

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 mother is placing her child into the bathtub. The child immediately jumps out of the tub and begins to cry, stating her feet are "burning." The nurse in the emergency department knows that the child's response is based on which pathophysiologic principle listed below?

The tactile sensation occurs well in advance of the burning sensation. The local withdrawal reflex reacts first.

Which statement describes benign paroxysmal positional vertigo (BPPV)?

The vertigo is usually accompanied by nausea and vomiting.

The health care provider is assessing the functional integrity of all spinal nerves utilizing a pinpoint pressed against the skin. A normal response would be interpreted as:

The withdrawal reflex is activated.

Which of the following would be incorporated as a teaching strategy for a hearing-impaired person?

Use slow, directed, and deliberate speech

A client with hearing loss gets very frustrated trying to carry on conversations with friends. Which type of stressor is the client experiencing?

sensory deficits

Which process is most likely to occur as a result of a spinal reflex?

Withdrawal of a hand from a hot stove element

Which type of reflex is stimulated by a nociceptive stimulus?

Withdrawal reflex

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with

abnormal sensations.

The cardiac monitor technician is installing new monitors. The intensive care unit (ICU) nurse asks that the monitors have different sound levels for the more lethal alarms as the repeated stimulus of a continuing noise often goes unnoticed. The ICU nurse explains that this phenomenon is known as:

adaptation

The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?

administering antibiotics as soon as they're available

Which term refers to the failure to recognize familiar objects perceived by the senses?

agnosia

The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate?

conductive

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

glaucoma

A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress?

glucocorticoids

A nurse asking questions during an infant's health surveillance visit has the mother tell her: "My baby was premature and weighed 3 pounds at birth." The medical record provides an Apgar score of 5 at 5 minutes and indicates the child received gentamicin in the neonatal intensive care unit (NICU). What should the nurse consider as the greatest risk for this child?

hearing deficit

A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition?

hyperopia

The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the:

importance of patching as prescribed.

After an eye examination, a client is diagnosed with open-angle glaucoma. The physician orders pilocarpine ophthalmic solution, 0.25% gtt i, OU q.i.d. Based on this prescription, the nurse should teach the client or a family member to administer the drug by

instilling one drop of pilocarpine 0.25% into both eyes four times daily.

A client who requested "no drugs" in labor asks the nurse what other options are available for pain relief. The nurse reviews several options for nonpharmacologic pain relief, and the client thinks effleurage may help her manage the pain. This indicates that the nurse will:

instruct the client or her partner to perform light fingertip repetitive abdominal massage.

What clinical manifestations does the nurse recognize when a patient has had a right hemispheric stroke?

left visual field deficit

Which of the following nursing intervention can prevent a client from experiencing autonomic dysreflexia?

monitoring the patency of an indwelling urinary catheter

A young teenager is brought to the clinic for an eye exam. The client has been reporting difficulty in school because of the inability to see the blackboard as clearly as when younger. The client tells the nurse that vision is blurry. What should the nurse suspect is wrong with this child?

myopia

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

myopia

What will conduct injurious stimuli to alert the body to potential damage?

nociceptors

Hypothalamic sensory neurons that promote thirst when stimulated are called:

osmoreceptors

A nurse conducted a history and physical for a newly admitted patient who states, "My arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing:

Loss of accommodative power in the lens.

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?

Maintain healthy blood pressure and blood sugar levels.

A client who is considered legally blind is diagnosed with a free-running sleep disorder (FRSD) after frequent reports of difficulty sleeping. Which scenario would the nurse advise for this client?

Maintaining a regular sleep-wake schedule

A client who is being treated in the critical care unit is experiencing a slowing of blood flow to the central retinal artery, ultimately resulting in edema of the client's optic papilla. Which assessment would most likely address the etiology of this health problem?

Monitoring of the client's intracranial pressure

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

Reading

A client begins to exhibit hallucinations and delusions along with disorganized speech after forgetting to take antipsychotic medication. The nurse suspects that the client is at which point in the clinical course of the disorder?

Relapse

A 74-year-old client has kyphosis and is reporting discomfort of the cervical vertebrate. Which nursing intervention is most appropriate?

placing a small towel under the neck

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

promethazine


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