Ch 41 Intro to Sensory

A nurse is helping a patient with her morning bath. The patient complains of having dry eyes. The nurse knows that the eyelids contain multiple glands that protect the eye. Which of the following eyelid glands should the nurse first assess? Sebaceous Sweat Lacrimal Meibomian

Lacrimal

The public health nurse is addressing eye health and vision protection during an educational event. What statement by a participant best demonstrates an understanding of threats to vision? "I'm planning to avoid exposure to direct sunlight on my next vacation." "I've never exercised regularly, but I'm going to start working out at the gym daily." "I'm planning to talk with my pharmacist to review my current medications." "I'm certainly going to keep a close eye on my blood pressure from now on."

"I'm certainly going to keep a close eye on my blood pressure from now on."

A client is ready to be discharged home after a cataract extraction with intraocular lens implant and the nurse is reviewing signs and symptoms that need to be reported to the ophthalmologist immediately. Which of the client's statements best demonstrates an adequate understanding? "I need to call the doctor if I get nauseated." "I need to call the doctor if I have a light morning discharge." "I need to call the doctor if I get a scratchy feeling." "I need to call the doctor if I see flashing lights."

"I need to call the doctor if I see flashing lights."

A 56-year-old client has come to the clinic for his routine eye examination and is told he needs bifocals. The client asks the nurse what change in his eyes has caused his need for bifocals. How should the nurse respond? "You know, you are getting older now and we change as we get older." "The parts of our eyes age, just like the rest of us, and this is nothing to cause you to worry." "There is a gradual thickening of the lens of the eye and it can limit the eye's ability for accommodation." "The eye gets shorter, back to front, as we age and it changes how we see things."

"There is a gradual thickening of the lens of the eye and it can limit the eye's ability for accommodation."

A client is receiving a hearing test after noticing a decline in hearing. During client education, the nurse indicates the lowest level of sound that individuals may normally hear. What is that level? 20 dB 10 dB 5 dB 25 dB

20 dB

A patient is suspected of having glaucoma. What reading of IOP would demonstrate an increase resulting from optic nerve damage? 0 to 5 mm Hg 6 to 10 mm Hg 11 to 20 mm Hg 21 mm Hg or higher

21 mm Hg or higher

A client has undergone tonometry to evaluate for possible glaucoma. Which result would the nurse record as abnormal? 10 mm Hg 15 mm Hg 20 mm Hg 25 mm Hg

25 mm Hg

The nurse is reviewing the results of a client's audiometric testing. The nurse determines that the client has a mild hearing loss based on the result signifying which loss of decibels? 20 30 45 80

30

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: 0 to 5 mm Hg. 6 to 10 mm Hg. 11 to 20 mm Hg. >21 mm Hg.

>21 mm Hg.

A 20-year-old healthy client is having an annual physical exam done by a nurse practitioner. Prior to the exam, the client asks the office nurse whether an eye examination is also needed despite having healthy eyes. Which would be the nurse's best response? A complete eye examination is recommended once in the 20s and twice in the 30s. A baseline comprehensive screening is not done until age 40 years. A baseline comprehensive screening is done in the 20s with complete annual exams beginning in the 30s. A complete eye examination is recommended once in the 20s and once in the 30s. A baseline comprehensive screening is not done until age 50 years. A baseline comprehensive screening is done in the 20s with complete eye examinations beginning in the 40s.

A complete eye examination is recommended once in the 20s and twice in the 30s. A baseline comprehensive screening is not done until age 40 years.

A patient comes to the clinic with a suspected eye infection. The nurse recognizes that the patient most likely has conjunctivitis, as evidenced by what symptom? Blurred vision Elevated IOP A mucopurulent ocular discharge Severe pain

A mucopurulent ocular discharge

A client in the emergency room was involved in a motor vehicle accident which caused blunt facial trauma, especially to the orbit of the skull. Which bones are in danger of fracture in this type of injury? Select all that apply. Lacrimal Ethmoid Mastoid Stapes Frontal

Lacrimal Ethmoid Frontal

A patient is complaining of ringing in the left ear and hearing loss in the same ear, but does not have any associated dizziness or vertigo. What should this patient be assessed for? Otitis media Acoustic neuroma Labyrinthitis Tinnitus

Acoustic neuroma

A 24-year-old client in good health is having an annual physical exam done by a nurse practitioner. The client wonders whether a hearing examination is needed. Which would be the nurse's bestresponse? Adults should be screened at least every decade through the age of 50 years and every 3 years after that. Adults should be screened every decade through the age of 40 years and every 5 years after that. Adults should have a baseline screening at age 40 years and every decade after age 50 years. The screening in adults is generally voluntary; therefore, there are not any current recommendations for screening.

Adults should be screened at least every decade through the age of 50 years and every 3 years after that

The nurse is performing the Rinne test on a client with a sensorineural hearing loss. Which of the following would the nurse expect? Hearing of the sound better in the affected ear Sound described as being centered in the middle of the head Air-conducted sound louder than bone-conducted sound Air-conducted sound heard longer than bone-conducted sound

Air-conducted sound heard longer than bone-conducted sound

It is important for the nurse to educate clients newly diagnosed with Ménière disease to avoid which foods in their diet? Select all that apply. Alcohol Milk High-salt foods Spicy food Monosodium glutamate Caffeine Whole grains

Alcohol High-salt foods Monosodium glutamate Caffeine

A client has informed the home health nurse that she has recently noticed distortions when she looks at the Amsler grid that she has mounted on her refrigerator. What is the nurse's most appropriate action? Reassure the client that this is an age-related change in vision. Arrange for the client to have her visual acuity assessed. Arrange for the client to be assessed for macular degeneration. Facilitate tonometry testing.

Arrange for the client to be assessed for macular degeneration.

A patient has been diagnosed with a fungal infection causing external otitis. What is the most common fungal infection in the ear? Staphylococcus aureus Aspergillus Pseudomonas Streptococcus

Aspergillus

A nurse is caring for a client scheduled to have angiography of the right eye in 1 hour. What is the highest priority nursing intervention? Assess blood urea nitrogen (BUN) and creatinine levels. Instruct the client to hold their head still during the procedure. Educate the client about the feeling of warmth and metallic taste that may occur during the procedure. Assess for dark yellow to orange urine.

Assess blood urea nitrogen (BUN) and creatinine levels.

A 78-year-old client reports decreased hearing in the right ear. The doctor orders irrigation of the right ear to remove cerumen. Which is the priority action by the nurse? Ensure that warm water is used for irrigation Assess for a ruptured tympanic membrane Protec the client's clothing from getting wet Use gentle pressure behind the cerumen impaction

Assess for a ruptured tympanic membrane

A client newly diagnosed with otitis media reports that the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? Assess the tympanic membrane. Educate the client on the therapeutic effects of medications. Document the effectiveness of medications. Irrigate the ear.

Assess the tympanic membrane.

A client with mastoiditis is admitted to the postsurgical unit after undergoing a radical mastoidectomy. The nurse should identify what priority of postoperative care? Assessing for mouth droop and decreased lateral eye gaze Assessing for increased middle ear pressure and perforated ear drum Assessing for gradual onset of conductive hearing loss and nystagmus Assessing for scar tissue and cerumen obstructing the auditory canal

Assessing for mouth droop and decreased lateral eye gaze

Which statement is consistent with acute otitis media? The infection usually lasts more than 6 weeks. It is a relatively uncommon childhood infection. It is usually caused by a fungal infection. Conductive hearing loss may occur.

Conductive hearing loss may occur.

A nurse is working with a client in an optometrist office. What is the role of the nurse with a client who is undergoing an eye examination and tests? Select all that apply. Assuring that the client receives eye care to preserve eye function and prevent further visual loss Assessing and obtaining an accurate baseline of the function and structure of the eyes Teaching the client about the diet and the exercise regimen to be followed after an eye examination Explaining the temporary inability to maintain visual focus after mydriatric eye medications Determining whether further action is warranted

Assuring that the client receives eye care to preserve eye function and prevent further visual loss Assessing and obtaining an accurate baseline of the function and structure of the eyes Explaining the temporary inability to maintain visual focus after mydriatric eye medications

The nurse is admitting a client to the unit who is scheduled to have an ossiculoplasty. What postoperative assessment will best determine whether the procedure has been successful? Otoscopy Audiometry Balance testing Culture and sensitivity testing of ear discharge

Audiometry

A client is diagnosed with otitis externa. Which instruction is most appropriate for the nurse to give? Keep the ear covered with a scarf. Avoid using cold water when shampooing hair. Avoid swimming for 7 to 10 days. Keep a dry cotton ball in the ear canal.

Avoid swimming for 7 to 10 days.

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography? BUN and creatinine AST and ALT Hemoglobin and hematocrit Platelet count

BUN and creatinine

To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it: Backward. Upward. Slightly outward. Downward.

Backward

An older adult reports burning and sensation of object in eye, increased tearing, and inflammation. The nurse explains that these findings are the result of: Changes in lid margins and loss of skin elasticity and orbital fat Alterations in lens accommodation capacity Lens opacities that interfere with pupil dilation and contraction Slackness of the conjunctiva

Changes in lid margins and loss of skin elasticity and orbital fat

Which of the following is the main refracting surface of the eye? Cornea Iris Pupil Conjunctiva

Cornea

The nurse is assessing a client's visual acuity using a Snellen chart. The client states he cannot read the letter at the top of the chart. What action should the nurse do next? Document the findings. Determine whether the client can count fingers. Obtain a tumbling "E" chart to assess visual acuity. Complete an internal eye examination.

Determine whether the client can count fingers

A client is scheduled to have an electronystagmography as part of a diagnostic workup for Ménière disease. What question is it most important for the nurse to ask the client in preparation for this test? Have you ever experienced claustrophobia or feelings of anxiety while in enclosed spaces? Do you currently take any tranquilizers or stimulants on a regular basis? Do you have a history of falls or problems with loss of balance? Do you have a history of either high or low blood pressure?

Do you currently take any tranquilizers or stimulants on a regular basis?

The nurse has taken shift report on a group of clients and has been told that one client has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the client? Ensure adequate lighting in the client's room. Provide a dimly lit room to aid vision by limiting contrast. Carefully point out color differences for the client. Carefully point out fine details for the client.

Ensure adequate lighting in the client's room.

Which of the following features should a nurse observe during an ophthalmic assessment? External eye appearance Internal eye function Visual acuity Intraocular pressure

External eye appearance

The nurse in the ED is caring for a 4 year old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis? External otitis is characterized by aural tenderness. External otitis is usually accompanied by a high fever. External otitis is usually related to an upper respiratory infection. External otitis can be prevented by using cotton-tipped applicators to clean the ear.

External otitis is characterized by aural tenderness.

Which test evaluates clinically significant macular edema? Fluorescein angiography Tonometry Slit lamp examination Perimetry testing

Fluorescein angiography

A 6-month-old infant is brought to the ED by his parents for inconsolable crying and pulling at his right ear. When assessing this infant, the advanced practice nurse is aware that the tympanic membrane should be what color in a healthy ear? Yellowish-white Pink Gray Bluish-white

Gray

A group of high school students is attending a concert, which will be at a volume of 80 to 90 dB. What is a health consequence of this sound level? Hearing will not be affected by a decibel level in this range. Hearing loss may occur with a decibel level in this range. Sounds in this decibel level are not perceived to be harsh to the ear. Ear plugs will have no effect on these decibel levels.

Hearing loss may occur with a decibel level in this range.

Loud, persistent noise has what effect on the body? Dilation of peripheral blood vessels Increased blood pressure Decreased heart rate Decreased gastrointestinal activity

Increased blood pressure

A child has been experiencing recurrent episodes of acute otitis media (AOM). The nurse should anticipate that what intervention is likely to be ordered? Ossiculoplasty Insertion of a cochlear implant Stapedectomy Insertion of a ventilation tube

Insertion of a ventilation tube

An ophthalmologist tells a patient that he has a cataract. The nurse explains to the patient that this means there is: Distortion and loss of central vision. A tendency for the retina to tear. Interference with focusing of a sharp image. Increased corneal exposure.

Interference with focusing of a sharp image.

A nurse is going to evaluate a client for near vision. Which chart would the nurse choose? Jaeger Ishihara polychromatic plates Snellen eye chart cover-uncover test

Jaeger

A client presents to the ED reporting a sudden onset of incapacitating vertigo, with nausea and vomiting and tinnitus. The client mentions to the nurse that she suddenly cannot hear very well. What would the nurse suspect the client's diagnosis will be? Ossiculitis Ménière disease Ototoxicity Labyrinthitis

Labyrinthitis

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? Photorefractive keratectomy (PRK) Laser-assisted stromal in situ keratomileusis (LASIK) Keratoconus Keratoplasty

Laser-assisted stromal in situ keratomileusis (LASIK)

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: Opacity in the lens. Loss of accommodative power in the lens. Shrinkage of the vitreous body. Decreased eye muscle tone.

Loss of accommodative power in the lens.

A nurse is preparing a presentation for a local senior citizen's group about changes in the eye that accompany aging. Which of the following would the nurse most likely include? Select all that apply. Loss of lens accommodative power Development of lens opacities Increased orbital fat Expansion of the vitreous body Loss of eyelid skin elasticity

Loss of lens accommodative power Development of lens opacities Loss of eyelid skin elasticity

An older adult patient has noticed a significant amount of vision loss in the last few years. What does the nurse recognize as the most common cause of visual loss in older adults? Macular degeneration Ocular trauma Retinal vascular disease Uveitis

Macular degeneration

The advanced practice nurse is attempting to examine the client's ear with an otoscope. Because of impacted cerumen, the tympanic membrane cannot be visualized. The nurse irrigates the client's ear with a solution of hydrogen peroxide and water to remove the impacted cerumen. What nursing intervention is most important to minimize nausea and vertigo during the procedure? Maintain the irrigation fluid at a warm temperature. Instill short, sharp bursts of fluid into the ear canal. Follow the procedure with insertion of a cerumen curette to extract missed ear wax. Have the client stand during the procedure.

Maintain the irrigation fluid at a warm temperature.

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find? Clear cornea Constricted pupil Marked blurring of vision Watery ocular discharge

Marked blurring of vision

During a routine eye examination, a patient complains that she is unable to read road signs at a distance when driving her car. What should the patient be assessed for? Astigmatism Anisometropia Myopia Presbyopia

Myopia

The nurse is reviewing the health history of a newly admitted client and reads that the client has been previously diagnosed with exostoses. How should the nurse accommodate this fact into the client's plan of care? The nurse should perform the Rinne and Weber tests. The nurse should arrange for audiometry testing as soon as possible. The nurse should collaborate with the pharmacist to assess for potential ototoxic medications. No specific assessments or interventions are necessary to address exostoses.

No specific assessments or interventions are necessary to address exostoses

To avoid the side effects of corticosteroids, which medication classification is used as an alternative in treating inflammatory conditions of the eyes? Miotics Nonsteroidal anti-inflammatory drugs (NSAIDs) Mydriatics Cycloplegics

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is assessing a client with multiple sclerosis who is demonstrating involuntary, rhythmic eye movements. What term will the nurse use when documenting these eye movements? Vertigo Tinnitus Nystagmus Astigmatism

Nystagmus

The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except: Lowering intraocular pressure to the target pressure Stable appearance of the optic nerve head Visual field Opacity of the lens

Opacity of the lens

A nursing student is learning how to adequately use an otoscope to examine the ear. What method should the instructor educate the student to use when examining with an otoscope? Otoscope should be held in the examiner's right hand, in a pencil-hold position, with the examiner's hand braced against the patient's face. Otoscope should be held in the examiner's left hand, with a full hand grasp to be able to guide the scope into the internal ear. Otoscope should be held in the examiner's dominant hand, with a full hand grasp to be able to guide the scope into the internal ear. Otoscope should be held in the examiner's left hand, in a pencil-hold position, with the examiner's hand braced against the patient's face.

Otoscope should be held in the examiner's right hand, in a pencil-hold position, with the examiner's hand braced against the patient's face.

Nursing students are reviewing the anatomy and physiology of the ears as part of a group presentation for their fellow classmates about the ear's function. The students demonstrate understanding when they identify which structures as separating the middle ear from the inner ear? Malleus and incus Oval window and round window Pars flaccida and pars tensa Utricle and saccule

Oval window and round window

The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are suggestive of otitis externa. What assessment finding is characteristic of this diagnosis? Tophi on the pinna and ear lobe Dark yellow cerumen in the external auditory canal Pain on manipulation of the auricle Air bubbles visible in the middle ear

Pain on manipulation of the auricle

Which term refers to swelling of the optic disc due to increased intracranial pressure? Ptosis Chemosis Papilledema Photophobia

Papilledema

The nurse is performing an assessment of a patient's ears. When looking at the tympanic membrane, the nurse observes a healthy membrane. What should the appearance be? Pearly gray and translucent White and cloudy Pink with white exudate Dark yellow with cerumen

Pearly gray and translucent

When educating a group of students about the different parts of the eyeball, the nurse identifies which as the function of the cornea? Permits light rays to enter the front of the eye Brings oxygen and nutrients to the eye Gives the eye its specific color Focuses the light rays on the retina

Permits light rays to enter the front of the eye

Nursing students are reviewing eye structures. The students demonstrate understanding of the material when they identify which of the following as the site of aqueous humor production? Canal of Shlemm Posterior chamber Limbus Ocular fundus

Posterior chamber

A nurse is required to care for older adult clients in an extended health care facility. The nurse understands which is a potential effect of aging on vision? Hyperopia Myopia Presbyopia Astigmatism

Presbyopia

A client is newly diagnosed with otitis externa. Which information should the nurse teach the client before the client leaves the clinic? Proper instillation of prescribed ear drops Side effects of oral antibiotics Cleaning ear canal with cotton-tipped applicator after showering Strategies to cope with temporary sensorineural hearing loss

Proper instillation of prescribed ear drops

A nurse is assisting the physician with a caloric-stimulation test. What response by the client does the nurse know is the expected finding? Quivering in the eyes Ringing sound in one ear Bending to one side Arm drifting

Quivering in the eyes

Which of the following tests uses a tuning fork between two positions to assess hearing? Rinne Whisper Watch tick Weber

Rinne

Which diagnostic test distinguishes between conductive and sensorineural hearing loss? Whisper test Rinne test Audiometry Weber test

Rinne test

Which test would be used to determine an inner ear dysfunction? Romberg test tympanometry pure-tone testing acoustic reflex testing

Romberg test

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has? Sebaceous cysts Seborrheic dermatitis Tophi Acute external otitis

Seborrheic dermatitis

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision: Sees an object from 200 feet away that a person with normal vision sees from 20 feet away. Sees an object from 20 feet away that a person with normal vision sees from 200 feet away. Sees an object from 20 feet away that a person with normal vision sees from 20 feet away. Sees an object from 200 feet away that a person with normal vision sees from 200 feet away.

Sees an object from 20 feet away that a person with normal vision sees from 200 feet away.

A nurse is preparing to perform the whisper test to assess a client's gross auditory acuity. Which of the following would be most appropriate for the nurse to do? Stand at a position diagonal to the client. Have the client use a finger to occlude the ear to be tested. Stand about 1 to 2 feet away from the ear to be tested. Speak a phrase in a low normal tone of voice.

Stand about 1 to 2 feet away from the ear to be tested.

A client comes to the clinic for a routine examination. After obtaining the ocular history, which of the following would the nurse do next? Examine the external eye. Test the client's visual acuity. Perform direct ophthalmoscopy. Prepare the client for a slit-lamp examination.

Test the client's visual acuity.

A client has been diagnosed with serous otitis media for the third time in the past year. How should the nurse best interpret this client's health status? For some clients, these recurrent infections constitute an age-related physiologic change. The client would benefit from a temporary mobility restriction to facilitate healing. The client needs to be assessed for nasopharyngeal cancer. Blood cultures should be drawn to rule out a systemic infection.

The client needs to be assessed for nasopharyngeal cancer

A patient comes to the clinic with some hearing loss. The physician is unable to observe the tympanic membrane due to the accumulation of cerumen. What intervention can the nurse provide so that observation can be made? The nurse can remove the wax with a cerumen curette. The ear can be irrigated with cool water until all of the wax is removed. The nurse can instill a small amount of mineral oil into the canal and have the patient return for removal of the wax. The nurse can instill mineral oil into the canal and immediately irrigate to remove the adherent wax.

The nurse can instill a small amount of mineral oil into the canal and have the patient return for removal of the wax.

The nurse is assessing the auricles of a patient. When the left auricle is manipulated, the patient complains of pain. What does this finding indicate? The patient may have seborrheic dermatitis. The patient may have an inner ear infection. The patient may have acute external otitis. The patient may have acute otitis media.

The patient may have acute external otitis.

The nurse at the eye clinic is caring for a patient with suspected glaucoma. What complaint would be significant for a diagnosis of glaucoma? A significant loss of central vision Diminished acuity Pain associated with a purulent discharge The presence of halos around lights

The presence of halos around lights

The nurse is discussing the results of a client's diagnostic testing with the nurse practitioner. What Weber test result would indicate the presence of a sensorineural loss? The sound is heard better in the ear in which hearing is better. The sound is heard equally in both ears. The sound is heard better in the ear in which hearing is poorer. The sound is heard longer in the ear in which hearing is better.

The sound is heard better in the ear in which hearing is better.

An older adult patient informs the nurse, "I don't see as well as I used to." What should the nurse explain to the patient about why vision becomes less efficient with age? Select all the apply. There is a decrease in pupil size. There is slowing of accommodation. There is an increase in lens opaqueness. Most older patients develop glaucoma. The optic nerve begins to degenerate.

There is a decrease in pupil size. There is slowing of accommodation. There is an increase in lens opaqueness.

A client comes to the ophthalmology clinic for an eye examination. The client tells the nurse that he often sees floaters in his vision. How should the nurse best interpret this subjective assessment finding? This is a normal aging process of the eye. Glasses will minimize this phenomenon. The client may be exhibiting signs of glaucoma. This may be a result of weakened ciliary muscles.

This is a normal aging process of the eye.

When educating clients on the parts and functions of the ear, the nurse identifies which as the function of the semicircular canal? Sends sensory information to the cerebellum and the midbrain Begins the transmission of nerve stimuli related to sound Transmits information on the body's position to the brain Equalizes the pressure in the middle ear with atmospheric pressure

Transmits information on the body's position to the brain

Which manifestation is most problematic for the client diagnosed with Ménière disease? Tinnitus Diaphoresis Vertigo Hearing loss

Vertigo

A patient is scheduled to have an auditory brain stem response in 2 days. What does the nurse instruct the patient to do in preparation for the test? Shave several areas on the scalp where the electrodes will be placed. Do not eat or drink 8 hours prior to testing. Wash and rinse hair before test but do not apply any other hair products. Omit daily medications prior to testing.

Wash and rinse hair before test but do not apply any other hair products.

Which of the following is indicated when asymmetrical movement is noted during a positions test? Weakness in the extraocular muscles Retinal tears and detachment Cataract Glaucoma

Weakness in the extraocular muscles

A child goes to the school nurse and reports being unable to hear the teacher. What test could the school nurse perform that would preliminarily indicate hearing loss? Audiometry Rinne test Whisper test Weber test

Whisper test

Macular degeneration is suspected in a client experiencing blurred vision when reading. The nurse performs an ophthalmoscopic examination. Which finding would the nurse identify as helping to support this suspicion? Silvery physiologic cup Flame-shaped red smudges on the fundus Yellowish appearing area on the retina Yellow areas with indistinct edges beneath the retina

Yellow areas with indistinct edges beneath the retina

During assessment for cranial nerve functions, the client closes the eyes and begins to fall to one side. Which cranial nerve alteration causes this response? cranial nerve VIII optic nerve cranial nerve VII facial nerve

cranial nerve VIII

A client is having a caloric stimulation test to assess vestibular reflexes of the inner ear that control balance. Which response would indicate a disorder is present? diminished response in one eye nystagmus slight dizziness

diminished response in one eye

Changes in pressure at high altitudes can cause discomfort in the ears. Which structure within the middle ear is instrumental in equalizing pressure? eustachian tubes fallopian tubes semicircular canals incus tubes

eustachian tubes

Which features should a nurse observe during an ophthalmic assessment? Select all that apply. external eye appearance pupil responses intraocular pressure visual acuity

external eye appearance pupil responses

A client suffered trauma to the sclera and is being treated for a subsequent infection. During client education, the nurse indicates where the sclera is attached. Which structure would not be included? eyelids cornea iris pupil

eyelids

A client is in the ED after being struck in the left eye with a baseball, leaving a large ecchymosis and edema. In client education, the nurse explains to the client the functions of the various structures of the eye. What are functions of the eyelids? Select all that apply. impact ocular light spread tears produce tears eliminate dust

impact ocular light spread tears

A client is being evaluated after noticing a decline in hearing. The client's level of hearing loss will be determined by a hearing test administered by an audiologist. The description of hearing loss is based on the: intensity of the first heard sound. location of the aural abnormality. depth of tone used in testing. physician's estimation.

intensity of the first heard sound.

A young baseball player was fielding a ground ball when it bounced and struck the player in the left eye, leaving a large ecchymosis and edema. In client education, after applying an ice pack, the nurse explains the functions of the various structures of the eye. What glands, contained in the eyelids, produce tears? lacrimal sebaceous sweat olfactory

lacrimal

Which would be a negative result in a cover-uncover test? movement in the uncovered eye lack of movement in the uncovered eye lack of color vision in the uncovered eye inability to identify letters of decreasing size in the uncovered eye

movement in the uncovered eye

A client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend? optic nerve oculomotor nerve trochlear nerve trigeminal nerve

optic nerve

A child has been reporting having trouble seeing the board at school. Initially, the client was taken to an _______ to test vision, but was sent to an ________ because a medical condition that may need treatment was suspected. optometrist; ophthalmologist ophthalmologist; optometrist optician; optometrist optician; ophthalmologist

optometrist; ophthalmologist

A client with multiple sclerosis is being seen by a neuroophthalmologist for a routine eye exam. The nurse explains to the client that during the examination, the client will be asked to maintain a fixed gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when the object becomes visible The nurse further explains that the test being performed is called a: perimetry test color vision test slit-lamp examination retinal angiography

perimetry test

A nurse notices that a client's left upper eyelid is drooping. The nurse has observed: ptosis ptolemy proptosis nystagmus

ptosis

A client visits the doctor's office regularly to have impacted cerumen removed from the ears. During client education, the nurse discusses the daily functions that typically move cerumen to the external acoustic meatus. What are those functions? Select all that apply. talking chewing breathing clearing one's throat

talking chewing

A client is having a routine eye examination. The procedure being performed is done by using an instrument to indent or flatten the surface of the eye. This is known as ________ and it is routinely done to test for ________. tonometry; intraocular pressure retinoscopy; detached retina tonometry; macular degeneration retinoscopy; cataracts

tonometry; intraocular pressure

During an assessment using the positions test (cardinal positions of gaze), what does an asymmetrical movement indicate? Select all that apply. weakness in the extraocular muscles dysfunction of the cranial nerve cataract glaucoma

weakness in the extraocular muscles dysfunction of the cranial nerve