Patho PrepU: Ch. 38

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

Promethazine (Phenergan)

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 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 teaching a teenaged client strategies to avoid recurrent ear infections. The nurse understands that further teaching is required when the client states which of the following?

"I will dry the inside of my ears thoroughly with cotton-tipped applicators after swimming."

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

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." Correct

A 70 year-old woman 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."

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

While working at the triage desk in the local emergency department, which of the following patients is likely having a medical emergency and needs to be seen first?

55 year old truck-driver complaining of sudden onset of ocular pain and blurred vision.

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

Amblyopia

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 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 is assessing a patient's risk for sensorineural hearing loss. Which of the following places the patient at greatest risk?

Chronic noise exposure

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

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

Which of the following nursing interventions is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo implement?

Fall precautions

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 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 assisting with a client who is undergoing caloric testing. The nurse expects which of the following actions will be needed to complete the test?

Have ice water available.

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

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

During an eye assessment the nurse notes inflammation of the client's cornea. The nurse should document this as which of the following?

Keratitis

A patient has been diagnosed with hemianopia. The patient asks the nurse what this is describing concerning the eye?

Loss of half of the visual field in one eye

Amblyopia, or lazy eye, occurs at a time when visual deprivation or abnormal binocular interactions occur in visual infancy. Whether amblyopia is reversible depends on what?

Maturity of the visual system at time of onset

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 a triad of hearing loss, vertigo, and tinnitus.

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

A patient has glaucoma. The nurse is taking a health history and knows that the most common form of glaucoma is which type?

Open angle

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

Which type of receptor is mediated through vision in dim light?

Photoreceptors

The nurse takes a patient's blood pressure in the primary care provider's office. The last three times the patient has been in the office it has been high. What structure in the eye is this adverse effect of hypertension most likely to affect?

Retina

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.

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 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.

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 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 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 nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor which fills the anterior and posterior chambers of the eye as which disease?

glaucoma

The three layers of the cornea are separated by two important basement membranes. What are characteristics of the Descemet membrane?

• Regenerates readily after injury • Has a felt-like appearance

What are the symptoms of Ménière disease? Select all that apply.

• Severe ringing in the ear(s) • Feeling of fullness in the ear(s) • Episodes of disabling vertigo

The nurse understands that autonomic manifestations of vertigo may include which of the following? Select all that apply.

• Tachycardia • Hypotension

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