PrepU Sensory Perception

The nurse is talking with the mother of a 4-year-old boy who will soon be going to a pre-kindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision?

"Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness."

After the nurse has instructed a client with low-back pain about the use of a transcutaneous electrical nerve stimulation (TENS) unit for pain management, the nurse determines that the client has a need for further instruction when the client states

"I could use the TENS unit if I feel pain somewhere else on my body."

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response?

"I will report this to the pediatrician."

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

The nurse is preparing to administer ear drops to a 2-year-old client with an infection of the external auditory canal. The order reads, "2 drops in the right ear three times per day." Which steps should the nurse take to administer this medication? Select all that apply.

-Wash hands and arrange supplies at the bedside. -Warm the medication to the body temperature. -Examine the ear canal for drainage.

Which of the following preattack symptoms may a patient with Meniere's disease report prior to an attack?

A full feeling in the ear

A client with dementia who prefers to stay in his room has been brought to the dayroom. After 10 minutes, the client becomes agitated and retreats to his room again. The nurse decides to assess the conditions in the dayroom. Which is most likely the occurrence that is disturbing to this client?

A relaxation tape is playing in one corner of the room, and a television airing a special on crime is playing in the opposite corner.

A client with quadriplegia is in spinal shock. What finding should the nurse expect?

Absence of reflexes along with flaccid extremities

Which statement is true regarding analgesia versus anesthesia?

Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.

A patient exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination?

Cerebellum

A child is born with a talipes disorder. The child later receives a cast on the affected leg to correct the problem. Which measure should the nurse mention to the mother to ensure good circulation in the affected leg?

Check the infant's toes for coldness or blueness.

The nurse is conducting an assessment of an elderly client who is blind. Which of the following would the nurse expect to be present in the medical history?

Diabetes mellitus

The nurse is providing postsurgical care for a 4-year-old boy following hernia repair. Before surgery, the nurse taught the child to use the poker chip tool to rate his pain. When assessing the child's postsurgical pain, the boy refuses to touch the chips and clings to his mother. How should the nurse respond?

Give the mother the FACES pain rating scale to use with her son.

Which of the following medications is the most effective agent in the treatment of Parkinson's disease (PD)?

Levodopa (Larodopa)

Students are reviewing information about visual changes and conditions associated with aging. The group demonstrates understanding of the information when they identify which condition as the major cause of vision loss in the elderly?

Macular degeneration

A 17-year-old high school junior was involved in a motor vehicle collision and brought to the ED via squad. His left arm was severely traumatized in the accident and he was taken immediately to surgery. He is admitted to the ICU where you practice nursing, and the physician has ordered close monitoring for compartment syndrome. What musculoskeletal structure does compartment syndrome affect?

Nerve

A nursing student is preparing a class for new mothers about adaptations they can expect in their newborns. Which information about newborn vision should the student include in the presentation?

Newborns have the ability to focus only on objects in close proximity.

Which nerve is being assessed when the nurses asks the patient to dorsiflex his ankle and extend his toes?

Peroneal

The nurse is conducting a postparum examination on a client who reports pain and is unable to sit comfortably. The perineal exam reveals an episiotomy appropriately approximated without signs of a hematoma. Which action should the nurse prioritize?

Place an ice pack.

The elderly client, who lives alone, has been admitted to the intensive care unit (ICU) following a stroke. She is now agitated and complaining about the noise. Which of the following will the nurse add to her care plan?

Provide a consistent, predictable pattern of stimulation

Eardrops have been prescribed to be instilled in the adult client's left ear to soften cerumen. To position the client, what should the nurse do?

Pull the auricle lobe up and back.

The nurse is taking a rectal temperature on a patient who reports feeling light-headed during the procedure. What would be the nurse's priority action in this situation?

Remove the thermometer and assess the blood pressure and heart rate.

A nurse is observing a child pick up a rattler and shake it to hear a sound. The nurse understands that the child is considered to be in which of the following of Piaget's Cognitive Development stages?

Sensorimotor stage

The mother of a 2-year-old is concerned because the child's right eye seems to turn in toward his nose when he is tired. The nurse should:

Test the child with the cover-uncover test and refer the mother and child to an ophthalmologist if the test is abnormal.

The nurse is performing a physical assessment for an 8-year-old with an earache. Which sign or symptom indicates acute otitis externa?

The child cries out when the ear is grasped.

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which observation needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near.

The nurse is caring for a 2-year-old postoperative PET client. Which consideration is the most appropriate for this child's developmental stage?

Uses words for pain such as owie, boo-boo, or hurt

In order to prevent recurrent vasospastic episodes with Raynaud's phenomenon, what should the nurse instruct the client to do?

Wear gloves when obtaining food from the refrigerator.

During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect:

a drop in the client's heart rate.

A client prescribed COC has presented for a routine visit. Which finding upon assessment should the nurse prioritize?

abdominal pain

The nurse caring for a client with diabetes realizes that the client has a higher risk of developing cataracts and should also assess the client for indications of:

diabetic retinopathy.

A patient with uncontrolled hypertension experienced a stroke 1 week ago, leading to significant motor losses. A successful and normal adaptive response to these new limitations is evident if the patient:

exhibits signs of grief.

The AGPAR score is based on which 5 parameters?

heart rate, muscle tone, reflex irritability, respiratory effort, and color

Which measure should the nurse include in the plan of care for a client with alcohol withdrawal delirium?

remaining with the client when she is confused or disoriented