Chapter 13: Care of the Patient with a Sensory Disorder

What is the visual disorder characterized by slow, progressive loss of central and near vision? A. Age-related macular degeneration B. Diabetic retinopathy C. Retinal detachment D. Glaucoma

Age-related macular degeneration

When the newly blind male home health patient asks the nurse how he might get assistance, who might the nurse suggest he contact? a. American Red Cross b. American Foundation for the Blind for a list of agencies c. Local hospital social worker d. The public health department

American Foundation for the Blind for a list of agencies

When the patient stares at the black dot on an Amsler grid, what should the nurse ask him to report? a. Any color visible on the grid b. Fading of the edges of the grid c. Any distortion of the grid d. Movement of the black dot

Any distortion of the grid

A patient who had an enucleation of the right eye has been admitted PACU. What should the nurse include in the plan of care? a. Turn, cough, and deep breathe every 3 hours b. Apply a pressure dressing over the right eye socket c. Document dressing assessment every 2 hours d. Turn on the affected side

Apply a pressure dressing over the right eye socket

What should the nurse advise the 20-year-old to do who has been put on cefaclor (Ceclor) for a resistant otitis media? a. Store suspension at room temperature b. Discontinue drug when symptoms abate c. Avoid alcoholic beverages d. Take with meals only

Avoid alcoholic beverages

Arrange the parts of the eye from the exterior to the most interior. (Separate letters by a comma and space as follows: A, B, C, D) a. Choroid b. Cornea c. Aqueous humor d. Retina e. Lens f. Iris

B C F E D A

What does the cataract treatment of phacoemulsification involve? a. "Drying" the cataract with hypertonic saline b. Removing the lens through the anterior capsule c. The insertion of a new lens d. Breaking the cataract with ultrasound

Breaking the cataract with ultrasound

What does a tympanoplasty correct? a. Conductive hearing loss b. Sensorineural hearing loss c. Congenital hearing loss d. Functional hearing loss

Conductive hearing loss

What do miotic eyedrops do for a patient with glaucoma? a. Dilate the pupil and sharpen vision b. Lubricate and moisten the dry eye c. Irrigate the surface of the eye d. Constrict the pupil and open the canal of Schlemm

Constrict the pupil and open the canal of Schlemm

What is the thick, white, opaque connective tissue that is part of the outermost layer of the eye-ball? A. Conjunctiva B. Cornea C. Sclera D. Retina

Cornea

The nurse explains that a pneumatic retinopexy is a repair of a retinal detachment using a bubble of_________ to put pressure on the damaged retina. a. water b. gas c. nitrogen d. saline

Gas

Four hours after a stapedectomy the patient complains that hearing has not improved at all. What knowledge would the nurse use to shape a response? a. A large percentage of stapedectomies are not successful b. It will take at least 10 days for the graft to heal c. Hearing will not return until edema subsides d. Hearing will improve after irrigation of the ear

Hearing will not return until edema subsides

What must a patient do following a left vitrectomy? a. Remain flat in bed for 48 hours b. Position self in a face-down position for 4 to 5 days c. Assume a side-lying position with the left side down for 3 days d. Keep head upright and cushioned with pillows for 24 hours

Position self in a face-down position for 4 to 5 days

What should the nurse remind the hearing aid wearer to do when the nurse hears a whistling hearing aid? a. Reinsert the ear mold b. Change the battery c. Recharge the hearing aid d. Wash the ear mold with warm water

Reinsert the ear mold

Select all the conditions that may cause conductive hearing loss. (Select all that apply.) a. Buildup of cerumen b. Foreign bodies c. Otosclerosis of external auditory canal d. Trauma e. Exposure to ototoxic drugs f. Otitis media with effusion

a. Buildup of cerumen b. Foreign bodies c. Otosclerosis of external auditory canal f. Otitis media with effusion

What are the most appropriate nursing care and patient teaching for the patient with external otitis? A. Applying cold compresses to the affected ear B. Continuing antibiotic therapy until symptoms of the infection are relieved C. Advising patient to rinse ears out each morning in the shower D. Washing hands before and after changing cotton plugs

Washing hands before and after changing cotton plugs

What factors must the nurse consider when assessing readiness to learn when teaching health promotion practices for the visually and hearing impaired? (Select all that apply.) a. Cultural beliefs b. Values c. Habits d. Income e. Occupation

a. Cultural beliefs b. Values c. Habits

Which may contribute to otitis media? (Select all that apply.) a. Exposure to cigarette smoke b. Allergies c. Upper respiratory infections d. Swimming e. Trauma f. Prolonged exposure to loud noise

a. Exposure to cigarette smoke b. Allergies c. Upper respiratory infections

What should the nurse do when assisting a blind person to walk in an unfamiliar hospital environment? (Select all that apply.) a. Discourage the use of the cane b. Advise the patient to walk quickly c. Describe the surroundings d. Encourage the patient to ask for verbal cues e. Place patient hand on nurse's shoulder or elbow

c. Describe the surroundings d. Encourage the patient to ask for verbal cues e. Place patient hand on nurse's shoulder or elbow

The nurse will assess for _____________ when the older adult home health patient complains that the entire right side of his head hurts and he cannot chew without pain. a. mumps b. external otitis c. otitis media d. labyrinthitis

external otitis

The nurse takes into consideration that the Weber test indicated a conductive hearing loss in a patient because the patient reported hearing the tone: a. equally in both ears. b. as a shrill noise. c. louder in his affected ear. d. very faintly.

louder in his affected ear.

The surgical incision into the eardrum with either a knife or a heated wire loop to relieve pressure in the middle ear is a(n) ___________. a. polypectomy b. salpingectomy c. myringotomy d. ileectomy

myringotomy

Progressive deafness caused by the ankylosis of the stapes is the condition of__________. a. otosclerosis b. calcification c. otitis media d. tinnitus

otosclerosis

The nurse clarifies that the difference between a photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a LASIK: a. reshapes the central cornea. b. makes partial-thickness radial incisions in the cornea. c. removes some internal layers of the cornea. d. implants intracorneal rings.

removes some internal layers of the cornea.

The nurse is aware that the patient has 20/40 vision. This means that the patient can see at 20 feet what the normal eye can see at _______ feet. a. 10 b. 20 c. 30 d. 40

40

What factors have been associated with the formation of cataracts? (Select all that apply.) A. Aging B. Ultraviolet light C. History of eye surgery D. Exposure to maternal rubella E. Smoking F. Loud music G. Diabetes mellitus

A B D E G

The nurse is caring for a patient who has had functional blindness for 10 years. Which statement is true? A. Pain is not associated with blindness, since the pain receptors have been destroyed. B. Since this patient has been blind for a number of years, the patient is in the acceptance phase of the illness. C. Since the patient's blindness is functional, not total, the patient is not considered to be legally blind. D. A comprehensive approach to patient care is essential with blind patients.

A comprehensive approach to patient care is essential with blind patients.

What is the ability of the eye to focus on objects at various distances? A. Refraction B. Accommodation C. Constriction D. Convergence

Accommodation

What is the process when the lens of the eye changes its curvature to focus on the retina? a. Accommodation b. Constriction c. Convergence d. Refraction

Accommodation

Place the nursing intervention in appropriate order for the immediate care of a patient with a penetrating wound of the eye. (Separate letters by a comma and space as follows: A, B, C, D) a. Assess eye, do not remove object b. Cover both eyes with an eye shield or cup c. Lay the patient down flat d. Check for the irregularity of the pupil e. Obtain medical attention immediately

C A D B E

What does diabetes retinopathy result from? a. Capillaries in retina hemorrhage b. Long-term overdosing of insulin c. Retinal detachment d. Aging

Capillaries in retina hemorrhage

When the patient in the emergency room complains of seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom of which condition? a. Detached retina b. Macular degeneration c. Early sign of cataract d. Diabetic retinopathy

Detached retina

When taking care of a patient with newly diagnosed type 1 diabetes mellitus, the nurse notes the patient is expressing some fears about long-term complications of the disease. She states, "I know I'll go blind within 10 years. Why should I bother controlling my blood sugar?" On what knowledge can the nurse's best response be based? A. After 10 years with diabetes mellitus, most type 1 patients have advanced diabetic reti-nopathy. B. Diabetic retinopathy occurs more frequently in patients with long-standing, poorly con-trolled diabetes mellitus. C. The initial stage of diabetic retinopathy only lasts for a couple of months. D. The initial stage consists of vision loss and the presence of "floaters" in the visual field.

Diabetic retinopathy occurs more frequently in patients with long-standing, poorly con-trolled diabetes mellitus.

Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts? a. Pain in the eyes b. Difficulty driving at night c. Loss of peripheral vision d. Dry eyes

Difficulty driving at night

What should the nurse include in the plan of care following a tympanoplasty? a. Elevating head of bed with operative side facing upward b. Enforcing bed rest for 72 hours c. Frequent turning, coughing, and deep breathing d. Continuous irrigation of the ear canal with antibiotic solutions

Elevating head of bed with operative side facing upward

The home health patient complains of tearing and a feeling of dryness in the right eye. The nurse assesses that the eyelid is turned inward and the sclera is red. The nurse documents the presence of a(n)_________________. a. Aminoacid b. Entropion c. Vertigo d. Calcification

Entropion

The total removal of an eye is a(n) ___________. a. Enucleation b. Calcification c. Ophthalmic d. Polypectomy

Enucleation

Why is otitis media found more frequently in children 6 to 36 months? a. Eustachian tubes in children are shorter and straighter. b. Infection descends via the eustachian tube to the throat. c. Children's eustachian tubes are more vertical and longer. d. Otitis media is seen equally in both children and adults.

Eustachian tubes in children are shorter and straighter.

The nurse is caring for a 75-year-old patient who has experienced some sensory deficits. What change might be explained by age-related changes of the sensory system? A. Decreased sensitivity to glare B. Inability to hear low-frequency sounds C. Difficulty with red/orange color discrimination D. Increased difficulty focusing on close objects

Increased difficulty focusing on close objects

One of the housekeepers splashes a chemical in the eyes. What should be the first priority? a. Transport to a physician immediately b. Cover the eyes with a sterile gauze c. Irrigate with H2O for 5 minutes d. Irrigate with normal saline solution for 20 minutes

Irrigate with normal saline solution for 20 minutes

Which is a sign of acute angle closure glaucoma (AACG)? a. Large fixed pupil b. Nystagmus c. Bluish color in sclera d. Drooping eyelid

Large fixed pupil

How should the nurse advise a patient who has severe vertigo from labyrinthitis? a. Lean against a wall and not head forward until vertigo lessens. b. Bend at the waist and take several deep breaths. c. Drink an iced drink slowly. d. Lie immobile and hold the head in one position until the vertigo lessens.

Lie immobile and hold the head in one position until the vertigo lessens.

What is a common mistake that hinders communication when communicating with the hearing impaired? a. Overaccentuating words b. Facing the patient when speaking c. Speaking in conversational tones d. Speaking into the ear with the hearing aid

Overaccentuating words

When caring for a patient who has just undergone a corneal transplant (keratoplasty), what is the most important nursing intervention? A. Preparing written postoperative instructions for the patient to read over B. Positioning the patient on the operative side C. Reporting any severe or progressive pain to the surgeon immediately D. Teaching the patient to avoid bending, lifting, or straining for 1 week

Reporting any severe or progressive pain to the surgeon immediately

What type of hearing loss involves normal sound conduction through the external and middle ear, but distortion in the inner ear, making discrimination difficult? A. Sensorineural hearing loss B. Conductive hearing loss C. Mixed hearing loss D. Functional hearing loss

Sensorineural hearing loss

The 62-year-old home health patient who is recovering from eye surgery complains of a feeling of "grittiness" in the eye and is having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints indicate? a. Sjögren syndrome b. Early cataracts c. Macular degeneration d. Retinal detachment

Sjögren syndrome

Why would the nurse encourage a group of teenagers to protect their eyes with dark sunglasses while using a UV lamp? a. The lamp can cause cataracts. b. The lamp can cause presbycusis. c. The lamp can cause keratitis. d. The lamp can cause ectropion.

The lamp can cause cataracts.

What should a patient who has had a cataract repair avoid? a. The use of eye patches b. The use of sunglasses c. The lifting of heavy objects d. Reading for long periods of time

The lifting of heavy objects

What is the first indication of macular degeneration? a. The loss of peripheral vision b. The loss of central vision c. The loss of color discrimination d. Eye fatigue

The loss of central vision

The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient? a. The patient would be considered totally blind. b. This patient probably has some light perception, but no usable vision. c. This patient has some usable vision, which enables function at an acceptable level. d. The nurse would need to determine how this patient's visual impairment affects normal functioning.

The nurse would need to determine how this patient's visual impairment affects normal functioning.

How would the nurse explain the purpose of photocoagulation to a diabetic patient with diabetic retinopathy? a. The procedure will destroy the retina, which is not getting enough blood supply. b. The procedure will reduce edema in the macula of the eye. c. The procedure will vaporize fatty deposits that appear in the retina. d. The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema.

The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema.

Which of the following are causes of cataracts? (Select all that apply.) a. Long-term use of corticosteroids b. Hypotension c. Congenital from exposure to maternal rubella d. Diabetes mellitus e. Exposure to sand and dust f. Smoking

a. Long-term use of corticosteroids c. Congenital from exposure to maternal rubella d. Diabetes mellitus f. Smoking

What would a nurse do when the patient arrives in the PACU after a left stapedectomy? (Select all that apply.) a. Turn the patient to his right side b. Change dressing as it becomes soiled c. Turn patient every 2 hours d. Leave the bed flat e. Medicate immediately on the complaint of nausea

a. Turn the patient to his right side d. Leave the bed flat e. Medicate immediately on the complaint of nausea

The nurse counsels the 16-year-old boy that playing his music at high volume can result in impairment in hearing related to: a. damaged tympanic membrane. b. protective buildup of cerumen. c. damage of the fine hair cells in the organ of Corti. d. rupture of the oval window.

damage of the fine hair cells in the organ of Corti.