NURS 313 Ch. 18-
A nurse is assessing the pain level of a client who has just had surgery. The client tells the nurse he does not think he should take any medication until the pain becomes extreme. The best response would be: a) "If you wait for a longer period of time, the pain will decrease in intensity." b) "The use of pain medication before the pain becomes extreme will help prevent hyperexcitability of the CNS." c) "Asking for pain medication with the early onset of pain will cause addiction." d) "If you wait longer, you will receive stronger medication."
"The use of pain medication before the pain becomes extreme will help prevent hyperexcitability of the CNS." Explanation: Usually, less medication is needed when the drug is given before the pain becomes severe and the pain pathways become sensitized. Addiction should not occur with short-term use. Pain from acute illness, trauma, surgery, or medical procedures should be aggressively managed, and preemptive analgesia provided before the pain becomes severe. Waiting longer periods of time may increase pain intensity and will not result in stronger medication.
A nurse is teaching sleep-promoting strategies to a patient. Which of the following beverages would the nurse recommend to promote sleep? a) Cold beer b) Hot chocolate c) Warm milk d) Hot tea
c) Warm milk
A 78-year-old female client has been scheduled for outpatient cataract surgery. While taking a presurgery history, which statement by the client correlates to the surgical procedure? a) "I have blurred vision in both my eyes and my visual is distorted." b) "One of my eyes has redness and purulent drainage." c) "I had intense eye pain coupled with photosensitivity." d) "I feel like I have a buildup of pressure in my eyeball."
a) "I have blurred vision in both my eyes and my visual is distorted."
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? a) "Surgery is the only effective treatment for cataracts." b) "You are wrong and should not listen to your doctor." c) "The doctor was correct and you are doing everything you can to help with this condition." d) "Strong bifocal lenses can often cure cataracts."
a) "Surgery is the only effective treatment for cataracts."
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? a) 55 year old truck-driver complaining of sudden onset of ocular pain and blurred vision. b) 45 year old school teacher complaining of a red eye that is draining yellow secretions. c) Infant with red eyes who is irritable and refusing to eat. d) 17 year old high school student who has a red, itchy eye.
a) 55 year old truck-driver complaining of sudden onset of ocular pain and blurred vision.
A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing: a) Acute angle-closure glaucoma b) Acute-onset wide-angle glaucoma c) Subacute angle-closure glaucoma d) Primary open-angle glaucoma
a) Acute angle-closure glaucoma
What is the most common cause of progressive dementia? a) Alzheimer disease b) Wernicke-Korsakoff syndrome c) Huntington disease d) Vascular dementia
a) Alzheimer disease
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: a) Imbalance between aqueous production and outflow b) A breakdown of cells in the macula lutea c) The development of degenerative cataracts d) Damage to the retina leading to vision changes
a) Imbalance between aqueous production and outflow
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? a) Retina b) Lens c) Iris d) Ciliary body
a) Retina
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? a) glaucoma b) cataract c) amblyopia d) retinopathy
a) glaucoma
The nurse is caring for a group of clients in the hospital. Which of the following clients are at most risk for obstructive sleep apnea? a) A female client that has ascites from liver cirrhosis. b) A male client with a neck circumference of 44 having a laparoscopic cholecystectomy. c) A male client with an upper respiratory infection. d) A female client that has a bulging cervical spine disc.
b) A male client with a neck circumference of 44 having a laparoscopic cholecystectomy.
A patient has been diagnosed with hemianopia. The patient asks the nurse what this is describing concerning the eye? a) Loss of a quarter of the visual field in one eye b) Loss of half of the visual field in one eye c) Loss of the temporal or peripheral visual fields on both sides d) Blindness in one eye
b) Loss of half of the visual field in one eye
A patient with a history of snoring and tiredness in the morning would most likely be diagnosed with which type of apnea? a) Central sleep apnea b) Obstructive sleep apnea c) Noise apnea d) Obese apnea
b) Obstructive sleep apnea
A patient has glaucoma. The nurse is taking a health history and knows that the most common form of glaucoma is which type? a) Angle closure b) Open angle c) Congential d) Infantile
b) Open angle
Early symptoms of Alzheimer's dementia can be difficult to diagnose in elderly clients due to which normal age-related occurrence? a) Eating two meals a day because of complaints that they have a loss of appetite b) Subtle short-term memory loss that is difficult to differentiate from normal forgetfulness c) Refusal to drive a motor vehicle to run errands for themselves when they are capable d) Inability to walk long distances when clients were able to do so earlier without difficulty
b) Subtle short-term memory loss that is difficult to differentiate from normal forgetfulness
A client is experiencing acute pain. The nurse would anticipate the client to manifest: a) Bradypnea b) Tachycardia c) Hyperthermia d) Hypotension
b) Tachycardia
Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes: a) light-headedness. b) an illusion of motion. c) loss of consciousness. d) permanent hearing loss.
b) an illusion of motion.
A client with a history of migraine headaches tells the physician that he or she usually experiences an aura before the onset of the headache. The client is most likely experiencing: a) Dysphasia b) Dizziness c) Visual disturbances d) Lethargy
c) Visual disturbances
A severe type of headache that occurs more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called what? a) Chronic daily headache b) Tension headache c) Cluster headache d) Migraine headache
c) Cluster headache
What is understood to be the cause of Huntington disease (HD)? a) It is the result of brain trauma. b) It is the result of chronic alcoholism. c) It is inherited as an autosomal dominant disorder. d) It is caused by a virus.
c) It is inherited as an autosomal dominant disorder.
A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as, "like an electric shock." The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with the pain. What is most likely causing her pain? a) Migraine headache b) Post-herpetic neuralgia c) Trigeminal neuralgia d) Complex regional pain syndrome
c) Trigeminal neuralgia
A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize? a) "Weight loss and exercise are very important components of your treatment." b) "Stopping all of your current medications, even temporarily, should provide some relief." c) "Your headaches are likely a result of a nerve disorder and, unfortunately, cannot be treated successfully." d) "It would be helpful for you to take control of your diet, sleep schedule, and stress levels."
d) "It would be helpful for you to take control of your diet, sleep schedule, and stress levels."
Which of the following clients may be experiencing the effects of neuropathic pain? a) A girl whose playground accident resulted in an arm fracture b) An elderly woman with a stage III pressure ulcer c) A man whose pain is caused by gastric cancer d) A man with pain secondary to his poorly controlled diabetes
d) A man with pain secondary to his poorly controlled diabetes
A client fell from a ladder and broke his ankle and is being seen in the emergency department for severe ankle pain with swelling and limited range of motion. What type of pain does the nurse recognize the client experiencing? a) Chronic pain b) Subacute pain c) Visceral pain d) Acute pain
d) Acute pain
The nurse is caring for a client who has returned from surgery after having a colon resection. What is the best method for the nurse to use when administering an opioid for pain in order to optimize pain control? a) Administer the opioid if the client is becoming restless. b) If the client is asleep, wait until she awakens to administer an opioid, because sleeping clients are not in pain. c) Administer the opioid each time the client asks for it. d) Administer the opioid preemptively and before pain becomes extreme.
d) Administer the opioid preemptively and before pain becomes extreme.
The client asks the health care provider to explain what the purpose is for the application of cold to a sprained ankle. The best response would be: a) Cold dilates the blood vessels and can be left on for as long as needed. b) Cold provides alternating vasoconstriction and dilatation when applied locally. c) Cold causes extravasation of blood into the damaged area. d) Cold provides pain relief and suppresses the release of products from tissue damage.
d) Cold provides pain relief and suppresses the release of products from tissue damage.
A patient with memory loss is concerned about the possibility that it may be inherited. Which of the following disorders is an inherited dementia? a) Vascular dementia b) Wernicke-Korsakoff syndrome c) Frontotemporal dementia d) Huntington's disease
d) Huntington's disease
Select the statement that best describes Meniere disease. a) Meniere disease is a disorder of the middle ear due to constriction of the endolymphatic compartment of the inner ear, causing hearing loss. b) Meniere disease is a disorder of the inner ear due to distention of the endolymphatic compartment of the inner ear: the client will be asymptomatic. c) Meniere disease is a bacterial infection of the outer inner ear due to distention of the endolymphatic compartment. d) 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.
d) 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.
A nurse is caring for a patient who weighs 325 pounds. The client's wife reports that the patient snores loudly and stops breathing frequently when he sleeps. For which of the following possibly related symptoms will the nurse assess? a) Excessive thirst b) Nocturia c) Vivid dreams d) Morning headaches
d) Morning headaches
An elderly woman comes to the clinic complaining of seeing flashing lights and small spots. She tells the nurse that this has been going on for over 24 hours but now it is as if she sees a dark curtain whenever she opens her eyes. She asks the nurse if this means she is going to be blind.What diagnosis should the nurse suspect ? a) glaucoma b) conjunctivitis c) cataracts d) retinal detachment
d) retinal detachment
