Patho Unit 8 Chapter 12 Altered Somatic and Special Sensory Function
A 60-year-old client's long history of poorly controlled hypertension has culminated in a diagnosis of retinal detachment. What type of retinal detachment is this client most likely to have experienced?
Exudative retinal detachment
A client asks if pain threshold and pain tolerance are the same. The best response by the health care provider would be:
"Pain threshold is the point at which a stimulus is perceived as painful."
The nurse offers a client recovering from knee surgery a prescribed opioid analgesic. The client states, "I don't find the pain that severe. I think acetaminophen will be fine." How should the nurse respond?
"This is fine as long as your pain tolerance allows you to participate in the prescribed postoperative exercises."
The nurse is caring for a client experiencing phantom limb pain after amputation. The nurse applies which theory of pain to best help explain the client's pain?
Neuromatrix
The nurse is caring for a client with visual impairment who states recent difficulty seeing clearly at night. Which condition does the nurse suspect the client may suffer from?
Vitamin A deficiency
The nurse is teaching a client about various methods of pain control. Which information will the nurse include when teaching the client about applying heat for pain control?
"Heat promotes more blood flow to the area to improve oxygen supply."
An older adult client is scheduled for outpatient cataract surgery. While taking a presurgery history, which statement by the client correlates to the manifestations of cataracts, thereby verifying the client has received information about the condition?
"I have blurred vision in both my eyes and my vision is distorted."
An older adult client has been diagnosed with macular degeneration. Which statement by the client best demonstrates an accurate understanding of the new diagnosis?
"I suppose that this may be one of the things that happens when you get older."
An adult has sought care for treatment of headaches that have been increasing in severity and frequency. Recently, the client was diagnosed with migraines. Which teaching points should the health care provider emphasize?
"It would be helpful for you to take control of your diet, sleep schedule, and stress levels."
The nurse is teaching a client who has tinnitus about suggested dietary modifications. What information is most important for the nurse to include?
"Try cutting down on foods high in monosodium glutamate."
The nurse is assessing a client who recently experienced significant barotrauma associated with air travel. The client states, "I have flown dozens of times without issue. Why did this happen this time?" What is the nurse's best response?
"Upper airway congestion can increase the risk. Were you congested at the time of travel?"
A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be:
"What prescription medication and over-the-counter medication do you take?"
A new mother brings her infant to the clinic reporting that the child is not sleeping or eating much. Upon assessment, the health care provider notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)? Select all that apply. -"He's been very irritable and fussy the past couple of days." -"He jabbers all the time usually." -"When I dropped a pan on the floor, he jumped." -"We like to throw him up in the air hoping any water in his ear will drain." -"Yes, he has been pulling at his ear."
-"He's been very irritable and fussy the past couple of days." -"Yes, he has been pulling at his ear."
Which clients are at risk for developing an acute episode of angle-closure glaucoma? Select all that apply. -A surgical client who has received many doses of IV atropine to keep heart rate above 50 -A 60-year-old female emotionally devastated after divorcing her husband of 35 years -A soldier ordered to stay in a pitch-black cave to observe enemy militants for an extended period of time -A person with low dietary intake of lutein, omega-3 fatty acids, and zinc -A person with a high grade of myopia
-A surgical client who has received many doses of IV atropine to keep heart rate above 50 -A 60-year-old female emotionally devastated after divorcing her husband of 35 years -A soldier ordered to stay in a pitch-black cave to observe enemy militants for an extended period of time
Which intervention would be considered a nonpharmacologic method of pain control? Select all that apply. -OTC acetaminophen -Distraction by knitting -Biofeedback -Guided imagery
-Distraction by knitting -Guided imagery -Biofeedback
What are the clinical manifestations of Meniere disease? Select all that apply. -Dizziness triggered by turning the head -Episodes of disabling vertigo -Acute pain in ear(s) -Feeling of fullness in the ear(s) -Severe ringing in the ear(s)
-Severe ringing in the ear(s) -Feeling of fullness in the ear(s) -Episodes of disabling vertigo -Dizziness triggered by turning the head
The nurse is implementing distraction strategies for a client who is experiencing pain. Which distraction strategy(ies) will the nurse to implement? Select all that apply. -offering acetaminophen to the client -encouraging the client to watch a movie -providing the client with earbuds for listening to music -offering a deck of cards to the client and visitor -engaging in conversation about the client's hobbies -providing the client with a quiet environment
-engaging in conversation about the client's hobbies -providing the client with earbuds for listening to music -encouraging the client to watch a movie -offering a deck of cards to the client and visitor
The nurse is caring for a client in acute pain. Which categories will the nurse use to classify the client's pain? (Select all that apply.) -Severity -Duration -Quality -Location -Type
-quality -duration -location
Which client may be experiencing the effects of neuropathic pain?
A man with pain secondary to his poorly controlled diabetes
When pupillary dilation partially compensates for the reduced size of the retinal image by increasing the light entering the pupil, this is a component of which eye adjustment?
Accommodation
A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing:
Acute angle-closure glaucoma
For which older adult client would pain assessment likely be most challenging for the nurse?
An 87-year-old client with vascular dementia and numerous other health problems, such as heart failure
The nurse is caring for an older adult client who reports a recent decline in hearing acuity and suspects "wax buildup." Which action will the nurse take first?
Assess the client to ensure the tympanic membrane is intact.
The client asks the health care provider, "What is the purpose of applying cold to a sprained ankle?" Which response by the health care provider is best?
Cold provides pain relief and suppresses the release of products from tissue damage.
For which type of hearing loss should the nurse assess in a child who has had recurrent otitis media since birth?
Conductive Loss
A client presents to the clinic complaining, "I have something in my eye." When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed:
Conjunctivitis
Which principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?
Dosing and timing should aim for a steady serum level of the prescribed drug.
A client has been diagnosed with conductive hearing loss. Which issue can cause this type of hearing loss?
Excess middle ear wax
What is the major cause of sensorineural hearing loss in children?
Genetic Causes
A client suffering from chronic sinusitis arrives at the urgent care center complaining of a sudden onset of dizziness and difficulty walking straight. What diagnosis does the admitting nurse suspects this client has?
Labyrinthitis
The nurse is assessing a client who has been diagnosed with esotropia. The nurse would expect the assessment findings to include:
Medial Deviation
Which statement is true of migraine headaches?
Migraines may have a hormonal etiology in some clients.
To maintain fixation on stable objects during head rotation, the eyes slowly drift in the opposite direction and then jump rapidly back toward the direction of rotation. This process is known by what term?
Nystagmus
A 38-year-old client who has begun to develop hearing loss is being evaluated by the nurse practitioner. The client tells the nurse that hearing improves when she is on the telephone and that chewing sounds very loud. What does the nurse practitioner suspect?
Otosclerosis
What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli?
Pattern
Which visual deficit is a clinician justified in attributing to the normal aging process?
Presbyopia
A client is experiencing chest pain that radiates to the left arm and neck. The nurse would interpret this pain as:
Referred
A client expresses concern about feeling fullness in the ear. Which additional manifestation leads the health care provider to suspect Menière disease?
Rotary vertigo and tinnitus
A client with rheumatoid arthritis has taken high doses of aspirin for several years. Which type of hearing loss is this client at high-risk of developing due to ototoxicity?
Sensorineural hearing loss
The nurse is caring for an older adult client with a suspected diagnosis of presbycusis. Select the most likely manifestation.
Sensorineural hearing loss caused by natural aging
Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by which region of the brain?
Somatosensory cortex
A client has been diagnosed with sensorineural hearing loss. What should the care team assess to determine a plausible cause?
The client's recent medication use
A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items?
The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron
The nurse is caring for a premature neonate who requires supplemental oxygen therapy. Which action does the nurse prioritize to best prevent complications?
Titrate oxygen therapy based on oxygen saturation levels.
Which pain disorder is a manifestation of a disruption of cranial nerve function?
Trigeminal neuralgia
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
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:
Visual Disturbances
Which characteristic differentiates a migraine with aura from a migraine without aura?
Visual symptoms such as flickering lights precede the headache
The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be:
administration of topical beta-adrenergic antagonists to lower the pressure.
Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:
an illusion of motion
Sites of referred pain are determined by:
embryonic development of visceral and somatic structures.
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 a client who reports having a mildly painful, itchy ear canal with no other associated symptoms. For which condition will the nurse assess the client based on the presenting symptoms?
external otitis (acute otitis externa or swimmer's ear)
A client tells the health care provider he has noticed a recent change in his vision: he can bring distant images into focus, but near images become blurred. The client has most likely developed:
hyperopia.
Which stimulus would be used to elicit the withdrawal reflex when testing response to nociceptive stimuli?
pressure from a sharp object
A client seeks medical care when he wrecks his car because of poor eyesight. At the time of admission, his blood glucose level was 390 mg/dL. The client is diagnosed with diabetes (type 2). The ophthalmologist must perform an urgent intravitreal injection. The nurse explains this to the client by stating the doctor will:
put a needle with syringe into your eyeball and inject some medication to decrease active bleeding.
A client who experiences constant cloudiness of vision, sees floaters, and has an opaque lens is diagnosed with a cataract. The most appropriate treatment would be:
surgical lens replacement to correct vision.
The school nurse is assessing an adolescent female client who reports a recent decrease in hearing acuity. Which questions will the nurse include in the assessment interview? Select all that apply. -"Have you experienced any ear pain or fever recently?" -"Do you have high cholesterol or high blood pressure?" -"Is there a family history of hearing loss in your family?" -"Do you have any issues with dizziness or vertigo?" -"Do you recall if you have ever had a hearing test done?"
-"Is there a family history of hearing loss in your family?" -"Have you experienced any ear pain or fever recently?" -"Do you have any issues with dizziness or vertigo?" -"Do you recall if you have ever had a hearing test done?"
The nurse is explaining the role of aqueous humor in the development of glaucoma to a client who has just been diagnosed with the condition. How should the nurse describe the role of aqueous humor in the pathogenesis of glaucoma?
Aqueous humor is continually produced and drained to maintain the appropriate pressure. In glaucoma, the normal drainage is impeded and the increased pressure can damage the optic
The nurse is making a plan of care for a client in the initial stage of otosclerosis. Which assessment finding correlates to the early development of this diagnosis?
inability to hear whispering
