ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 23 Questions
Question 1 of 5
The nurse is obtaining a health history from an older-adult patient, who is new to the eye clinic and who has glaucoma. Which of the following information given by the patient will have the most implications for the patient's treatment?
Correct Answer: C
Rationale: It is important to note whether the patient takes any β-adrenergic blockers because this category of medications also is used to treat glaucoma, and there may be an increase in adverse effects. The use of Aspirin does not increase intraocular pressure and is safe for patients with glaucoma. Although older patients should have yearly eye examinations, the treatment for this patient will not be affected by the 10-year gap in eye care. Conjunctivitis does not increase the risk for glaucoma.
Question 2 of 5
Which assessment information obtained by the nurse when performing an eye examination for an older-adult patient indicates that more extensive examination of the eyes is needed?
Correct Answer: B
Rationale: Photophobia is not a normally occurring change with aging and would require further assessment. The other assessment data are common age-related differences and would not be unusual in an older-adult patient.
Question 3 of 5
The nurse is obtaining a nursing history from a patient when the patient indicates symptoms of dizziness when bending over and nausea and dizziness associated with physical activities. Which of the following topics should the nurse include in this patient's teaching plan?
Correct Answer: B
Rationale: The patient's clinical manifestations of dizziness and nausea suggest a disorder of the labyrinth, which controls balance and contains three semicircular canals and the vestibule. Rotary chair testing is used to test vestibular function. The other tests are used to test for problems with hearing.
Question 4 of 5
The nurse is conducting an auditory assessment with a patient. Which of the following findings should the nurse document as normal?
Correct Answer: A,C,E
Rationale: Normal findings in the physical assessment of the auditory system include ears symmetrical in location and shape, auricles and tragus nontender, without lesions; clear canal and tympanic membrane intact, landmarks and light reflex intact; ability to hear low whispers at 30 cm and no lateralization Weber's test result. Rinne's test result for a normal finding is that air conduction is better than bone conduction.
Question 5 of 5
The nurse is taking a health history of a new patient at the ear clinic and the patient states, 'I always sleep with the radio on.' Which of the following questions is most appropriate to obtain more information about possible hearing problems?
Correct Answer: C
Rationale: Patients with tinnitus may use masking techniques, such as playing a radio, to block out the ringing in the ears. The responses 'Do you grind your teeth at night?' and 'Are you dizzy when lying down?' would be used to obtain information about other ear problems, such as vestibular disorders and referred temporomandibular joint (TMJ) pain. The response 'What time do you usually fall asleep?' would not be helpful in assessing problems with the patient's ears.