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55 Cards in this Set

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  • Back
Presbyopia occurs in older individuals because

A. the retina degenerates.
B. the crystalline lens becomes inflexible.
C. the corneal curvature becomes irregular.
D. it is associated with cataract development.
B. the crystalline lens becomes inflexible
The most important nursing intervention in patients with epidemic keratoconjunctivitis is

A. applying patches to the affected eyes.
B. accurately measuring intraocular pressure.
C. monitoring near visual acuity every 4 hours.
D. teaching patient and family members good hygiene techniques.
D. teaching patient and family members good hygiene techniques.
Patients with an eye inflammation or infection should be taught

A. to wear dark glasses to prevent irritation from UV light.
B. that acute conditions commonly lead to chronic problems.
C. to apply a cold washcloth with pressure to the inflamed area frequently.
D. that regular careful hand washing may prevent the infection from spreading.
C. to apply a cold washcloth with pressure to the inflamed area frequently.
Rubella can cause hearing problems if

A. exposure is after 20 weeks of gestation.
B. exposure is before 16 weeks of gestation.
C. the mother had rubella before age 18 years.
D. the mother is vaccinated during the postpartum.
B. exposure is before 16 weeks of gestation.
In preparing patients for retinal detachment surgery, the nurse should

A. begin explaining how to care for an ocular prosthesis.
B. assure patients that they can expect 20/20 vision following surgery.
C. teach the family how to recognize when the patient is hallucinating.
D. assess the patient’s level of knowledge about retinal detachment and provide information appropriate to the situation.
D. assess the patient’s level of knowledge about retinal detachment and provide information appropriate to the situation.
The nurse should instruct patients with glaucoma that

A. they should see their family practitioner or internist every 2 months.
B. punctal occlusion will lessen systemic absorption of glaucoma eyedrops.
C. if they use their drops properly, they can expect full resolution of the glaucoma.
D. the frequent pain caused by the increased intraocular pressure can be controlled with analgesics.
B. punctal occlusion will lessen systemic absorption of glaucoma eyedrops.
The nurse would suspect otosclerosis from assessment findings of hearing loss in

A. a 26-year-old woman who has three biologic children under 5 years of age.
B. a 52-year-old man whose hearing loss is accompanied by vertigo and tinnitus.
C. a 42-year-old African American woman who has a history of serous otitis media.
D. a 63-year-old man who can hear high-pitched sounds more effectively than low-pitched sounds.
A. a 26-year-old woman who has three biologic children under 5 years of age.
The patient who has a sensorineural hearing loss

A. has difficulty understanding speech.
B. experiences clearer sounds with the use of a hearing aid.
C. may have a reversal of damage caused by ototoxic drugs.
D. hears low-pitched sounds better than high-pitched sou
A. has difficulty understanding speech.
Patients with permanent visual impairment

A. feel most comfortable with other visually impaired persons.
B. may feel threatened when others make eye contact during a conversation.
C. usually need others to speak louder so they can communicate appropriately.
D. may experience the same grieving process that is associated with other losses.
D. may experience the same grieving process that is associated with other losses.
In teaching a patient who is using topical corticosteroids to treat an acute dermatitis, the nurse should tell the patient that

A. the cream form is the most efficient system of delivery.
B. topical corticosteroids usually do not cause systemic side effects.
C. creams and ointments should be applied with a glove in small amounts to prevent further infection.
D. abruptly discontinuing the use of topical corticosteroids will cause a reappearance of the dermatitis.
B. topical corticosteroids usually do not cause systemic side effects.
In teaching a patient with malignant melanoma about this disorder, the nurse recognizes that the prognosis of the patient is most dependent on

A. the thickness of the lesion.
B. the degree of color change in the lesion.
C. how much superficial spread the lesion has.
D. the amount of ulceration present in the lesion.
A. the thickness of the lesion.
During assessment of a patient the nurse notes an area of red, sharply defined plaques covered with silvery scales that are mildly itchy on the patient’s knee and elbow. The nurse recognizes this finding as

A. lentigo.
B. psoriasis.
C. actinic keratoses.
D. seborrheic keratoses.
B. psoriasis.
Age-related changes in the skin include

A. oily scalp.
B. a loss of collagen.
C. thinner, flexible nails.
D. improved blood supply.
B. a loss of collagen.
Of the following patients, the nurse recognizes that the one with the highest risk for a stroke is

A. an obese 45-year-old Native American.
B. a 35-year-old Asian American woman who smokes.
C. a 32-year-old white woman taking oral contraceptives.
D. a 65-year-old African American man with hypertension.
D. a 65-year-old African American man with hypertension.
The factor related to cerebral blood flow that most often determines the extent of cerebral damage from a stroke is the

A. amount of cardiac output.
B. oxygen content of the blood.
C. degree of collateral circulation.
D. level of carbon dioxide in the blood.
C. degree of collateral circulation.
Information provided by the patient that would help differentiate a hemorrhagic stroke from a thrombotic stroke includes

A. sensory disturbance.
B. a history of hypertension.
C. presence of motor weakness.
D. sudden onset of severe headache.
D. sudden onset of severe headache.
A patient with right-sided hemiplegia and aphasia resulting from a stroke most likely has involvement of the

A. brainstem.
B. vertebral artery.
C. left middle cerebral artery.
D. right middle cerebral artery.
C. left middle cerebral artery.
Nursing management of the patient with hemiplegia during the acute phase of a stroke includes

A. restricting active movement.
B. positioning each joint higher than the proximal joint.
C. performing passive range of motion on all limbs every 4 hours.
D. maintaining the patient in a recumbent, side-lying position.
B. positioning each joint higher than the proximal joint.
Bladder training in a male patient who has urinary incontinence after a stroke includes

A. limiting fluid intake.
B. keeping a urinal in place at all times.
C. assisting the patient to stand to void.
D. catheterizing the patient every 4 hours
C. assisting the patient to stand to void.
The most common response of the stroke patient to the change in body image is

A. denial.
B. depression.
C. disassociation.
D. intellectualization.
B. depression.
The home health care nurse is providing instructions to a nursing assistant regarding care of an older client with visual loss. The nurse is considering normal age-related visual changes by telling the nurse assistant that clients with visual loss:

A. Have better visual acuity with fluorescent lighting
B. Are able to live independently in restricted environments
C. Have reduced adaptation to the dark; however, peripheral vision is unchanged
D. Often use colored tape to distinguish settings on electrical appliances and to highlight the edge of stairs
D. Often use colored tape to distinguish settings on electrical appliances and to highlight the edge of stairs
The client is a 74-year-old woman who has returned to the nursing home following surgical removal of bilateral cataracts. She reports feeling a little uncertain about walking by herself. Which of the following approaches should a nurse use to assist the client with ambulation?

A. Walk one half step behind the client and slightly to the side of the client.
B. If the client requires assistance, place a hand around the client's waist.
C. Allow the client to stand alone in unfamiliar areas to encourage confidence building.
D. Have the client grasp the nurse's arm just above the elbow and walk at a comfortable pace, warning the client when obstacles are approached.
D. Have the client grasp the nurse's arm just above the elbow and walk at a comfortable pace, warning the client when obstacles are approached.
The nurse is conducting discharge teaching for a client with diminished tactile sensation. Which of the following statements, if made by the client, would indicate that teaching was ineffective?

A. "I may be able to dress more easily if I wear clothes with zippers or pullover sweaters."
B. "I am at risk for injury from temperature extremes."
C. "A home health referral may help me to achieve a maximum degree of independence."
D. "I have right-sided partial paralysis and reduced sensation, so I should dress the left side of my body first.
D. "I have right-sided partial paralysis and reduced sensation, so I should dress the left side of my body first.
To help prevent sensory overload the nurse controls stimuli and:

A. Orients the client to the environment
B. Uses a communication board with the client
C. Provides the client with books and a pocket magnifier
D. Keeps the lights on in the client's room both day and night
A. Orients the client to the environment
.
A client in the intensive care unit (ICU) seems withdrawn and is mumbling to herself. Her hands keep fidgeting with her intravenous (IV) tubing. Her daughter expresses concern because her mother has never acted this way before. The nurse bases her response on the knowledge that:

A. Some senses may become more acute to compensate for a sensory deficit.
B. Symptoms of sensory overload may include scattered attention, restlessness, and anxiety.
C. Many adults are sensitive about admitting sensory losses and may hesitate to share information.
D. The absence or presence of visitors has little effect on the sensory status of clients in hospital intensive care settings.
B. Symptoms of sensory overload may include scattered attention, restlessness, and anxiety.
An older adult client experienced a stroke (cerebrovascular accident) and has garbled speech, although he seems to understand what is being said. The nurse recognizes this as:

A. Global aphasia
B. Receptive aphasia
C. Perception aphasia
D. Expressive aphasia
D. Expressive aphasia
A client does not seem to be paying attention during conversations with the nurse. When asked how she rates her hearing, the client states, "Poor." An appropriate nursing diagnosis may be:

A. Social isolation
B. Self-care deficit
C. Disturbed thought processes
D. Disturbed sensory perception (auditory)
D. Disturbed sensory perception (auditory)
Clients may be at risk for a sensory perception deficit if they:

A. Keep their ears free of cerumen
B. Are taking a vitamin supplement
C. Have been immunized for rubella
D. Have a family history of glaucoma
D. Have a family history of glaucoma
The nurse is assessing a client for sensory alterations. Which of the following pieces of information would not be a significant finding suggesting risk of sensory impairment?

A. African American ethnicity
B. Noticeably low self-esteem
C. History of having worn hearing protection devices
D. Decreased involvement in social activities over the past 6 months
C. History of having worn hearing protection devices
In promoting health maintenance for prevention of strokes, the nurse understands that the highest risk for the most common type of stroke is present in:

a. African-Americans
b. women who smoke
c. individuals with hypertension and diabetes
d. obese with high dietary fat intake
c. individuals with hypertension and diabetes
A patient comes to the ER immediately after experiencing numbness of the face and inability to speak, but while the patient awaits exam, symptoms disappear and the patient requests discharge. The nurse stresses importance to be evaluated, primarily because:

a. the patient probably experienced an asymptomatic stroke
b. symptoms are likely to return
c. neurologic deficits that are transient occur most often as a result of small hemorrhage that clot off
d. the patient has probably experienced a TIA that is a sign of progressive cerebral vascular disease
d. the patient has probably experienced a TIA that is a sign of progressive cerebral vascular disease
Patient with right sided paresthesia and hemiparesis is hospitalized and diagnosed with a thrombotic stroke. Over the next 72 hrs the nurse plans care wit hthe knowledge that the patient:

a. is ready for aggressive rehab
b. will show gradual improvement of initial neurologic deficits
c. may show signs of deteriorating neurologic function as cerebreal edema increases
d. should not be turned or exercised to prevent extension of the thrombus
c. may show signs of deteriorating neurologic function as cerebreal edema increases
The neurologic funtions that are affected by a stroke are primarily related to:

a. the amt of tissue area involved
b. rapidity of the onset of symptoms
c. the brain area perfused by the affected artery
d. presence or absence of collateral circulation
c. the brain area perfused by the affected artery
Patient admitted to hospital with left hemplegia. To determine the size, location, and whether a stroke is ischemic or hemorrhagic the nurse anticipates that the physician will request a:

a. CT
b. lumbar puncture
c. cerebral arteriogram
d. PET
a. CT
A carotid endarterectomy is being considered as treatment for a patient who has had several TIAs. The nurse eplains to the patient that this surgery:

a. is used to restore blood circulation to the breain
b. involves intracranial surgery to joina superficial extracranial artery to an intracranial artery
c. involves removing an atherosclerotic plaque in the carotid artery to prevent an impending stroke
d. used to open a stenosis in a carotid artery wit ha balloon and stent
c. involves removing an atherosclerotic plaque in the carotid artery to prevent an impending stroke
A nursing intervention that is indicated for the patient with hemiplegia is:

a. use of a footboard to prevent plantar flexion
b. immobilization of the affected arm against the chest with sling
c. positioning the patient in bed with each joint lower than the joint proximal
d. having the patient perform passive ROM of the affected limb with the unaffected limb
d. having the patient perform passive ROM of the affected limb with the unaffected limb
A newly admitted patient who has suffered a right brain stroke has a nursing diagnosis of disturbed visual sensory perception related to homonymous hemianopsia. Early in the care of the patient, the nurse should:

a. place objects on the right side within the patient's field of vision
b. approach patient from the left side to encourage pt to turn head
c. place objects on the pt's left side to assess ability to compensate
d. patch teh affected eye
`a. place objects on the right side within the patient's field of vision
Four days following a stroke, a patient is to start oral fluids and feedings. Before feeding the patient, the nurse should first:

a. check patient's gag reflex
b. order a soft diet
c. raise HOB to sitting
d. evaluate ability to swallow small sips of water
a. check patient's gag reflex
Appropriate food for a patient with a stroke who has mid dysphagia is:

a. fruit juice
b. pureed meat
c. scrambled eggs
d. fortified milkshakes
c. scrambled eggs
Patient who has suffered a stroke is expereincing urinary incontinence. Nursing management includes:

a. limiting fluid
b. ambulating patient to bathroom q 4 hrs
c. determining the pattern and cause of incontinence
d. using briefs
c. determining the pattern and cause of incontinence
To promote communication during rehab of patient with aphasia, an appropriate nursing intervention is to:

a. use gestures, pix, and music
b. talk about ADLs that are familiar to patient
c. structure statements in yes /no
d. use flash cards with simple words
b. talk about ADLs that are familiar to patient
A patient with right hemisphere stroke has a nursing diagnosis of unilateral neglect r/t sensory perceptual deficits. During rehab it is important for the nurse to:

a. avoid positioning the patient on affected side
b. place all objects on patient's unaffected side
c. teach patient to consciously care for the affected side
d. protect the affected side from injury
c. teach patient to consciously care for the affected side
Patient with stroke has a right-sided hemiplegia. The nurse prepares family members to help control behavior changes seen with this type of stroke by teaching them to:

a. ignore undesirable behaviors
b. provide directions to patient verbally in small steps
c. distract patient from inappropriate emotional responses
d. supervise all acitivites before allowing the patient to usue them independently
c. distract patient from inappropriate emotional responses
Nurse can assist patient and the family in coping with the long term effects of a stroke by:

a. informing that patient will need assistance with almost all ADLs
b. explain that patient's prestroke behavior will return
c. encourage support groups
d. helping the patient and family understand the significance of residual stroke damage to promote problem solving and planning
d. helping the patient and family understand the significance of residual stroke damage to promote problem solving and planning
A patient tells the nurse on admission that he recently has been classified as legally blind. The nurse recognizes that the patient:

a. has lost usuable vision but has some light perception
b. will need time for grieving and adjustment
c. will be dependent on others for a safe environment
d. may be able to perform many tasks and activities with vision enhancement techniques
d. may be able to perform many tasks and activities with vision enhancement techniques
Nurse teaches all patients with conjunctival infections to use:

a. artificial tears to moisten and soothe eyes
b. dark glasses to prevent discomfort
c. warm moist compresses to eyes to promote drainage and healing
d. frequent and thorough hand washing to avoid spreading infection
d. frequent and thorough hand washing to avoid spreading infection
Patient with early cataracts tell the nurse that he is afraid of cataract surgery. Nurse informs patient that:

a. progression of cataracts can be prevented by avoidance of UV light and good diet
b. cataracts will only become worse with time and should be removed as early as possible
c. cataract surgery is very safe and need for corrective lenses will be eliminated
d. vision enhancement techniques may improve vision until surgery becomes an acceptable option to maintain desired activities
d. vision enhancement techniques may improve vision until surgery becomes an acceptable option to maintain desired activities
60 yr old patient with cataracts would have symptoms of:

a. painless, sudden, severe loss of vision
b. blurred vision, colored halos, and eye pain
c. gradual loss of vision with abnormal color perception and glare
d. light flashes, floaters, and loss of central / peripheral vision
c. gradual loss of vision with abnormal color perception and glare
Patient with bilateral cataracts is scheduled for an extracapsular cataract extraction with an intraocular lens implantation of one eye. Preop the nurse should:

a. assess the visual acuity in the inoperative eye to plan the need for postop assistance
b. inform patient that the operative eye will be patched for 3-5 days
c. assure patient vision in operative eye will return immediately
d. teach routine TCDB
a. assess the visual acuity in the inoperative eye to plan the need for postop assistance
Following scleral bulking the nurse plans postop care based on the knowledge that:

a. specific positioning and activity restrictions are likely to be required for several days
b. patient hospitalized for 7-10 days
c. experience little or no pain
d. reattachment commonly fails
a. specific positioning and activity restrictions are likely to be required for several days
In caring for the patient with age-related macular degeneration ARMD, it is important to:

a. teach how to correctly use topical eyedrops for treatment
b. emphasize the use of vision enhancement techniques to improve what vision is present
c. encourage to undergo laser treatment
d. explain that nothing can be done
b. emphasize the use of vision enhancement techniques to improve what vision is present
Visual impairment occuring with glaucoma results from:

a. ischemic pressure on the retina and optic nerve
b. clouding of aq humor in anterior chamber
c. deposition of drusen and degeneration of the macula
d. loss of accommodation
a. ischemic pressure on the retina and optic nerve
An important health promotion nursing intervention that is relevant to glaucoma is:

a. teaching individuals at risk about early signs and symptoms
b. preparing patients with glaucoma for lifestyle changes to adapt to blindness
c. promoting regular measurements of intraocular pressure for early detection and treatment of gluacoma
d. informing patients that glaucoma is curable if eye meds are administered before visual imparement has occured
c. promoting regular measurements of intraocular pressure for early detection and treatment of gluacoma
One of the nurse's roles in preservation of hearing includes:

a. advising patients to keep the ears clean of wax with Q-tips
b. monitoring patients at risk for drug-induced ototoxicity for tinnitus and vertigo
c. promoting use of ear protection at work
b. monitoring patients at risk for drug-induced ototoxicity for tinnitus and vertigo
Nursing intervention for patient during an acute attack of Meniere's disease includes providing

a. TV for diversion
b. quiet darkened room
c. padded side rails on bed
b. quiet darkened room