Chapter 13 Care of the Patient with a Sensory Disorder

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Chapter 13  Care of the Patient with a Sensory Disorder

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

MULTIPLE CHOICE

1. 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

ANS: B
The Snellen Eye Chart tests visual acuity. A vision evaluation of 20/40 means that the patient can see at 20 feet what the person with normal vision can see at 40 feet.

DIF: Cognitive Level: Application REF: Page 625 OBJ: 7
TOP: Snellen evaluation KEY: Nursing Process Step: I Assessment MSC: NCLEX: Physiological Integrity

2. The patient tells the nurse that he is legally blind. How would this information impact the nurse’s plan of care for this patient?

  1. The patient would be considered totally blind.
  2. This patient probably has some light perception, but no usable vision.
  3. This patient has some usable vision, which enables function at an acceptable level.
  4. The nurse would need to determine how this patient’s visual impairment affects

    normal functioning.

ANS: D
“Legal blindness” refers to individuals with a maximum visual acuity of 20/200 with corrective eyewear and/or visual field sight capacity reduced by 20 degrees. Categories have been established to help determine the exact extent of the vision loss and what assistive measures are appropriate for the individual. The nurse will need more information as to the exact extent of the vision loss for this patient.

DIF: Cognitive Level: Analysis REF: Page 626 OBJ: N/A TOP: Legal blindness KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

3. One of the housekeepers splashes a chemical in the eyes. What should be the first priority?

  1. Transport to a physician immediately
  2. Cover the eyes with a sterile gauze
  3. Irrigate with H2O for 5 minutes
  4. Irrigate with normal saline solution for 20 minutes

ANS: D
Burns are medically treated with a prolonged, 15- to 20-minute or longer normal saline flush immediately after burn exposure.

DIF: Cognitive Level: Analysis REF: Page 646 OBJ: 11
TOP: Chemical burn of eye KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity

4. What does a tympanoplasty correct?

  1. Conductive hearing loss
  2. Sensorineural hearing loss
  3. Congenital hearing loss
  4. Functional hearing loss

ANS: A
Tympanoplasty can correct a conductive hearing loss.

DIF: Cognitive Level: Knowledge REF: Page 664 OBJ: 17
TOP: Tympanoplasty KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity

5. 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?

  1. Sjögren syndrome
  2. Early cataracts
  3. Macular degeneration
  4. Retinal detachment

ANS: A
The Sjögren syndrome of “dry eye” frequently appears after eye surgery. There is insufficient production of tears. Excessive use of antihistamines, antidepressants, and decongestants may cause this syndrome to appear.

DIF: Cognitive Level: Application REF: Page 633 OBJ: 8
TOP: Sjögren syndrome KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

6. 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?

  1. A large percentage of stapedectomies are not successful
  2. It will take at least 10 days for the graft to heal
  3. Hearing will not return until edema subsides
  4. Hearing will improve after irrigation of the ear

ANS: C
Hearing improvement will not be noted until edema subsides and the packing is removed.

DIF: Cognitive Level: Application REF: Page 662 OBJ: 17
TOP: Stapedectomy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity

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