Chapter 37 Sensory Alterations

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Chapter 37  Sensory Alterations

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Kirby is a 63-year-old welder who has gone to the clinic for his annual check-up. He shares with the nurse that he has been having difficulty hearing conversations at the coffee shop in the mornings. After looking in his ears to determine if there is a build-up of cerumen, the nurse tells Kirby that his hearing loss needs to be checked further, but that it may be associated with aging. What is the best term to describe this?
A.
Tinnitus
B.
Accommodation
C.
Presbycusis
D.
Presbyopia

ANS: C
Hearing changes often associated with aging include decreased hearing acuity, speech intelligibility, and pitch discrimination, which is referred to as presbycusis. Low-pitched sounds are easiest to hear, but it is difficult to hear conversation over background noise. A decrease in active sebaceous glands causes the cerumen to become dry and completely obstruct the external auditory canal.

PTS: 1 DIF: Cognitive Level: Application REF: 1113
OBJ: Discuss common sensory changes that occur with aging
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

2. Mr. Barnes is a 64-year-old house painter who is seeing his health care provider for his annual check-up. When the nurse asks him if he has had any problems, he tells her that he doesn’t think his vision is as good as it used to be. He states that “things look more yellow than they used to.” She knows that this is a visual change in older adults because the:
A.
iris yellows.
B.
lens yellows.
C.
pupils take longer to dilate.
D.
pupils take longer to constrict.

ANS: B
Visual changes often include reduced visual fields, increased glare sensitivity, impaired night vision, reduced accommodation, reduced depth perception, and reduced color discrimination. Many of these symptoms occur because the pupils in the older adult take longer to dilate and constrict secondary to weaker iris muscles. Color vision decreases because the retina is duller and the lens yellows.

PTS: 1 DIF: Cognitive Level: Application REF: 1113
OBJ: Discuss common sensory changes that occur with aging
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

3. Omar is a 47-year-old divorced man who recently moved back in with his elderly mother after she had been hospitalized several times with gastrointestinal problems. He is concerned because as he was going through her refrigerator, he noticed food that had turned rancid. His mother hadn’t seemed to notice the spoiled food and was going to heat up some rancid soup for lunch. What is the most likely physiologic reason that Omar’s mother does not realize that the food is spoiled?
A.
She has early Alzheimer disease.
B.
She has a diminished sense of smell.
C.
She is frugal and does not want to throw things out.
D.
She has a limited vision.

ANS: B
Olfactory changes begin around age 50 and include a loss of cells in the olfactory bulb of the brain and a decrease in the number of sensory cells in the nasal lining. Reduced sensitivity to odors is common.

PTS: 1 DIF: Cognitive Level: Application REF: 1113
OBJ: Discuss common sensory changes that occur with aging
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

4. Roberta has had a MRSA infection in an abdominal surgical wound. Laura is a student nurse who works on the postsurgical unit of the hospital. Roberta is in a private room, is receiving vancomycin for the MRSA, and her pain is well controlled with a morphine patient-controlled analgesia pump. She is also receiving docusate sodium to prevent constipation. She begins complaining of ringing in the ears on Laura’s shift. Which is the most likely cause of her tinnitus?
A.
Surgical anesthesia
B.
Morphine
C.
Vancomycin
D.
Docusate sodium

ANS: C
Ototoxic medications, such as analgesics, antibiotics (such as vancomycin and aminoglycosides), or diuretics, affect hearing acuity, balance, or both, with the most common symptom being tinnitus (ringing in the ears).

PTS: 1 DIF: Cognitive Level: Analysis REF: 1114
OBJ: Discuss common causes and effects of sensory alterations
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

5. Bernice is a 76-year-old retired secretary with diabetes who is seeing her health care provider because she is having visual changes. She explains to the nurse that she is experiencing distortion that makes the edges of objects appear wavy. The nurse knows that this is an early sign of:
A.
cataracts.
B.
glaucoma.
C.
diabetic retinopathy.
D.
age-related macular degeneration.

ANS: D
Age-related macular degeneration occurs when the macula (specialized portion of the retina responsible for central vision) degenerates as a result of aging and loses its ability to function efficiently. An early sign includes distortion that causes edges or lines to appear wavy. In later stages, patients may see dark or empty spaces that block the center of vision.

PTS: 1 DIF: Cognitive Level: Analysis REF: 1114
OBJ: Discuss common causes and effects of sensory alterations
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity

 

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