Chapter 64 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 64  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are suggestive of otitis externa. What assessment finding is characteristic of otitis externa?

  1. A)  Tophi on the pinna and ear lobe
  2. B)  Dark yellow cerumen in the external auditory canal
  3. C)  Pain on manipulation of the auricle
  4. D)  Air bubbles visible in the middle ear

Ans: C

Feedback:

Pain when the nurse pulls gently on the auricle in preparation for an otoscopic examination of the ear canal is a characteristic finding in patients with otitis externa. Tophi are deposits of generally painless uric acid crystals; they are a common physical assessment finding in patients diagnosed with gout. Cerumen is a normal finding during assessment of the ear canal. Its presence does not necessarily indicate that inflammation is present. Air bubbles in the middle ear may be visualized with the otoscope; however, these do not indicate a problem involving the ear canal.

2. While reviewing the health history of an older adult experiencing hearing loss the nurse notes the patient has had no trauma or loss of balance. What aspect of this patient’s health history is most likely to be linked to the patient’s hearing deficit?

  1. A)  Recent completion of radiation therapy for treatment of thyroid cancer
  2. B)  Routine use of quinine for management of leg cramps
  3. C)  Allergy to hair coloring and hair spray
  4. D)  Previous perforation of the eardrum

Ans: B

Feedback:

Long-term, regular use of quinine for management of leg cramps is associated with loss of hearing acuity. Radiation therapy for cancer should not affect hearing; however, hearing can be significantly compromised by chemotherapy. Allergy to hair products may be associated with otitis externa; however, it is not linked to hearing loss. An ear drum that perforates spontaneously due to the sudden drop in altitude associated with a high dive usually heals well and is not likely to become infected. Recurrent otitis media with perforation can affect hearing as a result of chronic inflammation of the ossicles in the middle ear.

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3. A nurse is planning preoperative teaching for a patient with hearing loss due to otosclerosis. The patient is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to include in the patient’s preoperative teaching?

  1. A)  The procedure is an effective, time-tested treatment for sensory hearing loss.
  2. B)  The patient is likely to experience resolution of conductive hearing loss after the

    procedure.

  3. C)  Several months of post-procedure rehabilitation will be needed to maximize benefits.
  4. D)  The procedure is experimental, but early indications suggest great therapeutic benefits.

Ans: B

Feedback:

Stapedectomy is a very successful time-tested procedure, resulting in the restoration of conductive hearing loss. Lengthy rehabilitation is not normally required.

4. Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired patient?

  1. A)  Ask the patient to repeat what was said in order to evaluate understanding.
  2. B)  Stand directly in front of the patient to facilitate lip reading.
  3. C)  Reduce environmental noise and distractions before communicating.
  4. D)  Raise the voice to project sound at a higher frequency.

Ans: C

Feedback:

Communication with the hearing impaired can be facilitated by talking in a quiet space free of competing noise stimuli and other distractions. Asking the patient to repeat what was said is likely to provoke frustration in the patient. A more effective strategy would be to repeat the question or statement, choosing different words. Raising the voice to project sound at higher frequency would make understanding more difficult. The nurse cannot assume that the patient reads lips. If the patient does read lips, on average he or she will understand only 50% of words accurately.

5. The nurse is providing discharge education for a patient with a new diagnosis of Ménière’s disease. What food should the patient be instructed to limit or avoid?

  1. A)  Sweet pickles
  2. B)  Frozen yogurt
  3. C)  Shellfish
  4. D)  Red meat

Ans: A

Feedback:

The patient with Ménière’s disease should avoid foods high in salt and/or sugar; sweet pickles are high in both. Milk products are not contraindicated. Any type of meat, fish, or poultry is permitted, with the exception of canned or pickled varieties. In general, the patient with Ménière’s disease should avoid or limit canned and processed foods.

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