Caring for the Adult Test 2 Chapter Review

The skin regulates body temperature by which of the following?
a.       Reacting to foreign substances that invade the epidermis
b.      Dilating and constriction surface blood vessels
c.       Secreting sebum to insulate the outer layers of skin
d.      Reacting to sunlight by producing vitamin C

When inspecting the skin of an older adult, you observe flat, pigmented spots on the backs of both hands. You should recognize these as                                            .

Which of the following interventions will help prevent scratching and skin injury in a patient with atopic dermatitis? (Select all that apply.)
a.       Maintain the room temperature around 70⁰ F.
b.      Apply keratolytic agents liberally to promote healing.
c.       Wash new clothing before wearing it.
d.      Encourage hot baths.

Contact dermatitis is caused by which of the following?
a.       Infestations of parasites
b.      Reactions to drugs
c.       Excessive skin dryness
d.       An allergic response

Patient teaching related to psoriasis should include which of the following? (Select all that apply.)
a.       Psoriasis usually can be cured with drug therapy.
b.      Direct contact with others cannot transmit psoriasis.
c.       Anthralin must be kept on the skin continuously.
d.      In most people, psoriasis affects only the skin.

An obese older patient in a long-term care facility has had intertrigo in body folds (axilla, beneath the breasts) on several occasions. Which measure is most appropriate to reduce the risk of a recurrence?
a.       Keep body folds clean and dry.
b.      Reduce bathing to three times each week.
c.       Liberally sprinkle cornstarch on body creases.
d.      Scrub affected areas with topical antiseptic agents.

A female patient is being treated with isotretinoin (Accutane) at the clinic for severe acne after other treatments have failed. All of the following statements should be included in the teaching plan. Which is most important?
a.       "Your skin may become very dry and peel."
b.      "It may take several months to see improvement."
c.       "You will sunburn very easily while on this drug."
d.      "If sexually active, then you must use reliable contraception."

Which of the following is a drug used to treat HSV-1?
a.       Hydrocortisone (Cortizone)
b.      Isotretinoin (Accutane)
c.       Acyclovir (Zovirax)
d.      Methoxsalen (Oxsoralen)

What is the best way to prevent skin cancer?

Characteristics of typical melanomas include which of the following?
a.       Nodular lesion with a pearly appearance
b.      Irregular lesion with uneven coloration
c.       Scaly ulcer with no clear margins
d.      Painful red, blue, or purple macules

Which of the following is the fluid that fills the anterior chamber of the eye?
a.       Aqueous humor
b.      Ciliary fluid
c.       Vitreous humor
d.      Refractive fluid

Your examination of the eyes of an older adult reveals eyeballs slightly sunken in the orbits, small pupils that do not respond to light, a grayish ring around the iris, and a complaint that the eyes feel dry sometimes. Which of these would you consider normal in an older adult? (Select all that apply.)
a.       Eyeballs slightly sunken
b.      Small pupils
c.       Pupils not responsive to light
d.      Eyes that feel dry sometimes

You are assisting with a community vision screening project. A participant says, "The nurse says my vision is 20/40 in both eyes. What does that mean?" Your response should be which of the following?
a.       "You see best at 20 to 40 feet from objects."
b.      "You cannot see more than 40 feet in the distance."
c.       "At 40 feet, you can read what most people can read at 20 feet."
d.      "At 20 feet, you can read what a person with normal vision could read at 40 feet."

What a patient comes to the office for an eye examination, the ophthalmologist administers phenylephrine 2.5% eye drops for which of the following reasons?
a.       To reveal any scratches on the cornea
b.      To dilate the pupil
c.       To anesthetize the cornea
d.      To dilate retinal blood vessels

A patient is being discharged after cataract surgery. Discharge instructions should include which of the following statements? (Select all that apply.)
a.       "Always lie on the unaffected side."
b.      "Avoid pressure on the operative eye."
c.       "Moderate to severe pain is expected."
d.      "Resume normal activities immediately."

To guide a visually impaired person, you should do which of the following?
a.       Stand side by side and hold the person's hand.
b.      Let the person hold your upper arm.
c.       Walk behind the patient and advise of obstacles.
d.      Have the person walk behind you with hands on your shoulders.

After keratoplasty, you observe that the patient's cornea is cloudy. Which of the following should you do?
a.       Reassure the patient that cloudiness is normal for several weeks after surgery.
b.      Elevate the patient's head and encourage increased fluid intake.
c.       Report signs of corneal rejection to the physician.
d.      Prepare the patient for emergency surgery.

Drugs used to treat open-angle glaucoma act by which of the following mechanisms? (Select all that apply.)
a.       Increasing aqueous outflow
b.      Dilating the canal of Schlemm
c.       Relaxing the trabecular meshwork
d.      Decreasing aqueous formation

Which of the following is the most serious complication of angle-closure glaucoma?
a.       Rupture of the eyeball
b.      Permanente blindness
c.       Nausea and vomiting
d.      Increased intracranial pressure

Positioning after surgery for retinal detachment depends on which of the following? (Select all that apply.)
a.       Patient preference
b.      Intraocular pressure
c.       Location of the repaired tear
d.      Use of air or saline to support the repair

For an otoscopic examination of the external auditory canal of an adult, the examiner should do which of the following?
a.       Pull the auricle straight up.
b.      Pull the earlobe down.
c.       Pull the auricle up and back.
d.      Pull the auricle straight back.

During the Rinne test, a patient reports hearing the tuning fork when it is placed on the mastoid bone and when the tines are then positioned near the ear canal. How should this information be interpreted?
a.       The patient probably has a an obstruction in the ear canal.
b.      The patient probably has a conductive hearing loss.
c.       The patient's response to this test is normal.
d.      The patient probably has a sensorineural hearing loss.

Normal age-related changes in the ears of the older adult include which of the following? (Select all that apply.)
a.       Increased cerumen secretion
b.      Coarser hair in the ear canal
c.       Progressive hearing loss
d.      Thickening of the ear drum

A slightly confused patient in a long-term care facility points to her ear and loudly says, "I can't hear!" The patient's hearing aid appears to be positioned  correctly in her ear canal. What is the first thing you should do?
a.       Remove the aid and clean it.
b.      Replace the battery.
c.       Turn up of the volume.
d.      See if it set to the on position.

During shift change, it is noted that a new patient is severely hard of hearing. What is the most important question for you to ask about this patient initially?
a.       What means of communication does the patient use?
b.      Is the patient aware of the latest technology?
c.       Has the patient ever been hospitalized before?
d.      Can a family member stay with the patient to interpret?

You are preparing to administer otic drops when you notice the patient has gauze in the affected ear with a piece of narrow gauze extending from the ear. What should you do?
a.       Gently remove the packing, instill the drops, and replace the packing.
b.      Apply the drops to the narrow piece of gauze for transport into the ear.
c.       Trim the gauze so that the packing is not accidentally pulled out of the ear.
d.      Inform the registered nurse (RN) that the drops cannot be given at this time.

Which nursing measures are appropriate for the patient who is having an acute attack of Ménière disease? (Select all that apply.)
a.       Keep the room quiet and dark.
b.      Advise the patient to drink additional fluids.
c.       Delay routine care until the patient is no longer dizzy.
d.      Monitor vitals every hours until stable and then every 4 hours.

When a patient is taking an aminoglycoside antibiotic agent, instructions should include which of the following?
a.       "Let me know if you have any 'ringing' in your ears."
b.      "Check the white part of your eyes for a color change."
c.       "Restrict your fluid intake to 1 L each day."
d.      "Change position slowly in case your BP drops."

Stapedectomy is used to correct which of the following?
a.       Sensorineural hearing loss
b.      Ménière disease
c.       Otosclerosis
d.      Otitis media

Patients who are considering having a cochlear implant should be told which of the following?
a.       "This procedure restores perfect hearing in 99% of patients."
b.      "Complications of cochlear implant are often disabling."
c.       "Results vary from minimal to excellent improvement in hearing."
d.      "Cochlear implants cannot enable you to discriminate speech."

Which of the following is the function of the turbinates in the internal nose?
a.       To trap inspired particles
b.      To destroy microorganisms
c.       To warm inspired air
d.      To detect odors

Age-related changes in the nose, sinuses, and throat include which of the following?
a.       Thinning of the mucous membrane
b.      Decreased mucus production
c.       Decreased sense of smell
d.      Less risk of epistaxis

Which of the following is the maximum time that suction should be applied during nasotracheal suctioning?
a.       10 seconds
b.      15 seconds
c.       20 seconds
d.      25 seconds

After nasal surgery, a patient has packing place and a nasal drip ("moustache") dressing on the upper lip. When the moustache dressing has become saturated, which of the following should you do?
a.       Replace the packing and the moustache dressing.
b.      Notify the physician.
c.       Reinforce the moustache dressing.
d.      Change the moustache dressing.

A patient who had nasal surgery is restless. His pulse rate has increased from 70 to 90 bpm, and his respiratory rate is 20 breaths per minute. His nasal dressing has no fresh bleeding. What should you do first?
a.       Order 1 U of blood.
b.      Take his vital signs again.
c.       Inspect the back of his throat.
d.      Encourage increased fluid intake.

The most serious complications of sinusitis include which of the following?
a.       Headache
b.      Pain
c.       Meningitis
d.      Rhinitis

A patient who has triad disease has which of the following?
a.       Asthma
b.      Nasal polyps
c.       Aspirin allergy
d.      Laryngeal nodules

Immediate treatment of epistaxis is to have the patient do which of the following?
a.       Sit up, lean slightly forward, and pinch the nostrils.
b.      Assume a semi-Fowler position with the head tilted back.
c.       Lie supine and apply a cold pack to the nose.
d.      Sit up and lean forward to put the head between his knees.

Which of the following is the priority nursing diagnosis after total laryngectomy?
a.       Anxiety
b.      Acute pain
c.       Ineffective airway clearance
d.      Impaired verbal communication

Which of the following are true for the patient with a supraglottic laryngectomy? (Select all that apply.)
a.       Swallowing is easier.
b.      The voice is preserved.
c.       The tracheostomy is permanent.
d.      A greater risk of aspiration exists.