Caring for the Adult Test 2 Study Guide

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MarieRN
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172787
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Caring for the Adult Test 2 Study Guide
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2012-09-23 14:56:31
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Caring Adult
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Chapters 50-53
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  1. Which are true statements about impetigo? (Select all that apply.)
    a.       Vesicle or pustule that ruptures, leaving a thick crust
    b.      Inflamed hair follicles with white pustules
    c.       Inflamed skin and subcutaneous tissue with deep, inflamed nodules
    d.      Treated with antibiotic therapy: erythromycin or dicloxacillin
    a, d
  2. Which are true statements about cellulitis? (Select all that apply.)
    a.       Local  tenderness and redness at first, then malaise, chills, and fever
    b.      At first, small shiny lesions; then they enlarge and become rough
    c.       Treated with electrical current to destroy lesion followed by removal with curette, cryotherapy (freezing), topical medications
    d.      Site becomes more erythematous; nodules and vesicles may form; vesicles may rupture, releasing purulent material
    a, d
  3. Which are changes that occur in older men and women? (Select all that apply.)
    a.       Increased elastic tissue
    b.      Increased facial hair
    c.       Increased subcutaneous tissue
    d.      Thickening of capillaries
    e.      Thinning of scalp hair
    b, e
  4. Nevi (moles) are carefully inspected for pigmentation, ulcerations, changes in surrounding skin, and:
    a.       vascular irregularities.
    b.      amount of edema.
    c.       amount of pus.
    d.      irregularities in shape.
    d
  5. When assessing capillary refill, after applying pressure to cause blanching and then releasing the pressure, the nurse would observe that the color returns to normal within:
    a.       1-2 minutes.
    b.      3-5 seconds.
    c.       30-40 seconds.
    d.      50-60 seconds.
    b
  6. The potassium hydroxide (KOH) examination is used in combination with a culture to diagnose infections of the skin, hair, or nails that are:
    a.       viral.
    b.      bacterial.
    c.       caused by parasites.
    d.      fungal.
    d
  7. Which are assessments of the fingernails and toenails that nurses monitor? (Select all that apply.)
    a.       Capillary refill
    b.      Edema
    c.       Hemorrhage
    d.      Mobility
    e.      Color of nail bed
    a, e
  8. The most common problem for patients with pruritus is Risk for impaired skin integrity related to:
    a.       excessive dryness.
    b.      intense itching.
    c.       moist environment.
    d.      inadequate circulation.
    b
  9. Nursing diagnoses for the patient with atopic dermatitis may include Impaired skin integrity related to:
    a.       decreased resistance to infection.
    b.      self-care practices.
    c.       poor peripheral circulation.
    d.      excessive dryness.
    d
  10. The assessment of patients with seborrheic dermatitis includes inspecting affected areas for:
    a.       bleeding and exudate.
    b.      edema and redness.
    c.       scales and crusts.
    d.      yellow skin and ascites.
    c
  11. A common risk factor for developing candidiasis is:
    a.       hypertension.
    b.      antibiotic therapy.
    c.       emotional stress.
    d.      tachycardia.
    b
  12. A primary problem for patients with candidiasis is:
    a.       activity intolerance.
    b.      altered oral mucous membranes.
    c.       decreased cardiac output.
    d.      self-care deficit.
    b
  13. Acne is caused by:
    a.       eating too much chocolate.
    b.      fatty foods.
    c.       poor hygiene.
    d.      blocked hair follicles.
    d
  14. The nurse advises the patient with shingles that the condition is communicable to people who have never been exposed to:
    a.       measles.
    b.      pertussis.
    c.       chickenpox.
    d.      mumps.
    c
  15. The most serious form of skin cancer is:
    a.       basal cell carcinoma.
    b.      melanoma.
    c.       squamous cell carcinoma.
    d.      cutaneous T-cell lymphoma.
    b
  16. Following a burn injury, plasma leaks into the tissue due to increased capillary:
    a.       constriction.
    b.      dilation.
    c.       production.
    d.      permeability.
    d
  17. After a burn injury, shifts in fluids and electrolytes cause local edema and a decrease in:
    a.       respiratory rate.
    b.      CNS stimulation.
    c.       cardiac output.
    d.      red blood cell production.
    c
  18. A patient with a burn experiences a shift of plasma proteins from the capillaries. This is likely to result in:
    a.       hypoprotienemia.
    b.      increased blood volume.
    c.       dehydration.
    d.      increased urine output.
    a
  19. Which is a complication of untreated fluid shifts in burn patients?
    a.       Hypovolemic shock
    b.      Kidney failure
    c.       Pneumonia
    d.      Convulsions
    a
  20. A type of therapy used in the treatment of psoriasis, vitiligo, and chronic eczema is:
    a.       phototherapy.
    b.      soaks.
    c.       wet wraps.
    d.      debridement.
    a
  21. Vitamin A is essential for:
    a.       blood clotting.
    b.      bone formation.
    c.       wound healing.
    d.      healthy skin.
    d
  22. Food allergies can cause:
    a.       scabies.
    b.      basal cell carcinoma.
    c.       psoriasis.
    d.      atopic dermatitis.
    d
  23. Which is a topical herbal preparation used as an emollient?
    a.       Aloe
    b.      Angelica
    c.       Balm of Gilead
    d.      Ginseng
    c
  24. What should be included in the teaching plan for a patient with atopic dermatitis? (Select all that apply.)
    a.       Avoid constrictive clothing.
    b.      Use sunscreens and moisturizers.
    c.       Topical corticosteroids provide the best control of inflammation.
    d.      It is helpful to take nystatin for itching.
    • a
    • b
    • c
  25. Acne lesions develop when there is:
    a.       increased fatty food intake.
    b.      increased sebum production.
    c.       increased chocolate intake.
    d.      poor hygiene.
    b
  26. Which drug used to remove heavy scales in patients with psoriasis can stain normal skin and hair?
    a.       Tazarotene (Tazorac)
    b.      Glucocorticoids
    c.       Methotrexate sodium
    d.      Anthralin (Anthra-Derm)
    d
  27. Which skin disorder characterized by irritation and redness in body folds is fairly common among patients in long-term care facilities?
    a.       Intertrigo
    b.      Impetigo
    c.       Candidiasis
    d.      Pemphigus
    a
  28. Which should not be used in patients with intertrigo because it supports the growth or C. albicans?
    a.       Topical corticosteroid
    b.      Cornstarch
    c.       Anthralin (Anthra-Derm)
    d.      Moisturizer
    b
  29. Who is at greatest risk for skin cancer?
    a.       Caucasians
    b.      African-Americans
    c.       Native Americans
    d.      Hispanics
    a
  30. A prominent symptom of psoriasis, dermatitis, eczema, and insect bites is:
    a.       fever.
    b.      pain.
    c.       pruritus.
    d.      edema.
    c
  31. If one arm and one leg are burned, what is the estimated burn size, according to the rule of nines?
    a.       18%
    b.      27%
    c.       36%
    d.      54%
    b
  32. The burn patient is at great risk for:
    a.       hyperthermia.
    b.      paralysis.
    c.       edema.
    d.      infection.
    d
  33. A patient has just been prescribed isotretinoin (Accutane) for resistant acne. Which are teaching points for this patient? (Select all that apply.)
    a.       A serious adverse effect of isotretinoin (Accutane) is fetal deformities.
    b.      Isotretinoin (Accutane) can cause mental depression, possible leading to suicidal ideation.
    c.       Do not apply to eyes, mouth, or angles of the nose.
    d.      Avoid sun exposure and use sunscreen.
    a, b
  34. Which are true statements about acne skin disorders? (Select all that apply.)
    a.       Mild cases of acne respond well to Acyclovir (Zovirax).
    b.      Comedones (whiteheads and blackheads), pustules, and cysts are characteristics of acne.
    c.       Two oral antibiotics that are frequently given for acne are tetracycline and erythromycin.
    d.      A drug prescribed for patients if acne is severe and unresponsive to antibiotics isotretinoin (Accutane).
    e.      Acne is a condition in which androgenic hormones cause increased sebum production and bacteria proliferation, causing hair follicles to block and become inflamed.
    b, c, d, e
  35. Which are true statements about herpes zoster virus? (Select all that apply.)
    a.       Older adults are especially
    susceptible to complications, including ophthalmic involvement, from herpes zoster virus.
    b.      Patients with herpes zoster virus exhibit early symptoms of heightened sensitivity along a nerve pathway, pain, and itching.
    c.       Cold sores or fever blisters or oral lesions caused by herpes zoster virus.
    d.      The sites most often infected by herpes zoster virus are the nose, lips, cheeks, ears, and genitalia.
    e.      Wet dressing soaked in Burow's solution may be used to treat lesions associated with herpes zoster virus.
    f.        Herpes zoster infection is commonly called shingles.
    a, b, e, f
  36. Which are true statements about candidiasis? (Select all that apply.)
    a.       Candidiasis infections, which are manifested as red lesions with white plaques, are found on the mucous membranes.
    b.      Three common sites for candidiasis include the mouth, skin, and vagina.
    c.        Candidiasis is a bacterial infection caused by herpes simplex.
    d.      Oral candidiasis is treated with nystatin.
    e.      One area that is susceptible to candidiasis, owing to the constant moisture found there, is the ostomy site.
    a, b, d, e
  37. Which are skin changes related to malnutrition? (Select all that apply.)
    a.       Hives
    b.      Pruritus
    c.       Cracked skin
    d.      Dermatitis
    e.      Dry skin (xerosis)
    c, d, e
  38. Which types of skin lesions require contact precautions? (Select all that apply.)
    a.       Wart lesions
    b.      Infected lesions
    c.       Plaque lesions
    d.      Draining lesions
    e.      Weeping lesions
    f.        Scaly lesions
    b, d, e
  39. Which problems are most likely to occur in the emergent stage of patients with burns? (Select all that apply.)
    a.       Risk for infection
    b.      Risk for imbalanced nutrition
    c.       Decreased cardiac output
    d.      Excess fluid volume
    c, d
  40. Which of the following problems are related to patients with burns? (Select all that apply.)
    a.       Acute pain related to tissue trauma
    b.      Risk for infection related to loss of protective skin barrier
    c.       Impaired skin integrity related to scratching
    d.      Hypothermia related to impaired heat-regulating ability of injured skin
    e.      Impaired physical mobility related to contractures, pain
    f.        Impaired skin integrity related to inflammation
    a, b, d, e
  41. Which is a problem for the patient with shingles?
    a.       Impaired skin integrity related to excessive dryness, scratching
    b.      Risk for infection related to moist environment, broken skin
    c.       Disturbed body image related to comedones, pustules, and cysts
    d.      Acute pain related to lesions or postherpetic neuralgia
    d
  42. Which are problems for the patient with psoriasis? (Select all that apply.)
    a.       Risk for injury related to improper nail trimming, poor peripheral circulation
    b.      Decreased cardiac output related to hypovolemia secondary to shift of fluid from vascular to extracellular compartment
    c.       Disturbed body image related to lesions and scales on skin
    d.      Excess fluid volume related to changes in capillary permeability and accumulation of fluid in body tissues
    e.      Social isolation related to embarrassment about flake skin lesions
    c, e
  43. When a skin biopsy is scheduled, the physician may advise the patient to avoid which drug before the procedure to reduce bleeding?
    a.       Diphenhydramine
    b.      Tetracycline
    c.       Aminophylline
    d.      Aspirin
    d
  44. Which foods are vital for healthy skin? (Select all that apply.)
    a.       Liver
    b.      Sweet potato
    c.       Grapefruit
    d.      Bananas
    e.      Cantaloupe
    f.        Spinach
    g.       Carrots
    a, b, e, f, g
  45. Which are true statements about glaucoma? (Select all that apply.)
    a.       Tunnel vision occurring in patients with glaucoma
    b.      A condition in which intraocular pressure is decreased below normal
    c.       Excess pressure impairs blood flow to the optic nerve, resulting in vision impairment
    d.      The type of vision that is lost first in glaucoma
    a, c
  46. Which are true statements about drugs used to treat glaucoma? (Select all that apply.)
    a.       Timolol maleate (Timpoptic), used in glaucoma to lower intraocular pressure,, is classified as a beta blocker.
    b.      Acetazolamide (Diamox) is used to reduce intraocular pressure by increasing the production of aqueous humor.
    c.       Chronic glaucoma, open-angle glaucoma, is usually treated first with drug therapy, which include miotics.
    d.      Adrenergics are used to decrease intraocular pressure, by decreasing the formation of aqueous humor and increasing its outflow.
    a, c, d
  47. As light enters the eye, it passes through the transparent cornea, aqueous humor, lens, and:
    a.       conjunctiva.
    b.      sclera.
    c.       vitreous humor.
    d.      lacrimal glands.
    c
  48. Dark spots that are actually bits of debris in the vitreous are called:
    a.       flashes.
    b.      floaters.
    c.       blind spots.
    d.      cataracts.
    b
  49. If a patient has sensitivity to light, the nurse would document this as:
    a.       photophobia.
    b.      presbyopia.
    c.       myopia.
    d.      hyperopia.
    a
  50. When the nurse is performing a physical assessment of the eyes, the lids should cover the eyeball completely when closed; when the eyes are open, the lower lid should be at the level of the:
    a.       conjunctiva.
    b.      retina.
    c.       iris.
    d.      lacrimal gland.
    c
  51. The eyeball is inspected for color and moisture; the sclera should be clear:
    a.       yellow.
    b.      white.
    c.       gray.
    d.      black.
    b
  52. The pupils are assessed for size, equality, and reaction to light; pupils that are unequal, dilated, or do not respond to light suggest:
    a.       diabetes.
    b.      liver dysfunction.
    c.       inflammation.
    d.      neurologic problems.
    d
  53. When the nurse asks the patient to focus on the nurse's finger as it is moved slowly toward the patient's nose, the nurse is assessing:
    a.       presbyopia.
    b.      astigmatism.
    c.       accommodation.
    d.      refraction.
    c
  54. Visual acuity is commonly tested using:
    a.       the Snellen chart.
    b.      the accommodation test.
    c.       tonometry.
    d.      fluorescein angiography.
    a
  55. Eye surgery may involve surgical incisions, the application of cold probes (cryotherapy), or the use of:
    a.       tonometry.
    b.      lasers.
    c.       fluorescein angiography.
    d.      topical dyes.
    b
  56. Following eye surgery, the patient is usually positioned:
    a.       flat in bed.
    b.      prone.
    c.       side-lying on affected side.
    d.      with the head of the bed elevated.
    d
  57. An important aspect of the care of postoperative eye patients is to prevent increased:
    a.       blood pressure.
    b.      cardiac output.
    c.       intraocular pressure.
    d.      ocular movement.
    c
  58. Medications prescribed after cataract surgery usually include antibiotics and:
    a.       miotics.
    b.      antihistamines.
    c.       anticholinergics.
    d.      corticosteroids.
    d
  59. One of the leading causes of blindness in the United States is:
    a.       conjunctivitis.
    b.      retinal detachment.
    c.       glaucoma.
    d.      cataracts.
    c
  60. Which drug has a side effect of vision disturbances?
    a.       Digitalis
    b.      Lasix
    c.       Aspirin
    d.      Synthroid
    a
  61. A vision of 20/30 on the Snellen chart means that the person can:
    a.       read at 20 feet from the left eye and 30 feet from the right eye what a normal person reads at these distances.
    b.      read at 20 feet what a normal person reads at 50 feet.
    c.       read at 30 feet what a person with normal vision reads at 20 feet.
    d.      read at 20 feet what a person with normal vision reads at 30 feet.
    d
  62. The measurement of pressure in the anterior chamber of the eye is:
    a.       refraction.
    b.      electroretinopathy.
    c.       tonometry.
    d.      angiography.
    c
  63. Which is an inflammation of hair follicles along the eyelid?
    a.       Hordeolum (stye)
    b.      Conjunctivitis
    c.       Blepharitis
    d.      Keratitis
    c
  64. Corticosteroids are contraindicated in patients with conjunctivitis caused by:
    a.       herpes.
    b.      bacteria.
    c.       fungi.
    d.      chlamydia.
    a
  65. Which drug is ordered before surgery for a patient with cataracts?
    a.       An analgesic
    b.      A mydriatic
    c.       A miotic
    d.      An anticholinergic
    b
  66. Which herb should not be taken by patients with glaucoma because it increases intraocular pressure?
    a.       Kava kava
    b.      Garlic
    c.       Ginkgo
    d.      Ephedra
    d
  67. A patient see floaters and states: "It is like a curtain has come down across my vision." This is a symptom of:
    a.       cataracts.
    b.      macular degeneration.
    c.       retinal detachment.
    d.      glaucoma.
    c
  68. Which antioxidant is believed to slow the progression of age-related macular degeneration?
    a.       Vitamin A
    b.      Vitamin B
    c.       Vitamin E
    d.      Vitamin K
    c
  69. Which are signs and symptoms of cataracts? (Select all that apply.)
    a.       Tunnel vision
    b.      Loss of peripheral vision
    c.       Cloudy vision
    d.      Seeing spots
    e.      Floaters in eyes
    c, e
  70. Which are interventions that relate to lighting for patients who are partially sighted? (Select all that apply.)
    a.       Reduce flare because it interferes with vision.
    b.      Make sure the furniture is a different color from the floors and walls.
    c.       Use dishes and cups with a solid, single color to facilitate self-feeding and reduce spills.
    a, b
  71. Which are the most common problems for patients with impaired vision? (Select all that apply.)
    a.       Disturbed sensory perception related to inflammation, rejection of transplanted tissue
    b.      Ineffective coping related to decreased independence
    c.       Disturbed sensory perception related to altered reception, transmission, and interpretation of visual stimuli
    d.      Self-care deficit (feeding, hygiene, grooming) related to visual impairment
    b, c, d
  72. Which are problems for patients with glaucoma? (Select all that apply.)
    a.       Disturbed sensory perception related to vision changes caused by rejection of transplanted tissue
    b.      Fear related to actual or potential loss of vision
    c.       Acute pain related to acute increased intraocular pressure
    b, c
  73. What are the goals/patient outcomes related to risk for injury for a patient who is postoperative eye surgery? (Select all that apply.)
    a.       Patient states pain is relieved.
    b.      Patient avoids rubbing eyes.
    c.       Patient is careful not to bend forward.
    d.      Patient demonstrates self-care activities.
    b, c
  74. If more than one medication is being given, the nurse must wait how long between each medication?
    a.       60 seconds
    b.      5 minutes
    c.       30 minutes
    d.      60 minutes
    b
  75. Nurses can teach people how to care for their eyes in order to protect their vision; it is important to tell people that:
    a.       burning sensations in the eyes should be reported to the physician.
    b.      watching too much television or sitting too close to the television injures the eyes.
    c.       eating foods with high vitamin A content will improve vision.
    d.      eyes need to be rinsed regularly to protect vision.
    a
  76. The nurse should treat nausea promptly in the postoperative eye surgery patient in order to prevent:
    a.       infection.
    b.      hemorrhage.
    c.       pain.
    d.      increased intraocular drainage.
    d
  77. Which is correct patient teaching regarding protection of health of the eyes?
    a.       "Watching too much TV or sitting too close the TV can injure your eyes."
    b.      "Gently cleanse your eyelids each time you wash your face."
    c.       "Eating foods that contain large amounts of vitamin A improves vision."
    d.      "Eyes need to be rinsed on a daily basis."
    b
  78. A primary consideration of the patient with visual impairment is:
    a.       safety.
    b.      infection.
    c.       hemorrhage.
    d.      nutrition.
    a
  79. Following cataract surgery, the nurse should:
    a.       advise the patient to sleep on the affected side.
    b.      have the patient cough and deep-breathe.
    c.       administer mydriatic agents.
    d.      keep the bed low.
    d
  80. Which nursing interventions for the patient are planned to prevent increased intraocular pressure? (Select all that apply.)
    a.       Keep the bed in low position.
    b.      Keep head of bed elevated.
    c.       Instruct the patient not to rub the operative eye, strain, or lean forward
    d.      Instruct the patient to lie on the affected side.
    e.      Administer antiemetics immediately as ordered for nausea and vomiting.
    f.        Encourage patient to take stool softeners as ordered to prevent constipation.
    g.       Acknowledge fear of vision loss common with eye surgery.
    b, c, e, f
  81. Which statements are related to sensorineural hearing loss? (Select all that apply.)
    a.       Patients who hear better in noisy settings than in quiet settings have sensorineural hearing loss.
    b.      Causes include congenital problems, noise, trauma, aging, Meniere syndrome, ototoxicity, diabetes, and syphilis.
    c.       A condition in which the stapes in the middle ear does not vibrate.
    d.      A disturbance of the neural structures in the inner ear or the nerve pathways to the brain.
    e.      Sometimes called nerve deafness.
    f.        Patients can hear sounds but have difficulty understanding speech.
    b, d, e, f
  82. Which statements are related to conductive hearing loss? (Select all that apply.)
    a.       Patients who either cannot perceive or cannot interpret sounds that are heard
    b.      A hearing loss that results from interference with the transmission of sound waves from the external or middle ear to the inner ear
    c.       People with conductive hearing losses are usually helped to hear by hearing aids
    d.      May be caused by otosclerosis or obstruction of the external canal or eustachian tube
    e.      Patients either cannot perceive or cannot interpret sounds that are heard
    b, c, d
  83. Which are true statements about otitis externa? (Select all that apply.)
    a.       It is also called swimmer's ear.
    b.      Treatment of otitis externa includes topical corticosteroids and diuretics.
    c.       Drainage in otitis externa may be blood-tinged or purulent.
    d.      May be caused by scratching or cleaning the ear with sharp objects.
    e.      The most characteristic symptom of otitis externa is itching.
    a, c, d
  84. Age-related changes in the inner ear affect sensitivity to sound, understanding of speech, and:
    a.       balance.
    b.      infection.
    c.       cerumen production.
    d.      blood pressure.
    a
  85. The type of hearing loss usually associated with aging is:
    a.       otitis media.
    b.      cholesteatoma.
    c.       otosclerosis.
    d.      presbycusis.
    d
  86. Pain in the ear is called:
    a.       otosclerosis.
    b.      otitis.
    c.       ototoxicity.
    d.      otalgia.
    d
  87. Ototoxicity means that a drug can damage the eighth cranial nerve or the organs of:
    a.       hearing and balance.
    b.      vision and sight.
    c.       smell and taste.
    d.      movement and coordination.
    a
  88. Examples of drugs that can have ototoxic effects are:
    a.       aspirin and antibiotics.
    b.      anticoagulants and corticosteroids.
    c.       central nervous system stimulants and adrenergics.
    d.      diuretics and antihypertensive.
    a
  89. When assessing the position of the auricles, the nurse should observe that the top of the auricle normally will be at about the level of the:
    a.       nostrils.
    b.      forehead.
    c.       eye.
    d.      mouth.
    c
  90. The external auditory canal is inspected for obvious obstructions or:
    a.       edema.
    b.      cyanosis.
    c.       drainage.
    d.      jaundice.
    c
  91. Which is the only normal secretion in the external auditory canal?
    a.       Sebum
    b.      Purulent drainage
    c.       Cerumen
    d.      Mucus
    c
  92. Otic drops, or ear drops, are intended to be placed directly into the:
    a.       middle ear canal.
    b.      inner ear canal.
    c.       tympanic membrane.
    d.      external ear canal.
    d
  93. The use of solution to cleanse the external ear canal or to remove something from the canal is called:
    a.       audiometry.
    b.      irrigation.
    c.       debridement.
    d.      electronystagmography.
    b
  94. Which is a common indication for irrigation?
    a.       Clot formation
    b.      Impacted cerumen
    c.       Purulent drainage
    d.      Bleeding
    b
  95. Which is a device that amplifies sound?
    a.       An audiometer
    b.      A tuning fork
    c.       A hearing aid
    d.      An otoscope
    c
  96. People who benefit the most from hearing aids are those with:
    a.       sensorineural loss.
    b.      mixed hearing loss.
    c.       conductive hearing loss.
    d.      hearing loss due to Ménière disease.
    c
  97. Postoperative dizziness or vertigo following ear surgery may put the patient at risk for:
    a.       injury.
    b.      impaired skin integrity.
    c.       infection.
    d.      pain.
    a
  98. Patients who have had ear surgery may have altered auditory sensory perception as a result of:
    a.       dizziness or vertigo.
    b.      knowledge deficit.
    c.       self-care deficit.
    d.      packing and edema in affected ear.
    d
  99. Following ear surgery, patients often complain of the sensation that the room is spinning or that their bodies are spinning. This is documented as:
    a.       dizziness.
    b.      otalgia.
    c.       edema.
    d.      vertigo.
    d
  100. After ear surgery, patients are advised to move slowly and carefully and to avoid sudden movement, which may cause:
    a.       hemorrhage.
    b.      vertigo.
    c.       infection.
    d.      edema.
    b
  101. Of all patients with sensory disorders, people who probably suffer the most severe social isolation are those with:
    a.       hearing impairment.
    b.      sight impairment.
    c.       smell impairment.
    d.      taste impairment.
    a
  102. To prevent one form of congenital hearing impairment, all women of childbearing age should be immunized for:
    a.       pertussis.
    b.      influenza.
    c.       rubella.
    d.      hepatitis B
    c
  103. One of the most common causes of obstruction of the external ear canal is:
    a.       hemorrhage.
    b.      infection.
    c.       impacted cerumen.
    d.      blood clots.
    c
  104. Patients with impacted cerumen may complain of hearing loss or:
    a.       sharp pain.
    b.      tinnitus.
    c.       bloody discharge.
    d.      headache.
    b
  105. A very common problem after mastoidectomy or middle ear surgery is:
    a.       nausea.
    b.      constipation.
    c.       oliguria.
    d.      seizures.
    a
  106. Because the fixed stapes cannot vibrate in patients with otosclerosis, sound waves cannot be transmitted to the:
    a.       middle ear.
    b.      tympanic membrane.
    c.       inner ear.
    d.      external auditory canal.
    c
  107. Slow progressive hearing loss in the absence of infection is the primary symptom of:
    a.       acute otitis media.
    b.      labyrinthitis.
    c.       perforated eardrum.
    d.      otosclerosis.
    d
  108. The most common treatment for otosclerosis is a surgical procedure called:
    a.       myringotomy.
    b.      stapedectomy.
    c.       mastoidectomy.
    d.      incision and drainage.
    b
  109. A hereditary condition in which an abnormal growth causes the footplate of the stapes to become fixed is:
    a.       cholesteatoma.
    b.      otosclerosis.
    c.       labyrinthitis.
    d.      conductive hearing loss.
    b
  110. An upper ear infection that usually follows an upper respiratory infection and that may lead to Ménière disease is:
    a.       otitis media.
    b.      otosclerosis.
    c.       mastoiditis.
    d.      labyrinthitis.
    d
  111. The treatment of labyrinthitis is:
    a.       antiemetics.
    b.      analgesics.
    c.       corticosteroids.
    d.      beta blockers.
    a
  112. Which is a major concern for a patient with vertigo?
    a.       infection
    b.      safety
    c.       nutrition
    d.      edema
    b
  113. Which is the primary symptom of ototoxicity which salicylates?
    a.       Vertigo
    b.      Tinnitus
    c.       Dizziness
    d.      Anorexia
    b
  114. A low buzzing sound that sometimes becomes a roar and that is a symptom of Ménière disease is documented as:
    a.       vertigo.
    b.      tinnitus.
    c.       dizziness.
    d.      otitis.
    b
  115. When the caloric test or electronystagmography is done in patients with Ménière disease, they will experience severe:
    a.       vertigo.
    b.      seizures.
    c.       headache.
    d.      flushing.
    a
  116. Following surgery for Ménière disease, the nurse needs to assess the patient for:
    a.       facial nerve damage.
    b.      fluid volume excess.
    c.       decreased cardiac output.
    d.      urinary retention.
    a
  117. Presbycusis is the result of changes in one or more parts of the:
    a.       middle ear.
    b.      external auditory canal.
    c.       eustachian tube.
    d.      cochlea.
    d
  118. A labyrinth disorder in which there is an accumulation of fluid in the inner ear is:
    a.       otosclerosis.
    b.      otitis media.
    c.       Ménière disease.
    d.      presbycusis.
    c
  119. Drugs that can cause permanent hearing loss are:
    a.       antihypertensives.
    b.      aminoglycosides (antibiotics).
    c.       anticholinergics.
    d.      diuretics.
    b
  120. Patients who are at special risk of developing ototoxicity because their bodies excrete drugs more slowly are those with:
    a.       renal failure.
    b.      pneumonia.
    c.       myocardial infarction.
    d.      liver disease.
    a
  121. Rinne's and Weber's tests use a tuning fork to assess the:
    a.       ability to hear whispers.
    b.      presence of lesions in the vestibule.
    c.       conduction of sound by air and bone.
    d.      function of the eighth cranial nerve.
    c
  122. Which diet may be recommended for patients' with Ménière disease?
    a.       Increased calcium
    b.      Increased vitamin K
    c.       Increased potassium
    d.      Low sodium
    d
  123. Which are potential complications of surgery for Ménière disease? (Select all that apply.)
    a.       Tinnitus
    b.      Infection
    c.       Hearing loss
    d.      Ataxia
    e.      Loss of cerebral spinal fluid
    f.        Damage to cranial nerve VII (facial nerve)
    b, c, e, f
  124. Which is true about drying agents used as drug therapy for patients with ear infections? (Select all that apply.)
    a.       Decrease risk of infection by drying the external canal after swimming or bathing.
    b.      Prevent or treat nausea, vomiting, motion sickness.
    c.       They soften ear wax.
    d.      An example is boric acid.
    e.      Contraindicated with perforated tympanic membrane.
    f.        Used with ear surgery.
    a, d, e
  125. Which are true statements about the use of topical corticosteroids for patients with ear infections? (Select all that apply.)
    a.       Prevent or treat nausea, vomiting, and motion sickness.
    b.      Treat inflammation, pruritus, and allergic response.
    c.       Side effects include sedation, drowsiness, and dry mouth.
    d.      Side effects include hypersensitivity: redness, rash, burning.
    e.      Otocort, neomycin, colistin (Coly-Mycin S Otic), and polymyxin B are examples.
    b, e
  126. A patient with rheumatoid arthritis is taking aspirin. The nurse will monitor the patient for which signs and symptoms of toxicity? (Select all that apply.)
    a.       Hearing loss
    b.      Ataxia
    c.       Infection
    d.      Tinnitus
    e.      Dizziness
    f.        Drainage
    a, b, d, e
  127. The nurse is taking care of a patient with Ménière disease. Which of the following is the priority problem for this patient?
    a.       Impaired verbal communication related to inability to hear
    b.      Risk for deficient fluid volume related to vomiting
    c.       Social isolation related to inability to communicate verbally
    d.      Ineffective coping related to change in social interaction
    b
  128. Which is the correct postoperative intervention for a patient who has had ear surgery?
    a.       Position patient on the unaffected side to promote drainage.
    b.      Instruct patient to keep his mouth closed if he needs to cough or sneeze.
    c.       Increase vitamin K and protein intake in the diet.
    d.      Avoid shampooing for 2 weeks.
    d
  129. Which is the priority intervention for patients with impaired verbal communication?
    a.       Provide adequate lighting away from the patient's face.
    b.      Raise the tone of your voice.
    c.       If the patient has a good ear, speak to that side.
    d.      Explain the use of the call button and bedside intercom.
    c
  130. For patients with throat disorders, for what does the nurse inspect the mucous membranes and tonsils of the throat? (Select all that apply.)
    a.       Cyanosis
    b.      Lesions
    c.       Pallor
    d.      Redness
    e.      Drainage
    f.        Swelling
    b, d, e, f
  131. Inspection and palpation of the neck may reveal enlarged:
    a.       lymph nodes.
    b.      tonsils.
    c.       adenoids.
    d.      vocal cords.
    a
  132. Epistaxis (nosebleed) is more common in older people, especially in those taking:
    a.       antibiotics.
    b.      analgesics.
    c.       anticoagulants.
    d.      diuretics.
    c
  133. A patient has a weakened esophageal sphincter that allows gastric contents to flow back into the throat when the patient lies down. Where does this patient experience a burning sensation?
    a.       Larynx
    b.      Nares
    c.       Trachea
    d.      Stomach
    a
  134. Following laryngoscopy, the patient takes nothing by mouth until:
    a.       respirations are normal.
    b.      vomiting has stopped.
    c.       the gag reflex returns.
    d.      24 hours after surgery.
    c
  135. Before suctioning a patient, it is important to:
    a.       administer antiemetics as ordered.
    b.      ambulate the patient.
    c.       oxygenate the patient.
    d.      administer antibiotics as ordered.
    c
  136. Which is a key point to remember when suctioning a patient?
    a.       Keep the vent closed when inserting the catheter.
    b.      Apply suction continuously as the catheter is withdrawn.
    c.       Suction for no longer than 30 seconds.
    d.      Use sterile procedure.
    d
  137. When providing tracheostomy care to a patient, which is the appropriate intervention?
    a.       Use standard precautions.
    b.      Suction the tracheostomy after removing the old dressings.
    c.       Use a sterile solution of iodine to clean the inner cannula.
    d.      Cut a new pad to fit around the tracheostomy site.
    a
  138. Which are common problems the nurse monitors in a patient who has had nasal surgery? (Select all that apply.)
    a.       Tachycardia
    b.      Dyspnea
    c.       Pain
    d.      Pressure
    e.      Anxiety
    f.        Hypotension
    g.       Pallor
    b, c, d, e
  139. After nasal surgery, the patient's vital signs are monitored to detect signs of which of the following?
    a.       Hypokalemia
    b.      Hypernatremia
    c.       Hypovolemia
    d.      Inadequate circulation
    c
  140. The patient who has had nasal surgery may be at risk for decreased cardiac output because of:
    a.       blood loss from nasal passageways.
    b.      nasal packing.
    c.       airway obstruction.
    d.      facial bruising.
    a
  141. Following nasal surgery, what is the priority problem for this patient?
    a.       Hemorrhage
    b.      Infection
    c.       Hypertension
    d.      Confusion
    a
  142. Laxatives or stool softeners may be ordered for patients after nasal surgery in order to prevent which of the following?
    a.       Diarrhea
    b.      Vomiting
    c.       Hypertension
    d.      Straining
    d
  143. Which is the best position for patients after nasal surgery in order to prevent which of the following?
    a.       Lying flat in bed
    b.      Lying with the head of bed elevated
    c.       Side-lying
    d.      Supine
    b
  144. When the nasal cavity is packed following surgery, the patient is breathing through the mouth. Which is the best measure that helps decrease dryness of the mucous membranes?
    a.       Frequent oral hygiene
    b.      Humidifiers
    c.       Oral fluids high in vitamin C
    d.      Ice packs
    b
  145. Patients may experience disturbed body image following nasal surgery due to:
    a.       airway obstruction.
    b.      blood loss.
    c.       hypovolemia.
    d.      facial bruises.
    d
  146. Serious neurologic complications should be suspected in patients with sinusitis if the patient develops which of the following?
    a.       Tachycardia and restlessness
    b.      High fever and seizures
    c.       Confusion and cyanosis
    d.      Dyspnea and anxiety
    b
  147. Which is the type of surgery performed for chronic maxillary sinusitis?
    a.       Laryngoscopy
    b.      Tonsillectomy and adenoidectomy
    c.       The Caldwell-Luc operation
    d.      Nasal septoplasty
    c
  148. Desensitizing injections, or "allergy shots," are composed of dilute solutions of which of the following?
    a.       Allergens
    b.      Histamines
    c.       Antihistamines
    d.      Plasma
    a
  149. A deviated septum may obstruct the nasal passage and block which of the following?
    a.       Sinus drainage
    b.      Eustachian tube drainage
    c.       Pharyngeal drainage
    d.      Jugular vein drainage
    d
  150. Patients with a deviated septum may complain of epistaxis, sinusitis, and:
    a.       palpitations.
    b.      headaches.
    c.       insomnia.
    d.      sweating.
    b
  151. When epistaxis occurs, the patient should sit down and lean forward and direct pressure should be applied for:
    a.       1-2 minutes.
    b.      3-5 minutes.
    c.       7-10 minutes.
    d.      15-20 minutes.
    b
  152. Suctioning is limited to 10 seconds because prolonged suctioning may lead to which of the following?
    a.       Hypoxia
    b.      Hypertensions
    c.       Increased intracranial pressure
    d.      Bradycardia
    a
  153. Patients with severe epistaxis may be at high risk for infection due to:
    a.       possible airway obstruction.
    b.      nasal packing.
    c.       hypotension.
    d.      hypovolemia.
    b
  154. The two major problems that may develop in the postoperative phase of tonsillectomy are respiratory distress and:
    a.       infection.
    b.      hemorrhage.
    c.       hypersensitivity reaction.
    d.      cardiac dysrythmia.
    b
  155. Following a tonsillectomy, a treatment that may be applied to the neck to decrease swelling and pain is:
    a.       a heating pad.
    b.      a TENS unit.
    c.       antibiotic ointment.
    d.      an ice collar.
    d
  156. A postoperative tonsillectomy patient is ready to be discharged. Which symptoms should be reported to the physician if the nurse observes them?
    a.       Bleeding
    b.      Earache
    c.       White patches in the throat (surgical site)
    d.      Sore throat
    a
  157. Which treatment is usually prescribed to reduce irritation of the larynx in patients with laryngitis?
    a.       Surgery
    b.      Voice rest
    c.       Intravenous fluids
    d.      Application of heat
    b
  158. A primary nursing diagnosis for patients with laryngitis due to aphonia is:
    a.       Risk for infection.
    b.      Risk for injury.
    c.       Impaired verbal communication.
    d.      Altered tissue perfusion.
    c
  159. What is the correct term for benign masses of fibrous tissue that result primarily from overuse of the voice tor that follow infections?
    a.       Nodules
    b.      Myomas
    c.       Fibromas
    d.      Tumors
    a
  160. The only symptom of laryngeal nodules is:
    a.       pain.
    b.      fever.
    c.       dysphagia.
    d.      hoarseness.
    d
  161. Which is the term for a swollen mass of mucous membrane attached to the vocal cord?
    a.       Nodule
    b.      Tumor
    c.       Cancer
    d.      Polyp
    d
  162. Individuals who both smoke and use alcohol are at particularly high risk for:
    a.       tonsillitis.
    b.      pneumonia.
    c.       cancer of the larynx.
    d.      nasal polyps.
    c
  163. What is the most common site of metastasis in a patient with laryngeal cancer?
    a.       Liver
    b.      Colon
    c.       Lung
    d.      Brain
    c
  164. Total laryngectomy causes permanent loss of the:
    a.       voice.
    b.      cough.
    c.       sterncoleidomastoid muscle movement.
    d.      swallow reflex.
    a
  165. A total laryngectomy involves removal of the entire larynx, vocal cords, and which of the following?
    a.       Pharynx
    b.      Epiglottis
    c.       Tonsils
    d.      Esophagus
    b
  166. Gently closing one naris at time and instructing the patient to breathe through the other naris is a way to assess:
    a.       lung sounds.
    b.      aphonia.
    c.       sense of smell.
    d.      patency of the nostrils.
    d
  167. Normally, the frontal and maxillary sinuses are filled with which of the following?
    a.       Fluid
    b.      Air
    c.       Polyps
    d.      Cysts
    b
  168. In the immediate postoperative period after total laryngectomy, the nurse's assessment focuses on comfort, circulation, and:
    a.       fluid balance.
    b.      oxygenation.
    c.       infection.
    d.      hypovolemia.
    b
  169. Which position promotes maximal lung expansion in the patient with a laryngectomy?
    a.       Semi-prone
    b.      Flat
    c.       Semi-Fowler's
    d.      Side-lying
    c
  170. To prevent pooling of secretions in the lungs of patients with laryngectomies, which should the nurse encourage?
    a.       Coughing and deep-breathing
    b.      Increase fluid intake
    c.       Early ambulation
    d.      Avoidance of dusty places
    a
  171. Which herb is used to boost the immune system and is taken by some to decrease the severity of a cold?
    a.       Ginseng
    b.      Ephedra
    c.       Echinacea
    d.      St. John's wort
    c
  172. To decrease the patient's reaction to offending allergens, the allergist may recommend injections for what purpose?
    a.       Prevent inflammation
    b.      Treat tissue injury
    c.       Increase immunity
    d.      Provide desensitization
    a
  173. Which are true statements about sinusitis? (Select all that apply.)
    a.       Pain or a feeling of heaviness over the frontal or maxillary area is a common symptom.
    b.      Toothache-like pain is a common symptom of sinusitis that involves the front sinus.
    c.       Complications of sinusitis include brain abscess and meningitis.
    d.      Most sinus infections are caused by a virus.
    a, c
  174. Which are true statements about acute viral coryza? (Select all that apply.)
    a.       Acute viral coryza is contagious and spread by droplet infection.
    b.      Complications of acute viral coryza are more common in people with increased resistance.
    c.       Complications of acute viral coryza include otitis media, sinusitis, bronchitis, and pneumonia.
    d.      Antibiotics are effective against acute viral coryza.
    e.      Decongestants and antihistamines are used to treat acute viral coryza.
    a, c, e
  175. Which are true statements about pharyngitis? (Select all that apply.)
    a.       Pharyngitis is treated with rest, fluids, analgesics, and throat gargles.
    b.      A soft or liquid diet may be ordered because of nausea.
    c.       A treatment that may be ordered is humidification.
    d.      The recommended daily fluid intake for patients with pharyngitis is 1000-1500 ml
    a, c
  176. Which are complications of bacterial pharyngitis that may occur 1-5 weeks after the throat infection? (Select all that apply.)
    a.       Acute glomerulohephritis
    b.      Meningitis
    c.       Sinusitis
    d.      Brain abscess
    e.      Rheumatic fever
    a, e
  177. Which are true statements about patients with tonsillitis? (Select all that apply.)
    a.       Tonsillitis is a contagious infection spread by food or airborne routes.
    b.      A patient with tonsillitis usually reports a sore throat, difficulty swallowing, fever, chills, and muscle aches.
    c.       If swollen tissue blocks the eustachian tubes in patients with tonsillitis, there may also by pain in the lungs.d.      An elevated white blood cell count in patients with tonsillitis suggest a viral infection.e.      The medical treatment of tonsillitis usually includes the use of antibiotics
    a, b, e
  178. Which are common problems for a patient with epistaxis? (Select all that apply.)
    a.       Ineffective airway clearance related to increased pulmonary secretions or weak cough
    b.      Decreased cardiac output related to hypovolemia secondary to hemorrhage
    c.       Risk for injury related to pressure (of packing, balloon) and possible airway obstruction
    d.      Risk for infection related to presence of nasal packing
    e.      Disturbed body image related to facial bruising
    b, c, d
  179. With facial trauma or nasal fracture, the recommended treatment initially is application of:
    a.       an ice pack.
    b.      a warm compress.
    c.       direct pressure.
    d.      heat.
    a
  180. Which are early signs of inadequate oxygenation in the postoperative tonsillectomy patient? (Select all that apply.)
    a.       Cyanosis
    b.      Pallor
    c.       Numbness
    d.      Confusion
    e.      Restlessness
    f.        Increased pulse rate
    d, e, f
  181. Which foods should be avoided in patients after a tonsillectomy?
    a.       Frozen liquids
    b.      Ice cream
    c.       Applesauce
    d.      Citrus juices
    d
  182. In the patient with a laryngectomy, the nurse monitors the need for suctioning by observing which of the following? (Select all that apply.)
    a.       Increased pulse
    b.      Swelling
    c.       Pain
    d.      Restlessness
    e.      Audible or visible mucus
    a, d, e
  183. The nurse is taking care of a patient who has had a laryngectomy. Which of the following are factors that affect the respiratory status of this patient. (Select all that apply.)
    a.       Nutrition
    b.      Verbal communication
    c.       Humidification
    d.      Personal hygiene
    e.      Positioning
    f.        Fluids
    c, e, f
  184. An older adult has pharyngitis. Why must fluids be increased slowly in older adults?
    a.       They do not adjust well to sudden changes in blood volume.
    b.      They have decreased kidney function.
    c.       They may develop cardiac edema if the fluids are given to rapidly.
    d.      The esophagus is more narrow.
    a

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