Nokea
A client complains of tinnitus and dizziness and has a diagnosis of Ménière's disease. She asks the nurse, 'What is the cause of Ménière's disease?' What is the nurse's best response?
- A. Ménière's disease is caused by a virus.'
- B. The cause of Ménière's disease is unknown.'
- C. Ménière's disease frequently follows a streptococcal infection.'
- D. It is hereditary. Both of your parents carried the gene for Ménière's disease.'
Correct Answer: B
Rationale: The exact cause of Ménière's disease is unknown, though it involves fluid imbalance in the inner ear.
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The nurse completes an assessment of the older adult client. Which disorder should the nurse associate with the finding illustrated?
- A. Glaucoma
- B. Arcus senilis
- C. Cataract
- D. Mydriasis
Correct Answer: C
Rationale: The illustration shows opacity of the lens of the eye. The nurse should associate this finding with a cataract. Glaucoma causes increased pressure within the eye and is not visible. Arcus senilis is a bluish-white ring within the outer edge of the cornea, which is not present in this illustration. Mydriasis is constriction of the pupil, which is not present in the illustration.
Which of the following would not be included in the nursing care plan for a client with Parkinson's disease?
- A. Restricting his intake of oral fluids
- B. Range of motion exercises
- C. Allowing him to carry out activities of daily living by himself even though he is very slow
- D. Providing him with diversionary tasks that require motor coordination of hands
Correct Answer: A
Rationale: Fluids should be encouraged to prevent dehydration and manage drooling in Parkinson's disease, making restriction inappropriate.
The client comes to the clinic and is diagnosed with otitis media. Which intervention should the clinic nurse include in the discharge teaching?
- A. Instruct the client not to take any over-the-counter pain medication.
- B. Encourage the client to apply cold packs to the affected ear.
- C. Tell the client to call the HCP if an abrupt relief of ear pain occurs.
- D. Wear a protective ear plug in the affected ear.
Correct Answer: C
Rationale: Abrupt pain relief in otitis media may indicate tympanic membrane rupture, requiring HCP notification. OTC pain meds are safe, cold packs are less effective, and ear plugs are unnecessary.
The day following a stapedectomy, the client tells the nurse that he cannot hear much in the operative ear and thinks the stapedectomy was a failure. What is the best response for the nurse to make?
- A. There is packing in your ear. You will not hear well for a few days.'
- B. The doctors have not yet turned on the stapes replacement.'
- C. You may not have hearing, but you will now be free of pain.'
- D. You seem upset that you aren't hearing well.'
Correct Answer: A
Rationale: Ear packing post-stapedectomy temporarily reduces hearing, which improves as packing is removed.
An older woman has had a CVA. The nurse notes that she seems to be unaware of objects on her right side (right homonymous hemianopia). Which nursing action is most important in planning to assist her to compensate for this loss?
- A. Place frequently used items on the affected side
- B. Position her so that her affected side is toward the activity in the room
- C. Encourage her to turn her head from side to side to scan the environment on the affected side
- D. Stand on the affected side while assisting her in ambulating
Correct Answer: C
Rationale: Encouraging head turning to scan the environment compensates for right homonymous hemianopia by ensuring awareness of the affected side.