Nokea
The nurse is caring for a patient with neural presbycusis. Which of the following hearing changes should the nurse expect with this type of presbycusis?
- A. Loss of high-pitched sounds
- B. Loss of speech discrimination
- C. Uniform loss for all frequencies
- D. Range of hearing loss with low frequencies
Correct Answer: B
Rationale: The hearing change with a neural presbycusis is a loss of speech discrimination. Loss of high-pitched sounds accompanies a sensory presbycusis. A metabolic presbycusis has a hearing change that is uniform for all frequencies, accompanied by recruitment. A cochlear presbycusis has a hearing change that is a range of hearing loss that increases from low to high frequencies.
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An older-adult patient with presbycusis is fitted with binaural hearing aids. Which of the following information should the nurse include when teaching the patient how to use the hearing aids?
- A. Experiment with volume and hearing ability in a quiet environment initially.
- B. Keep the volume low on the hearing aids for the first week while adjusting to them.
- C. Add the second hearing aid after making the initial adjustment to the first hearing aid.
- D. Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.
Correct Answer: A
Rationale: Initially the patient should use the hearing aids in a quiet environment like the home, experimenting with increasing and decreasing the volume as needed. There is no need to gradually increase the time of wear. The patient should experiment with the level of volume to find what works well in various situations. Both hearing aids should be used.
The nurse is admitting a patient with a head injury after a motor vehicle accident who has shortness of breath and severe eye pain. Which of the following actions should the nurse take first?
- A. Elevate the head to 45 degrees.
- B. Administer the ordered analgesic.
- C. Check the patient's oxygen saturation.
- D. Examine the eye for evidence of trauma.
Correct Answer: C
Rationale: The priority action for a patient after a head injury is to assess and maintain airway and breathing. Because the patient is complaining of shortness of breath, it is essential that the nurse assess the oxygen saturation. The other actions also are appropriate but are not the first action the nurse will take.
The nurse is assessing a patient in the outpatient eye clinic who has myopia and presbyopia. Which of the following assessments should the nurse implement to evaluate the effectiveness of the prescribed bifocals?
- A. Strength of the eye muscles
- B. Both near and distant vision
- C. Cloudiness in the eye lenses
- D. Intraocular pressure changes
Correct Answer: B
Rationale: The lenses are prescribed to correct the patient's near and distant vision. The nurse also may assess for cloudiness of the lenses, increased intraocular pressure, and eye movement, but these data will not evaluate whether the patient's bifocals are effective.
The nurse is caring for a patient with an acute attack of Méni?¨re's disease. Which of the following actions carried out by a family member that is visiting the patient should the nurse intervene?
- A. Raises the side rails on the bed
- B. Turns on the patient's television
- C. Turns the patient to the right side
- D. Places an emesis basin at the bedside
Correct Answer: B
Rationale: Watching television may exacerbate the symptoms of an acute attack of Méni?¨re's disease. The other actions are appropriate.
The nurse is caring for a patient with age-related macular degeneration who has just had photodynamic therapy. Which of the following statements by the patient indicates that the discharge teaching has been effective?
- A. I will need to use bright lights to read for at least the next week.
- B. I will use drops to keep my pupils dilated until my appointment.
- C. I will not use facial lotions near my eyes during the recovery period.
- D. I will keep covered with long-sleeve shirts and pants for the next 5 days.
Correct Answer: D
Rationale: The photosensitizing drug used for photodynamic therapy is activated by exposure to bright light and can cause burns in areas exposed to light for 5 days after the treatment. There are no restrictions on use of facial lotions, medications to keep the pupils dilated are not appropriate, and bright lights would increase the risk for damage caused by the treatment.