Nokea
The nurse is caring for a patient with persistent otitis media. Which of the following findings should the nurse expect to assess?
- A. Ear pain
- B. Fever
- C. Hearing loss
- D. Tinnitus
- E. Fluid drainage from the ear
Correct Answer: A,C,E
Rationale: Persistent otitis media is characterized by ear pain, hearing loss, and potential fluid drainage from the ear. Fever may occur but is less consistent, and tinnitus is not a primary symptom unless associated with complications.
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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.
The nurse is caring for a patient with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which of these actions should be included in the plan of care?
- A. Discussing the need for sexually transmitted infection testing
- B. Applying topical corticosteroids to prevent further inflammation
- C. Assisting with applying for community visual rehabilitation services
- D. Educating about the use of antiviral eye drops to treat the infection
Correct Answer: A
Rationale: Patients with AIC have a high risk for concurrent genital Chlamydia infection and should be referred for STI testing. AIC is treated with antibiotics, antiviral and corticosteroid medications are not appropriate therapies. Although some types of Chlamydia infection do cause blindness, AIC does not lead to blindness, so referral for visual rehabilitation is not appropriate.
The nurse is caring for a patient who had a stapedotomy yesterday. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. The patient complains of 'congestion' in the ear.
- B. The patient's oral temperature is 38°C (100.4°F).
- C. The patient reports mild dizziness when standing.
- D. The patient has slight redness at the surgical site.
Correct Answer: B
Rationale: An oral temperature of 38°C (100.4°F) after a stapedotomy may indicate a postoperative infection, which requires prompt reporting to the healthcare provider. Congestion, mild dizziness, and slight redness are less urgent, as they may be expected postoperative symptoms unless severe or persistent.
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.
Which of the following actions is an example of an approach magnification?
- A. Using a telescopic lens
- B. Sitting closer to a television while watching it
- C. Using a black-tipped felt marker when writing
- D. Reading books with large-type print
Correct Answer: B
Rationale: Approach magnification is a simple but sometimes overlooked technique for enhancing the patient's residual vision. The nurse can recommend that the patient sit closer to the television or hold books closer to the eyes, which the patient may be reluctant to do unless encouraged. Using a telescopic lens is an optical device. Using a black-tipped marker to write is a contrast enhancement technique. Reading large-type print books may be helpful but is not an approach magnification action unless the book was brought close to the eyes, which is not indicated in the answer choice.