Nokea
To decrease the risk for future hearing loss, which of the following actions should the nurse working with college students at the on-campus health clinic implement?
- A. Arrange to include otoscopic examinations for all patients.
- B. Administer rubella immunizations to all students at the clinic.
- C. Discuss the importance of limiting exposure to very high amplified music.
- D. Teach patients to regularly irrigate the ear to decrease cerumen impaction.
Correct Answer: C
Rationale: Exposure to high amplified music is a significant risk factor for hearing loss in young adults. Otoscopic exams and cerumen irrigation do not directly prevent hearing loss, and rubella immunization is unrelated to noise-induced hearing damage.
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The charge nurse observes a newly hired nurse caring for a patient who has just arrived in the postanesthesia care unit after having right cataract removal and an intraocular lens implant. Which of the following interventions requires that the charge nurse intervene?
- A. The nurse leaves the eye shield in place.
- B. The nurse encourages the patient to cough.
- C. The nurse elevates the patient's head to 45 degrees.
- D. The nurse applies corticosteroid drops to the right eye.
Correct Answer: B
Rationale: Because coughing will increase intraocular pressure, patients are generally taught to avoid coughing during the acute postoperative time. The other actions are appropriate for a patient after having this surgery.
Which of the following nursing diagnoses is priority when caring for a patient who is experiencing an acute attack of Méni?¨re's disease?
- A. Risk for falls as evidenced by impaired balance
- B. Impaired verbal communication related to vulnerability (tinnitus)
- C. Bathing self-care deficit related to weakness (vertigo)
- D. Imbalanced nutrition: less than body requirements related to insufficient dietary intake (nausea)
Correct Answer: A
Rationale: All the nursing diagnoses are appropriate, but because sudden acute attacks of vertigo, the major focus of nursing care is to prevent injuries associated with impaired balance.
These medications are prescribed by the health care provider for a patient who has just been admitted to hospital with acute angle-closure glaucoma. Which of the following medications should the nurse give first?
- A. Morphine sulphate 4 mg intravenously
- B. Betaxolol 1 drop in each eye
- C. Acetazolamide 250 mg orally
- D. Mannitol 100 mg intravenously
Correct Answer: D
Rationale: The most immediate concern for the patient is to lower intraocular pressure, which will occur most rapidly with IV administration of a hyperosmolar diuretic such as mannitol. The other medications also are appropriate for a patient with glaucoma but would not be the first medication administered.
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 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.