Deck 14: Sensation: Hearing, Vision, Taste, Touch, and Smell
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Deck 14: Sensation: Hearing, Vision, Taste, Touch, and Smell
1
The nurse is caring for an older patient who has a loss of smell. How does the nurse best describe this phenomenon to the patient?
1) "You have been exposed to a toxin that has stopped your neurotransmitter function."
2) "If the mucus membranes in your nose are damaged, it may affect your sense of smell."
3) "The number of sensory cells increases with age, which lowers your sense of smell."
4) "Allergies, polyps, and viral infections can cause an increased sense of smell."
1) "You have been exposed to a toxin that has stopped your neurotransmitter function."
2) "If the mucus membranes in your nose are damaged, it may affect your sense of smell."
3) "The number of sensory cells increases with age, which lowers your sense of smell."
4) "Allergies, polyps, and viral infections can cause an increased sense of smell."
2
2
An older patient who has been diagnosed with hearing loss asks the nurse what caused the condition. What is the nurse's best response? Select all that apply.
1) "Hearing loss occurs in all patients as they get older."
2) "Sometimes hearing loss is caused by nerve damage in the ear."
3) "If earwax is impacted, it may cause conductive hearing loss."
4) "Middle-ear infections may be the cause of hearing loss."
5) "If your eardrum has burst, you may develop hearing loss."
1) "Hearing loss occurs in all patients as they get older."
2) "Sometimes hearing loss is caused by nerve damage in the ear."
3) "If earwax is impacted, it may cause conductive hearing loss."
4) "Middle-ear infections may be the cause of hearing loss."
5) "If your eardrum has burst, you may develop hearing loss."
2, 3, 4, 5
3
The nurse is performing an otoscope examination on an older patient and assesses a bulging red membrane with absent distorted light reflex. What is the nurse's priority action?
1) Document findings as normal.
2) Prepare for antibiotic therapy.
3) Irrigate ear canal.
4) Apply pressure dressing.
1) Document findings as normal.
2) Prepare for antibiotic therapy.
3) Irrigate ear canal.
4) Apply pressure dressing.
2
4
The nurse is caring for a patient newly prescribed antihistamine therapy. Which side effect(s) will be included in the medication instruction? Select all that apply.
1) Altered taste
2) Altered smell
3) Altered touch
4) Altered vision
5) Altered hearing
1) Altered taste
2) Altered smell
3) Altered touch
4) Altered vision
5) Altered hearing
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5
The staff nurse is admitting a diabetic who is newly diagnosed with peripheral neuropathy. Which should the nurse include when teaching home management?
1) "Set water heater at 120°F."
2) "Wear open-toed shoes to allow circulation."
3) "Use a mirror to inspect feet daily."
4) "Increase medication for pain as necessary."
1) "Set water heater at 120°F."
2) "Wear open-toed shoes to allow circulation."
3) "Use a mirror to inspect feet daily."
4) "Increase medication for pain as necessary."
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6
Which interventions should the nurse suggest an older patient use to reduce safety issues in the home? Select all that apply.
1) Use lampshades to prevent glare.
2) Recommend designed rug patterns.
3) Increase lighting in high-traffic areas.
4) Add extra lighting in areas that are dark.
5) Paint the edges of stairs to identify steps.
1) Use lampshades to prevent glare.
2) Recommend designed rug patterns.
3) Increase lighting in high-traffic areas.
4) Add extra lighting in areas that are dark.
5) Paint the edges of stairs to identify steps.
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7
The daughter of an older patient is concerned that the patient continues to drive at age 8
1) What should the nurse share with the daughter and patient about motor vehicle accidents and older people?
1) The elderly have few wrecks, as they are more cautious drivers.
2) There are few studies available looking at this particular concern.
3) The risks of seniors over age 80 are similar to those of teen drivers.
4) Accidents are the result of cognitive changes not related to sensory problems.
1) What should the nurse share with the daughter and patient about motor vehicle accidents and older people?
1) The elderly have few wrecks, as they are more cautious drivers.
2) There are few studies available looking at this particular concern.
3) The risks of seniors over age 80 are similar to those of teen drivers.
4) Accidents are the result of cognitive changes not related to sensory problems.
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8
The nurse is teaching safety to a patient with a dulled sensitivity to touch. What statement by the patient demonstrates understanding?
1) "I have to be careful around hot liquids such as water for my coffee."
2) "If I wear my winter gloves all of the time, I won't get hurt."
3) "I should use the back of my hands to test temperatures of liquids."
4) "I have a high tolerance to pain so I'll be okay."
1) "I have to be careful around hot liquids such as water for my coffee."
2) "If I wear my winter gloves all of the time, I won't get hurt."
3) "I should use the back of my hands to test temperatures of liquids."
4) "I have a high tolerance to pain so I'll be okay."
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9
The nurse is caring for an older patient with diabetes who is on antibiotics for a local infection. Which observation by the nurse would be anticipated?
1) Slight weight gain
2) Increased appetite
3) Diminished sense of taste
4) Increased use of salt on foods
1) Slight weight gain
2) Increased appetite
3) Diminished sense of taste
4) Increased use of salt on foods
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10
A 75-year-old patient complains that his vision continues to get worse every year. How should the nurse respond to this patient's complaint?
1) "I certainly understand your frustration."
2) "The problems you are experiencing are likely the early stages of glaucoma."
3) "The visual problems you are reporting become increasingly common after age 70."
4) "Maybe you have a medical problem that may be causing these drastic visual problems."
1) "I certainly understand your frustration."
2) "The problems you are experiencing are likely the early stages of glaucoma."
3) "The visual problems you are reporting become increasingly common after age 70."
4) "Maybe you have a medical problem that may be causing these drastic visual problems."
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11
Which interventions should the nurse perform when an older patient reports a change in hearing? Select all that apply.
1) Perform a Rinne test.
2) Eliminate extraneous noise.
3) Review prescribed medications.
4) Report the change to the physician.
5) Speak in a tone that includes shouting.
1) Perform a Rinne test.
2) Eliminate extraneous noise.
3) Review prescribed medications.
4) Report the change to the physician.
5) Speak in a tone that includes shouting.
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12
An older patient wants to use holistic ways to reduce the risk of age-related macular degeneration. What should the nurse instruct the patient to consume to promote eye health?
1) Cabbage, eggs, and orange juice
2) Whole-wheat bread, eggs, and milk
3) Sweet potatoes, spinach, and broccoli
4) Lean meats, whole-wheat breads, and blueberries
1) Cabbage, eggs, and orange juice
2) Whole-wheat bread, eggs, and milk
3) Sweet potatoes, spinach, and broccoli
4) Lean meats, whole-wheat breads, and blueberries
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13
A family is making home modifications for a visually impaired older family member. Which recommendation should the home-care nurse make to the family?
1) Instruct family to always have lights on inside the home.
2) Use soft blue, gray, and light-green tones.
3) Install motion-sensor lights when possible.
4) Have magnifying glasses on at all time.
1) Instruct family to always have lights on inside the home.
2) Use soft blue, gray, and light-green tones.
3) Install motion-sensor lights when possible.
4) Have magnifying glasses on at all time.
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14
The nurse is completing an assessment of an older patient's eyes. Which findings does the nurse identify as being normal age-related changes? Select all that apply.
1) Cataracts
2) Ectropion
3) Entropion
4) Glaucoma
5) Arcus senilis
1) Cataracts
2) Ectropion
3) Entropion
4) Glaucoma
5) Arcus senilis
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15
An older patient who wears glasses is being admitted to a long-term-care facility. Which action should the nurse take when assessing the patient's visual acuity?
1) Ask the patient to wear their glasses during acuity test.
2) Ask the patient to read a newspaper out loud.
3) Allow the patient to move closer to the eye chart if needed.
4) If the patient wears glasses to eat, then glasses should be removed.
1) Ask the patient to wear their glasses during acuity test.
2) Ask the patient to read a newspaper out loud.
3) Allow the patient to move closer to the eye chart if needed.
4) If the patient wears glasses to eat, then glasses should be removed.
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16
An older patient has sensitivity to light. What should the nurse teach the patient to help with this problem?
1) Dim the lights on sunny days.
2) Place dark patterned rugs on stairs.
3) Use supplementary lamps near work.
4) Remove lampshades to provide more light.
1) Dim the lights on sunny days.
2) Place dark patterned rugs on stairs.
3) Use supplementary lamps near work.
4) Remove lampshades to provide more light.
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17
The nurse is caring for a patient with xerostomia. Which nursing interventions should be included in the plan of care? Select all that apply.
1) Use a humidifier.
2) Provide oral fluids after meals.
3) Provide sugar-free hard candies.
4) Reinforce regular dental examinations.
5) Administer only liquid medications.
1) Use a humidifier.
2) Provide oral fluids after meals.
3) Provide sugar-free hard candies.
4) Reinforce regular dental examinations.
5) Administer only liquid medications.
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18
The nurse has identified the diagnosis Self-Care Deficit for an older patient with hyposmia. What should the nurse include in the discharge instructions? Select all that apply.
1) Date and label all foods.
2) Remove kitchen waste weekly.
3) Use only disposable body wipes and avoid bathing or showering.
4) Establish a schedule for house cleaning or hire a housekeeper.
5) Place natural-gas detectors near the gas heater or stove.
1) Date and label all foods.
2) Remove kitchen waste weekly.
3) Use only disposable body wipes and avoid bathing or showering.
4) Establish a schedule for house cleaning or hire a housekeeper.
5) Place natural-gas detectors near the gas heater or stove.
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19
The nurse is performing a vision assessment on an older patient who is having difficulty reading small print. What best explains this finding?
1) Non-reactive to light
2) Weak eye muscles
3) Lack of peripheral vision
4) Altered accommodation
1) Non-reactive to light
2) Weak eye muscles
3) Lack of peripheral vision
4) Altered accommodation
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20
A patient is complaining of blurred vision after beginning medication therapy of propranolol (Inderal) and tamoxifen (Nolvadex). What is the nurse's best response(s)? Select all that apply.
1) "Both propranolol and tamoxifen have the side effect of blurred vision and should be reported."
2) "Scheduling an eye examination with an ophthalmologist would be a good idea."
3) "Blurred vision is not known to be caused by propranolol nor tamoxifen."
4) "Stop taking both medications since the blurred vision may result in blindness."
5) "Daily eye drops will make the blurred vision go away."
1) "Both propranolol and tamoxifen have the side effect of blurred vision and should be reported."
2) "Scheduling an eye examination with an ophthalmologist would be a good idea."
3) "Blurred vision is not known to be caused by propranolol nor tamoxifen."
4) "Stop taking both medications since the blurred vision may result in blindness."
5) "Daily eye drops will make the blurred vision go away."
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21
An older patient is being treated for glaucoma with Timoptic. Which assessment finding indicates an adverse effect associated with the medication?
1) Diarrhea
2) Slow heart rate
3) Excessive salivation
4) Reduced urinary output
1) Diarrhea
2) Slow heart rate
3) Excessive salivation
4) Reduced urinary output
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22
When assessing the tympanic membrane of an older patient, the nurse notes the presence of two jagged white lines. What best describes these findings?
1) The tympanic membrane is preparing to rupture.
2) The tympanic member has become infected.
3) The white lines indicate a past history of a tympanic rupture.
4) The presence of these markings is a normal finding.
1) The tympanic membrane is preparing to rupture.
2) The tympanic member has become infected.
3) The white lines indicate a past history of a tympanic rupture.
4) The presence of these markings is a normal finding.
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23
The nurse is planning a teaching session for nursing assistants regarding effective communication with hearing-impaired patients. Which principles should be included in the program? Select all that apply.
1) Use gestures if appropriate.
2) Raise voice pitch when talking.
3) Pause at the end of each sentence.
4) Stand 1 to 2 feet away from the patient.
5) Speak in a normal tone of voice during the interaction.
1) Use gestures if appropriate.
2) Raise voice pitch when talking.
3) Pause at the end of each sentence.
4) Stand 1 to 2 feet away from the patient.
5) Speak in a normal tone of voice during the interaction.
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24
The home care nurse observes a buildup of cerumen in both ears of an older patient. What should the nurse do to help this patient?
1) Instruct the patient to use a curate to remove the cerumen.
2) Show the patient how to use a bulb syringe to remove the cerumen.
3) Advise the patient to seek medical attention to remove the cerumen.
4) Teach the patient to use a cotton-tipped swab to remove the cerumen.
1) Instruct the patient to use a curate to remove the cerumen.
2) Show the patient how to use a bulb syringe to remove the cerumen.
3) Advise the patient to seek medical attention to remove the cerumen.
4) Teach the patient to use a cotton-tipped swab to remove the cerumen.
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25
An older patient, experiencing a significant loss of hearing after being involved in an explosion, wants to know how long the loss will last. Which response by the nurse is most appropriate at this time?
1) "Surgery will help restore the hearing you have lost."
2) "Hearing loss attributed to loud noises is normally reversible."
3) "Loud noises can cause immediate, permanent losses of hearing."
4) "The most common cause of hearing impairments is the result of exposure to loud noises."
1) "Surgery will help restore the hearing you have lost."
2) "Hearing loss attributed to loud noises is normally reversible."
3) "Loud noises can cause immediate, permanent losses of hearing."
4) "The most common cause of hearing impairments is the result of exposure to loud noises."
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