NURS 2539 SENSORY PERCEPTION

SENSORY PERCEPTION Question 1 Which measure should the nurse include in the plan of care for a client with alcohol withdrawal delirium? Question 2 See full question 1m 7s A client is sitting in the corner of the dayroom cocking his head to one side as if he hears something, but no one is nearby. The nurse suspects he is having auditory hallucinations. Which question should the nurse ask first? Question 3 See full question 24s The mother of a 2-year-old is concerned because the child's right eye seems to turn in toward his nose when he is tired. The nurse should: Question 4 See full question 26s Which goal is a priority for a client who has undergone surgery for retinal detachment? Question 5 See full question 18s For a neurologically injured client, the nurse should assess motor strength by: Question 6 See full question 19s The nurse should inform a client with Ménière’s disease that before an attack of the disease, the client may experience: Question 7 See full question 19s Which nursing assessment finding most supports this diagnosis? Question 8 See full question 39s Two days after surgery to amputate his left lower leg, a client states that he has pain in the missing extremity. Which action by the nurse is most appropriate? Question 9 See full question 18s When obtaining the health history from a client with retinal detachment, a nurse expects the client to report: Question 10 See full question 37s Which activity is least effective in preventing sensory deprivation during a client's stay in the cardiac care unit? Question 11 See full question 23s Parents of a 3-week-old healthy newborn ask the nurse why their daughter is intermittenly cross-eyed. The nurse's best response is: Question 12 See full question 26s A client with dementia who prefers to stay in his room has been brought to the dayroom. After 10 minutes, the client becomes agitated and retreats to his room again. The nurse decides to assess the conditions in the dayroom. Which is most likely the occurrence that is disturbing to this client? Question 13 See full question 22s The nurse is assessing a 4-year-old child who demonstrates unintelligible speech. The parents are concerned and ask about the cause of the speech problem. What is the most appropriate response by the nurse? Question 14 See full question 1m 48s An 11-year-old child is sent to the school nurse reporting difficulty reading the blackboard in the classroom. The nurse assesses that the child does not have difficulty reading a laptop screen or reading books. What is the best action by the nurse? Question 15 See full question 19s A client is admitted to the psychiatric unit with a diagnosis of functional neurologic symptom disorder. Since witnessing a beating at gunpoint, the client is paralyzed. Which action should the nurse initially focus on when planning this client's care? Question 16 See full question 35s A nurse is caring for a client who has left homonymous hemianopsia following a recent cerebral vascular accident (CVA). Which nursing diagnosis should take the highest priority? Question 17 See full question 1m 2s A nurse is developing a teaching plan for a client who has recently been diagnosed with open angle glaucoma. The healthcare provider ordered pilocarpine 0.25% ophthalmic drops, two drops to eyes each eye four times a day. How should the nurse instruct the client to instill the eye drops? Select the correct order. Question 18 See full question 30s The nurse is bathing a client and discovers a pressure ulcer on the buttocks (see photo). Which nursing intervention, following completion of the bath, is completed first? Question 19 See full question 27s The nurse is discharging a client who had a fish hook embedded in the eye. The fish hook was removed surgically in the emergency department, but the client currently has no vision in that eye. The surgeon has informed the client that a corneal transplant may restore some vision but the surgery cannot be performed for 6 to 8 weeks and only if no infection occurs. A priority in the teaching plan includes: Question 20 See full question 23s A client who has Ménière’s disease is experiencing an acute attack of vertigo. The nurse should: Question 1 See full question 1m 10s A client begins to experience alcoholic hallucinosis. After administering medication, what is the best nursing intervention? Question 2 See full question 35s A client with a severe staphylococcal infection is receiving the aminoglycoside gentamicin sulfate by the I.V. route. The nurse should assess the client for which adverse reaction? .............................................CONTINUED................................