Medical-Surgical Nursing Exam 1 (questions) - Jersey College Questions and Answers

Medical-Surgical Nursing Exam 1 (questions) - Jersey College Questions and Answers VIII Vestibucochlear Balance and equilibrium are functions of the ________ nerve. tympanic membrane The external ear is separated from the middle ear by a disk-shaped structure called the ________________________. auricle (pinna) The _______ collects the sound waves and directs vibrations in to the external auditory canal. cerumen (ear wax) A brown, waxlike substance secreted by ceruminous glands is called? 1 mm How wide is the eustacian tube? 35 mm How long is the eustacian tube? It helps to conduct sound vibration. What is the function of the tympanic membrane? pearly grey What color is NORMAL for the tympanic membrane? pars tensa Approximately 80% of the tympanic membrane is composed of all three layers and is called the ___________. pars flaccida The remaining 20% of the tympanic membrane that lacks the middle layer is called ? annulus The fibrous border that attaches the eardrum to the temporal bone ? perilymph The bony labyrinth surrounds and protects the membranous labyrinth, which is bathed in a fluid called ___________. hearing balance and equilirium What are the two functions of the ears? eustacian tube Helps to equalize pressure in the ear ? seborrheic dermatitis A flaky scaliness on or behind the auricle usually indicates _____________________ and can be present on the scalp and facial structures as well 5 mm The largest speculum that the ear canal can accommodate ____mm. gently irrigate the canal with warm water If the tympanic membrane cannot be visualized because of cerumen, the cerumen may be removed how? Weber and Rinne tests Name two tests used to assess a patient's hearing ability. Weber test This test for hearing uses bone conduction to test lateralization of sound. What is it called? Rinne test This hearing test is done by shifting the stem of a vibrating tuning fork between two positions: 2 inches from the opening of the ear canal and against the mastoid bone. As the position changes, the patient is asked to indicate which tone is louder or when the tone is no longer available. What is it called? The Weber Test Results of this test are used to determine whether the patient has conductive hearing loss or sensorineural hearing loss. Which test? air conduction Which type of conduction should be longer for sensiorneural hearing loss? Air or Bone? TRUE Conductive hearing loss such as from otosclerosis or otitis media, when performing the Weber test the sound lateralizes toward the affected ear T/F? Bone Weber test just does ____ conduction. Audiometry confirms a client's chronic progressive hearing loss. Further investigation reveals ankylosis of the stapes in the oval window, a condition that prevents sound transmission. This type of hearing loss is called a: conductive hearing loss frequency, pitch, and intensity Name three characteristics that are important when evaluating hearing. frequency The number of sound waves emanating from a source per second, measured as cycles per second, or Hertz. 20-20,000 Hz What is the range of human hearing? intensity Loudness of sound is known as _________. decibel (dB) The unit for measuring loudness, the pressure exerted by sound. Hearing loss is measured using this unit. 0-15 dB The normal hearing in decibels ? 15-25 dB Slight hearing loss in decibels ? 25-40 dB Mild hearing loss in decibels ? 40-55 dB Moderate hearing loss in decibels ? 55-70 dB moderately severe hearing loss in decibels ? 70-90 dB Severe hearing loss in decibels ? 90 Profound hearing loss in decibels ? tympanogram measures middle ear muscle reflex to sound stimulation and compliance of the tympanic membrane by changing the air pressure in a sealed ear canal ? -family history of sensorineural impairment -congential malformations of the cranial structure (ear) -low birth weight (1500g) -use of ototoxic medications (e.g., gentamycin, loop diuretics) -recurrent ear infections -bacterial meningitis -chronic exposure to loud noises (jobs, hobbies) -perforation of the tympanic membrane Risk factors for hearing loss (8) ? presbycusis hearing loss associated with old age is called ? Aural Rehabilitation intervention aimed at minimizing and alleviating the communication difficulties associated with hearing loss ? Can be used if hearing loss is permanent or untreatable or if the patient elects not to be treated. There are no activity restrictions after this procedure What patient education for post mastoid surgery would be incorrect? -Avoid getting water in the ear. -Constant throbbing pain may be a sign of infection. -Call for assistance to ambulate to prevent injury. -There are no activity restrictions after this procedure. TRUE A cochlear implant is an auditory prosthesis used for people with profound sensorineural hearing loss bilaterally who do not benefit from conventional hearing aids. T/F ? -Glycerin -mineraloil -½ strength H2O2, or peroxide in glycerol What can you use to soften earwax/cerumen and irrigate the ear canal? (3) Malignant external otitis rare, progressive infection that effects the external auditory canal, surrounding tissue, and skull -pain and tenderness -discharge -edema -erythema -pruritus -hearing loss -feelings of fullness in the ear S/S of external otitis (7) wick A _______ may be inserted in the canal to keep it open and facilitate medication administration. acute otitis media This type of ear infection is most often seen in children ? -otalgia (ear pain) -fever -hearing loss S/S of acute otitis media (3) Serous otitis media fluid in the middle ear without evidence of infection is called? Often due to eustacian tube dysfunction or blockage. mastoidectomy Removal of diseased bone, mastoid air cells, and cholesteatoma to create a noninfected, healthy ear. What is this procedure called? Cholesteatoma benign tumor, an ingrowth of skin that causes persistently high pressure in the middle ear, which causes hearing loss and neurologic disorders and destroys structures. What is it called? tympanotomy, myringotomy incision into the eardrum for inserting tubes is known by 2 names; what are they? ossiculoplasty Surgical repair of an ossicle (small bone) of the middle ear is called ? stapedotomy An alternative procedure to stapedectomy. A small opening is created in the fixed stapes footplate with a small drill or laser. This allows for transmission of sound waves or placement of prosthesis ? antihistamines What classification of medications can be used in vertigo? taste - food will taste different until the nerve is healed After an ear procedure, what change in the senses will the patient experience? 6 weeks After ear surgery, how long should the patient keep the ears dry? cotton ball with vaseline How can patients prevent water from entering the ear? endolymphatic sac decompression procedure that equalizes pressure int the endolymphatic space. A shunt or a drain is inserted in the endolymphatic sac through a postauricular incision. What is this procedure called? vestibular nerve sectioning Procedure that provides the greatest success rate in eliminating the attacks of vertigo. It can be performed by a translabyrinthine approach or in a manner that can conserve hearing, depending on the degree of hearing loss. Cutting the nerve prevents the brain from receiving input from the semicircular canals. What is it called? Benign Paroxysmal Positional Vertigo (BPPV) Brief episodes of vertigo ( 1 min.) assoc. w/position change; result of degen. of the utricular otoconia tinnitus roaring, buzzing, or hissing sound in one or both ears is called? -diuretic agents: ethancrynic acid, fuosemide, acetazolamide -chemotherapeutic (antineoplastic) agents: cisplatin, nitrogen mustard, carboplatin -antimalarial agents: quinine, choroquine -anti-inflammatory agents: salicylates (aspirin), indomethacin -chemicals: alcohol, arsenic -aminoglycoside antibiotic agents: amikacin, gentamicin kanamycin, netlimicin, neomycin, streptomycin, tobramycin -other antibiotic agents: erythromycin, minocycline, polymyxin B, vancomycin -metals: gold, mercury, lead Name Selected Ototoxic Substances & examples acoustic neuromas slow-growing, benign tumors of cranial nerve VIII, usually arising from the Schwann cells of the vestibular portion of the nerve. What are these tumors called? Menieres Disease Abnormal inner ear fluid balance caued by malabsoption of he endolymphatic sac or blockage of the endolymphatic duct. This disease is called? low sodium diet Diet for patient with Meniere's disease? HCTZ - hydrochlorothiazide Diuretic that can be used for a patient with Meniere's disease? Valium (diazepam) Tranquilizers to help control vertigo? Used in patients with Meniere's disease. brain stem A patient who has suffered a stroke is unable to maintain respiration and is intubated and placed on mechanical ventilator support. What portion of the brain is most likely responsible for the inability to breathe? cerebellum A patient recently noted difficulty maintaining his balance and controlling fine movements. The nurse explains that the provider will order diagnostic studies for the part of his brain known as the: Transmits motor impulses from the brain to the spinal cord The brain stem holds the medulla oblongata. What is the function of the medulla oblongata? occipital A client is diagnosed with a brain tumor. The nurse's assessment reveals that the client has difficulty interpreting visual stimuli. Based on these findings, the nurse suspects injury to which lobe of the brain? evaluation of the corneal reflex response. After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patent airway and attends to the client's immediate needs, then prepares to perform an initial neurologic assessment. The nurse should perform an: encourage the client to drink liberal amounts of fluids. A client has undergone a lumbar puncture as part of a neurological assessment. The client is put under the care of a nurse after the procedure. Which important postprocedure nursing intervention should be performed to ensure the client's maximum comfort? "I am trying to quit smoking and have a patch on." A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI? Contrast will be given and a rapid sequence of radiographs will be taken. A client suspected of having a distortion of cerebral arteries and veins is scheduled for a cerebral angiography. What would the nurse tell the client about the upcoming test? observing the client's response to painful stimuli The nurse is caring for a comatose client. The nurse knows she should assess the client's motor response. Which method may the nurse use to assess the motor response? "Although the required position may not be comfortable, it will make the procedure safer and easier to perform." A client preparing to undergo a lumbar puncture states he doesn't think he will be able to get comfortable with his knees drawn up to his abdomen and his chin touching his chest. He asks if he can lie on his left side. Which statement is the best response by the nurse? flaccid muscles Lower motor neuron lesions cause ? comatose The critical care nurse is giving report on a client they are caring for. The nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a female client and reports to the on-coming nurse that the client has an LOC of 6. What does an LOC score of 6 in a client indicate? 1+ Diminished or hypoactive DTRs are indicated by a score of ______. 0 DTRs indicated by a score of ____ means that the patient did not have a response. 2+ What is the normal DTR response score? 3+ Increased response of DTRs are indicated by a score of ______. refrain from eating or drinking for now. The nurse has completed evaluating the client's cranial nerves. The nurse documents impairment of the right cervical nerves (CN IX and CN X). Based on these findings, the nurse should instruct the client to ?