Adaptive Quizzing Questions - MCA 1 Test 4: Diabetes, Renal & Urologic System, Visual & Auditory

Adaptive Quizzing Questions - MCA 1 Test 4: Diabetes, Renal & Urologic System, Visual & Auditory A patient reports an inability to understand speech in spite of being able to hear sounds properly. The patient has a history of Paget's disease of the bone and is being treated with antibiotics. The nurse recognizes that the patient is most likely experiencing which type of hearing loss? a) Mixed hearing loss b) Conductive hearing loss c) Sensorineural hearing loss d) Central and functional hearing loss Correct answer- c) Sensorineural hearing loss The patient is able to hear sound but is unable to understand speech. The patient also has a history of Paget's disease of the bone and is receiving antibiotic therapy. These factors lead to sensorineural hearing loss. Sensorineural hearing loss is caused by impairment of function of the inner ear or the vestibulocochlear nerve. Mixed hearing loss occurs due to a combination of conductive and sensorineural causes. In conductive hearing loss, the patient often speaks softly because he can hear his own voice quite loud. The patient hears better in a noisy environment. In central and functional hearing loss, the patient is unable to interpret sound, including speech. This is caused mainly due to a problem in the brain area controlling speech. The nurse is providing care for a 73-year-old male patient who has sought care because of a loss in hearing acuity over the past several years. Which statement by the nurse is most accurate? a) "This is often caused by an infection that will resolve on its own." b) "Many people experience an age-related decline in their hearing." c) "This is likely an effect of your medications. Try stopping them for a few days." d) "You can likely accommodate for your hearing loss with a few small changes in your routine." Correct answer- b) "Many people experience an age-related decline in their hearing." Presbycusis is a loss of hearing that is both common and age related. Infections most often are accompanied by different symptoms. It would be inappropriate to counsel the patient to stop medications. It would be simplistic to advise the patient to accommodate the hearing loss rather than seek intervention. A 22-year-old female patient had a physical for a new job. Her blood pressure was 110/68. At the health fair two months later, her blood pressure is 154/96. What renal problem should the nurse be aware of that could contribute to this abrupt rise in blood pressure? a) Renal trauma b) Renal artery stenosis c) Renal vein thrombosis d) Benign nephrosclerosis Correct answer- b) Renal artery stenosis Renal artery stenosis contributes to an abrupt rise in blood pressure, especially in people under 30 or over 50 years of age. Renal trauma usually causes hematuria. Renal vein thrombosis causes flank pain, hematuria, fever, or nephrotic syndrome. Benign nephrosclerosis usually occurs in adults 30 to 50 years of age and is a result of vascular changes resulting from hypertension. After providing education to a patient with otosclerosis, the nurse determines that the teaching was effective when the patient states that the hearing loss is due to what? a) A tumor in the middle ear b) Too much ear wax buildup c) Taking too much aspirin over the years d) A problem with the bones in the middle ear Correct answer- d) A problem with the bones in the middle ear Otosclerosis, the deterioration of the bones of the middle ear, is the most common cause of conductive hearing loss. Tumors, too much ear wax, and too much aspirin are problems that may affect hearing but are not related to otosclerosis. What substance is most appropriate for the nurse to use to remove an insect from a patient's ear? a) Water b) Alcohol c) Mineral oil d) Hydrogen peroxide Correct answer- c) Mineral oil Mineral oil causes the least amount of trauma and irritation to the ear canal. Water and hydrogen peroxide should not be used because the insect could swell, which would make it more difficult to remove. Alcohol may cause both irritation of the ear canal and swelling of the insect. A patient presents with diabetic ketoacidosis (DKA). The nurse initiates the collaborative plan of care with the understanding that the initial goal of the treatment plan is: a) Treatment for hypokalemia b) Rapid reduction of elevated blood glucose c) Rehydration through intravenous fluid replacement d) Reduction of ketosis by encouraging oral nourishment Correct answer- c) Rehydration through intravenous fluid replacement Fluid imbalance is potentially life threatening for patients with DKA. The initial goal of therapy is to establish intravenous (IV) access and begin fluid replacement. Once urine output is established, electrolyte replacement will be addressed. Potassium levels will need to be monitored, because insulin therapy, which is needed to correct the hyperglycemia, may further reduce the potassium level. Insulin therapy will be used to lower the blood glucose gradually, to prevent rapid drops in serum glucose, which could lead to fluid shifts and the potential for cerebral edema. Ketosis results from the use of fat stores for energy, because excess glucose is not being transported to the cells and used as a source of energy. Patients with DKA often present with nausea and vomiting; oral nourishment may be limited until symptoms lessen. Which are immune diseases that cause glomerulonephritis? Select all that apply. a) Scleroderma b) Diabetic nephropathy c) Goodpasture syndrome d) Wegener's granulomatosis e) Systemic lupus erythematosus (SLE) Correct answer- a) Scleroderma c) Goodpasture syndrome e) Systemic lupus erythematosus (SLE) Scleroderma, Goodpasture syndrome, and SLE are immune diseases that cause glomerulonephritis. Diabetic nephropathy results in scarring of glomeruli. Wegener's granulomatosis is a form of vasculitis that causes glomerulonephritis. After administering glucagon to an unconscious patient, the nurse should place the patient in which position? a) Supine b) Side-lying c) High-Fowler's d) Semi-Fowler's Correct answer- b) Side-lying Nausea is a common reaction after glucagon injection. The patient should be placed in the side-lying position to prevent aspiration should the patient vomit. The supine, high-Fowler's, and semi-Fowler's positions are not advisable because of the risk of aspiration of vomitus. A patient has undergone a nephrectomy due to a renal tumor. What nursing interventions are appropriate for the postoperative care of this patient? Select all that apply. a) Record urine output. b) Weigh the patient daily. c) Monitor abdominal distention. d) Instruct the patient to minimize coughing. e) Allow oral intake immediately after operation. f) Provide adequate pain relief through analgesics Correct answer- a) Record urine output. b) Weigh the patient daily. c) Monitor abdominal distention. f) Provide adequate pain relief through analgesics