NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
1
,NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
Ch. 15
● Using a Snellen chart
The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed?
Use the Snellen chart positioned 20 feet away from the patient.
● Assessing eyes/sight in infants (normal growth and development)
A mother asks when her newborn infants eyesight will be developed. The nurse should reply:
By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an
object.
A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. The nurse would:
Consider this a normal finding.
● Assessing for strabismus
The nurse is performing an eye-screening clinic at a daycare center. When examining a 2- year-old child, the nurse
suspects that the child has a lazy eye and should:
Test for strabismus by performing the corneal light reflex test.
The nurse flashes light into the eyes of a 5-year-old child and observes ocular misalignment and a deviated gaze. Which
term would the nurse use to document this finding?
Strabismus
Which patient characteristic indicates strabismus?
Deviation in the eye axis
Ch. 16
● Hearing in the aging adult
A 70-year-old patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups. He
says that he cant always tell where the sound is coming from and the words often sound mixed up. What might the nurse
suspect as the cause for
2
,NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
this change?
Nerve degeneration in the inner ear
The nurse is performing an ear examination of an 80-year-old patient. Which of these findings would be considered normal?
High-tone frequency loss
The nurse is testing the hearing of a 78-year-old man and is reminded of the changes in hearing that occur with aging that
include which of the following? Select all that apply.
Progression of hearing loss is slow.
The aging person may find it harder to hear consonants than vowels. Sounds may be garbled and
difficult to localize.
● Assessment of tympanic membrane (abnormals)
While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his
left tympanic membrane is bright red and that the light reflex is not visible. The nurse interprets these findings to indicate
a(n):
Acute otitis media.
When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections, the nurse sees
that his right tympanic membrane is amber-yellow in color and that air bubbles are visible behind the tympanic membrane.
The child reports occasional hearing loss and a popping sound with swallowing. The preliminary analysis based on this
information is that the child:
Most likely has serous otitis media.
The nurse suspects that a patient has otitis media. Early signs of otitis media include which of these findings of the
tympanic membrane?
Hypomobility
3
, NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
The nurse is performing a middle ear assessment on a 15-year-old patient who has had a history of chronic ear infections.
When examining the right tympanic membrane, the
4
TEST BANK 2023
1
,NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
Ch. 15
● Using a Snellen chart
The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed?
Use the Snellen chart positioned 20 feet away from the patient.
● Assessing eyes/sight in infants (normal growth and development)
A mother asks when her newborn infants eyesight will be developed. The nurse should reply:
By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an
object.
A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. The nurse would:
Consider this a normal finding.
● Assessing for strabismus
The nurse is performing an eye-screening clinic at a daycare center. When examining a 2- year-old child, the nurse
suspects that the child has a lazy eye and should:
Test for strabismus by performing the corneal light reflex test.
The nurse flashes light into the eyes of a 5-year-old child and observes ocular misalignment and a deviated gaze. Which
term would the nurse use to document this finding?
Strabismus
Which patient characteristic indicates strabismus?
Deviation in the eye axis
Ch. 16
● Hearing in the aging adult
A 70-year-old patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups. He
says that he cant always tell where the sound is coming from and the words often sound mixed up. What might the nurse
suspect as the cause for
2
,NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
this change?
Nerve degeneration in the inner ear
The nurse is performing an ear examination of an 80-year-old patient. Which of these findings would be considered normal?
High-tone frequency loss
The nurse is testing the hearing of a 78-year-old man and is reminded of the changes in hearing that occur with aging that
include which of the following? Select all that apply.
Progression of hearing loss is slow.
The aging person may find it harder to hear consonants than vowels. Sounds may be garbled and
difficult to localize.
● Assessment of tympanic membrane (abnormals)
While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his
left tympanic membrane is bright red and that the light reflex is not visible. The nurse interprets these findings to indicate
a(n):
Acute otitis media.
When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections, the nurse sees
that his right tympanic membrane is amber-yellow in color and that air bubbles are visible behind the tympanic membrane.
The child reports occasional hearing loss and a popping sound with swallowing. The preliminary analysis based on this
information is that the child:
Most likely has serous otitis media.
The nurse suspects that a patient has otitis media. Early signs of otitis media include which of these findings of the
tympanic membrane?
Hypomobility
3
, NUR2407 HEALTH ASSESMENT ANSWERED
TEST BANK 2023
The nurse is performing a middle ear assessment on a 15-year-old patient who has had a history of chronic ear infections.
When examining the right tympanic membrane, the
4