NUR 143 Module D Test With
Solution
HEENT - ANSWER head, eyes, ears, neck, and throat
Neuro - ANSWER HEENT highly involved in many sensory processes—smell,
taste, sensation, speech, feeding, expression
Sensory - ANSWER addresses the ability to intake and interpret information
through senses by internal or external stimuli.
Nurses must be able to recognize normal and abnormal sensory response
while providing care for patients.
Diagnostics - ANSWER provide scientific data which is reviewed to determine
the state of the individual's previous or present health status.
Nurses must be able to correctly interpret this scientific data while caring for
their patients.
Health History - ANSWER _Includes_
/Head injury/- could impair the patient to do a simple task
/Hoarseness/- could mask an underlying problem
/Hearing problems-hearing aids/- could effect the patients ability to
understand what the nurse is saying
/Vision problems/- could effect the patient to notice something abnormal
/Eye/ear infections/
,/UV light exposure/- melanoma?
/Work exposure-noise, pollutants/
/Chronic illnesses/-DM, thyroid, HTN
/Smoking/chewing tobacco/cocaine/
/Oral and dental care practices/
Common Variations-Older Adult - ANSWER -Impaired near
vision(presbyopia)
-Decreased color vision
-Decreased adaptation to light and dark
-Entropion and Ectropion (eyelids)
-Hearing loss(presbycusis)
-Elongated ear lobes
-Decreased neck range of motion
-Smaller, more easily palpable lymph nodes
presbyopia - ANSWER impaired vision
, entropion - ANSWER eyelid is rolled inward against the eyeball
typically caused by muscle spasm or by inflammation or scarring of the
conjunctiva
resulting in irritation of the eye by the lashes
Ectropion - ANSWER a condition, typically a consequence of advanced age, in
which the eyelid is turned outward away from the eyeball.
presbycusis - ANSWER hearing loss
General Approach - ANSWER -Greet patient, explain assessment techniques
-What concerns may your client have about these assessments?
-Environment
--Warm
--Private
--Adequate lighting
Solution
HEENT - ANSWER head, eyes, ears, neck, and throat
Neuro - ANSWER HEENT highly involved in many sensory processes—smell,
taste, sensation, speech, feeding, expression
Sensory - ANSWER addresses the ability to intake and interpret information
through senses by internal or external stimuli.
Nurses must be able to recognize normal and abnormal sensory response
while providing care for patients.
Diagnostics - ANSWER provide scientific data which is reviewed to determine
the state of the individual's previous or present health status.
Nurses must be able to correctly interpret this scientific data while caring for
their patients.
Health History - ANSWER _Includes_
/Head injury/- could impair the patient to do a simple task
/Hoarseness/- could mask an underlying problem
/Hearing problems-hearing aids/- could effect the patients ability to
understand what the nurse is saying
/Vision problems/- could effect the patient to notice something abnormal
/Eye/ear infections/
,/UV light exposure/- melanoma?
/Work exposure-noise, pollutants/
/Chronic illnesses/-DM, thyroid, HTN
/Smoking/chewing tobacco/cocaine/
/Oral and dental care practices/
Common Variations-Older Adult - ANSWER -Impaired near
vision(presbyopia)
-Decreased color vision
-Decreased adaptation to light and dark
-Entropion and Ectropion (eyelids)
-Hearing loss(presbycusis)
-Elongated ear lobes
-Decreased neck range of motion
-Smaller, more easily palpable lymph nodes
presbyopia - ANSWER impaired vision
, entropion - ANSWER eyelid is rolled inward against the eyeball
typically caused by muscle spasm or by inflammation or scarring of the
conjunctiva
resulting in irritation of the eye by the lashes
Ectropion - ANSWER a condition, typically a consequence of advanced age, in
which the eyelid is turned outward away from the eyeball.
presbycusis - ANSWER hearing loss
General Approach - ANSWER -Greet patient, explain assessment techniques
-What concerns may your client have about these assessments?
-Environment
--Warm
--Private
--Adequate lighting
