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Medical-Surgical Nursing Exam 1 (questions
with answers) - Jersey College
Balance and equilibrium are functions of the ________ nerve. - CORRECT ANSWER✔✔S ✔✔VIII Vestibucochlear The external ear is separated from the middle ear by a disk-shaped structure called the ________________________. - CORRECT ANSWER✔✔S ✔✔tympanic membrane The _______ collects the sound waves and directs vibrations in to the external auditory canal. - CORRECT ANSWER✔✔S ✔✔auricle (pinna) A brown, waxlike substance secreted by ceruminous glands is called? - CORRECT ANSWER✔✔S ✔✔cerumen (ear wax) How wide is the eustacian tube? - CORRECT ANSWER✔✔S ✔✔1 mm How long is the eustacian tube? - CORRECT ANSWER✔✔S ✔✔35 mm What is the function of the tympanic membrane? - CORRECT ANSWER✔✔S ✔✔It helps to conduct sound vibration. What color is NORMAL for the tympanic membrane? - CORRECT ANSWER✔✔S ✔✔pearly grey
Approximately 80% of the tympanic membrane is composed of all three layers and is called the ___________. - CORRECT ANSWER✔✔S ✔✔pars tensa The remaining 20% of the tympanic membrane that lacks the middle layer is called? - CORRECT ANSWER✔✔S ✔✔pars flaccida The fibrous border that attaches the eardrum to the temporal bone? - CORRECT ANSWER✔✔S ✔✔annulus The bony labyrinth surrounds and protects the membranous labyrinth, which is bathed in a fluid called ___________. - CORRECT ANSWER✔✔S ✔✔perilymph What are the two functions of the ears? - CORRECT ANSWER✔✔S ✔✔hearing balance and equilirium Helps to equalize pressure in the ear? - CORRECT ANSWER✔✔S ✔✔eustacian tube A flaky scaliness on or behind the auricle usually indicates _____________________ and can be present on the scalp and facial structures as well - CORRECT ANSWER✔✔S ✔✔seborrheic dermatitis The largest speculum that the ear canal can accommodate ____mm. - CORRECT ANSWER✔✔S ✔✔5 mm
conductive hearing loss - CORRECT ANSWER✔✔S ✔✔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: Name three characteristics that are important when evaluating hearing. - CORRECT ANSWER✔✔S ✔✔frequency, pitch, and intensity The number of sound waves emanating from a source per second, measured as cycles per second, or Hertz. - CORRECT ANSWER✔✔S ✔✔frequency What is the range of human hearing? - CORRECT ANSWER✔✔S ✔✔20-20, Hz Loudness of sound is known as _________. - CORRECT ANSWER✔✔S ✔✔intensity The unit for measuring loudness, the pressure exerted by sound. Hearing loss is measured using this unit. - CORRECT ANSWER✔✔S ✔✔decibel (dB) The normal hearing in decibels? - CORRECT ANSWER✔✔S ✔✔0-15 dB Slight hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔>15-25 dB Mild hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔>25-40 dB
Moderate hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔>40-55 dB moderately severe hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔>55-70 dB Severe hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔>70-90 dB Profound hearing loss in decibels? - CORRECT ANSWER✔✔S ✔✔> measures middle ear muscle reflex to sound stimulation and compliance of the tympanic membrane by changing the air pressure in a sealed ear canal? - CORRECT ANSWER✔✔S ✔✔tympanogram Risk factors for hearing loss (8)? - CORRECT ANSWER✔✔S ✔✔-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 hearing loss associated with old age is called? - CORRECT ANSWER✔✔S ✔✔presbycusis
-discharge -edema -erythema -pruritus -hearing loss -feelings of fullness in the ear A _______ may be inserted in the canal to keep it open and facilitate medication administration. - CORRECT ANSWER✔✔S ✔✔wick This type of ear infection is most often seen in children? - CORRECT ANSWER✔✔S ✔✔acute otitis media S/S of acute otitis media (3) - CORRECT ANSWER✔✔S ✔✔-otalgia (ear pain) -fever -hearing loss fluid in the middle ear without evidence of infection is called? Often due to eustacian tube dysfunction or blockage. - CORRECT ANSWER✔✔S ✔✔Serous otitis media Removal of diseased bone, mastoid air cells, and cholesteatoma to create a noninfected, healthy ear. What is this procedure called? - CORRECT ANSWER✔✔S ✔✔mastoidectomy
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? - CORRECT ANSWER✔✔S ✔✔Cholesteatoma incision into the eardrum for inserting tubes is known by 2 names; what are they? - CORRECT ANSWER✔✔S ✔✔tympanotomy, myringotomy Surgical repair of an ossicle (small bone) of the middle ear is called? - CORRECT ANSWER✔✔S ✔✔ossiculoplasty 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? - CORRECT ANSWER✔✔S ✔✔stapedotomy What classification of medications can be used in vertigo? - CORRECT ANSWER✔✔S ✔✔antihistamines After an ear procedure, what change in the senses will the patient experience? - CORRECT ANSWER✔✔S ✔✔taste - food will taste different until the nerve is healed After ear surgery, how long should the patient keep the ears dry? - CORRECT ANSWER✔✔S ✔✔6 weeks How can patients prevent water from entering the ear? - CORRECT ANSWER✔✔S ✔✔cotton ball with vaseline
-metals: gold, mercury, lead 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? - CORRECT ANSWER✔✔S ✔✔acoustic neuromas Abnormal inner ear fluid balance caued by malabsoption of he endolymphatic sac or blockage of the endolymphatic duct. This disease is called? - CORRECT ANSWER✔✔S ✔✔Menieres Disease Diet for patient with Meniere's disease? - CORRECT ANSWER✔✔S ✔✔low sodium diet Diuretic that can be used for a patient with Meniere's disease? - CORRECT ANSWER✔✔S ✔✔HCTZ - hydrochlorothiazide Tranquilizers to help control vertigo? Used in patients with Meniere's disease. - CORRECT ANSWER✔✔S ✔✔Valium (diazepam) 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? - CORRECT ANSWER✔✔S ✔✔brain stem 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: - CORRECT ANSWER✔✔S ✔✔cerebellum
The brain stem holds the medulla oblongata. What is the function of the medulla oblongata? - CORRECT ANSWER✔✔S ✔✔Transmits motor impulses from the brain to the spinal cord 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? - CORRECT ANSWER✔✔S ✔✔occipital 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: - CORRECT ANSWER✔✔S ✔✔evaluation of the corneal reflex response. 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? - CORRECT ANSWER✔✔S ✔✔encourage the client to drink liberal amounts of fluids. 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? - CORRECT ANSWER✔✔S ✔✔"I am trying to quit smoking and have a patch on." 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? - CORRECT ANSWER✔✔S ✔✔Contrast will be given and a rapid sequence of radiographs will be taken.
Increased response of DTRs are indicated by a score of ______. - CORRECT ANSWER✔✔S ✔✔3+ 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? - CORRECT ANSWER✔✔S ✔✔refrain from eating or drinking for now. A patient is being tested for a gag reflex. When the nurse places the tongue blade to the back of the throat, there is no response elicited. What dysfunction does the nurse determine the patient has? - CORRECT ANSWER✔✔S ✔✔dysfuction of the vagus nerve. CSF pressure with the patient in a lateral recumbent position is normally ____-_____ mm H2O. - CORRECT ANSWER✔✔S ✔✔70-20 mm H2O Pressures of more than ____mm H2O are considered abnormal. - CORRECT ANSWER✔✔S ✔✔200 mm H2O The nurse is assessing the client's mental status. Which question will the nurse include in the assessment? - CORRECT ANSWER✔✔S ✔✔"Who is the president of the United States?" The nurse is completing the physical assessment of a patient suspected of a neurologic disorder. The patient reports to the nurse that he has recently suffered a head trauma. In such a case, which of the following precautions should the nurse take for the patient? Select all that apply. - CORRECT ANSWER✔✔S
✔✔The nurse should not move or manipulate the patient's head while assessing for bleeding or swelling. The nurse is performing an assessment of cranial nerve function and asks the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of which cranial nerve? - CORRECT ANSWER✔✔S ✔✔CN I A client in the emergency department has a suspected neurologic disorder. To assess gait, the nurse asks the client to take a few steps; with each step, the client's feet make a half circle. To document the client's gait, the nurse should use which term? - CORRECT ANSWER✔✔S ✔✔Helicopod Which cerebral lobe contains the auditory receptive areas? - CORRECT ANSWER✔✔S ✔✔temporal A nurse is working in a neurologist's office. The physician orders a Romberg test. The nurse should have the client: - CORRECT ANSWER✔✔S ✔✔close his or her eyes and stand erect. What part of the brain controls and coordinates muscle movement? - CORRECT ANSWER✔✔S ✔✔the cerebellum The physician's office nurse is caring for a client who has a history of a cerebral aneurysm. Which diagnostic test does the nurse anticipate to monitor the status of the aneurysm? - CORRECT ANSWER✔✔S ✔✔cerebral angiography
that the liver will: - CORRECT ANSWER✔✔S ✔✔convert glycogen to glucose for immediate use. Cranial nerve IX is also known as which of the following? - CORRECT ANSWER✔✔S ✔✔Glossopharyngeal A patient comes to the emergency department with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain? - CORRECT ANSWER✔✔S ✔✔V A nurse is preparing a client for lumbar puncture. The client has heard about post-lumbar puncture headaches and asks how to avoid having one. The nurse tells the client that these headches can be avoided by doing which of the following after the procedure? - CORRECT ANSWER✔✔S ✔✔"Remain prone for 2 to 3 hours." The provider orders the Romberg test for a patient. The nurse tells the patient that the provider wants to evaluate his equilibrium by assessing which cranial nerve? - CORRECT ANSWER✔✔S ✔✔CN VIII A potential complication of a hemorrhagic stroke is interference with the ability of the arachnoid villi to absorb CSF. Therefore, fluid in the ventricles increase beyond the amount that is usually absorbed daily, which is: - CORRECT ANSWER✔✔S ✔✔350 to 375 mL. The provider orders the Romberg test for a patient. The nurse tells the patient that the provider wants to evaluate his equilibrium by assessing which cranial nerve? - CORRECT ANSWER✔✔S ✔✔VIII for Rom Test
Which of the following neurotransmitters are deficient in myasthenia gravis? - CORRECT ANSWER✔✔S ✔✔Acetylcholine Cranial nerves for gag reflex? - CORRECT ANSWER✔✔S ✔✔IX and X What is the name of cranial nerve IX? - CORRECT ANSWER✔✔S ✔✔Glossopharyngeal nerve To help assess a client's cerebral function, a nurse should ask: - CORRECT ANSWER✔✔S ✔✔"Have you noticed a change in your memory?" Which lobe of the brain is responsible for spatial relationships? - CORRECT ANSWER✔✔S ✔✔Parietal Which of the following is a manifestation of an upper motor neuron lesion? - CORRECT ANSWER✔✔S ✔✔Muscle spasticity The trochlear nerve controls which function? - CORRECT ANSWER✔✔S ✔✔eye muscle movement Which diagnostic test may be performed to evaluate blood flow within intracranial blood vessels? - CORRECT ANSWER✔✔S ✔✔transcranial doppler A client has sustained a head injury to the parietal lobe and cannot identify a familiar object by touch. The nurse knows that this deficit is - CORRECT ANSWER✔✔S ✔✔Astereognosis
To avoid the side effects of corticosteroids, which medication classification is used as an alternative in treating inflammatory conditions of the eyes? - CORRECT ANSWER✔✔S ✔✔NSAIDS Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? - CORRECT ANSWER✔✔S ✔✔Coumadin The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment? - CORRECT ANSWER✔✔S ✔✔The power of the lens to accommodate will be decreased The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: - CORRECT ANSWER✔✔S ✔✔pulls the tissue near the cheek downward to instill medication. Which term refers to swelling of the optic disc due to increased intracranial pressure? - CORRECT ANSWER✔✔S ✔✔papilledema The nurse is preparing a presentation for a local community group comparing photorefractive keratectomy and LASIK refractive surgeries. Which of the following would the nurse include? - CORRECT ANSWER✔✔S ✔✔LASIK involves working with the cornea on a deeper level. A patient is suspected of having glaucoma. What reading of IOP would demonstrate an increase resulting from optic nerve damage? - CORRECT ANSWER✔✔S ✔✔21 mm Hg or higher
Which term refers to the absence of the natural lens? - CORRECT ANSWER✔✔S ✔✔aphakia An ophthalmologist diagnoses a patient with myopia. The nurse explains that this type of impaired vision is a refractive error characterized by: - CORRECT ANSWER✔✔S ✔✔blurred distance vision On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as: - CORRECT ANSWER✔✔S ✔✔acute angle-closure Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear? - CORRECT ANSWER✔✔S ✔✔scleral buckle Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? - CORRECT ANSWER✔✔S ✔✔Laser- assisted stromal in situ keratomileusis (LASIK) After a fall at home, a client hits their head on the corner of a table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms? - CORRECT ANSWER✔✔S ✔✔retinal detachment A nurse notices that a client's left upper eyelid is drooping. The nurse has observed: - CORRECT ANSWER✔✔S ✔✔ptosis
