Review Practice Exercise 2

Sensation, perception, and cognition > Fundamentals

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Practice Exercise 2

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Total Questions : 6

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Question 1:

The nursing diagnosis Risk for Impaired Skin Integrity related to sensory-perception disturbance would best fit a client who:

A. Cut a foot by stepping on broken glass. B. Uses a wheelchair due to paraplegia. C. Wears glasses because of poor vision. D. Is legally blind and smokes in bed

Answer and Explanation

Choice A:

Cut a foot by stepping on broken glass: This is an actual problem (a wound), not a potential risk and it is not directly linked to sensory-perceptual disturbance.

Choice B:

Uses a wheelchair due to paraplegia: Because of paralysis, the client lacks sensation in the lower body and cannot feel discomfort from prolonged pressure. This makes them at risk for impaired skin integrity from pressure ulcers.

Choice C:

Wears glasses because of poor vision: Glasses correct the visual deficit, so the client is not at increased risk.

Choice D:

Is legally blind and smokes in bed: This situation fits Risk for Injury, since blindness plus smoking creates risk for burns, but it is not specifically related to skin integrity from sensory-perception disturbance.

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Question 2:

Which statement indicates the client needs a sensory aid in the home?

A. “I tripped over that throw rug again.” B. “I can’t hear the doorbell.” C. “My eyesight is good if I wear my glasses.” D. “I can hear the TV if I turn it up high.”

Answer and Explanation

Choice A:

“I tripped over that throw rug again.” This reflects a safety hazard, but it does not directly point to a sensory deficit. Removing the rug would address the problem, not a sensory aid.

Choice B:

“I can’t hear the doorbell.” This indicates a hearing deficit, and the client would benefit from a sensory aid such as a flashing light doorbell or hearing assistive device.

Choice C:

“My eyesight is good if I wear my glasses.” The sensory deficit is already corrected with glasses, so no new aid is required.

Choice D:

“I can hear the TV if I turn it up high.” This suggests mild hearing loss but doesn’t necessarily confirm the need for a sensory aid, since volume adjustment may be sufficient.

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Question 3:

A client with impaired vision is admitted to the hospital. Which interventions are most appropriate to meet the client’s needs? Select all that apply

A. Identify yourself by name. B. Decrease background noise before speaking. C. Stay in the client’s field of vision. D. Explain the sounds in the environment. E. Keep your voice at the same level throughout the conversation.

Answer and Explanation

Choice A:

Identify yourself by name: A client with impaired vision relies more on hearing, so naming yourself establishes trust, prevents confusion, and reassures the client.

Choice B:

Decrease background noise before speaking: This intervention is more appropriate for hearing-impaired clients, as vision loss does not affect auditory processing.

Choice C:

Stay in the client’s field of vision: Clients with impaired vision may not see well even if you are in their field of vision; instead, verbal cues and safe environmental arrangements are more helpful.

Choice D:

Explain the sounds in the environment: Unfamiliar sounds may cause anxiety for visually impaired clients. Explaining what is happening (e.g., alarms, staff movement) helps orient and reassure them.

Choice E:

Keep your voice at the same level throughout the conversation: Visual impairment does not affect hearing, so altering or maintaining voice level is unnecessary; clarity and descriptive explanations are more effective.

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Question 4:

An 85-year-old client has impaired hearing. When creating the care plan, which intervention should have the highest priority?

A. Obtaining an amplified telephone B. Teaching the importance of changing his position C. Providing reading material with large print D. Checking expiration dates on food packages

Answer and Explanation

Choice A:

Obtaining an amplified telephone: This intervention directly supports communication, social interaction, and safety (e.g., ability to call for help in emergencies). It is the highest priority because it addresses the client’s immediate functional needs.

Choice B:

Teaching the importance of changing his position: Position changes help with circulation or mobility but are unrelated to hearing impairment.

Choice C:

Providing reading material with large print: This supports vision, not hearing. While useful for visually impaired clients, it does not address the specific problem here.

Choice D:

Checking expiration dates on food packages: This is more relevant for clients with vision or memory deficits. It does not directly meet the needs of someone with impaired hearing.

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Question 5:

Which of the following would be most important to include in the plan of care for a patient who is 85 years old and has presbycusis?

A. Obtaining large-print written material B. Speaking distinctly using lower frequencies C. Decreasing tactile stimulation D. Initiating a safety program to prevent falls

Answer and Explanation

Choice A:

Obtaining large-print written material: This intervention addresses visual impairment, not presbycusis (age-related hearing loss).

Choice B:

Speaking distinctly using lower frequencies: Presbycusis is a gradual sensorineural hearing loss associated with aging, particularly affecting the ability to hear high-frequency sounds. Speaking clearly at a lower pitch and moderate pace enhances communication.

Choice C:

Decreasing tactile stimulation: Tactile input is not related to presbycusis and decreasing it may increase isolation.

Choice D:

Initiating a safety program to prevent falls: Although fall prevention is essential for older adults, it is not the most specific or direct intervention for presbycusis.

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Question 6:

An older adult with pneumonia is admitted from a skilled nursing home to a medical unit. A review of the medical record reveals that he had a stroke affecting the right hemisphere of the brain 6 months ago and was placed in the skilled nursing home because he was unable to care for himself. Which of these assessment findings does the nurse expect to find? Select all that apply

A. Slow, cautious behavioral style B. Inattention and neglect, especially to the left side C. Cloudy or opaque areas in part of the lens or the entire lens D. Visual spatial alterations such as loss of half of a visual field E. Loss of sensation and motor function on the right side of the body

Answer and Explanation

Choice A:

Slow, cautious behavioral style: This is more typical of left hemisphere stroke, where patients are often slow, cautious, and hesitant. Right hemisphere stroke patients are more likely to be impulsive and lack judgment.

Choice B:

Inattention and neglect, especially to the left side: Right hemisphere strokes commonly cause left-sided neglect (the patient ignores or is unaware of the left side of the body/environment).

Choice C:

Cloudy or opaque areas in part of the lens or the entire lens: This describes cataracts, an age-related eye disorder, not a direct effect of stroke.

Choice D:

Visual spatial alterations such as loss of half of a visual field: Right hemisphere damage often results in left homonymous hemianopsia, where the patient loses vision in the left half of the visual field in both eyes.

Choice E:

Loss of sensation and motor function on the right side of the body: Right hemisphere strokes cause left-sided motor and sensory deficits, because the motor pathways cross over in the brainstem.

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Practice Exercise 2

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