WorksheetsIn-Class Activities Cases Sept 10 - HEARING and VISION
Total questions: 14
Worksheet time: 7mins
Mrs. Gen, 78, presents with the following history: retired factory worker (textile mill - 30 years), takes furosemide 40mg daily and aspirin 81mg daily, type 2 diabetes, reports difficulty hearing conversations in the nursing home, but can listen to one-on-one. Which combination of interventions addresses her HIGHEST priority modifiable risk factors?
Refer for diabetes management and reduce restaurant noise exposure
Review ototoxic medication effects and assess for cerumen impaction
Recommend hearing aids and provide communication techniques
Schedule annual hearing screening and educate about noise protection
As an RN during assessment, you observe that the patient turns his left ear toward you, asks "what?" frequently, speaks loudly, and his wife states, "He hasn't heard the smoke alarm twice this month." Otoscopic exam reveals clear bilateral ear canals. Based on this assessment data, the most likely diagnosis is conductive hearing loss caused by cerumen impaction.
True
False
RN is developing a unit protocol for hearing assessment in older adults. Research shows that 47.2% of adults 75+ have hearing loss, yet only 20% of those with sensorineural hearing loss use hearing aids. Which evidence-based screening approach would have the GREATEST impact on identifying undiagnosed hearing loss?
Annual audiometry testing for all patients over 65
HHIE-S screening combined with behavioral cue observation for all admissions
Otoscopic examination only when patients report hearing problems
Family member interviews about communication difficulties
Mr. Kay, 82, nursing home resident with mild dementia, has bilateral hearing aids, but staff report he "refuses to wear them" and "gets agitated during group activities." His daughter visits weekly and reports that he converses normally with her. As an RN in this situation, what is the MOST likely contributing factor to his behavior?
Progressive dementia is affecting his ability to process auditory information
Hearing aids are malfunctioning and need professional adjustment
Background noise in group settings overwhelms his compromised auditory processing
He has developed depression and is withdrawing from social interaction
The RN implemented communication techniques with Mr. Rod (speaking slowly, facing him, and reducing background noise), but he still appears frustrated and says, "I still can't understand you." The appropriate nursing action is to speak louder and more slowly.
True
False
Mrs. C, 82, has been taking the same cardiac medications for 6 years without problems. Recently, she's been found with pills scattered on her kitchen floor twice. Her daughter reports Mom seems "confused about her medicines." Assessment reveals visual acuity of 20/60 and difficulty reading medication labels due to small print.
Early dementia affecting cognitive function
Age-related vision changes impacting functional ability
Medication side effects causing confusion
Intentional non-compliance with treatment regimen
An 85-year-old resident with macular degeneration becomes agitated during medication administration, saying, "I can't see what you're giving me!"
A) Explain that you're a licensed nurse and she needs to trust you
B) Describe each medication, its purpose, and ask if she has questions
C) Have the family member present give permission for the medications
D) Document the resident as "non-compliant" and notify the physician
Mrs. Pat received low-vision rehabilitation services, including magnification training and environmental modifications. Six months later, her reports showed increased confidence, a resumption of reading, and improved medication adherence. However, her daughter says Mom still seems "sad and withdrawn." What additional intervention would most likely address the remaining concern?
Refer for stronger prescription glasses
Recommend antidepressant medication evaluation
Facilitate participation in support groups for vision loss
Increase frequency of occupational therapy sessions
Mr. Has, a 78-year-old Muslim resident with diabetic retinopathy, refuses to make eye contact during vision assessment. His adult son answers most questions directed to him. The nursing student feels frustrated and considers the resident "non-cooperative." What cultural consideration should guide the nursing approach?
Insist on direct communication to ensure accurate assessment
Respect cultural communication patterns while ensuring thorough assessment
Document that cultural barriers prevent proper vision evaluation
Request a different nurse who can relate better to the resident
As a student nurse on clinicals in a nursing home setting, the RN asks you to answer the following question in risk factors recognition for vision loss. Select True or False to answer questions 10-14.
a) Smoking cessation can reduce the risk of developing cataracts and macular degeneration.
True
False
b) Wearing sunglasses indoors is recommended for all older adults to prevent eye strain.
True
False
Older adults with diabetes should have annual eye examinations even if they have no vision complaints.
True
False
Family history of glaucoma is a non-modifiable risk factor that requires regular screening.
True
False
e) Long-term use of corticosteroids can increase the risk of developing cataracts.
True
False
