Nursing Practice Exam Preparation Notes

Ear Disorders and Assessment

Hearing Disorders

• Mrs. Sotto, 77, presents with difficulty hearing high-pitched sounds.

  • Assessment Options:

  • Weber Test: Assesses lateralization of sound.

  • Whisper Test: Rough estimate of hearing ability.

  • Audiometry: Comprehensive testing of hearing.

  • Rinne Test: Compares air and bone conduction.

Types of Hearing Loss

• Conductive Hearing Loss: Problems in the outer or middle ear.

• Sensorineural Hearing Loss: Issues with the inner ear or auditory nerve.

• Mixed Loss: Combination of both types.

Communication Strategies for Hearing Impaired

• Strategies include:

  • Avoid strong light backgrounds (silhouette).

  • Maintain visibility of the speaker’s mouth.

  • Face the person while speaking.

  • Discuss familiarity with subject matter beforehand.

Predisposing Factors & Management

• Causes of Sensorineural Hearing Loss:

  • Ototoxic agents (e.g., certain drugs).

• Management: Sensorineural hearing loss is typically irreversible.

Documentation in Nursing

Key Issues in Malpractice

• Importance of documenting response to treatments and medications.

Proper Recording Practices

• Document treatments and medications only after administration.

• Risks of electronic record misuse (logging in under another's account).

Telephone Orders

• Read back or repeat orders for accuracy.

Sexuality and Identity in Patient Care

Patient Comfort with Sexual Topics

• Many patients prefer discussing sexual health with same-sex providers or feel uncomfortable discussing with strangers.

Transsexuality Considerations

• Will need to address identity concerns appropriately.

Sleep Disorders: Narcolepsy

Treatment Objectives

• Use medications like Methylphenidate (Ritalin) to improve alertness.

Sleep Hygiene

• Establish good sleep conditions and avoid substances before bed.

Symptoms of Narcolepsy

• Excessive daytime sleepiness, disturbed sleep at night.

Substance Use and Abuse

Assessing Substance Abuse

• Examination for signs such as disorientation and withdrawal symptoms.

Interventions

• Building therapeutic rapport and providing appropriate education can guide treatment plans.

Stress Management in Nursing

Burnout Identification

• Characterized by emotional exhaustion and depersonalization.

Lifestyle Modifications

• Identify unhealthy habits to promote better well-being and patient care quality.

Cognitive Impairment Disorders

Recognition of Confabulation

• Indicating attempts to fill memory gaps, which aids in self-esteem maintenance.

Memory Assessments

• Assess recent and remote memory through familiar questions.

Ethical Principles in Nursing

Balancing Patient Autonomy with Safety

• Considerations for legally blind patients and their rights with driving.

Beneficence vs. Autonomy

• Understanding patient decision-making against safety concerns.

Psychiatric Nursing

Anxiety Disorders Management

• Cognitive-behavioral techniques for managing patient's fears.

Addressing Panic Attacks

• Staying close and offering support with adequate personal space.

Therapeutic Activities

• Selecting activities that provide distraction and meet therapeutic goals for patients with manic behavior.

Research and Quality Assurance in Nursing

Evidence-based Practice

• Promoting best practices in patient care and integrating new findings into nursing protocols.

Research Methods

• Stratified sampling for gender-specific studies in psychiatric populations.