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1. A client admitted to outpatient surgery for a cataract extraction on c.

Activity levels will be restricted for several months, so


the right eye. The client asks the nurse, what causes cataracts in old she could plan on being sedentary
people? Which of the following statements should form the basis d. Activity can be returned to normal and may include
for the nurse’s response? Cataracts most commonly regular aerobic exercise
a. Are a result of chronic systemic disease 10. the client who has been treated for chronic open angle glaucoma
b. Are a result of aging process
for 5 years asks the clinic nurse, “How does glaucoma damage my
c. Are a a result of injuries sustained early in life
eyesight?” the nurses reply should be based on the knowledge that
d. Are a result of prolonged use of drugs
COAG
2. A client asks; “What does the lens of my eye do?” the nurse should a. result from chronic eye inflammation
explain that the lens of the eye: b. causes increased intraocular pressure
a. produces aqueous humor c. leads to the detachment of the retina
b. holds the rods and cones d. is caused by decreased blood flow to the retina
11. Which of the following signs and symptoms is most commonly
c. focuses light rays to the retina
experienced by clients with COAG?
d. regulates the amount of light entering the eye
a. Eye pain
3. The client with a cataract tells the nurse that she is afraid of being b. Excessive lacrimation
awake during eye surgery. Which of the following responses of the c. Colored light flashes
nurse would be the most appropriate? d. Decreasing peripheral vision
a. “Have you ever had any reactions to local anesthetics in 12. The nurse observes the client while he instills his eye drops. The
the past?” client says, “I just try to hit the middle of my eyeball so the drops
b. “What is it that disturbs you about the idea of being don’t run out of my eye.” The nurse explains to the client that the
awake?” method he is now using may cause
c. “By using a local anesthetic, you won’t have nausea a. Scleral staining
b. Corneal injury
and vomiting after the surgery.”
c. Excessive lacrimation
d. “There is really nothing to fear about being awake.
d. Systematic drug absorption
You’ll be given a medication that will help you relax.”
13. The client with glaucoma is scheduled for minor surgical
4. A client with a cataract would most likely complain of what
procedure.which of the following orders would require
symptoms?
clarification or correction before the nurse carry it out?
a. Halos and rainbows around lights
a. Administer morphine sulfate
b. Eye pain and irritations which worsens at night
b. Administer atropine sulfate
c. Blurred and hazy visions
c. Teach deep breathing exercises
d. Eye strain and headache when doing close work
d. Teach leg exercises
5. A client is scheduled for removal of a cataract OD. Before surgery, 14. Which of the following clinical manifestations would the nurse
the nurse is to instill eye drops of phenylephrine Hcl into the client associate with acute angle-closure glaucoma?
OD. This preparation acts in the eye to a. Gradual loss of central vision
a. Dilation of the pupil and the blood vessels b. Acute light sensitivity
b. Dilation of the pupil and constriction of the blood c. Loss of color vision
vessels d. Sudden eye pain
c. Constriction of pupil and blood vessels 15. A 27y/o woman is admitted for elective nasal surgery for a
d. Constriction of pupils and dilation of blood vessels deviated septum. Which of the following would be an important
6. A short time after cataract surgery, the client complains of nausea. initial clue that bleeding was occurring even if the nasal drip pad
Which of the following represents the nurse’s best course of remained dry and intact?
action? a. Complaints of nausea
a. Instruct the client to take a few deep breaths until b. Repeated swallowing
nausea subsides c. Rapid respiratory rate
b. Explain that this is a common feeling that will pass d. Feeling of anxiety
quickly 16. The client is ready for discharge after surgery for a deviated
c. Tell the client to call the nurse promptly, if vomiting septum. Which of the following discharge instructions would be
occurs appropriate?
d. Medicate the client with an anti emetic as ordered. a. Avoid activities that elicit the valsalva maneuver
7. After returning home, the client will need to continue to instill eye b. Take aspirin to control nasal discomfort
c. Avoid brushing the teeth until the nasal packing is
drops in the affected eye. The client is instructed to apply slight
removed
pressure against the nose at the inner canthus of the eye after
d. Apply heat to the nasal area to control swelling
instilling the eye drops. The rationale that supports applying
17. Which of the following statements would indicate to the nurse that
pressure is that it
the client who has undergone repair of her nasal septum has
a. Prevents the medication from entering the tear duct
understood the discharge instructions?
b. Prevents the drug from running down the patient’s face
a. “I should not shower until my packing is removed.”
c. Allows the sensitive cornea to adjust to the medication
b. “I will take stool softeners and modify my diet to
d. Facilitates the distribution of the medication over the
prevent constipation”
eye surface
c. “Coughing every 2 hours is important to prevent
8. A client with detachment of the retina asks the nurse why it is
respiratory complications.”
necessary to patch both of her eyes. The nurse’s reply should be
d. “It is important to blow my nose each day to remove
based on the knowledge that eye patches serve to:
the dried secretions.”
a. Reduce rapid eye movements
b. Decrease the irritation caused by the light entering the 18. A 75 y/o client who has been taking furosemide regularly for 4mos
damaged eye tells the nurse that he is having trouble hearing. What would be the
c. Protect the injured eye from infection nurse’s best response to this statement?
d. Rest the eye to promote healing a. Tell the client that because he is 75 y/o, his hearing
9. Which of the following statements would provide the best guide deteriorates.
for activity for a client who has been treated for retinal detachment b. Have the client report the hearing loss immediately to
during the rehabilitation period? physician.
a. Activity is resumed gradually, the client can resume her c. Schedule the client for audiometric testing and a
usual activities in 5 to 6 weeks hearing aid.
b. Activity level is determined by the client’s tolerance; d. Tell the client that the hearing loss is only temporary,
she can be active as she wishes when the system adjusts with the furosemide, his
hearing will improve.
19. Which of the following describes the effect of hearing aid for a a. Antihistamines
client with sensorineural hearing loss? b. Antiemetics
a. It makes sounds louder and clearer c. Diuretics
b. It has no effect on hearing d. Glucocorticoids
c. It makes sounds louder but not clearer 30. When assessing an older adult with macular degeneration the
d. It improves the clients ability to separate words from nursed would expect to find:
background noise a. Loss of central vision
20. A client states that she was told she has sensorineural hearing loss b. Loss of peripheral vision
and asks the nurse that this sensorineural hearing loss results from c. Total blindness
which of the following condition? d. Blurring of vision
a. Presence of fluid and cerumen in the external canal 31. A 75 y/o male client has a history of macular degeneration. While
he is in the hospital, the priority nursing goal will be:
b. Sclerosis of the bones of the middle ear
a. To provide education regarding community services for
c. Damage to the cochlear or vestibulocochlear nerve clients with adult macular degeneration (AMD)
d. Emotional disturbance resulting in functional hearing b. To provide heath care regarding his condition
loss c. To promote a safe, effective environment
21. A 65 y/o man complains of hearing loss and a sensation of fullness d. To improve vision
in both ears. The nurse examines his ears with the understanding 32. when admitting a blind female client to the hospital, the nurse
that a common cause of hearing loss in older adults is related to: should:
a. Accumulation of cerumen in the external canal a. Ask the client to have someone with her at all times
b. Accumulation of cerumen in the internal canal b. Encourage her to stay in bed until the nurse can assist
c. External otitis c. Orient the client to the room environment by providing
d. Exostosis opportunity to touch objects
22. The best method to remove cerumen from a client’s ear involves d. Allow time for client to orient to the environment
a. Inserting a cotton tipped applicator into the external 33. Although the following measures might be useful in reducing the
canal visual disability of a client with AMD, which measures should the
b. Irrigating the ear gently nurse teach the client primarily as a safe precaution?
c. Using aural suction a. Wear a patch over one eye
d. Using a cerumen curette b. Place personal items on the sighted side
23. To prepare the irrigation solution used for removal of cerumen, the c. Lie in bed with the unaffected side toward the door
nurse uses: d. Turn the head from side to side when walking
a. Normal saline 34. The physician has prescribed timolol ophthalmic drops and
b. Sterile water gentamicin ophthalmic ointment for a client with glaucoma and
c. Antiseptic solution conjunctivitis. When administering eye drops and eye ointments to
d. Lactated ringers solution the same client, the nurse should:
24. A 26 y/o client has a history of chronic otitis media. Which of the a. Administer the drops, wait 5 minutes, and administer
the ointment
following procedures is the most common surgical intervention for
b. Administer the two medications together
chronic otitis media?
c. Administer the ointment, wait 30 minutes and
a. Ossiculoplasty
administer the drops
b. Tympanoplasty
d. Ask the physician to prescribe both medications as
c. Mastoidectomy
drops or ointments
d. Myringotomy
35. The nurse is caring for a client with suspected retinal detachment
25. A client is about to have tympanoplasty. She is asking the nurse
of the right eye. Which subjective finding is common in clients
what the surgical procedure involves. The nurse begins the
with retinal detachment?
conversation by
a. Dull, throbbing pain
a. Assessing what the client’s doctor has told her
b. Veil-like loss of vision
b. Describing the surgical procedure
c. Sudden blindness
c. Educating the client that the procedure will close the
d. Loss of color discrimination
perforation and prevent recurrent infection
36. A client is to be discharged following removal of a cataract on her
d. Informing the client that the procedure will improve her
right eye. The nurse should tell the client to:
hearing
a. Wear the metal eye shield only during waking hours
26. A classic triad of symptoms associated with Meniere’s disease is b. Report any eye pain to the doctor immediately
vertigo, tinnitus and: c. Refrain from using a pillow under the bed
a. Headache d. Avoid wearing dark glasses indoors
b. Otitis media 37. An elderly client with glaucoma has been prescribed Timolol eye
c. Fluctuating hearing loss drops. Timoptic should be used with caution in clients with history
d. Vomiting of:
27. Which of the following statements of the client would indicate that a. Diabetes
b. Gastric ulcers
she understands the expected course of Meniere’s disease?
c. Emphysema
a. “The disease process will gradually extent to the eyes.”
d. Pancreatitis
b. ”Control of the episodes is usually possible, but a cure
38. The nurse is teaching a patient with detached retina who underwent
is not yet available.”
scleral buckling on the left eye. The procedure included gas
c. “Continued medication will cure the disease.”
injection into the vitreous. Which of the following statements
d. “Bilateral deafness is an inevitable outcome of the indicates that the patient understands the nurse’s instructions?
disease.” a. “I should lie on my abdomen with my head turned to
28. The potential injury during an attack of Meniere’s disease is great. the right.”
b. “I should lie face down with my head turned to the
The nurse should instruct the client to take which immediate action
left.”
when experiencing vertigo?
c. “I’ll lie face up with my head turned to the right.”
a. “Place your head between your knees.”
d. “I should lie on my back with my head turned to the
b. “Concentrate on deep breathing.”
left.”
c. “Close your eyes tightly.”
39. The nurse is providing care for a client following cataract removal
d. “Assume a reclining flat position.”
surgery. In which position should the nurse place the patient?
29. The nurse would anticipate all of the following drugs may be used
a. Right side lying
in the attempt to control the symptoms of Meniere’s disease
b. Prone
except:
c. Supine
d. Trendelenburg d. Vasodilator that has an affinity for cerebral blood
40. When assessing a client with glaucoma, a nurse expects which of vessels.
the following findings? 49. A nurse is in the room with a client when a seizure begins. The
a. Complaints of double vision client’s entire body becomes rigid, and the muscles in all four
b. Complaints of halos around lights extremities alternate between relaxation and contraction.
c. Intraocular pressure of 15mmHg Following the seizure, the nurse documents that the client has
d. Soft globe on palpation experienced:
41. A client with Bell’s palsy is distressed about the change in facial a. Absent seizure
appearance. The nurse tells the client about which of the following b. Generalized tonic-clonic seizure
characteristics of Bell’s palsy to help the client cope with the c. Simple partial seizure
disorder? d. Complex partial seizure
a. The symptoms will completely go away once the tumor 50. A client has an order for seizure precautions. The nurse avoids
is removed doing which of the following when planning care of the client?
b. It usually resolves when treated with vasodilators a. Monitor the client closely while the client is showering
c. It is similar to stroke, but all symptoms will go away b. Push the lock-out button on the electric bed to keep the
eventually. bed in the lowest position
d. It is not caused by stroke, and many clients recover in 3 c. Keep all the lights on in the room at night
to 5 weeks. d. Assist the client to ambulate in the hallway
42. A physician is writing medication orders for a client with Bell’s 51. When performing the history and physical examination of a client
palsy. The nurse reviews the clients record for an order which of with Parkinson’s disease, the nurse should assess the client for:
the following medications commonly used to decrease edema of a. Frequent bouts of diarrhea
nerve tissue: b. Hyperextension of neck
a. Naprosyn (Aleve) c. Low itched monotonous voice
b. Prednisone (Deltasone) d. Increase in appetite and weight gain
c. ASA (Aspirin) 52. While assessing a client with Parkinson’s disease, the nurse
d. Ibuprofen (Motrin) identifies bradykinesia when the client exhibits:
a. Muscle flaccidity
43. A client with trigeminal neuralgia asks the nurse what can be done
b. Intentional tremor
to minimize the episodes of pain, the nurse response is based on
c. Paralysis of the limbs
the understanding that the symptoms can be triggered by:
d. Lack of spontaneous movement
a. Infection or stress
53. A nurse is caring for a client who is comatose. The nurse notes in
b. Excessive watering of the eyes or nasal stuffiness the chart that the client is exhibiting decerebrate posturing. Based
c. Sensations of pressure or extremes in temperature on this documented finding, the nurse expects to note which of the
d. Hypoglycemia and fatigue following?
44. A client has been diagnosed with Bell’s palsy. The nurse assesses a. Extension of the extremities after a stimulus
the client to see if which of the following signs and symptoms is b. Flexion of the extremities after a stimulus
visible? c. Upper extremity flexion with lower extremity extension
a. Speech difficulties and facial droop d. Upper extremity extension with lower extremity flexion
b. Twitching of one side of the face and ruddy cheeks 54. The nurse is caring for a comatose patient who has suffered a
c. Eye paralysis and ptosis of both eyes closed head injury.which intervention should the nurse implement
d. Fixed pupil and an elevated eyelid on one side to prevent an increase in the ICP?
45. A client is admitted to the hospital in myesthenic crisis. A nurse a. Suctioning the airway every hour
questions the family about the occurrence of which of the b. Elevating the head of the bed 15 to 40 degrees
following precipitating factors for this event? c. Turning the patient and changing his position every
a. Not taking prescribed medication hour
b. Taking excess prescribed medication d. Marinating a well-lit room
c. Getting more sleep than usual 55. The nurse explains to the patients family that which of the
d. A decrease in food intake recently following disorders is characterized by progressive degeneration of
46. Benztropine mesylate (Cogentin) is prescribed to a client with a the cerebral cortex?
diagnosis of Parkinsosn’s disease. The clinic nurse is reinforcing a. Alzheimer’s disease
instructions to the client regarding the medication and tells the b. Epilepsy
client to: c. Guillain-barre syndrome
a. Avoid driving if drowsiness or dizziness occurs d. Stroke
b. Expect difficulty swallowing while taking this 56. To encourage adequate nutritional intake for a patient with
medication moderate Alzheimer’s disease, the nurse should:
c. Sped time sitting in the sun to enhance effectiveness of a. Stay with the patient and encourage him to eat
the medication b. Help the patient fill out his menu
d. Expect episodes of vomiting and constipation while c. Give the patient privacy during meals
taking this medication d. Fill out the menu for the patient
47. A nurse is reviewing the nursing care plan for a patient with a right 57. The nurse is caring for a client with increase ICP/ which procedure
is contraindicated in this case?
cerebrovascular accident (CVA) who has left side deficits. The
a. EEG
nurse notes a nursing diagnosis of unilateral neglect. The nurse
b. Skull x-rays
would tell a family member who is assisting the client that it would
c. Lumbar tap
be helpful to do which of the following?
d. CT scan
a. Approach the client from the right side
58. An adult has a medical dx of increased ICP and is being cared for
b. Teach the client to scan the environment
in the neurological unit.the nursing care plan includes positioning
c. Move the commode and chair to the left side
the head in proper alignment. The nurse realizes that these actions
d. Place bedside articles on the left side
are effective because they act by:
48. A physician has prescribed nimodipine for a client with a. Making it easier for the client to breath
subarachnoid hemorrhage. The nurse administering the first dose b. Preventing valsalva maneuver
tells the client that this medication is a: c. Promoting venous drainage
a. Ca-channel blocker used to decrease the blood pressure d. Reducing pain
b. Ca-channel blocker used to decrease cerebral blood 59. Which of the following reduces cerebral edema by constricting
vessel spasm cerebral veins?
c. Beta-adrenergic blocker used to decrease blood a. Dexamethasone
pressure b. Mechanical hyperventilation
c. Mannitol
d. Ventriculostomy
60. A nurse is obtaining a GCS on a client. The score is as follows:
BEO: 3, BMR: 6, BVR: 4. the nurse interprets these findings as the
client:
a. Opens eyes to speech, obeys verbal commands and is
confused
b. Opens eyes to pain, decorticates to pain, and does not
speak
c. Opens eyes to pain, no motor response, and has
inappropriate speech
d. Opens eyes spontaneously, obeys commands, and is
oriented