1. A client admitted to outpatient surgery for a cataract extraction on the right eye. The client asks the nurse, what causes cataracts in old people? Which of the following statements should form the basis for the nurse’s response? Cataracts most commonly

a. Are a result of chronic systemic diseaseb. Are a result of aging processc. Are a a result of injuries sustained early in lifed. Are a result of prolonged use of drugs

2. A client asks; “What does the lens of my eye do?” the nurse should explain that the lens of the eye:a. produces aqueous humorb. holds the rods and conesc. focuses light rays to the retinad. regulates the amount of light entering the eye

3. The client with a cataract tells the nurse that she is afraid of being awake during eye surgery. Which of the following responses of the nurse would be the most appropriate?

a. “Have you ever had any reactions to local anesthetics in the past?”b. “What is it that disturbs you about the idea of being awake?”c. “By using a local anesthetic, you won’t have nausea and vomiting after the surgery.”d. “There is really nothing to fear about being awake. You’ll be given a medication that will

help you relax.”4. A client with a cataract would most likely complain of what symptoms?

a. Halos and rainbows around lightsb. Eye pain and irritations which worsens at nightc. Blurred and hazy visionsd. Eye strain and headache when doing close work

5. A client is scheduled for removal of a cataract OD. Before surgery, the nurse is to instill eye drops of phenylephrine Hcl into the client OD. This preparation acts in the eye to

a. Dilation of the pupil and the blood vesselsb. Dilation of the pupil and constriction of the blood vesselsc. Constriction of pupil and blood vesselsd. Constriction of pupils and dilation of blood vessels

6. A short time after cataract surgery, the client complains of nausea. Which of the following represents the nurse’s best course of action?

a. Instruct the client to take a few deep breaths until nausea subsidesb. Explain that this is a common feeling that will pass quicklyc. Tell the client to call the nurse promptly, if vomiting occursd. Medicate the client with an anti emetic as ordered.

7. After returning home, the client will need to continue to instill eye drops in the affected eye. The client is instructed to apply slight pressure against the nose at the inner canthus of the eye after instilling the eye drops. The rationale that supports applying pressure is that it

a. Prevents the medication from entering the tear ductb. Prevents the drug from running down the patient’s facec. Allows the sensitive cornea to adjust to the medicationd. Facilitates the distribution of the medication over the eye surface

8. A client with detachment of the retina asks the nurse why it is necessary to patch both of her eyes. The nurse’s reply should be based on the knowledge that eye patches serve to:

a. Reduce rapid eye movementsb. Decrease the irritation caused by the light entering the damaged eyec. Protect the injured eye from infectiond. Rest the eye to promote healing

9. Which of the following statements would provide the best guide for activity for a client who has been treated for retinal detachment during the rehabilitation period?

a. Activity is resumed gradually, the client can resume her usual activities in 5 to 6 weeksb. Activity level is determined by the client’s tolerance; she can be active as she wishesc. Activity levels will be restricted for several months, so she could plan on being sedentaryd. Activity can be returned to normal and may include regular aerobic exercise

10. the client who has been treated for chronic open angle glaucoma for 5 years asks the clinic nurse, “How does glaucoma damage my eyesight?” the nurses reply should be based on the knowledge that COAG

a. result from chronic eye inflammationb. causes increased intraocular pressurec. leads to the detachment of the retinad. is caused by decreased blood flow to the retina

11. Which of the following signs and symptoms is most commonly experienced by clients with COAG?a. Eye painb. Excessive lacrimationc. Colored light flashesd. Decreasing peripheral vision

12. The nurse observes the client while he instills his eye drops. The client says, “I just try to hit the middle of my eyeball so the drops don’t run out of my eye.” The nurse explains to the client that the method he is now using may cause

a. Scleral stainingb. Corneal injuryc. Excessive lacrimationd. Systematic drug absorption

13. The client with glaucoma is scheduled for minor surgical procedure.which of the following orders would require clarification or correction before the nurse carry it out?

a. Administer morphine sulfateb. Administer atropine sulfatec. Teach deep breathing exercisesd. Teach leg exercises

14. Which of the following clinical manifestations would the nurse associate with acute angle-closure glaucoma?

a. Gradual loss of central visionb. Acute light sensitivityc. Loss of color visiond. Sudden eye pain

15. A 27y/o woman is admitted for elective nasal surgery for a deviated septum. Which of the following would be an important initial clue that bleeding was occurring even if the nasal drip pad remained dry and intact?

a. Complaints of nauseab. Repeated swallowingc. Rapid respiratory rated. Feeling of anxiety

16. The client is ready for discharge after surgery for a deviated septum. Which of the following discharge instructions would be appropriate?

a. Avoid activities that elicit the valsalva maneuverb. Take aspirin to control nasal discomfortc. Avoid brushing the teeth until the nasal packing is removedd. Apply heat to the nasal area to control swelling

17. Which of the following statements would indicate to the nurse that the client who has undergone repair of her nasal septum has understood the discharge instructions?

a. “I should not shower until my packing is removed.”b. “I will take stool softeners and modify my diet to prevent constipation”c. “Coughing every 2 hours is important to prevent respiratory complications.”d. “It is important to blow my nose each day to remove the dried secretions.”

18. A 75 y/o client who has been taking furosemide regularly for 4mos tells the nurse that he is having trouble hearing. What would be the nurse’s best response to this statement?

a. Tell the client that because he is 75 y/o, his hearing deteriorates.b. Have the client report the hearing loss immediately to physician.c. Schedule the client for audiometric testing and a hearing aid.d. Tell the client that the hearing loss is only temporary, when the system adjusts with the

furosemide, his hearing will improve.19. Which of the following describes the effect of hearing aid for a client with sensorineural hearing

loss?a. It makes sounds louder and clearerb. It has no effect on hearingc. It makes sounds louder but not clearerd. It improves the clients ability to separate words from background noise

20. A client states that she was told she has sensorineural hearing loss and asks the nurse that this sensorineural hearing loss results from which of the following condition?

a. Presence of fluid and cerumen in the external canalb. Sclerosis of the bones of the middle earc. Damage to the cochlear or vestibulocochlear nerved. Emotional disturbance resulting in functional hearing loss

21. A 65 y/o man complains of hearing loss and a sensation of fullness in both ears. The nurse examines his ears with the understanding that a common cause of hearing loss in older adults is related to:

a. Accumulation of cerumen in the external canalb. Accumulation of cerumen in the internal canalc. External otitisd. Exostosis

22. The best method to remove cerumen from a client’s ear involvesa. Inserting a cotton tipped applicator into the external canalb. Irrigating the ear gentlyc. Using aural suctiond. Using a cerumen curette

23. To prepare the irrigation solution used for removal of cerumen, the nurse uses:a. Normal salineb. Sterile waterc. Antiseptic solutiond. Lactated ringers solution

24. A 26 y/o client has a history of chronic otitis media. Which of the following procedures is the most common surgical intervention for chronic otitis media?

a. Ossiculoplastyb. Tympanoplastyc. Mastoidectomyd. Myringotomy

25. A client is about to have tympanoplasty. She is asking the nurse what the surgical procedure involves. The nurse begins the conversation by

a. Assessing what the client’s doctor has told herb. Describing the surgical procedurec. Educating the client that the procedure will close the perforation and prevent recurrent

infectiond. Informing the client that the procedure will improve her hearing

26. A classic triad of symptoms associated with Meniere’s disease is vertigo, tinnitus and:a. Headacheb. Otitis mediac. Fluctuating hearing lossd. Vomiting

27. Which of the following statements of the client would indicate that she understands the expected course of Meniere’s disease?

a. “The disease process will gradually extent to the eyes.”b. ”Control of the episodes is usually possible, but a cure is not yet available.”c. “Continued medication will cure the disease.”d. “Bilateral deafness is an inevitable outcome of the disease.”

28. The potential injury during an attack of Meniere’s disease is great. The nurse should instruct the client to take which immediate action when experiencing vertigo?

a. “Place your head between your knees.”b. “Concentrate on deep breathing.”c. “Close your eyes tightly.”d. “Assume a reclining flat position.”

29. The nurse would anticipate all of the following drugs may be used in the attempt to control the symptoms of Meniere’s disease except:

a. Antihistaminesb. Antiemeticsc. Diureticsd. Glucocorticoids

30. When assessing an older adult with macular degeneration the nursed would expect to find:a. Loss of central visionb. Loss of peripheral visionc. Total blindnessd. Blurring of vision

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:

a. To provide education regarding community services for clients with adult macular degeneration (AMD)

b. To provide heath care regarding his conditionc. To promote a safe, effective environmentd. To improve vision

32. when admitting a blind female client to the hospital, the nurse should:a. Ask the client to have someone with her at all timesb. Encourage her to stay in bed until the nurse can assistc. Orient the client to the room environment by providing opportunity to touch objectsd. Allow time for client to orient to the environment

33. Although the following measures might be useful in reducing the visual disability of a client with AMD, which measures should the nurse teach the client primarily as a safe precaution?

a. Wear a patch over one eyeb. Place personal items on the sighted sidec. Lie in bed with the unaffected side toward the doord. Turn the head from side to side when walking

34. The physician has prescribed timolol ophthalmic drops and gentamicin ophthalmic ointment for a client with glaucoma and conjunctivitis. When administering eye drops and eye ointments to the same client, the nurse should:

a. Administer the drops, wait 5 minutes, and administer the ointmentb. Administer the two medications togetherc. Administer the ointment, wait 30 minutes and administer the dropsd. Ask the physician to prescribe both medications as drops or ointments

35. The nurse is caring for a client with suspected retinal detachment of the right eye. Which subjective finding is common in clients with retinal detachment?

a. Dull, throbbing painb. Veil-like loss of visionc. Sudden blindnessd. Loss of color discrimination

36. A client is to be discharged following removal of a cataract on her right eye. The nurse should tell the client to:

a. Wear the metal eye shield only during waking hoursb. Report any eye pain to the doctor immediatelyc. Refrain from using a pillow under the bedd. Avoid wearing dark glasses indoors

37. An elderly client with glaucoma has been prescribed Timolol eye drops. Timoptic should be used with caution in clients with history of:

a. Diabetesb. Gastric ulcersc. Emphysemad. Pancreatitis

38. The nurse is teaching a patient with detached retina who underwent scleral buckling on the left eye. The procedure included gas injection into the vitreous. Which of the following statements indicates that the patient understands the nurse’s instructions?

a. “I should lie on my abdomen with my head turned to the right.”b. “I should lie face down with my head turned to the left.”c. “I’ll lie face up with my head turned to the right.”d. “I should lie on my back with my head turned to the left.”

39. The nurse is providing care for a client following cataract removal surgery. In which position should the nurse place the patient?

a. Right side lyingb. Pronec. Supined. Trendelenburg

40. When assessing a client with glaucoma, a nurse expects which of the following findings?a. Complaints of double visionb. Complaints of halos around lightsc. Intraocular pressure of 15mmHgd. Soft globe on palpation

41. A client with Bell’s palsy is distressed about the change in facial appearance. The nurse tells the client about which of the following characteristics of Bell’s palsy to help the client cope with the disorder?

a. The symptoms will completely go away once the tumor is removedb. It usually resolves when treated with vasodilators

c. It is similar to stroke, but all symptoms will go away eventually.d. It is not caused by stroke, and many clients recover in 3 to 5 weeks.

42. A physician is writing medication orders for a client with Bell’s palsy. The nurse reviews the clients record for an order which of the following medications commonly used to decrease edema of nerve tissue:

a. Naprosyn (Aleve)b. Prednisone (Deltasone)c. ASA (Aspirin)d. Ibuprofen (Motrin)

43. A client with trigeminal neuralgia asks the nurse what can be done to minimize the episodes of pain, the nurse response is based on the understanding that the symptoms can be triggered by:

a. Infection or stressb. Excessive watering of the eyes or nasal stuffinessc. Sensations of pressure or extremes in temperatured. Hypoglycemia and fatigue

44. A client has been diagnosed with Bell’s palsy. The nurse assesses the client to see if which of the following signs and symptoms is visible?

a. Speech difficulties and facial droopb. Twitching of one side of the face and ruddy cheeksc. Eye paralysis and ptosis of both eyesd. Fixed pupil and an elevated eyelid on one side

45. A client is admitted to the hospital in myesthenic crisis. A nurse questions the family about the occurrence of which of the following precipitating factors for this event?

a. Not taking prescribed medicationb. Taking excess prescribed medicationc. Getting more sleep than usuald. A decrease in food intake recently

46. Benztropine mesylate (Cogentin) is prescribed to a client with a diagnosis of Parkinsosn’s disease. The clinic nurse is reinforcing instructions to the client regarding the medication and tells the client to:

a. Avoid driving if drowsiness or dizziness occursb. Expect difficulty swallowing while taking this medicationc. Sped time sitting in the sun to enhance effectiveness of the medicationd. Expect episodes of vomiting and constipation while taking this medication

47. A nurse is reviewing the nursing care plan for a patient with a right cerebrovascular accident (CVA) who has left side deficits. The nurse notes a nursing diagnosis of unilateral neglect. The nurse would tell a family member who is assisting the client that it would be helpful to do which of the following?

a. Approach the client from the right sideb. Teach the client to scan the environmentc. Move the commode and chair to the left sided. Place bedside articles on the left side

48. A physician has prescribed nimodipine for a client with subarachnoid hemorrhage. The nurse administering the first dose tells the client that this medication is a:

a. Ca-channel blocker used to decrease the blood pressureb. Ca-channel blocker used to decrease cerebral blood vessel spasmc. Beta-adrenergic blocker used to decrease blood pressured. Vasodilator that has an affinity for cerebral blood vessels.

49. A nurse is in the room with a client when a seizure begins. The client’s entire body becomes rigid, and the muscles in all four extremities alternate between relaxation and contraction. Following the seizure, the nurse documents that the client has experienced:

a. Absent seizureb. Generalized tonic-clonic seizurec. Simple partial seizured. Complex partial seizure

50. A client has an order for seizure precautions. The nurse avoids doing which of the following when planning care of the client?

a. Monitor the client closely while the client is showeringb. Push the lock-out button on the electric bed to keep the bed in the lowest positionc. Keep all the lights on in the room at nightd. Assist the client to ambulate in the hallway

51. When performing the history and physical examination of a client with Parkinson’s disease, the nurse should assess the client for:

a. Frequent bouts of diarrheab. Hyperextension of neckc. Low itched monotonous voiced. Increase in appetite and weight gain

52. While assessing a client with Parkinson’s disease, the nurse identifies bradykinesia when the client exhibits:

a. Muscle flaccidityb. Intentional tremorc. Paralysis of the limbsd. Lack of spontaneous movement

53. A nurse is caring for a client who is comatose. The nurse notes in the chart that the client is exhibiting decerebrate posturing. Based on this documented finding, the nurse expects to note which of the following?

a. Extension of the extremities after a stimulusb. Flexion of the extremities after a stimulusc. Upper extremity flexion with lower extremity extensiond. Upper extremity extension with lower extremity flexion

54. The nurse is caring for a comatose patient who has suffered a closed head injury.which intervention should the nurse implement to prevent an increase in the ICP?

a. Suctioning the airway every hourb. Elevating the head of the bed 15 to 40 degreesc. Turning the patient and changing his position every hourd. Marinating a well-lit room

55. The nurse explains to the patients family that which of the following disorders is characterized by progressive degeneration of the cerebral cortex?

a. Alzheimer’s diseaseb. Epilepsyc. Guillain-barre syndromed. Stroke

56. To encourage adequate nutritional intake for a patient with moderate Alzheimer’s disease, the nurse should:

a. Stay with the patient and encourage him to eatb. Help the patient fill out his menuc. Give the patient privacy during mealsd. Fill out the menu for the patient

57. The nurse is caring for a client with increase ICP/ which procedure is contraindicated in this case?a. EEGb. Skull x-raysc. Lumbar tapd. CT scan

58. An adult has a medical dx of increased ICP and is being cared for in the neurological unit.the nursing care plan includes positioning the head in proper alignment. The nurse realizes that these actions are effective because they act by:

a. Making it easier for the client to breathb. Preventing valsalva maneuverc. Promoting venous drainaged. Reducing pain

59. Which of the following reduces cerebral edema by constricting cerebral veins?a. Dexamethasoneb. Mechanical hyperventilationc. Mannitold. 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 confusedb. Opens eyes to pain, decorticates to pain, and does not speakc. Opens eyes to pain, no motor response, and has inappropriate speechd. Opens eyes spontaneously, obeys commands, and is oriented