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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 nurses response? Cataracts most commonlya. Are a result of chronic systemic disease

b. Are a result of aging process

c. Are a a result of injuries sustained early in life

d. Are a result of prolonged use of drugs

2. A client asks; What does the lens of my eye do? the nurse shouldexplain that the lens of the eye:

a. produces aqueous humor

b. 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 beingawake 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 wont have nauseaand vomiting after the surgery.

d. There is really nothing to fear about being awake.

Youll be given a medication that will help you relax.

4. A client with a cataract would most likely complain of whatsymptoms?

a. Halos and rainbows around lightsb. Eye pain and irritations which worsens at night

c. Blurred and hazy visions

d. 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 vessels

b. Dilation of the pupil and constriction of the bloodvessels

c. Constriction of pupil and blood vessels

d. 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 nurses best course ofaction?

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

occurs

d. Medicate the client with an anti emetic as ordered.

7. After returning home, the client will need to continue to instill eyedrops 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 patients face

c. Allows the sensitive cornea to adjust to the medication

d. Facilitates the distribution of the medication over the

eye surface

8. A client with detachment of the retina asks the nurse why it isnecessary to patch both of her eyes. The nurses reply should be

based on the knowledge that eye patches serve to:

a. Reduce rapid eye movements

b. Decrease the irritation caused by the light entering the

damaged eyec. Protect the injured eye from infection

d. 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 weeks

b. Activity level is determined by the clients tolerance;

she can be active as she wishes

c. Activity levels will be restricted for several months, so

she could plan on being sedentary

d. Activity can be returned to normal and may include

regular aerobic exercise

10. the client who has been treated for chronic open angle glaucomafor 5 years asks the clinic nurse, How does glaucoma damage my

eyesight? the nurses reply should be based on the knowledge that

COAGa. result from chronic eye inflammation

b. causes increased intraocular pressure

c. leads to the detachment of the retina

d. is caused by decreased blood flow to the retina

11. Which of the following signs and symptoms is most commonlyexperienced by clients with COAG?

a. Eye pain

b. Excessive lacrimation

c. Colored light flashes

d. Decreasing peripheral vision12. 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

dont run out of my eye. The nurse explains to the client that the

method he is now using may cause

a. Scleral stainingb. Corneal injury

c. Excessive lacrimation

d. 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 sulfate

b. Administer atropine sulfate

c. Teach deep breathing exercises

d. Teach leg exercises14. Which of the following clinical manifestations would the nurse

associate with acute angle-closure glaucoma?

a. Gradual loss of central vision

b. Acute light sensitivity

c. 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 nausea

b. Repeated swallowing

c. Rapid respiratory rated. Feeling of anxiety

16. The client is ready for discharge after surgery for a deviatedseptum. Which of the following discharge instructions would be

appropriate?

a. Avoid activities that elicit the valsalva maneuver

b. Take aspirin to control nasal discomfortc. Avoid brushing the teeth until the nasal packing is

removed

d. 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 hasunderstood 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 preventrespiratory 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 4mostells the nurse that he is having trouble hearing. What would be thenurses 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.

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19. Which of the following describes the effect of hearing aid for a

client with sensorineural hearing loss?

a. It makes sounds louder and clearer

b. It has no effect on hearingc. It makes sounds louder but not clearer

d. 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 fromwhich of the following condition?

a. Presence of fluid and cerumen in the external canalb. Sclerosis of the bones of the middle ear

c. 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 understandingthat a common cause of hearing loss in older adults is related to:

a. Accumulation of cerumen in the external canal

b. Accumulation of cerumen in the internal canal

c. External otitis

d. Exostosis22. The best method to remove cerumen from a clients ear involves

a. Inserting a cotton tipped applicator into the external

canal

b. Irrigating the ear gently

c. Using aural suctiond. Using a cerumen curette

23. To prepare the irrigation solution used for removal of cerumen, thenurse uses:

a. Normal saline

b. Sterile water c. Antiseptic solution

d. Lactated ringers solution

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

chronic otitis media?a. Ossiculoplasty

b. Tympanoplasty

c. Mastoidectomy

d. Myringotomy

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

conversation by

a. Assessing what the clients doctor has told herb. Describing the surgical procedure

c. Educating the client that the procedure will close theperforation and prevent recurrent infection

d. Informing the client that the procedure will improve her

hearing

26. A classic triad of symptoms associated with Menieres disease isvertigo, tinnitus and:

a. Headache

b. Otitis media

c. Fluctuating hearing loss

d. Vomiting

27. Which of the following statements of the client would indicate thatshe understands the expected course of Menieres disease?

a. The disease process will gradually extent to the eyes.

b. Control of the episodes is usually possible, but a cureis not yet available.

c. Continued medication will cure the disease.

d. Bilateral deafness is an inevitable outcome of thedisease.

28. The potential injury during an attack of Menieres 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 Menieres disease

except:

a. Antihistamines

b. Antiemetics

c. Diuretics

d. Glucocorticoids30. When assessing an older adult with macular degeneration the

nursed would expect to find:

a. Loss of central vision

b. Loss of peripheral vision

c. 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 forclients with adult macular degeneration (AMD)

b. To provide heath care regarding his condition

c. To promote a safe, effective environment

d. To improve vision

32. when admitting a blind female client to the hospital, the nurseshould:

a. Ask the client to have someone with her at all times

b. Encourage her to stay in bed until the nurse can assist

c. 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 side

c. 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 andconjunctivitis. When administering eye drops and eye ointments to

the same client, the nurse should:

a. Administer the drops, wait 5 minutes, and administer

the ointment

b. Administer the two medications togetherc. Administer the ointment, wait 30 minutes and

administer the drops

d. Ask the physician to prescribe both medications as

drops or ointments

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

with retinal detachment?

a. Dull, throbbing painb. Veil-like loss of vision

c. 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 hours

b. Report any eye pain to the doctor immediatelyc. Refrain from using a pillow under the bed

d. 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. Diabetes

b. Gastric ulcers

c. Emphysema

d. Pancreatitis

38. The nurse is teaching a patient with detached retina who underwenscleral buckling on the left eye. The procedure included gas

injection into the vitreous. Which of the following statements

indicates that the patient understands the nurses 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. Ill 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 lying

b. Prone

c. Supine

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d. 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 lights

c. Intraocular pressure of 15mmHg

d. Soft globe on palpation

41. A client with Bells palsy is distressed about the change in facial

appearance. The nurse tells the client about which of the followingcharacteristics of Bells 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 Bells

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 stress

b. 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 Bells 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 cheeks

c. Eye paralysis and ptosis of both eyes

d. 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 thefollowing precipitating factors for this event?

a. Not taking prescribed medication

b. Taking excess prescribed medicationc. Getting more sleep than usual

d. A decrease in food intake recently46. Benztropine mesylate (Cogentin) is prescribed to a client with a

diagnosis of Parkinsosns 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

medication

c. Sped time sitting in the sun to enhance effectiveness of

the medication

d. Expect episodes of vomiting and constipation whiletaking this medication

47. A nurse is reviewing the nursing care plan for a patient with a rightcerebrovascular accident (CVA) who has left side deficits. The

nurse notes a nursing diagnosis of unilateral neglect. The nursewould 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 side

b. Teach the client to scan the environment

c. 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 withsubarachnoid 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 spasm

c. Beta-adrenergic blocker used to decrease blood

pressure

d. Vasodilator that has an affinity for cerebral blood

vessels.

49. A nurse is in the room with a client when a seizure begins. The

clients entire body becomes rigid, and the muscles in all fourextremities alternate between relaxation and contraction.

Following the seizure, the nurse documents that the client has

experienced:

a. Absent seizure

b. Generalized tonic-clonic seizurec. Simple partial seizure

d. 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 showering

b. Push the lock-out button on the electric bed to keep the

bed in the lowest position

c. Keep all the lights on in the room at night

d. Assist the client to ambulate in the hallway51. When performing the history and physical examination of a client

with Parkinsons disease, the nurse should assess the client for:

a. Frequent bouts of diarrhea

b. Hyperextension of neck

c. Low itched monotonous voiced. Increase in appetite and weight gain

52. While assessing a client with Parkinsons disease, the nurse

identifies bradykinesia when the client exhibits:

a. Muscle flaccidity

b. Intentional tremorc. Paralysis of the limbs

d. Lack of spontaneous movement53. 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 thefollowing?

a. Extension of the extremities after a stimulus

b. Flexion of the extremities after a stimulus

c. Upper extremity flexion with lower extremity extension

d. Upper extremity extension with lower extremity flexion54. 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 hour

b. Elevating the head of the bed 15 to 40 degreesc. Turning the patient and changing his position every

hour

d. Marinating a well-lit room55. The nurse explains to the patients family that which of the

following disorders is characterized by progressive degeneration othe cerebral cortex?

a. Alzheimers disease

b. Epilepsy

c. Guillain-barre syndrome

d. Stroke56. To encourage adequate nutritional intake for a patient with

moderate Alzheimers disease, the nurse should:

a. Stay with the patient and encourage him to eat

b. Help the patient fill out his menu

c. 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. EEG

b. Skull x-raysc. Lumbar tap

d. 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 actionsare effective because they act by:

a. Making it easier for the client to breath

b. Preventing valsalva maneuver

c. Promoting venous drainage

d. Reducing pain59. Which of the following reduces cerebral edema by constricting

cerebral veins?

a. Dexamethasone

b. Mechanical hyperventilation

c. Mannitol

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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 isconfused

b. Opens eyes to pain, decorticates to pain, and does not

speakc. Opens eyes to pain, no motor response, and has

inappropriate speech

d. Opens eyes spontaneously, obeys commands, and is

oriented