Wk 11 Test
A client comes to the occupational health nurse complaining of eye irritation. The client works in a dusty, outdoor environment. Why should the nurse advise periodic blinking to this client? a. To clear the dust and particles from the surface of the eyes b. To prevent the collection of tears over the surface of the eye c. To minimize the impact of the wind on the eye and to trap foreign debris d. To control the amount of sunlight that enters the eye
A
A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear? a. Instillation of mineral oil b. Instillation of hot water c. Use of a small forceps d. Instillation of carbamide peroxide
A
A middle-aged client reports increasing difficulty reading the newspaper print. Which of the following nursing explanations best describes this type of refractive error? a. Loss of elasticity of the lens b. Lens has become cloudy and thick. c. Floaters in the eye increase with age. d. Client is nearsighted.
A
A nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about Ménière's disease? a. It is referred to as endolymphatic hydrops. b. It originates in the outer ear. c. It is referred to as lymphatic hydrops. d. It originates in the middle ear.
A
An eight-grade boy tells the school nurse that the eye doctor told him he had astigmatism and that meant his eyeball wasn't shaped right. The boy says he went home and looked in the mirror and both eyes looked just alike. What is the school nurse's best response? a. "Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes." b. "Astigmatism means that the inside of the eye is shaped differently than the inside of most eyes." c. "Astigmatism means that the eye is shaped more like an olive than most eyes." d. "Astigmatism means that the lens of the eye is more of an oval shape than the lens in most eyes."
A
At morning report, the nurse learns the assigned client is blind. Which question should the nurse ask the client upon initial assessment? a. "Can you perceive light and motion?" b. "Are you dependent with your care?" c. "Have you always been blind?" d. "What caused your vision problem?"
A
Audiometry is testing that measures hearing acuity precisely. Who does the nurse know can perform audiometric testing? a. audiologist b. school nurse c. office nurse d. hearing aide salesperson
A
The client is having a Weber test. During a Weber test, where should the tuning fork be placed? a. In the midline of the client's skull or in the center of the forehead b. Near the external meatus of each ear c. On the mastoid process behind the ear d. Under the bridge of the nose
A
The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working? a. Intraocular pressure 15 mm Hg b. Halos around lights c. Decrease in nausea and vomiting d. Reduced peripheral vision
A
The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern? a. meningitis b. labyrinthitis c. sinusitis d. mastoiditis
A
The nurse is caring for a client with symptoms of ototoxicity from aminoglycoside administration. On which structure does the medication produce the ototoxic effect? a. The eighth cranial nerve b. The tympanic membrane c. The auditory canal d. The cochlear nerve
A
The nurse is obtaining a history from a client complaining of ear pain and dizziness. Which assessment finding is the best evidence that the client has a perforated eardrum? a. Fluid draining in the external canal b. Inflammation and a reddened eardrum c. Elevated white blood cell count d. Pain has resolved
A
The nurse is teaching the family member how to instill ear drops to the client to remove impacted cerumen. What is important to teach this woman? a. Place the container in warm water before instillation. b. Insert the irrigating syringe deeply. c. Refrigerate before instillation. d. Direct the flow of the ear drops toward the eardrum.
A
The client has been diagnosed with objective vertigo. Which symptom would the nurse relate to the tentative diagnosis? a. Frequency of a headache b. A sensation of things moving c. Hearing ability fluctuations d. Pain in the outer ear
B
The nurse is working in the emergency department when a physician asks for help as the client is undergoing a Romberg test. In which position would the nurse stand to be most helpful? a. The nurse would stand laterally to the client, opposite side to where the physician is standing. b. The nurse would stand directly in front of the client. c. The nurse would stand between the client and physician. d. The nurse would stand across the room but in direct alignment from the client.
A
There are several types of hearing loss. Which type of hearing loss benefits most from the use of a hearing aid? a. conductive b. acquired c. genetic d. sensorineural
A
Which assessment finding would contraindicate the use of atropine in a client scheduled for general anesthesia? a. Glaucoma b. Cerebrovascular accident c. Detached retina d. Cataracts
A
Which nursing suggestion would be most helpful to the client with recurrent otitis externa? a. Place ear plugs into the ears before swimming. b. Avoid lying on the side of the affected ear. c. Flush the ear with hydrogen peroxide. d. Use a cotton applicator to ensure that the ear canal is dry.
A
While cleaning gutters, a client reports getting debris in the eyes. On inspection, no obvious foreign object is noted. Which of the following diagnostic evaluation techniques would be most beneficial for this client? a. Administer fluorescein dye. b. Assess intraocular movements. c. Obtain an x-ray for orbital fractures. d. Assess with tonometer.
A
The nurse is employed in an ear, nose, and throat (ENT) physician's office, obtaining a client history. The nurse documents the following client statements. Which symptoms may indicate a diagnosis of otosclerosis? Select all that apply. a. "I now notice a ringing in my ears especially when I lay down to sleep at night." b. "I can hear best when you put the tuning fork behind my ear." c. "It seems that I increasingly could not hear my kids talk to me." d. "I woke up on Monday and had ear pain with a marked decrease in hearing." e. "I can hear better when someone speaks in low tones."
A, B, C,
The nurse is working in a long-term care facility. Which clues does the nurse note which suggests that the client is not hearing what the nurse said? Select all that apply. a. The client withdraws from activity. b. The client responds inappropriately. c. The client does not want to be social. d. The client asks for surrounding sounds be increased. e. The client nods the head and smiles.
A, B, C, E,
When caring for a client with a foreign object removed from the eye, the nurse is most correct to assess the eye protective functions of which structures? Select all that apply. a. Eyelids and lashes b. Conjunctiva c. Sclera d. Aqueous humor e. Superior and inferior oblique muscles f. Tears
A, F
The nurse is assessing client's eyes as part of the inspection part of the assessment process. For which reason does the nurse identify a normal variation in the angle of the lateral and medial canthus? a. Chromosomal differences b. Ethnic differences c. Structural changes d. Cosmetic alterations
B
A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client? a. Ishihara polychromatic plates b. Amsler grid c. Slit lamp d. Visual field
B
A client has exhibited repeated return of hordeolum (sty). Which assessment finding is most important in determining care for this client? a. Use of disposable wash cloths b. Use of mascara c. Low blood sugar d. Antibacterial facial wash
B
A client has just been diagnosed with glaucoma. What teaching should the nurse include with this client? a. When they can read again b. Maintain regular bowel habits c. What vegetables to eat d. How long they have to wear dark glasses
B
A client has undergone enucleation. What complication of enucleation should be addressed by the nurse? A. nausea and vomiting B. hemorrhage C. hypotension D. pneumonia
B
A client, diagnosed with a cataract, comes into the clinic. What assessment should the nurse observe in this client? a. A burning sensation and the sensation of an object in the eye b. Blurred or cloudy visual image c. A swollen lacrimal caruncle d. Inability to produce sufficient tears
B
An elderly client with macular degeneration has received injections of angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening? a. Loss of peripheral field vision b. Central vision impairment c. Burning sensation of the eyes d. Blurred vision
B
Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? A. Avoid washing face and eyes for first 24 hours. B. Avoid any activity that can increase intraocular pressure. C. Only sleep on back. D. Apply protective patch to both eyes at bedtime.
B
Immediately following cataract removal, which symptom would be most alarming to the nurse? a. Fever b. Dry, tickling cough c. Dilation of the pupil d. Irritation in the operative eye
B
Miotic eye solutions are often ordered in the treatment of glaucoma. Which is the best nursing rationale for the use of this medication? a. Paralyzes ciliary muscles b. Constricts pupil c. Dilates the pupil d. Constricts intraocular vessels
B
The nurse is assisting in providing coordination of services between the physician's office and vision specialist's office for a client who is being referred for potential retinal surgery. Which eye care specialist will the nurse make the referral to? a. optometrist b. ophthalmologist c. ophthalmic technician d. optician
B
The nurse is assisting the client in planning care during exacerbations of Ménière's disease. Which diet would the nurse identify as appropriate at this time? a. A high-protein diet b. A low-sodium diet c. A calorie-controlled diet d. A low-fat diet
B
The nurse is assisting with the administration of a caloric stimulation test. Which client response would the nurse document as an expected response? a. headache b. nystagmus c. double vision d. dizziness
B
The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate? a. central b. conductive c. sensorineural d. mixed
B
The nurse is caring for a client who just returned from a trip requiring an airline flight. The client commented on how his ears hurt upon descent. The nurse is correct in stating which site as being the pressure equalizer in the ear? a. auricle b. Eustachian tube c. tympanic membrane d. labyrinth
B
The nurse is caring for a client who underwent surgery for a retinal detachment. The surgery included the injection of an air bubble to promote contact between the retina and choroids. What position should the nurse keep the client in? a. With the client's head slightly elevated b. With the face parallel to the floor c. With the client lying in a high Fowler's position d. With the client in an upright position
B
The nurse is caring for an 8-year-old and anticipates that the client has otitis externa from symptoms stated on the history. Which symptoms, from the history and physical examination, would confirm the diagnosis? a. Difficulty hearing b. Pus noted in the ear canal c. Inflammation around the tympanic membrane d. Discomfort in the ear
B
The nurse is caring for geriatric clients stating that they are prescribed reading glasses. Some individuals state needing assistance with seeing writing far away, and others need assistance with closer vision. The nurse is correct to understand that the aging visual changes relate to which of the following? a. Changes in refraction b. Changes in accommodation c. Changes in the visual field d. Changes in central vision
B
The nurse is completing a corneal light reflex test using a penlight. Which result would indicate a normal test result? a. The eyes follow the light in all four directions. b. The light reflection is in the same spot on each eye. c. The pupils have reaction to light. d. The client can see the light using peripheral vision.
B
The nurse is evaluating the independent care of a client recovering from a stapedectomy. Which action, made by the client, indicates a need for further teaching? a. Ensure assistance upon ambulation. b. The client uses clean technique to clean the wound. c. The client turns head slowly when family approaches. d. Taking antibiotics on a convenient schedule
B
The nurse is instructing a client on the benefits of a cochlear implant. The client asks, "How am I able to interpret sound?" The nurse credits which of the following as significant in the production of hearing? a. Internal processor b. Auditory nerve c. External microphone d. Amplifier
B
The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at home methods of cerumen removal is discouraged? a. Using warm glycerin or mineral oil to soften the cerumen b. Removing the cerumen by means of a cotton tip applicator c. Irrigating the ear with warm water and a rubber-bulb syringe d. Instilling 1 to 2 drops of half-strength peroxide in the ear
B
The nurse is obtaining a history on a client stating the inability to read the newspaper and even seeing detail when looking at an image. Which assessment test would add additional data for a diagnosis? a. Assess vision on the Snellen chart. b. Assess peripheral vision. c. Assess color vision. d. Assess if the pupils are equal and reactive to light.
B
The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception? a. Pallor and diaphoresis are first symptoms. b. Once symptoms occur, they will always be present. c. Repeated motion is the cause. d. Medications help the symptoms.
B
The occupational nurse is advising a customer service representative client on assistive devices for hearing because the client has progressive hearing loss. In discussing the options with the client, which type would be the last option offered by the nurse? a. Text-based telecommunications b. American Sign Language c. Battery-operated hearing aid d. Headsets with amplifiers
B
What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids? a. Sterile otitis media b. Serous otitis media c. Purulent otitis media d. Infectious otitis media
B
When caring for a client with progressive macular degeneration, which teaching measure is primary for client safety? a. Avoid bending over. b. Turn head side to side when walking. c. Avoid straining the eyes. d. Patch the affected eye.
B
Which nursing goal is a priority when caring for a client newly diagnosed with vertigo? a. Client will maintain therapeutic medication schedule. b. Client will remain safe while ambulating in the home. c. Client will have a caretaker with him or her in the home. d. Client will close eyes as needed to reduce symptoms.
B
Which of the following assessment findings is least helpful in identifying a cause of Ménière's disease? a. Head injury b. Food intolerance c. Allergic reactions d. Family history
B
Which of the following teaching items would be a priority in maintaining normal pressure range in the eye? a. Treat allergy symptoms promptly. b. Increase fiber in the diet. c. East small meals. d. Avoid reading.
B
The nurse is caring for a client with open-angle glaucoma. The nurse knows that this disease causes which of the following? Select all that apply. a. Atrophy of nerve fibers in the central area of the retina b. Atrophy of nerve fibers in the peripheral areas of the retina c. Degeneration of the optic nerve d. Edema of the cornea e. Edema of the lens
B, C, D,
A client is diagnosed with blepharitis. What symptoms should a nurse monitor in this client? a. A halo around the pupil b. A red pustule in the internal tissue of the eyelid c. Patchy flakes clinging to the eyelashes d. Redness surrounding the conjunctival sac
C
A client presents to the emergency room with symptoms of blurred vision. Which type of question would be best to ask first? a. "Did these symptoms come on abruptly?" b. "Do you have a family history of vision problems?" c. "Have you ever had these symptoms before?" d. "Do you have any other diseases?"
C
A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure? a. Reverse optic nerve damage b. To relieve pain c. Improve outflow drainage d. Restore vision
C
A nurse is assessing a pediatric client in a public health clinic. The parent states that the client has been sneezing and rubbing the eyes. The nurse looks at the client's eyes and documents objective symptoms of watery and red eyes. When reporting to the physician the assessment findings, which word is appropriate? a. proptosis b. nystagmus c. conjunctivitis d. ptosis
C
An elderly client is scheduled for cataract surgery and asks the nurse, "Will I need to wear pop-bottle lenses after surgery?" Which is the most appropriate response from the nurse? a. "They can make corrective lenses much thinner now." b. "Contact lenses are preferred by most clients after this surgery." c. "An implanted lens has replaced the need for corrective glasses." d. "No lens is necessary with cataract surgery."
C
The client is consulting with a physician regarding a potential diagnosis of Ménière's disease. The nurse is assisting in positional testing and documentation. Which diagnostic test would the nurse anticipate to obtain a more precise evaluation of vestibular function? a. audiometry b. caloric stimulation test c. electronystamography d. Romberg test
C
The nurse is assessing a client for objective symptoms of hearing difficulties. Which symptom leads the nurse to take alternate measures to ensure client understanding of teaching? a. The client interrupts by asking the nurse to repeat instruction. b. The client is quiet and responds appropriately. c. The client leans forward and turns the head. d. The client quietly reads the instructional literature.
C
The nurse is assessing a client's hearing using the Rinne test. When providing instruction to elicit client feedback, which instruction is essential? a. Raise your hand when the sound exceeds the vibration. b. Raise your hand when you hear the vibration. c. Raise your hand when you no longer hear sound. d. Raise your hand when the vibration exceeds the sound.
C
The nurse is caring for a client being treated for Ménière's disease. Which medication is monitored closely due to its addictive properties? a. promethazine b. meclizine c. diazepam d. hydrochlorothiazide
C
The nurse is caring for a client ordered multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal? a. ultrasonography b. retinal imaging c. retinal angiography d. retinoscopy
C
The nurse is caring for a client who is post-stapedectomy. What would the nurse include in the nursing care? a. Keep the affected ear packed with cotton. b. Place the client on the operative side. c. Assess the facial nerve. d. Encourage the client to exercise within 24 hours.
C
The nurse is caring for a client with increased fluid accumulation in the eye. When assessing the client, which structure within the eye is noted to drain fluid from the anterior chamber? a. canthus b. choroid c. canals of Schlemm d. fovea centralis
C
The nurse is evaluating the client while taking the color vision test. Which response would the nurse anticipate when caring for a client with normal color vision? a. The nurse would anticipate responding to the color names in the pictures. b. The nurse would anticipate no differentiation in between colors. c. The nurse would anticipate the client identifying numbers and shapes. d. The nurse would anticipate a cross-eyed appearance.
C
The nurse is instructing a nursing student when a new client comes to the eye clinic. The client explains that he thinks he has a corneal abrasion. The nurse should explain what to the student nurse? a. "To detect corneal abrasions, retinal angiography is used." b. "To detect corneal abrasions, an ophthalmoscope is used." c. "To detect corneal abrasions, a slit lamp is used." d. "To detect corneal abrasions, ultrasonography is used."
C
The nurse is obtaining a visual history from a client who has noted an increased in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? a. Identification of yellowish aging spot on the retina b. Identification of white circle around the cornea c. Identification of opacities on the lens d. Identification of redness of the sclera
C
The nurse is teaching a parent how to instill drops in their 12-year-old son's eyes. Which action would the nurse teach the parent is accomplished first? a. Close the eye gently. b. Do not allow the tip of the container to touch the eye. c. Tilt the head slightly backward. d. Instill the prescribed number of drops into the conjunctival pocket.
C
The nurse is working in the triage section of a walk-in clinic. Which triad of common symptoms, when placed together, indicate Ménière's disease? a. Syncope, vertigo, ear pain b. Blurred vision, vertigo, nausea c. Hearing loss, vertigo, tinnitus d. Disorientation, vertigo, nausea
C
The nursing student is taking an anatomy and physiology class. What anatomical structure equalizes air pressure in the middle ear? a. the malleus b. the pinna c. Eustachian tube d. the meatus
C
The nurse is obtaining subjective data from a client with difficulty hearing. In order to assist the client in hearing the nurse's voice, which adjustments are made? Select all that apply. a. Use high-pitched tones b. Speak in a louder volume c. Speak in a lower tone d. Clearly articulate e. Face the client when speaking f. Speak in a clear voice
C, D, E, F,
An elderly client is admitted with the diagnosis of retinal detachment and is scheduled for laser surgery and scleral buckling procedure. The nurse anticipates which of the following symptoms to be exhibited in this client? Select all that apply. a. Loss of central vision b. Eye pain c. Flashing lights d. Complete loss of vision in both eyes e. Arcus senilis f. Cobwebs in vision field
C, F
A 24-year-old female client is diagnosed with otosclerosis. Which teaching is most accurate? a. Medications can interfere with birth control pills. b. Menstrual periods may be longer and more severe. c. Females otosclerosis is linked with infertility. d. Symptoms may be accelerated by pregnancy.
D
A client is diagnosed with keratitis. What advice should the nurse give this client? a. Use warm soaks frequently. b. Massage the surrounding area. c. Wash the face and hair frequently. d. Use dark glasses.
D
A client is diagnosed with uveitis. Which assessment finding is most important in determining likelihood of recurrence? a. Extended contact use b. Chemical exposure c. Glaucoma d. Ankylosing spondylitis
D
A client states having difficulty noting details on faces or television. Which of the following structures of the eye allows for detailed vision? a. the cornea b. the iris c. the pupil d. the macula lutea
D
A nurse is assessing a client for a fracture to the bony orbit. What would the nurse document if her assessment for fracture was positive? a. There is excessive tearing. b. A rust ring is seen around the pupil. c. The client's vision is blurred. d. The client has diplopia.
D
A nurse is doing preoperative and postoperative teaching with a client who is undergoing cataract surgery. What is an important teaching point the nurse should teach the client about? a. Development of a periorbital hematoma b. Feelings of depression c. Increased urine output d. Eat soft, easily chewed food until healing is complete
D
A nursing student is presenting a report on Ménière's disease to other members of the class. What symptom would the student list? a. Pinkish-orange eardrum b. Enlarged lymph nodes behind the ear c. Swelling and redness in the auditory canal d. Nystagmus of the eyes
D
During a pharmacology class, the students are told that some drugs need to be closely monitored. What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides? a. Reduced urinary output b. Signs of hypotension c. Impaired facial movement d. Tinnitus and sensorineural hearing loss
D
Following an ophthalmologic exam, an anxious client asks the nurse, "How serious is a refraction error?" Which of the following is the best response from the nurse? a. "Simple surgery can fix this problem." b. "This is normal for anyone your age." c. "It is nothing serious." d. "It means corrective lenses are required."
D
The nurse is assisting the eye surgeon in completing an examination of the eye. Which piece of equipment would the nurse provide to the physician to examine the optic disc under magnification? a. retinoscope b. tonometer c. Amsler grid d. ophthalmoscope
D
The nurse is conducting hearing tests at the local junior high school. Which of the following indicates normal hearing in a child? a. A client for whom the painful sound occurs at 100 dB b. A client who first perceives sound at 40 dB c. A client for whom the painful sound occurs at 80 dB d. A client who first perceives sound at 20 dB
D
The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand? a. A 40-feet distance b. A 10-feet distance c. A 30-feet distance d. A 20-feet distance
D
The nurse is instructing a client's family members on the most incapacitating symptom of Ménière's disease. Which nursing instruction associated with the symptom is most helpful? a. Keep a bucket beside the bed. b. Ensure low lighting in the room. c. Sit in front of the client when speaking. d. Assist the client when ambulating.
D
The nurse is obtaining a history from a client who indicates hearing loss due to drug toxicity. Which type of hearing loss is noted? a. conductive b. mixed c. central d. sensorineural
D
The nurse is supervising a family member who is instilling ear drops into the client's ear. Which of the following statements, made by the family member, would require further nursing instruction? a. "I squeeze the dropper to put a drop of medicine in the ear." b. "Turn your head to the side so I can put these drops in." c. "Let me put this cotton ball in your ear because I put the drop in." d. "These drops are cold from being on the window seal."
D
The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis? a. The client describing a recent upper respiratory infection b. The client being distressed in the mornings c. A red and swollen ear drum d. A progressive, bilateral loss of hearing
D
What is located in the cochlea of the inner ear? a. vestibulocochlear nerve b. semicircular cananls c. labyrinth d. organ of Corti
D
Which technique would be most beneficial for ambulation of a client who is visually impaired? a. Speak before touching the client. b. Provide the client with a see-eye guide dog. c. Provide a detailed description of the room and walkway. d. Allow client to follow your lead.
D
