Exam 2 EAQ

Which instructions would the nurse give a 60-year-old client who is at an increased risk for corneal damage? Select all that apply -use saline drops -increase humidity at home -wear prescribed lens for best vision -have corrective lenses solely for reading

-'use saline drops' -'wear prescribed lens for best vision' -'have corrective lenses solely for reading'

To avoid complications in a client who has developed severe bone marrow depression after receiving chemotherapy for cancer, which actions by the nurse are appropriate? Select all that apply.

-wash hands b4 entering the client's room -advise use of a soft toothbrush for oral hygiene -report an elevation in temp immediately

Which medication would the nurse anticipate may be prescribed to produced diuresis and inhibit formation of aqueous humor for a client with glaucoma?

acetazolamide

Which explanation would the nurse provide a client who asks what a cataract is?

an opacity of the lens

a client presents with hearing loss in the right ear. When the nurse performs a Weber test with a running fork, the client hears the sound better with the right ear. Which condition would the nurse suspect form these results?

conduction hearing loss

Which client condition is likely to improve significantly with the use of hearing aids? -destruction off the auditory nerve -diminished sensitivity of the cochlea -perforation off the tympanic membrane -immobilization off the auditory ossicles

diminished sensitivity of the cochlea

A client who is receiving methotrexate for cute lymphocytic leukemia (ALL) develops a temperature of 101 degrees F (38.3 degrees C), and the health care provider prescribes aspirin 650 mg every 4 hours as needed. Which action would the nurse take regarding this new prescription?

express concern about the type of antipyretic prescribed

When caring for a client with iron-deficiency anemia, which abnormal lab value will the nurse expect?

increased total iron-binding capacity (TIBC)

After many episodes of otitis media a 3-year-old child is to undergo myringotomy and have tubes implanted surgically. Which should the nurse include int he discharge preparation for this family?

insert earplugs during the child's bath

The nurse is preparing a child who has undergone a myringotomy for discharge. Which would the parents be taught about their child's care at home?

insert earplugs whenever a bath is given

Which structure helps bend light rays and allows them to fall onto the retina? -lens -zonule -cornea -aqueous humor

lens

After performing an optical assessment non a client, a primary health care provider notices impaired near vision. Which other finding in this client confirms the diagnosis as presbyopia?

loss of elasticity of the lesn

Which topic will the nurse include when teaching a client who has a new diagnosis of polycythemia vera?

need for high fluid intake

The nurse assess a client who complains of rapid, involuntary movement of the eyes after a minor eye injury. Which condition would the nurse suspect?

nystagmus

Which complication would the nurse expect if strabismus is not corrected in early childhood?

partial loss of sight

Which expected surgical outcome would the nurse include in the preoperative teaching for a client scheduled for a labyrinthectomy to treat Meniere syndrome?

permanent irreversible deafness

Which goal is the nurse trying to achieve by reinforcing to the client that it is important to seek treatment for primary open-angle glaucoma (POAG)?

prevent blindness

A client with pulmonary tuberculosis develops tinnitus and vertigo. Which antitubercular medication would the nurse suspect is causing these symptoms?

streptomycin

A 60-year-old client with gastric cancer has a shiny tongue, paresthesias of the limbs, and ataxia. The lab results show cobalamin levels of 125 pg/mL. Which medication would the nurse expect to be prescribed for the client?

vitamin B12 injections

The nurse is teaching a client about caring for a hearing aid. Which statements made by the client indicate the need for further learning? Select all that apply.

-'I should always keep my hearing aid on' -'I can use hair sprays and hair oil while wearing a hearing aid

Which actins would be considered in the collaborative plan of care for a client with increased lens density? Select all that apply/

-performing phacoemulsification -monitoring the client's blood glucose levels -assessing if the client is on antiplatelet medication

Which type of brain tumor can originate from cells that form the myelin sheath around nerves?

acoustic neuroma

A client reports feeling nauseated immediately after cataract surgery. Which action would the nurse take?

administer the prescribed antiemetic

After cataract surgery, a client reports felling nauseated. How can the nurse prevent vomiting?q

administer the prescribed antiemetic medication

Which situation may occur id monocular strabismus is not corrected early?

amblyopia will progress in the weaker eye

While assessing the eyes of a client, a health care provider notices there is an obstruction o the outflow of aqueous humor. Which additional finding would be noted to support a diagnosis of glaucoma?

elevated intraocular pressure

A client has a partial loss of peripheral vision. The client's eye examination report shows an intraocular pressure of 24 mm Hg. Which condition would the nurse suspect is causing these findings?

excess production of aqueous humor

Which assessment technique will the nurse avoid in a client with a suspected hematological disease? -auscultating heart sounds -palpating inguinal lymph nodes -percussing the costovertebral angle -palpating the abdominal left upper quadrant

palpating the abdominal left upper quadrant

The nurse assess a client for the development of pernicious anemia after reviewing the client's history. Which condition did the nurse most likely find in the history?

partial gastrectomy

A primary health care provider diagnoses the client's condition as otitis media. Which assessment finding supports that diagnosis?

redness of the eardrum

Which client statement is consistent with the presence of chalazion?

'I am unable to tolerate bright light'

Which statement made by a client who underwent a myringotomy indicates the need for further postoperative teaching?

'I can wash my hair after 2 days'

Which client statement indicates that the discharge teaching after a cataract extraction and an intraocular lens implant is effective?

'I should call the clinic of my eye begins to hurt'

Which statement by a client with cerumen accumulation indicates the need for further teaching?

'I will avoid irrigating my ear in the shower'

Which statement indicates that the preadolescent needs additional teaching regarding an impending bone marrow apsiration?

'I'll have to lie flat for 4 hours after the procedure'

When a client with newly diagnosed multiple myeloma asks, 'How long do you think I have to live?', which is the nurse's best response?

'tell me about what concerns you right now'

Which information would the nurse include in postoperative teaching for a client who had cataract surgery? Select all that apply.

-do not blow your nose -avoid bending from the waist

The nurse is caring for an older adult with hearing loss secondary to aging. Which would the nurse expect to identify when assessing this client? Select all that apply.

-dry cerumen -difficulty hearing high pitched voices

Which observation by the nurse indicates a client's decrease in hearing acuity? Select all that apply. -frequent use of words such as 'what' -postural changes while listening to the speaker -bending toward the other person while talking -mismatch between the questions asked and the responses given -startled expression to any unexpected sound in the environment

-frequent use of words such as 'what' -postural changes while listening to the speaker -bending toward the other person while talking -mismatch between the questions asked and the responses given

Which gerontologic assessment findings of the auditory system are related to the inner ear. Select all that apply.

-hair cell degeneration -reduced blood supply to the cochlea -less effective vestibular apparatus in the semicircular canals

The nurse is performing an eye assessment in an older adults. The older adult see near objects. Which conditions would be suspected in this older adult? Select all that apply.

-hyperopia -presbyopia

Which clinical findings would the nurse expect of a child with acute non lymphoid leukemia (acute myeloid leukemia)? Select all that apply.

-listlessness -bone marrow depression

Which muscle helps in moving the eye diagonally downward toward the middle of the head? Select all that apply.

-medial rectus muscle -inferior rectus muscle

When performing a focused assessment on a client with a possible diagnosis of iron deficiency anemia, which locations would the nurse examine? Select all that apply.

-nail beds -conjunctivae -palms of hands

Which clinical indicators would the nurse expect when assessing a client with Meniere disease? Select all that apply.

-nausea -dizziness -jerky lateral eye movements

When both parents have sickle cell trait, what is the chance that a child will have sickle cell disease? -25% -50% -75% -100%

25%

Which assessment finding would the nurse expect in an infant who has undergone myringotomy for recurrent otitis media?

drainage into the external auditory canal

Which finding int he client's history will alert the nurse to the most likely cause of the sensorineural hearing loss?

prolonged exposure to noise

A client who has multiple myeloma tells the nurse about plans for airline travel to visit family members. Which topic will the nurse include in discharge planning?

ways to prevent infection during travel

Which task can be delagated safely by the RN to unlicensed nursing personnel for a client with thrombocytopenia? -shaving the client -positioning the client -maintaining oral hygiene -giving IV platelet infusions

positioning the client

Which technique used by the nurse demonstrates medication safety and effectiveness when assisting an older client to instill prescribed eyedrops for glaucoma? -permitting 5 minutes to lapse between each drop -using an eyecup to assure drops are placed in the eye -administering 5 drops in each eye to total 10 drops -pressing the inner canthus for 1 to 2 minutes after instillation -placing cotton ball on the eye and hold gentle pressure after instillation

pressing the inner canthus for 1 to 2 minutes after instillation

Thee superior oblique muscle controls which eye movement?

pulls the eye downward

Which information, if reported by a client within 4 hours after repair of a retinal detachment, would the nurse plan to communicate to the primary health care provider? -has not voided -cannot open the eye -cannot remember the date -has sharp pain in the eye

has sharp pain in the eye

Which is being assessed when a school nurse conducts audiometric screenings?

hearing acuity

Which condition can cause a client severe pain after a cataract extraction?

hemorrhage into the eye

While inspecting the external eye structure of a client, the nurse finds bulging of the eye. Which condition would be suspected in the client?

hyperthyroidism

Which type of surgery would be planned for a client with degeneration of the corneal tissue?

keratoplasty

Which eye muscle is controlled by cranial nerve VI? -levator -lateral rectus -medial rectus -superior oblique

lateral rectus

The nurse concludes that the teaching about sickle cell anemia has been understood when an adolescent with the disorder makes which statement? -I'll start to have symptoms when I drink less fluid I'll start to have symptoms when I have fewer platelets -I'll start to have symptoms when I decrease the iron in my diet -I'll start to have symptoms when I have fewer white blood cells

'I'll start to have symptoms when I drink less fluid'

Which instruction will the nurse give a client recovering at home after ear surgery? -drink all liquids through a straw -you may wash your hair as soon as you get home -avoid excessive coughing and people who have had head colds -do not change the ear dressing - just reinforce it with more tape

'avoid excessive coughing and people who have head colds'

The nurse is teaching a client how to care for an eye infection. Which statement by the client reflects understanding of the teaching?

'wash your hands before and after washing and treating the eye'

Which statement correctly describes a bone marrow transplant?

'your child's immune system must be destroyed before the transplantation can take place'

The nurse is teaching a client about ear irrigation for serum removal at home. Which statements by the client indicate a need for further instruction. Select all that apply -I should fill the syringe with hot water -I should use a special ear syringe for wax removal -I should decrease the pressure if I feel any ear pain -I should use cotton to remove any extra water in my ear -I should irrigate until at least a cup of solution has been washed out of my ear canal

-'I should fill the syringe with hot water' -'I should use cotton to remove any extra water in my ear'

Which statement will the nurse include in the instructions for a client learning to self-administer eyedrops?

apply pressure to the nasolacrimal duct after instillation

An older adult is found to have a thin white ring around the margin of the iris. Which condition would the suggest?

arcus senilis

Which lab value will the nurse review to determine whether treatment for a client with a megaloblastic anemia has been successful? -serum iron -folate level -transferrin level -reticulocyte count

folate level

A client with multiple myeloma is scheduled to have a chest x-ray and bone scan. Which action is the priority responsibility of the nursing and radiology staff?

handle the client with supportive movements

After cataract surgery, the nurse teaches a client how to self-administer eyedrops. The nurse would reinforce the use of which technique?

holding the dropper tip above the conjunctival sac

Which actions would the nurse take when admitting a client having a sickle cell crisis to the nursing unit? -place on strict isolation -administer hydroxyurea -administer aspirin 325 mg daily -apply oxygen via nasal cannula -administer IV hydration -avoid opiate-type analgesics

-administer hydroxyurea -apply oxygen via nasal cannula -administer IV hydration

Which clinical manifestations of acute myelogenous (non lymphoid) leukemia (AML) would the nurse expect when assessing a child? Select all that apply -anorexia -petechiae -irritability -skin redness -listlessness -neuropathic pain

-anorexia -petechiae -irritability -listlessness

Which ophthalmic conditions can cause a client to have photophobia? Select all that apply.

-chalazion -trachoma -keratoconjunctivitis sicca

Which factors in a client's health history increase the risk of hearing loss? Select all that apply.

-diabetes -noisy environment -ear infections -loud music

Which clinical findings would the nurse anticipate when assessing a child with newly diagnosed acute lymphoblastic leukemia? Select all that apply.

-pallor -fatigue -multiple bruises

Which integumentary changes can be anticipated in a client with a platelet count go 60,000 (60 x 10^9/L)? Select all that apply.

-petechiae -ecchymosis -hematoma

Which food selection by a client with Meniere disease provides evidence that the nurse's teaching was effective?

macaroni

Which structure is a component of the auditory ossicles? -malleus -vestibule -tympanic membrane -external acoustic meatus

malleus

When a client develops iron-deficiency anemia, which of the client's lab test results would the nurse expect to be decreased? -ferritin level -platelet count -white blood cell count -total iron-binding capacity

ferritin level

Which information would the nurse include in explaining glaucoma to a client?

an increase in the pressure within the eyeball

Which is the priority emergency department nursing intervention for victims of a mine explosion who were exposed to dynamite and have injuries caused by a supersonic over-pressurization shock wave? -administering whole blood as needed -administering IV antibiotics as prescribed -assessing for liver, long bones, and eyes immediately -assessing for lung, GI tract, and middle ear injuries immediately

assessing for lung. GI tract, and middle ear injuries immediately

Which condition is associated with unevenly curved surfaces of the client's cornea?

astigmatism

Which ophthalmic solution is contraindicated for clients with glaucoma?

atropine

Which instruction is important for the nurse to provide to the client after cataract surgery? -remain flat for 3 hours -eat a soft diet for 2 days -breathe and cough deeply -avoid bending from the waist

avoid bending from the waist

The student nurse demonstrates correct understanding of anemia related to chronic disease with which statement?

'red blood cells (RBCs) are normal in size and color; however, the number of cells produced is decreased'

The measured hemoglobin level of a 30-year-old female client was 8 mg/dL (80 g/L). Which integumentary findings would the nurse identify in this client? Select all that apply.

-pallor -brittle nails -koilonychia

When caring for a client with multiple myeloma, which diagnostic test result will the nurse expect? -occult blood in the stool -low serum calcium levels -bence jones protein in the urine -positive bacterial culture off sputum

bence jones protein in the urine

Which finding would the nurse expect when assessing the nasal passages of a client with thrombocytopenia?

blood clots

When a client with multiple myeloma has questions about the disease and treatment, which information would the nurse include in the client's teaching?

blood transfusion may be necessary

Which test is used to diagnose diseases of the vestibular system? -rinne test -caloric reflex test -pure-tone audiometry -auditory brainstem response

caloric reflex test

The nurse is assessing a client working in a glass factory. Which occupational hazard would the nurse assess the client for?

cataracts

A 62-year-old client reports to the nurse, 'My eyes don't feel right, and I have a gritty and sandy sensation in my eyes.' Which condition might this client have?

changes in tear composition

Which information would the nurse include about future treatment and precautions when teaching a client who has glaucoma?

continuation of therapy for life

Which physiological process can be corrected with a prescribed convex lens? -constriction of the pupil -convergence of images behind the retina -descent of inverted images onto the retina -presence of an unevenly curved retinal surface

convergence of images behind the retina

When a client who has sickle cell anemia has been admitted with acute chest syndrome, which prescribed treatment would the nurse question? -oxygen administration -daily folic acid tablet -daily iron supplement -morphine sulfate as needed

daily iron supplement

Which is the priority nursing intervention to prevent thrombus formation in a child with sickle cell anemia?

encouraging fluids

What does the nurse know is the parental genotypic makeup of sickle cell disease? -father heterozygous (sickle trait), mother heterozygous (sickle trait) -mother homozygous (no sickle trait), father heterozygous (sickle trait) -father homozygous (no sickle trait), mother heterozygous (sickle trait) -mother homozygous (has sickle cell disease), father is homozygous (no sickle trait)

father heterozygous (sickle trait), mother heterozygous (sickle trait)