exam practice 1 questions

The patient is scheduled to have surgery to manage glaucoma. The patient correctly explains that the procedure will: a. increase outflow of aqueous humor. b. reduce amount of vitreous humor. c. widen pupils. d. reduce pain.

: A Glaucoma is a condition that causes increased ocular pressure. Surgical management for the condition seeks to provide an increased outflow of aqueous humor.

The nurse recognizes the need for further discharge education when the patient says: a. "I have no idea of how this drug will affect me." b. "Do you know if my physician is coming back today?" c. "Will my insurance pay for my stay?" d. "Am I going to have to go to a nursing home?"

ANS: A Lack of knowledge at discharge about medication effects and side effects is a concern that should be addressed by the vocational nurse. The other concerns in the options are the responsibility of other departments to which the nurse might refer the patient.

While assessing a group of patients, the nurse recognizes the patient who could qualify for Medicaid benefits is the: a. 35-year-old unemployed single mother with diabetes. b. 70-year-old Medicare recipient with retirement income who needs to be in a long-term care facility. c. 80-year-old blind woman living in her own home who has inadequate private insurance. d. 67-year-old stroke victim with Medicare Part A and an income from investments

ANS: A Medicaid is a joint effort of federal and state governments geared primarily for low-income people with no insurance.

When the patient asks the nurse what his Medicare Part A covers, the nurse responds that it covers: a. inpatient hospital costs. b. reimbursement to the physician. c. outpatient hospital services. d. ambulance transportation.

ANS: A Medicare Part A covers inpatient hospital expenses, drugs, x-rays, lab work, and intensive care. Medicare Part B pays the physician, ambulance transport, and outpatient services.

What is the most appropriate nursing intervention for a patient with presbycusis? a. Speak clearly and distinctly while facing the patient. b. Announce your presence when entering the patient's room. c. Place needed articles within easy reach. d. Orient the patient to time and place as needed.

ANS: A Presbycusis is hearing loss. Get the patient's attention so that the patient can concentrate on what you are saying or read lips.

What factor increases the risk of respiratory infection for older adults? a. Decreased ciliary action b. Decreased physical activity c. Inadequate hydration d. Poor personal hygiene

ANS: A The ability to perform strenuous work decreases with age. The ciliary action responsible for movement of secretions from the lung is compromised because of epithelial atrophy.

Postoperative teaching for a person who has had a cataract removed from the left eye would include: (Select all that apply.) a. sleeping on the right side. b. taking a stool softener to avoid straining at stool. c. bending over from the waist; not stooping. d. providing instruction for instilling eyedrops. e. providing instruction on signs of complications.

ANS: A, B, D, E The patient should not bend from the waist as the position increases intraocular pressure.

The nurse has completed the assessment on a newly admitted patient. Which findings would be associated with the development of cataracts? (Select all that apply.) a. Two-pack-a-day smoker for the last 10 years b. Radiation therapy for cancer completed 1 month ago c. Postmenopausal hormone replacement therapy d. Asthmatic on long-term corticosteroid protocol

ANS: A, D A cataract is opacity of the lens that produces an effect similar to one a person would get when looking through a sheet of falling water. Cataracts cause a blurring of vision because the lens, which is normally transparent, becomes cloudy and opaque. Most often cataracts occur as a result of aging and are found in people over age 50. Traumatic cataracts may occur from a physical blow, extreme heat, or chemical toxins. Cigarette smoking increases the risk of developing cataracts. Heavy drinking also is implicated. Chronic use of corticosteroids predisposes to the development of cataracts.

A patient is suspected of having macular degeneration. During the assessment the patient is asked to focus on an image. What evidence will support the diagnosis? a. The patient only sees disconnected pieces of the image. b. The patient sees a dark spot in center of what is viewed. c. The patient sees nothing in the peripheral vision. d. The patient sees wavy lines and bright flashing lights.

ANS: B The person with macular degeneration sees a dark spot in his central vision. Peripheral vision is not affected until later in the disease.

The nurse reviews the classic symptoms of a cataract, which are: (Select all that apply.) a. nystagmus. b. troubled by glare. c. increased myopia. d. color distortion. e. night blindness.

ANS: B, C, D, E A cataract is opacity of the lens that produces an effect similar to one a person would get when looking through a sheet of falling water. A cataract causes a blurring of vision because the lens, which is normally transparent, becomes cloudy and opaque. Nystagmus is not a symptom of a cataract. All other options are classic symptoms of a person with a developing cataract.

What are the effects of aging on the nervous system? a. Accelerated loss of neurons in the brain b. Gradually declining loss of intellectual capability c. Decreased conduction speed of neurons d. Loss of long-term memory

ANS: C Age-related effects on body systems are integral parts of the basis of nursing care for older adults. The aging nervous system is characterized by decreased conduction speed of neurons

Suggestions that a home health nurse could make to an elderly client with cataracts to reduce the risk of falls in his home would include a. arranging scatter rugs to prevent slipping on the hardwood floor. b. using lower-illumination bulbs to prevent eyestrain. c. using night lights in every room. d. wearing soft-soled house shoes indoors.

ANS: C The visual impairment requires increased illumination and an uncluttered environment. Soft-soled shoes enhance the fall potential as do scatter (or "throw") rugs.

The nurse planning a health promotion program with clients in the community will focus least on a. assisting the clients to make informed decisions. b. organizing methods to achieve optimal mental health. c. providing information and skills to maintain lifestyle changes. d. reducing genetic risk factors for illness.

ANS: D Health promotion programs are designed to improve the health and well-being of individuals and communities by providing people with information, skills, services, and support they need to undertake and maintain positive lifestyle changes. Genetic risks for illness cannot be controlled to promote health.

What should the nurse suspect a patient is developing when he is observed holding his Bible 6 inches from his face and turns his head to read out of the corner of his eyes? a. Cataracts b. Glaucoma c. Presbyopia d. Macular degeneration

ANS: D The leading cause of new blindness in old age is macular degeneration, which results in the loss of central vision.