Question 1

The priority nursing diagnosis for a patient with Ménière's disease who is experiencing an acute attack is

Accepted Answer

A)   risk for falls related to dizziness.
B)   impaired verbal communication related to tinnitus.
C)   self-care deficit (bathing and dressing)  related to vertigo.
D)   imbalanced nutrition: less than body requirements related to nausea. A

Question 2

A patient with glaucoma who has been using timolol ( Timoptic ) drops for several days tells the nurse that the eyedrops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is

Accepted Answer

A)   "These are normal side effects of the drug, which should become less noticeable with time."
B)   "If you occlude the puncta after you administer the drops, it will help relieve these side effects."
C)   "The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision."
D)   "These symptoms are caused by glaucoma and may indicate a need for an increased dosage of the eyedrops." C

Question 3

The nurse is assessing a patient who has recently been treated with amoxicillin (Amoxil) for acute otitis media of the right ear. Which assessment data obtained by the nurse is of most concern?

Accepted Answer

A)   The patient has a temperature of 100.6° F.
B)   The patient complains of "popping" in the ear.
C)   The patient frequently asks the nurse to repeat information.
D)   The patient states that the right ear has a feeling of fullness. A

Question 4

A patient is diagnosed with adult inclusion conjunctivitis ( AIC ) caused by Chlamydia trachomatis. Which of these actions will be included in the plan of care?

Accepted Answer

A)   Discussing the need for sexually transmitted disease testing
B)   Applying topical corticosteroids to prevent further inflammation
C)   Assisting with applying for community visual rehabilitation services
D)   Educating about the use of antiviral eyedrops to treat the infection

Question 5

To decrease the risk for future hearing loss, which action should the nurse working with college students at the on-campus health clinic implement?

Accepted Answer

A)   Arrange to include otoscopic examinations for all patients.
B)   Administer rubella immunizations to all students at the clinic.
C)   Discuss the importance of limiting exposure to very amplified music.
D)   Teach patients to regularly irrigate the ear to decrease cerumen impaction.

Question 6

Which assessment finding in a patient who was struck in the right eye with a baseball is a priority for the nurse to communicate to the health care provider in the emergency department?

Accepted Answer

A)   The patient complains of a right-sided headache.
B)   The sclerae on the right eye have broken blood vessels.
C)   The area around the right eye is bruised and tender to the touch.
D)   The patient complains of "a curtain" blocking part of the visual field.

Question 7

A patient with Ménière's disease is admitted with vertigo, nausea, and vomiting. Which nursing intervention will be included in the care plan?

Accepted Answer

A)   Keep the patient's room darkened.
B)   Encourage oral fluids to 3000 ml daily.
C)   Change the patient's position every 2 hours.
D)   Keep the head of the bed elevated 30 degrees.

Question 8

A patient who is being admitted to the hospital for abdominal pain and nausea tells the nurse about a history of glaucoma. Which of these prescribed medications should the nurse question?

Accepted Answer

A)   morphine sulfate 4 mg IV
B)   diazepam ( Valium )  5 mg IV
C)   betaxolol ( Betoptic )  0.25% eyedrops
D)   scopolamine patch ( Transderm Scop )  1.5 mg

Question 9

A patient with age-related macular degeneration has just had photodynamic therapy. Which statement by the patient indicates that the discharge teaching has been effective?

Accepted Answer

A)   "I will need to use bright lights to read for at least the next week."
B)   "I will use drops to keep my pupils dilated until my appointment."
C)   "I will not use facial lotions near my eyes during the recovery period."
D)   "I will keep covered with long-sleeved shirts and pants for the next 5 days."

Question 10

A patient with chronic otitis media is scheduled for a tympanoplasty. Before surgery, the nurse teaches the patient that postoperative expectations include

Accepted Answer

A)   keeping the head elevated.
B)   the need for prolonged bed rest.
C)   avoidance of coughing or blowing the nose.
D)   continuous antibiotic irrigation of the ear canal.

Question 11

When the nurse is admitting a 78-year-old patient, the patient repeatedly asks the nurse to "speak up so that I can hear you." Which action should the nurse take?

Accepted Answer

A)   Overenunciate while speaking.
B)   Speak normally but more slowly.
C)   Increase the volume when speaking.
D)   Use more facial expressions when talking.

Question 12

Which information will the nurse include when teaching a patient with keratitis caused by herpes simplex type 1?

Accepted Answer

A)   Application of corticosteroid ophthalmic ointment to the eyes.
B)   Application of povidone-iodine (Betadine)  gel around the eye.
C)   Avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) .
D)   Importance of taking all of the ordered oral acyclovir (Zovirax) .

Question 13

When admitting a patient for surgery, the nurse learns that the patient has functional blindness and that the spouse has cared for the patient for many years. During the initial assessment of the patient, it is most important for the nurse to

Accepted Answer

A)   obtain more information about the cause of the patient's vision loss.
B)   obtain information from the spouse about the patient's special needs.
C)   make eye contact with the patient and ask about any need for assistance.
D)   perform an evaluation of the patient's visual acuity using a Snellen chart.

Question 14

A patient with a left retinal detachment has a pneumatic retinopexy procedure. Which information will be included in the discharge teaching plan?

Accepted Answer

A)   The use of bilateral eye patches to reduce movement of the operative eye
B)   The need to wear dark or tinted glasses to protect the eyes from bright light
C)   The procedure for sterile dressing changes when the eye dressing is saturated
D)   The purpose of maintaining the head in a prescribed position for several weeks

Question 15

An older adult patient with presbycusis is fitted with binaural hearing aids. Which information will the nurse include when teaching the patient how to use the hearing aids?

Accepted Answer

A)   Experiment with volume and hearing ability in a quiet environment initially.
B)   Keep the volume low on the hearing aids for the first week while adjusting to them.
C)   Add the second hearing aid after making the initial adjustment to the first hearing aid.
D)   Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.

Question 16

Which topic will the nurse include in patient teaching after a patient has had outpatient cataract surgery and lens implantation?

Accepted Answer

A)   Use of oral opioids for pain control
B)   Administration of antibiotic eyedrops
C)   Importance of coughing and deep breathing exercises
D)   Need for bed rest for the first 24 hours after the surgery

Question 17

To evaluate the effectiveness of the prescribed bifocals for a patient with myopia and presbyopia, the nurse in the eye clinic will check the patient for

Accepted Answer

A)   strength of the eye muscles.
B)   both near and distant vision.
C)   cloudiness in the eye lenses.
D)   intraocular pressure changes.

Question 18

Which topic will the nurse plan to include when teaching the patient with herpes simplex keratitis of the left eye about management of the infection?

Accepted Answer

A)   How to apply an occlusive dressing to the affected eye
B)   Need for frequent hand washing and avoiding touching the eyes
C)   Application of antibiotic drops to the left eye several times daily
D)   Use of corticosteroid ophthalmic ointment to decrease inflammation

Question 19

Which teaching will the nurse implement for a patient who has just been diagnosed with viral conjunctivitis?

Accepted Answer

A)   Explain the purpose of antiviral eyedrops.
B)   Show how to perform eye irrigation safely.
C)   Instruct about how to insert soft contact lenses.
D)   Demonstrate appropriate hand-washing technique.

Question 20

The charge nurse observes a newly hired nurse performing all of the following interventions for a patient who has just arrived in the postanesthesia care unit after having right cataract removal and an intraocular lens implant. Which one requires that the charge nurse intervene?

Accepted Answer

A)   The nurse leaves the eye shield in place.
B)   The nurse encourages the patient to cough.
C)   The nurse elevates the patient's head to 45 degrees.
D)   The nurse applies corticosteroid drops to the right eye.

Exam 22: Nursing Management: Visual and Auditory Problems