22MD

Question 1

The nurse evaluates that wearing bifocals improved the patient’s myopia and presbyopia by assessing for

a. strength of the eye muscles.
b. both near and distant vision.
c. cloudiness in the eye lenses.
d. intraocular pressure changes.

Answer 1

b. both near and distant vision.

Question 2

A nurse should instruct a patient with recurrent staphylococcal and seborrheic blepharitis to

a. irrigate the eyes with saline solution.
b. apply cool compresses to the eyes three times daily.
c. use a gentle baby shampoo to clean the lids as needed.
d. schedule an appointment for surgical removal of the lesion.

Answer 2

c. use a gentle baby shampoo to clean the lids as needed.

Question 3

When assisting a blind patient in ambulating to the bathroom, the nurse should

a. take the patient by the arm and lead the patient slowly to the bathroom.
b. have the patient place a hand on the nurse’s shoulder and guide the patient.
c. stay beside the patient and describe any obstacles on the path to the bathroom.
d. walk slightly ahead of the patient and allow the patient to hold the nurse’s elbow.

Answer 3

d. walk slightly ahead of the patient and allow the patient to hold the nurse’s elbow.

Question 4

A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection?

a. Apply cold compresses at the first sign of recurrence.
b. Discard all open or used cosmetics applied near the eyes.
c. Wash the scalp and eyebrows with an antiseborrheic shampoo.
d. Be examined for recurrent sexually transmitted infections (STIs).

Answer 4

b. Discard all open or used cosmetics applied near the eyes.

Question 5

The nurse developing a teaching plan for a patient with herpes simplex keratitis should include which instruction?

a. Apply antibiotic drops to the eye several times daily.
b. Wash hands frequently and avoid touching the eyes.
c. Apply a new occlusive dressing to the affected eye at bedtime.
d. Use corticosteroid ophthalmic ointment to decrease inflammation.

Answer 5

b. Wash hands frequently and avoid touching the eyes.

Question 6

Which teaching point should the nurse plan to include when caring for a patient whose vision is corrected to 20/200?

a. How to access audio books
b. How to use a white cane safely
c. Where Braille instruction is available
d. Where to obtain specialized magnifiers

Answer 6

d. Where to obtain specialized magnifiers

Question 7

The nurse is developing a plan of care for an adult patient diagnosed with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which action should be included in the plan of care?

a. Discussing the need for sexually transmitted infection 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

Answer 7

a. Discussing the need for sexually transmitted infection testing

Question 8

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

a. Use of oral opioids for pain control
b. Administration of corticosteroid eye drops
c. Importance of coughing and deep breathing exercises
d. Need for bed rest for the first 1 to 2 days after the surgery

Answer 8

b. Administration of corticosteroid eye drops

Question 9

In reviewing a 55-year-old patient’s medical record, the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. The nurse will plan to assess

a. visual acuity.
b. pupil reaction.
c. color perception.
d. peripheral vision.

Answer 9

d. peripheral vision.

Question 10

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

a. The purpose of maintaining the head in a prescribed position
b. The use of eye patches to reduce movement of the operative eye
c. The need to wear dark glasses to protect the eyes from bright light
d. The procedure for dressing changes when the eye dressing is saturated

Answer 10

a. The purpose of maintaining the head in a prescribed position

Question 11

A 72-year-old patient with age-related macular degeneration (AMD) has just had photodynamic therapy. Which statement by the patient indicates that the discharge teaching has been effective?

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 cover up with long-sleeved shirts and pants for the next 5 days.”

Answer 11

d. “I will cover up with long-sleeved shirts and pants for the next 5 days.”

Question 12

To determine whether treatment is effective for a patient with primary open-angle glaucoma (POAG), the nurse can evaluate the patient for improvement by

a. questioning the patient about blurred vision.
b. noting any changes in the patient’s visual field.
c. asking the patient to rate the pain using a 0 to 10 scale.
d. assessing the patient’s depth perception when climbing stairs.

Answer 12

b. noting any changes in the patient’s visual field.

Question 13

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

a. “Those symptoms may indicate a need for an increased dosage of the eye drops.”
b. “The drops are uncomfortable, but it is important to use them to retain your vision.”
c. “These are normal side effects of the drug, which should be less noticeable with time.”
d. “Notify your health care provider so that different eye drops can be prescribed for you.”

Answer 13

b. “The drops are uncomfortable, but it is important to use them to retain your vision.”

Question 14

The nurse is completing the admission database for a patient admitted with abdominal pain and notes a history of hypertension and glaucoma. Which prescribed medications should the nurse question?

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

Answer 14

d. Scopolamine patch (Transderm Scop) 1.5 mg

Question 15

A patient who has bacterial endophthalmitis in the left eye is restless, frequently asking whether the eye is healing, and whether removal of the eye will be necessary. Based on the assessment data, which nursing diagnosis is most appropriate at this time?

a. Grieving related to current loss of functional vision
b. Anxiety related to the possibility of permanent vision loss
c. Situational low self-esteem related to loss of visual function
d. Risk for falls related to inability to see environmental hazards

Answer 15

b. Anxiety related to the possibility of permanent vision loss

Question 16

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

a. Arrange to include otoscopic examinations for all patients.
b. Administer influenza immunizations to all students at the clinic.
c. Discuss the importance of limiting exposure to amplified music.
d. Perform tympanometry on all patients between the ages of 18 to 24.

Answer 16

c. Discuss the importance of limiting exposure to amplified music.

Question 17

A patient diagnosed with external otitis is being discharged from the emergency department with an ear wick in place. Which statement by the patient indicates a need for further teaching?

a. “I will apply the eardrops to the cotton wick in the ear canal.”
b. “I can use aspirin or acetaminophen (Tylenol) for pain relief.”
c. “I will clean the ear canal daily with a cotton-tipped applicator.”
d. “I can use warm compresses to the outside of the ear for comfort.”

Answer 17

c. “I will clean the ear canal daily with a cotton-tipped applicator.”

Question 18

A patient who has undergone a left tympanoplasty should be instructed to

a. remain on bed rest.
b. keep the head elevated.
c. avoid blowing the nose.
d. irrigate the left ear canal.

Answer 18

c. avoid blowing the nose.

Question 19

The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the right ear. Which finding is a priority to report to the health care provider?

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.

Answer 19

a. The patient has a temperature of 100.6° F.

Question 20

A 42-year-old woman with Ménière’s disease is admitted with vertigo, nausea, and vomiting. Which nursing intervention will be included in the care plan?

a. Dim the lights in the patient’s room.
b. Encourage increased oral fluid intake.
c. Change the patient’s position every 2 hours.
d. Keep the head of the bed elevated 30 degrees.

Answer 20

a. Dim the lights in the patient’s room

Question 21

Which statement by the patient to the home health nurse indicates a need for more teaching about self-administering eardrops?

a. “I will leave the ear wick in place while administering the drops.”
b. “I should lie down before and for 5 minutes after administering the drops.”
c. “I will hold the tip of the dropper above the ear while administering the drops.”
d. “I should keep the medication refrigerated until I am ready to administer the drops.”

Answer 21

d. “I should keep the medication refrigerated until I am ready to administer the drops.”

Question 22

An 82-year-old patient who is being admitted to the hospital repeatedly asks the nurse to “speak up so that I can hear you.” Which action should the nurse take?

a. Overenunciate while speaking.
b. Speak normally but more slowly.
c. Increase the volume when speaking.
d. Use more facial expressions when talking.

Answer 22

b. Speak normally but more slowly.

Question 23

A 75-year-old 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?

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 a 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.

Answer 23

a. Experiment with volume and hearing ability in a quiet environment initially.

Question 24

Which information will the nurse include for a patient contemplating a cochlear implant?

a. Cochlear implants require training in order to receive the full benefit.
b. Cochlear implants are not useful for patients with congenital deafness.
c. Cochlear implants are most helpful as an early intervention for presbycusis.
d. Cochlear implants improve hearing in patients with conductive hearing loss.

Answer 24

a. Cochlear implants require training in order to receive the full benefit.

Question 25

Which statement by a patient with bacterial conjunctivitis indicates a need for further teaching?

a. “I will wash my hands often during the day.”
b. “I will remove my contact lenses at bedtime.”
c. “I will not share towels with my friends or family.”
d. “I will monitor my family for eye redness or drainage.”

Answer 25

b. “I will remove my contact lenses at bedtime.”

Question 26

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

a. Correct use of the antifungal eyedrops natamycin (Natacyn)
b. How to apply corticosteroid ophthalmic ointment to the eyes
c. Avoidance of nonsteroidal antiinflammatory drugs (NSAIDs)
d. Importance of taking all of the ordered oral acyclovir (Zovirax)

Answer 26

d. Importance of taking all of the ordered oral acyclovir (Zovirax)

Question 27

The nurse at the outpatient surgery unit obtains the following information about a patient who is scheduled for cataract extraction and implantation of an intraocular lens. Which information is most important to report to the health care provider at this time?

a. The patient has had blurred vision for 3 years.
b. The patient has not eaten anything for 8 hours.
c. The patient takes 2 antihypertensive medications.
d. The patient gets nauseated with general anesthesia.

Answer 27

c. The patient takes 2 antihypertensive medications.

Question 28

During the preoperative assessment of the patient scheduled for a right cataract extraction and intraocular lens implantation, it is most important for the nurse to assess

a. the visual acuity of the patient’s left eye.
b. how long the patient has had the cataract.
c. for a white pupil in the patient’s right eye.
d. for a history of reactions to general anesthetics.

Answer 28

a. the visual acuity of the patient’s left eye.

Question 29

The nurse learns that a newly admitted 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

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.

Answer 29

c. make eye contact with the patient and ask about any need for assistance.

Question 30

Which action could the registered nurse (RN) who is working in the eye and ear clinic delegate to a licensed practical/vocational nurse (LPN/LVN)?

a. Evaluate a patient’s ability to administer eye drops.
b. Use a Snellen chart to check a patient’s visual acuity.
c. Teach a patient with otosclerosis about use of sodium fluoride and vitamin D.
d. Check the patient’s external ear for signs of irritation caused by a hearing aid.

Answer 30

b. Use a Snellen chart to check a patient’s visual acuity.

Question 31

The occupational health nurse is caring for an employee who is complaining of bilateral eye pain after a cleaning solution splashed into the employee’s eyes. Which action will the nurse take first?

a. Apply ice packs to both eyes.
b. Flush the eyes with sterile saline.
c. Apply antiseptic ophthalmic ointment to the eyes.
d. Cover the eyes with dry sterile patches and shields.

Answer 31

b. Flush the eyes with sterile saline.

Question 32

Unlicensed assistive personnel (UAP) perform all the following actions when caring for a patient with Ménière’s disease who is experiencing an acute attack. Which action by UAP indicates that the nurse should intervene immediately?

a. UAP raise the side rails on the bed.
b. UAP turn on the patient’s television.
c. UAP turn the patient to the right side.
d. UAP place an emesis basin at the bedside.

Answer 32

b. UAP turn on the patient’s television.

Question 33

The nurse at the eye clinic made a follow-up telephone call to a patient who underwent cataract extraction and intraocular lens implantation the previous day. Which information is the priority to communicate to the health care provider?

a. The patient has questions about the ordered eye drops.
b. The patient has eye pain rated at a 5 (on a 0 to 10 scale).
c. The patient has poor depth perception when wearing an eye patch.
d. The patient complains that the vision has not improved very much.

Answer 33

b. The patient has eye pain rated at a 5 (on a 0 to 10 scale).

Question 34

Which finding in an emergency department patient who reports being struck in the right eye with a fist is a priority for the nurse to communicate to the health care provider?

a. The patient complains of a right-sided headache.
b. The sclera on the right eye has broken blood vessels.
c. The area around the right eye is bruised and tender to the touch.
d. The patient complains of “a curtain” over part of the visual field.

Answer 34

d. The patient complains of “a curtain” over part of the visual field.

Question 35

The charge nurse observes a newly hired nurse performing all the following interventions for a patient who has just undergone right cataract removal and an intraocular lens implant. Which one requires that the charge nurse intervene?

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.

Answer 35

b. The nurse encourages the patient to cough.

Question 36

Which nursing activity is appropriate for the registered nurse (RN) working in the eye clinic to delegate to experienced unlicensed assistive personnel (UAP)?

a. Instilling antiviral drops for a patient with a corneal ulcer
b. Application of a warm compress to a patient’s hordeolum
c. Instruction about hand washing for a patient with herpes keratitis
d. Looking for eye irritation in a patient with possible conjunctivitis

Answer 36

b. Application of a warm compress to a patient’s hordeolum

Question 37

A patient with a head injury after a motorcycle crash arrives in the emergency department (ED) complaining of shortness of breath and severe eye pain. Which action will the nurse take first?

a. Administer the ordered analgesic.
b. Check the patient’s oxygen saturation.
c. Examine the eye for evidence of trauma.
d. Assess each of the cranial nerve functions.

Answer 37

b. Check the patient’s oxygen saturation.

Question 38

Which prescribed medication should the nurse give first to a patient who has just been admitted to a hospital with acute angle-closure glaucoma?

a. Morphine sulfate 4 mg IV
b. Mannitol (Osmitrol) 100 mg IV
c. Betaxolol (Betoptic) 1 drop in each eye
d. Acetazolamide (Diamox) 250 mg orally

Answer 38

b. Mannitol (Osmitrol) 100 mg IV

Question 39

The priority nursing diagnosis for a patient experiencing an acute attack with Meniere’s disease is

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.

Answer 39

a. risk for falls related to dizziness.

Question 40

40. Which information about a patient who had a stapedotomy yesterday is most important for the nurse to communicate to the health care provider?
    a. The patient complains of “fullness” in the ear.
    b. The patient’s oral temperature is 100.8° F (38.1° C).
    c. The patient says “My hearing is worse now than it was right after surgery.”
    d. There is a small amount of dried bloody drainage on the patient’s dressing.

Answer 40

b. The patient’s oral temperature is 100.8° F (38.1° C).

Question 41

A 75-year-old patient who lives alone at home tells the nurse, “I am afraid of losing my independence because my eyes don’t work as well they used to.” Which action should the nurse take first?

a. Discuss the increased risk for falls that is associated with impaired vision.
b. Explain that there are many ways to compensate for decreases in visual acuity.
c. Suggest ways of improving the patient’s safety, such as using brighter lighting.
d. Ask the patient more about what type of vision problems are being experienced.

Answer 41

d. Ask the patient more about what type of vision problems are being experienced

Question 42

A patient who received a corneal transplant 2 weeks ago calls the ophthalmology clinic to report that his vision has not improved with the transplant. Which action should the nurse take?

a. Suggest the patient arrange a ride to the clinic immediately.
b. Ask about the presence of “floaters” in the patient’s visual field.
c. Remind the patient it may take months to restore vision after transplant.
d. Teach the patient to continue using prescribed pupil-dilating medications.

Answer 42

c. Remind the patient it may take months to restore vision after transplant.

Question 43

Which action will the nurse take when performing ear irrigation for a patient with cerumen impaction?

a. Assist the patient to a supine position for the irrigation.
b. Fill the irrigation syringe with body-temperature solution.
c. Use a sterile applicator to clean the ear canal before irrigating.
d. Occlude the ear canal completely with the syringe while irrigating.

Answer 43

b. Fill the irrigation syringe with body-temperature solution.

Question 44

Which action will the nurse include in the plan of care for a patient with benign paroxysmal positional vertigo (BPPV)?

a. Teach the patient about use of medications to reduce symptoms.
b. Place the patient in a dark, quiet room to avoid stimulating BPPV attacks.
c. Teach the patient that canalith repositioning may be used to reduce dizziness.
d. Speak slowly and in a low-pitch to ensure that the patient is able to hear instructions.

Answer 44

c. Teach the patient that canalith repositioning may be used to reduce dizziness.

Question 45

When teaching a patient about the treatment of acoustic neuroma, the nurse will include information about

a. a low sodium diet.
b. ways to avoid falls.
c. how to apply sunscreen.
d. the chemotherapy side effects.

Answer 45

b. ways to avoid falls.

Question 46

Which patient arriving at the urgent care center will the nurse assess first?

a. Patient with acute right eye pain that occurred while using home power tools
b. Patient with purulent left eye discharge, pruritus, and conjunctival inflammation
c. Patient who is complaining of intense discomfort after an insect crawled into the right ear
d. Patient who has Ménière’s disease and is complaining of nausea, vomiting, and dizziness

Answer 46

a. Patient with acute right eye pain that occurred while using home power tools

Question 47

The nurse is working in an urgent care clinic that has standardized treatment protocols for implementation by nursing staff. After reviewing the history, physical assessment, and vital signs for a 60-year-old patient as shown in the accompanying figure, which action should the nurse take first?

a. Check the patient’s blood glucose level.
b. Take the blood pressure on the left arm.
c. Use an irrigating syringe to clean the ear canals.
d. Report the vision change to the health care provider.

Answer 47

d. Report the vision change to the health care provider.