Multiple Choice
Identify the
choice that best completes the statement or answers the question.
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1.
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A nurse is attempting to inspect the lacrimal
apparatus of a client’s eye. Because of its anatomical location, the nurse should do which of
the following?
a. | Retract the upper eyelid and ask the client to look
down. | b. | Retract the upper eyelid and ask the client to look
up. | c. | Retract the lower eyelid and ask the client to look
up. | d. | Retract the lower eyelid and ask the client to look
down. |
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2.
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A client has been newly diagnosed with glaucoma. As
part of the discharge instructions, the nurse should plan to include which of the
following?
a. | The need to decrease table salt in the
diet | b. | The need for lifelong medication
therapy | c. | The need to restrict fluids in order to reduce
intraocular pressure | d. | The need to avoid
straining or overworking the eyes |
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3.
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A client is diagnosed with hyphema after
experiencing a traumatic blow to the eye. The nurse explains to the client that which activity
limitations need to be implemented following this type of injury?
a. | Bathroom privileges only | b. | Ambulation within the room only | c. | Bedrest with the head of the bed flat | d. | Bedrest with the head in semi-Fowler’s
position |
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4.
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A client arrives in the emergency department with
an eye injury due to metal fragments that hit the eye while the client was drilling into metal. The
nurse assesses the eye and notes small pieces of metal floating on the eyeball. Which action should
the nurse take first?
a. | Perform complete visual acuity
tests. | b. | Irrigate the eye with sterile
saline. | c. | Remove the objects using a sterile eye
clamp. | d. | Apply an eye
patch. |
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5.
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A client has been diagnosed with glaucoma. The
nurse who is teaching the client principles of self-care would encourage the client to limit or
refrain from which of the following usual activities on a repeated basis?
a. | Ironing | b. | Folding clothes on a laundry table | c. | Peeling vegetables | d. | Picking objects up
off the floor |
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6.
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A nurse is explaining how sound is conducted from
the middle ear to the inner ear in teaching a client who is experiencing hearing loss. The nurse
plans to use a diagram that illustrates how which of the following bones connects to the cochlea at
the oval window?
a. | Malleus | b. | Hammer | c. | Stapes | d. | Incus |
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7.
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A nurse is developing a poster to use in teaching
clients about the prevention of hearing loss. The nurse would diagram which of the following
structures as part of the inner ear?
a. | Malleus | b. | Incus | c. | Stapes | d. | Cochlea |
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8.
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An adult client has increased fluid in the middle
ear, which is causing vertigo. The nurse assesses this client for which associated signs and symptoms
of this condition?
a. | Headache and flushing | b. | Nausea and vomiting | c. | Ear pain and
tinnitus | d. | Hearing loss and difficulty in
swallowing |
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9.
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A nurse has been assigned to a client with a
hearing impairment. To enhance nurse-client communication, the nurse should plan to communicate with
the client by speaking:
a. | Directly into the impaired
ear | b. | In a normal tone while facing the
client | c. | On a more frequent basis | d. | Very loudly to the client |
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10.
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A nurse is reviewing the medication list for an
assigned client. The nurse becomes concerned because which of the following medications is the only
one on the client’s order sheet that does not have an ototoxic effect?
a. | Furosemide (Lasix) | b. | Vancomycin hydrochloride (Vancocin) | c. | Acetylsalicylic acid (aspirin) | d. | Acetaminophen (Tylenol) |
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11.
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A client is being discharged to home with a
prescription for eye drops to be given in the left eye. The nurse has shown the client how to
self-administer the drops. The nurse determines that the client needs further instruction if the
client does which of the following during a return demonstration?
a. | Lies with the head to the right, puts the drop in the
inner canthus, and slowly turns to the left while blinking | b. | Lies supine, pulls down on the lower lid, and puts the drop in the lower
lid | c. | Lies supine, pulls up on the upper lid, and puts the
drop in the upper lid | d. | Tilts the head
back, pulls down on the lower lid, and puts the drop in the lower
lid |
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12.
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A nurse is teaching a mother how to administer ear
drops to an infant. The nurse plans to demonstrate by pulling the ear:
a. | Down and back and directing the solution onto the
eardrum | b. | Down and back and directing the solution toward the wall
of the canal | c. | Up and back and
directing the solution onto the eardrum | d. | Up and back and
directing the solution toward the wall of the canal |
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13.
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A nurse is concerned that a client may experience
systemic effects from carteolol hydrochloride (Ocupress) ophthalmic solution. The nurse observes the
client self-administer the medication to be sure that the client:
a. | Instills the eye drops after a
meal | b. | Swallows at least five times after
instillation | c. | Blinks quickly to
form tears after instillation | d. | Applies digital
pressure to the lacrimal sac for 1 to 2 minutes after
instillation |
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14.
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A licensed practical nurse (LPN) is reviewing the
medication list of the client with a history of glaucoma. The LPN would consult with the registered
nurse if which of the following medications is ordered for this client?
a. | Pilocarpine (Ocusert Pilo-20) | b. | Pilocarpine hydrochloride (Isopto Carpine) | c. | Atropine sulfate (Isopto Atropine) | d. | Carteolol hydrochloride (Ocupress) |
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15.
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A client who has just been diagnosed with glaucoma
has been given a prescription for a miotic medication. When teaching the client about medication
effects, the nurse plans to tell the client that the medication will:
a. | Reshape the lens to eliminate blurred
vision. | b. | Interrupt the drainage of aqueous humor from the
eye. | c. | Lower intraocular pressure and enhance blood flow to the
retina. | d. | Dilate the pupil to reduce intraocular
pressure. |
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16.
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A client who has sustained an eye injury has been
prescribed corticosteroid eye drops. The nurse would most carefully monitor for side effects of this
medication if the client has which of the following health problems listed on the medical
record?
a. | Hypertension | b. | Diabetes mellitus | c. | Cirrhosis | d. | Chronic
constipation |
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17.
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A client with chronic glaucoma is being started on
medication therapy with acetazolamide (Diamox). The nurse teaches the client that which symptoms that
can occur early in use subsides or disappears in time?
a. | Diuresis | b. | Fatigue | c. | Headache | d. | Loss of
libido |
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18.
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A nurse is administering gentamicin sulfate
(Garamycin) ophthalmic ointment to a client. After instilling the ointment, the nurse instructs the
client to close the eye and:
a. | Keep it shut tightly for 2
minutes. | b. | Roll the eyeball in all
directions. | c. | Press on the
nasolacrimal duct for 10 minutes. | d. | Press tissue onto
the closed eyelids. |
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19.
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A client has been instructed to alternate the use
of hydrogen peroxide and glycerin eardrops to loosen an impacted accumulation of earwax. The nurse
gives the client which of the following directions to accomplish this daily procedure safely and
independently?
a. | Use the solutions chilled for 3 to 5
days. | b. | Use the solutions heated to 120 degrees for 5 to 7
days. | c. | Use the solutions at body temperature for 7 to 14
days. | d. | Use the solutions at room temperature for 1 to 3
days. |
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20.
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A client has just undergone lumbar puncture (LP).
The nurse assists the client into which most optimal position if tolerated by the
client?
a. | Supine, with the head of the bed elevated 15
degrees | b. | Side-lying, with a pillow under the
hip | c. | Prone, in slight Trendelenburg’s
position | d. | Prone, with a pillow under the
abdomen |
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21.
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A client with Bell’s palsy exhibits facial
asymmetry and cannot close the eye completely on one side. The client is also drooling and has loss
of tearing in one eye. The nurse documents that the client displays symptoms of involvement of which
of the following cranial nerves (CNs)?
a. | CN VI | b. | CN VII | c. | CN
III | d. | CN V |
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22.
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A nurse is caring for the client with a head injury
secondary to a motor vehicle accident. The nurse observes the client’s status regularly,
monitoring closely for which changes in vital signs?
a. | Increasing pulse, decreasing respirations, increasing
blood pressure (BP) | b. | Increasing pulse,
increasing respirations, decreasing BP | c. | Decreasing pulse,
decreasing respirations, increasing BP | d. | Decreasing pulse,
increasing respirations, decreasing BP |
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23.
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A client who sustained a closed head injury has a
new onset of copious urinary output. Urine output for the previous 8-hour shift was 3300 mL, and 2800
mL for the shift before that. The findings have been reported to the physician, and the nurse
anticipates an order for which of the following medications?
a. | Ethacrynic acid (Edecrin) | b. | Mannitol (Osmitrol) | c. | Desmopressin
(DDAVP) | d. | Dexamethasone
(Decadron) |
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24.
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A client who suffered a cervical spine injury had
Crutchfield tongs applied in the emergency department. The nurse would avoid which of the following
actions in the care of the client?
a. | Checking the amount of traction in use against the order
each shift | b. | Removing the
weights when repositioning the client | c. | Placing the client
on a Stryker frame | d. | Assessing the
status and integrity of the weights and pulleys |
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25.
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A nurse is providing instructions to the client who
has just been fitted for a halo vest. Which statement by the client indicates the need for further
instructions?
a. | “I will use a straw to make drinking
easier.” | b. | “I will
avoid driving at night because the vest limits the ability to turn the
head.” | c. | “I will use
caution because the vest alters the center of gravity and balance.” | d. | “I will wash my skin daily under the lamb's wool liner of the
vest.” |
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26.
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A client with spinal cord injury has experienced
more than one episode of autonomic dysreflexia. The nurse would plan to avoid which of the following
that could trigger an episode of this complication?
a. | Rigidly adhering to a bowel retraining
program | b. | Allowing the client’s bladder to become
distended | c. | Keeping the linen under the client free of
wrinkles | d. | Preventing pressure on the client’s lower
limbs |
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27.
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A nurse is assisting in admitting a client who
experienced seizure activity in the emergency department. The nurse avoids doing which of the
following when managing this client’s environment?
a. | Keeping the bed position raised to the nurse’s
waist level | b. | Having intravenous
(IV) equipment ready for insertion | c. | Ensuring that an
airway, oxygen, and suction equipment are at the bedside | d. | Placing padding on the side rails of the
bed |
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28.
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A client who is recovering from a brain attack
(stroke) has residual dysphagia. The licensed practical nurse instructs the nursing assistant to
avoid which of the following at mealtime?
a. | Placing food on the unaffected side of the
mouth | b. | Allowing ample time for chewing and
swallowing | c. | Giving the client
thin liquids | d. | Giving foods and
fluids with the consistency of oatmeal |
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29.
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A client with a history of spinal cord injury is
beginning medication therapy with baclofen (Lioresal). The nurse who is providing medication
information should caution the client about which side effect of this medication?
a. | High blood pressure | b. | Muscle pain | c. | Sensitivity to
bright light | d. | Drowsiness |
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30.
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A nurse is assisting in the care of a client who is
being evaluated for possible myasthenia gravis. The health care provider gives a test dose of
edrophonium (Tensilon). The nurse recalls that the client would have which of the following reactions
if the client does actually have this disease?
a. | An increase in muscle strength within 1 to 3
minutes | b. | A decrease in muscle strength within 1 to 3
minutes | c. | Joint pain for the next 15
minutes | d. | Feelings of faintness or dizziness for 5 to 10
minutes |
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31.
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A client with myasthenia gravis becomes
increasingly weaker. The physician injects a dose of edrophonium (Tensilon) to determine whether the
client is experiencing a myasthenia crisis or a cholinergic crisis. The nurse expects that the client
will have which of the following reactions if the client is in cholinergic crisis?
a. | An improvement of the
weakness | b. | A temporary worsening of the
condition | c. | No change in the condition | d. | Complaints of muscle spasms |
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32.
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A nurse is assisting in the care of a client with
Parkinson’s disease who is receiving carbidopa/levodopa (Sinemet). The nurse plans to monitor
the client for which of the following adverse effects, which could appear with elevated serum levels
of this medication?
a. | Pruritus | b. | Hypertension | c. | Tachycardia | d. | Impaired voluntary
movements |
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33.
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A nurse is providing instructions to a client
beginning medication therapy with divalproex sodium (Depakote ER) for the treatment of absence
seizures. The nurse instructs the client that which of the following is the most frequent side effect
of this medication?
a. | Nausea and vomiting | b. | Blue vision | c. | Irritability | d. | Tinnitus |
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34.
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A nurse is reading the laboratory results for a
client being treated with carbamazepine (Tegretol) for prophylaxis of complex-partial seizures. The
nurse interprets that which of the following values is consistent with an adverse reaction to this
medication?
a. | White blood cell count
3200/mm3 | b. | Blood urea
nitrogen 19 mg/dL | c. | Sodium 136
mEq/L | d. | Platelet count
350,000/mm3 |
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35.
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A postoperative client has been receiving morphine
sulfate every 3 to 4 hours for pain. The nurse should be sure to implement which measure to reduce
the risk of adverse effects from this medication?
a. | Monitor the client’s
temperature. | b. | Encourage
fluids. | c. | Maintain the client in a supine
position. | d. | Encourage coughing and deep
breathing. |
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36.
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A nurse is assisting in the care of a client
receiving codeine sulfate for pain. The nurse should make note of which of the following to detect
adverse effects of this medication?
a. | Onset of hypertension | b. | Fluid volume excess | c. | Frequency of bowel
movements | d. | Strength of peripheral
pulses |
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37.
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A client who recently began medication therapy with
levodopa (Larodopa) for Parkinson’s disease complains of nausea. The nurse reminds the client
to do which of the following to best manage this problem?
a. | Take the medication with three glasses of
water. | b. | Eat a snack before taking the
medication. | c. | Take an antiemetic
at the same time as the levodopa. | d. | Lie down and rest
after taking the dose. |
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38.
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Which of the following interventions would be
contraindicated in the postprocedure care of the client following a bone biopsy of the left
arm?
a. | Place the left arm in a dependent position for 24
hours. | b. | Monitor vital signs every 4
hours. | c. | Monitor site for swelling, bleeding,
hematoma. | d. | Administer oral analgesics as
needed. |
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39.
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A nurse is providing postprocedure instructions to
a client returning home after arthroscopy of the shoulder. The nurse would encourage the client
to:
a. | Not eat or drink anything until the following
morning | b. | Report to the physician the development of fever or
redness and heat at the site | c. | Keep the shoulder
completely immobilized for the rest of the day | d. | Resume regular
full activity the following day |
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40.
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A client with type 1 diabetes mellitus has had a
left above-the-knee amputation. The nurse carefully inspects the residual limb for which of the
following complications due to the history of diabetes?
a. | Separation of wound edges | b. | Pain | c. | Edema of the
stump | d. | Hemorrhage |
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41.
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A client has sustained multiple fractures in the
left leg and is in skeletal traction. The nurse has obtained an overhead trapeze for the
client’s use to aid in bed mobility. The nurse would pay particular attention to monitoring for
which of the following high-risk areas for pressure and breakdown?
a. | Right heel | b. | Left heel | c. | Scapulae | d. | Back of the
head |
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42.
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A nurse is teaching a client about foods in the
diet that could minimize the risk of osteoporosis. The nurse would encourage the client to increase
intake of which of these foods?
a. | Fish | b. | Turkey | c. | Sweet
potatoes | d. | Cheese |
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43.
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A client has just had an application of a
nonplaster (fiberglass) leg cast, and the nurse is giving the client instructions on cast care at
home. Which statement by the client indicates the need for further instructions?
a. | “I should not use anything to scratch underneath
the cast.” | b. | “I should
use a hair dryer set to the hot setting to dry my cast if it gets
wet.” | c. | “I need to
avoid walking on wet or slippery floors.” | d. | “I can use a
damp cloth to wipe off surface dirt on the cast.” |
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44.
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A client has just had skeletal traction applied
following insertion of pins. The nurse should place highest priority on doing which of the following
while caring for the client?
a. | Provide for diversion such as television or
newspaper. | b. | Explain to the
client the upcoming pin care procedure. | c. | Ensure that the
weights on the traction setup are hanging free. | d. | Perform pin site
care. |
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45.
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A nurse is reviewing the list of discharge
instructions for a client who underwent left total knee replacement (TKR) with insertion of a metal
prosthesis. Which statement by the client indicates the need for further instructions?
a. | “I need to report bleeding gums or tarry
stools.” | b. | “I need to
tell my other doctors about the metal implant.” | c. | “I need to report fever, redness, or increased
pain.” | d. | “I
don’t need to be worried if the shape of my knee
changes.” |
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46.
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A nurse is teaching the client with a
below-the-knee amputation (BKA) measures to protect the residual limb, or stump. The nurse would be
sure to include which of the following points in discussions with the client?
a. | Apply lotion daily to prevent cracking of the skin of
the residual limb. | b. | Use a mirror to
inspect all areas of the residual limb. | c. | Put a clean nylon
sock on the residual limb daily. | d. | Toughen the skin
of the residual limb by rubbing it with alcohol. |
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47.
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A client is experiencing an acute exacerbation of
bursitis. The nurse encourages the client to avoid which of the following least helpful measures
until the current episode is resolved?
a. | Applying moist heat | b. | Resting the joint | c. | Active
intermittent range of motion | d. | Elevation of the
joint |
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48.
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A client has a new medication order for allopurinol
(Zyloprim). A practical nursing student coassigned with the licensed practical nurse (LPN) states,
“I know this is for gout, but how does it work?” In formulating a response, the LPN
includes that allopurinol:
a. | Lowers the risk of sulfa crystal formation in the
urine | b. | Decreases uric acid
production | c. | Reduces the
production of fibrinogen | d. | Prevents influx of
calcium ions during cell depolarization |
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49.
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A client diagnosed with gout has been started on
medication therapy with allopurinol (Zyloprim). The nurse teaches the client which of the following
points about this medication?
a. | Take the medication on an empty
stomach. | b. | Development of a rash frequently occurs with this
medication. | c. | The medication
takes effect immediately. | d. | It is important to
drink 3 L of fluid per day. |
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50.
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A client with osteoarthritis is receiving
diclofenac sodium (Voltaren). The licensed practical nurse (LPN) reviewing the client’s
medication order sheet would plan to verify the order with the registered nurse (RN) if which of the
following other medications were listed?
a. | Primidone (Mysoline) | b. | Calcium carbonate (Tums) | c. | Warfarin
(Coumadin) | d. | Vitamin C
supplement |
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51.
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A licensed practical nurse (LPN) is administering
medications to a client with chronic rheumatoid arthritis. The client has difficulty swallowing, and
the film-coated form of diflunisal (Dolobid) is ordered. Which action by the LPN is most
appropriate?
a. | Give the client a large glass of water to aid in
swallowing. | b. | Consult with the
registered nurse (RN) about contacting the physician regarding a medication
change. | c. | Crush the tablet and mix it with
applesauce. | d. | Open the tablet
and mix the contents with food. |
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52.
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Baclofen (Lioresal) is prescribed for the client
with multiple sclerosis. The nurse evaluates that the medication is having the intended effect if
which of the following is noted in the client?
a. | Increased muscle tone | b. | Increased range of motion | c. | Decreased muscle spasms | d. | Decreased local
pain and tenderness |
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53.
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A licensed practical nurse (LPN) is reviewing
laboratory results for a client taking dantrolene sodium (Dantrium). The LPN should suggest to the
registered nurse to notify the physician if which of the following was noted on the laboratory report
sheet?
a. | Lactate dehydrogenase (LDH) 600
units/L | b. | Platelet count 290,000
cells/mm3 | c. | Blood urea
nitrogen 9 mg/dL | d. | Creatinine 0.6
mg/dL |
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54.
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A licensed practical nurse (LPN) is told that
baclofen (Lioresal) is prescribed for an assigned client. The LPN questions the registered nurse
about the physician’s order if which of the following conditions is noted on the client problem
list?
a. | Seizure disorder | b. | Hyperthyroidism | c. | Coronary artery
disease | d. | Diabetes mellitus |
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55.
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A licensed practical nurse (LPN) is reviewing the
medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine
hydrochloride (Flexeril) for the treatment of muscle spasms. The LPN questions the order if which of
the following disorders is noted in the admission history?
a. | Angle-closure glaucoma | b. | Hypothyroidism | c. | Chronic
bronchitis | d. | Recurrent
pneumonia |
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56.
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A client has just been given a prescription for
methocarbamol (Robaxin), and the nurse provides instructions to the client. Which statement by the
client indicates the need for further instructions?
a. | “This medication can cause nasal
congestion.” | b. | “This
mediation is intended to relieve muscle spasms.” | c. | “The medication may turn the urine brown or
green.” | d. | “Blurred
vision is a common but unimportant effect.” |
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