Multiple Choice
Identify the
choice that best completes the statement or answers the question.
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1.
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A 60-year-old patient who has had an enucleation
asks when he can get his prosthesis fitted. In approximately how many weeks should this patient
expect to be fitted?
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2.
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A patient who has been taking opioid medication for
postoperative pain exhibits pinpoint pupils. Which anatomic portion of the eye has been affected by
the medication?
a. | Sclera | b. | Retina | c. | Choroid | d. | Bulbar
conjunctiva |
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3.
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Which portion of the eye makes it possible for a
person to see in a darkened environment?
a. | Macula | b. | Rods | c. | Cones | d. | Optic
nerve |
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4.
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When being interviewed, a 50-year-old patient says
that he cannot see the newspaper as well as he used to. What is the reason this patient vision has
changed from near to far?
a. | The ciliary muscle changes the pupil
size. | b. | The lens of the eye changes shape as the ciliary muscle
contracts and relaxes. | c. | Nearsightedness
has set in. | d. | Clouding of the
vitreous humor has occurred. |
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5.
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During the initial assessment of a very thin
patient at the eye clinic, a nurse notes that the patient has very prominent eyes. What medical
diagnosis might the nurse find in this patient’s history?
a. | Diabetes | b. | Glomerulonephritis | c. | Graves
disease | d. | Hypertension |
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6.
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When asked about his vision, a patient says that
the last time he had it tested, his vision was recorded as 20/50. What does this mean?
a. | He can read at 20 feet what a person with normal vision
can read at 50 feet. | b. | He can read at 50
feet what a person with normal vision can read at 20 feet. | c. | He needs to be 50 feet from objects to see them. | d. | He can see objects the best between 20 and 50
feet. |
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7.
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Which intraocular pressure reading obtained by
tonometry indicates a patient being evaluated for a visual impairment does not have
glaucoma?
a. | 18 mm Hg | b. | 28 mm Hg | c. | 45 mm
Hg | d. | 52 mm Hg |
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8.
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What does a pneumatonometric study of the eye
require?
a. | Regional anesthesia | b. | A pneumotonometer to be placed into the eye | c. | A puff of air directed at the surface of the eye | d. | An applanation performed with a slit-lamp
microscope |
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9.
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What is an appropriate nursing action to implement
when performing eye irrigation?
a. | Ask the patient to tip up her head and run the
irrigation fluid over her open eye. | b. | Direct the
irrigating fluid from the inner canthus to the outer canthus. | c. | Not allow the patient to blink. | d. | Place the irrigating syringe directly onto the corner of the eye and allow the
fluid to move across the eye. |
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10.
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What information should a nurse include when
providing information to a patient using topical eye medications?
a. | Look upward and drop the medication into the inner
canthus. | b. | Pull the lower eyelid down and drop the medication into
the conjunctival sac. | c. | Hold both eyelids
open and drop the medication onto the sclera. | d. | Tilt the head to
the side and drop the medication into the outer canthus. |
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11.
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What does electroretinography
measure?
a. | A fluorescein dye is injected intravenously (IV) into a
vein in the arm, and the retina is observed as the dye circulates. | b. | Electrodes are placed on the scalp, each eye is stimulated, and retinal
activity is assessed. | c. | A small plunger is
used to apply pressure on the sclera while the retinal vessels are
evaluated. | d. | A contact lens
electrode is placed on the eye and exposed to flashes of light to evaluate the retinal
response. |
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12.
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What information should a nurse relay to a patient
when providing education about protecting vision?
a. | After 40 years of age, eye examinations should be
performed every 2 years. | b. | Crusted eyelids on
awakening are caused by decreased tear production. | c. | Floaters are a sign of eye infection. | d. | Blurred vision without pain is temporary eye
strain. |
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13.
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How should a nurse assist a visually impaired
patient to ambulate?
a. | Hold the visually impaired person by his or her
nondominant arm and walk side by side. | b. | Hold the
nondominant hand, wrap the arm around his or her waist, and walk side by
side. | c. | Allow the visually impaired person to hold the
helper’s arm, with the helper slightly ahead. | d. | Allow the visually impaired person to hold the shoulder of the helper and walk
slightly behind the helper. |
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14.
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A newly diagnosed patient with macular degeneration
flings her book at the television set and furiously says, “I can’t read this blasted
book, and I can’t see what is on the stupid TV!” How should the nurse define this
behavior?
a. | Anger stage of grieving | b. | Poor impulse control | c. | Ineffective
management of a therapeutic regimen | d. | Psychotic reaction
to loss |
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15.
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What is the correct term to use for a patient with
a vision disorder?
a. | Blind | b. | Handicapped | c. | Partially
blind | d. | Visually impaired |
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16.
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Which nursing diagnosis is not appropriate for a
visually impaired patient?
a. | Impaired sensory perception | b. | Risk for delayed development | c. | Self-care deficit | d. | Ineffective
coping |
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17.
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Which implementation is appropriate in the care
plan for a visually impaired person?
a. | Leaving the bed in the highest
position | b. | Keeping the door closed | c. | Announcing your presence when you enter and leave the
room | d. | Leaving the radio on all the time to help the patient
know the time of day |
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18.
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A patient with glaucoma is taking a beta-adrenergic
blocking agent, timolol (Timoptic). For which potential side effect should the nurse assess the
patient?
a. | Wheezing | b. | Hypertension | c. | Sudden eye
pain | d. | Blurred vision |
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19.
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A 52-year-old patient reports that he must hold his
paper farther and farther away from his face to read it. What is the nurse’s most informative
response?
a. | “You are describing myopia. Glasses will help you
read.” | b. | “You may
have astigmatism, but your eyes will finally adjust.” | c. | “You have presbyopia. Nonprescription reading glasses will help
you.” | d. | “An eye
infection may be the problem. Check with your physician for
medication.” |
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20.
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A nurse explains that laser-assisted in situ
keratomileusis (Lasik) and photorefractive keratectomy (PRK) are methods to correct refractive errors
surgically. What do these procedures reshape?
a. | Cornea | b. | Lens | c. | Iris | d. | Pupil |
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21.
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A patient reports to a home health care nurse of
having cloudy vision and seeing spots and halos around lights. What should the nurse suspect based on
these patient symptoms?
a. | Cataracts | b. | Glaucoma | c. | Detached
retina | d. | Macular
degeneration |
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22.
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How does closed-angle glaucoma differ from
open-angle glaucoma?
a. | The onset is acute. | b. | Trabeculectomy is the initial treatment. | c. | Treatment can be conservative. | d. | Intraocular pressure drops suddenly. |
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23.
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What is the cause of glaucoma?
a. | Cloudiness in the lens | b. | Increase in intraocular pressure | c. | Failed eye surgery | d. | Retinal
tears |
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24.
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A patient in the emergency department complains of
severe pain in his eye and is seeing halos around lights and feeling nauseous. Which diagnosis should
the nurse suspect?
a. | Open-angle glaucoma | b. | Angle-closure glaucoma | c. | Cataracts | d. | Retinal
detachment |
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25.
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Which surgical implementation is most effective
with retinal detachment?
a. | Removing the lens | b. | Macular bonding | c. | Lasik
surgery | d. | Scleral buckling |
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26.
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A nurse reads in a patient’s history that the
patient has experienced otalgia. How should the nurse interpret this term?
a. | Difficulty hearing | b. | Buildup of cerumen | c. | Ear
pain | d. | Ringing in the
ears |
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27.
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A nurse is assisting with a caloric test and notes
that the specific patient response that indicates a hearing disorder is a problem in the labyrinth.
Which response did the nurse witness?
a. | Blinking | b. | Grimacing | c. | Headache | d. | Nystagmus |
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28.
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A 75-year-old patient has normal age-related
changes in his ear. What change should not be considered a normal change in the aging
patient?
a. | Dry and wrinkled skin on the
auricle | b. | Otitis externa | c. | Dry cerumen | d. | Hair in the ear
canal |
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29.
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When making an initial assessment on a patient with
a hearing deficit, the patient reports that he often feels off balance and is dizzy when he stands
up. Which diagnosis might explain these symptoms?
a. | Sinus infection | b. | Rubella | c. | Otalgia | d. | Presbycusis |
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30.
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A 94-year-old patient is receiving gentamicin
sulfate (Garamycin) in a continuous intravenous (IV) infusion. The nurse adds to the nursing care
plan the diagnosis “Risk for injury.” What nursing action should be
implemented?
a. | Pull side rails in place. | b. | Assist with ambulation. | c. | Measure intake and
output. | d. | Provide for a possible
seizure. |
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31.
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A 75-year-old patient reports to a nurse that
although she has cleaned her ears with cotton-tipped applicators for weeks, she still cannot hear her
television unless the volume is loud, and she misses a great deal of conversations. What should the
nurse anticipate when examining her ears?
a. | Otitis externa | b. | Purulent drainage | c. | Dry cerumen across
the canal | d. | Pearly tympanic
membrane |
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32.
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A patient reports that her hearing loss has become
more severe over the past 3 months. The clinic nurse makes arrangements for an evaluation for a
hearing aid. What health care provider should provide this service?
a. | Otologist | b. | Otolaryngologist | c. | Audiometrist | d. | Audiologist |
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33.
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When a patient has a suspected vestibular disorder,
the physician orders an electronystagmography test. Which instruction should the nurse include when
educating the patient about this test?
a. | Use tea or coffee on the morning of
test. | b. | Electrodes will be placed on the
scalp. | c. | Air will be blown into the external
ear. | d. | The patient should have nothing to eat or drink (NPO) 3
hours before the test. |
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34.
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A nurse assessing the results of a Rinne test sees
the notation of BC > AC. How should the nurse translate this result?
a. | Conductive hearing loss | b. | Sensorineural hearing loss | c. | Normal hearing | d. | Cochlear
defect |
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35.
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A patient undergoing a Weber test says that the
sound is louder in her left ear. What should this result indicate?
a. | Normal hearing | b. | Nerve damage from listening to loud music | c. | Blocked ear canal in the right ear | d. | Conductive hearing loss in the left ear |
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36.
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Which instruction should a nurse include when
providing patient teaching information for a patient who will be self-administering ear drops for an
ear infection?
a. | Tip the affected ear up and keep it in that position for
several minutes after instilling the medication. | b. | Keep the medication in the refrigerator to preserve it. Instill the medication
with the affected ear tilted upward. | c. | Touch the dropper
to the opening of the ear canal to ensure that the drops are correctly
instilled. | d. | Warm the ear drops
and then tilt the head downward. |
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37.
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What nursing action should be implemented when
irrigating a patient’s ear?
a. | Straighten the ear canal and irrigate with a
large-tipped bulb syringe. | b. | Direct the
solution to the middle of the canal to avoid damaging the ear. | c. | Use a body temperature solution and have the patient hold a basin under the
ear while directing the solution toward the top of the canal. | d. | Repeat the irrigation with hotter
water. |
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38.
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A nursing report on a newly admitted patient who is
profoundly deaf says that the patient is confused and difficult to assess because she does not
appropriately respond to questions or sometimes fails to respond at all. What should be the first
action of the oncoming nurse?
a. | Consider asking the physician to assess the patient for
dementia. | b. | Assess the patient to determine whether her hearing aids
are in. | c. | Report to the physician that the patient is exhibiting
signs of the sundown syndrome. | d. | Assess the
patient’s medications to check for an overdose. |
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39.
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Which nursing diagnosis is most appropriate for a
patient having ear surgery?
a. | Disturbed body image | b. | Risk for injury | c. | Acute
confusion | d. | Ineffective
protection |
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40.
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What significant instruction should a nurse include
to a patient being discharged after ear surgery?
a. | Use stool softeners with
caution. | b. | Assume your usual activities. | c. | Avoid blowing your nose. | d. | Shampoo your hair
with baby shampoo. |
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41.
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A patient with diabetes says that he needs a
hearing aid because he cannot hear well, and everything sounds garbled and distant. What type of
hearing loss should the nurse suspect?
a. | Mixed hearing loss | b. | Conductive hearing loss | c. | Central hearing
loss | d. | Sensorineural hearing
loss |
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42.
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Which nursing diagnosis should take priority in a
nursing care plan for a patient with Ménière disease?
a. | Social isolation, related to
anxiety | b. | Risk for injury, related to
falls | c. | Risk for deficient fluid intake, related to
weakness | d. | Nutrition: Less than body requirements, related to
fatigue |
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43.
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Which nursing diagnosis is most appropriate when
considering the impact of a hearing deficit when planning care for a child who has been diagnosed
with a hearing impairment?
a. | Risk for injury, related to hearing
impairment | b. | Risk for social
isolation, related to hearing impairment | c. | Knowledge deficit,
related to hearing impairment | d. | Anxiety, related
to hearing impairment |
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44.
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What information should a nurse stress when
teaching a patient with Ménière disease about managing the disorder?
a. | Limiting fluid intake | b. | Avoiding the use of alcohol and tobacco | c. | Using antiemetic medications sparingly | d. | Staying active during the day |
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45.
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An 85-year-old patient has had age-related changes
in the cochlea. What is the most appropriate nursing action for the nurse to implement?
a. | Speak slowly. | b. | Provide assistance with ambulation. | c. | Speak in a lower tone. | d. | Communicate with
the patient in writing. |
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46.
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A patient comes to the primary care clinic
complaining of a head cold and ear pain with drainage. What should the nurse suspect this patient is
experiencing?
a. | Otitis externa | b. | Hearing loss | c. | Acute otitis
media | d. | Mastoiditis |
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47.
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A young woman being admitted to the clinic service
states that all the members of her family have been hard of hearing. She says her hearing loss became
more pronounced when she was pregnant. What term explains this type of hearing loss?
a. | Otosclerosis | b. | Ototoxicity | c. | Otalgia | d. | Otitis
media |
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48.
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What should a nurse include when educating a
patient with Ménière disease?
a. | “When you feel dizzy, just stay in bed and take
your medications.” | b. | “Decrease
your sodium intake and take your diuretic medication between
attacks.” | c. | “Vestibular
rehabilitation might help, and you can still drink your morning
coffee.” | d. | “Your
vertigo will get better if you take your medications. You won’t need any relaxation
techniques.” |
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49.
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A 75-year-old patient reports having difficulty
hearing in crowds but can hear just fine at home with his wife. What hearing disorder should the
nurse suspect?
a. | Otitis media | b. | Presbycusis | c. | Ototoxicity | d. | Central
deafness |
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50.
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During an intake physical examination, a patient
reports that he has been taking 10 aspirin tablets a day for his arthritis. What question should the
nurse ask based on this information?
a. | “Can you hear high-pitched
sounds?” | b. | “Have you
noticed deafness in just one ear?” | c. | “Do you have
ringing in your ears?” | d. | “Do you
experience dizziness when you stand?” |
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51.
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The nurse is aware that the patient has 20/40
vision. This means that the patient can see at 20 feet what the normal eye can see at _______
feet.
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52.
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The patient tells the nurse that he is legally
blind. How would this information impact the nurse’s plan of care for this
patient?
a. | The patient would be considered totally
blind. | b. | This patient probably has some light perception, but no
usable vision. | c. | This patient has
some usable vision, which enables function at an acceptable level. | d. | The nurse would need to determine how this patient’s visual impairment
affects normal functioning. |
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53.
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One of the housekeepers splashes a chemical in the
eyes. What should be the first priority?
a. | Transport to a physician
immediately | b. | Cover the eyes
with a sterile gauze | c. | Irrigate with
H2O for 5 minutes | d. | Irrigate with
normal saline solution for 20 minutes |
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54.
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What does a tympanoplasty correct?
a. | Conductive hearing loss | b. | Sensorineural hearing loss | c. | Congenital hearing loss | d. | Functional hearing
loss |
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55.
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The 62-year-old home health patient who is
recovering from eye surgery complains of a feeling of “grittiness” in the eye and is
having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints
indicate?
a. | Sjögren syndrome | b. | Early cataracts | c. | Macular
degeneration | d. | Retinal
detachment |
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56.
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Four hours after a stapedectomy the patient
complains that hearing has not improved at all. What knowledge would the nurse use to shape a
response?
a. | A large percentage of stapedectomies are not
successful | b. | It will take at
least 10 days for the graft to heal | c. | Hearing will not
return until edema subsides | d. | Hearing will
improve after irrigation of the ear |
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57.
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What is a common mistake that hinders communication
when communicating with the hearing impaired?
a. | Overaccentuating words | b. | Facing the patient when speaking | c. | Speaking in conversational tones | d. | Speaking into the ear with the hearing
aid |
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58.
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What is the process when the lens of the eye
changes its curvature to focus on the retina?
a. | Accommodation | b. | Constriction | c. | Convergence | d. | Refraction |
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59.
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When the newly blind male home health patient asks
the nurse how he might get assistance, who might the nurse suggest he contact?
a. | American Red Cross | b. | American Foundation for the Blind for a list of
agencies | c. | Local hospital social worker | d. | The public health department |
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60.
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The nurse clarifies that the difference between a
photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a
LASIK:
a. | reshapes the central cornea. | b. | makes partial-thickness radial incisions in the
cornea. | c. | removes some internal layers of the
cornea. | d. | implants intracorneal
rings. |
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61.
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What does the cataract treatment of
phacoemulsification involve?
a. | “Drying” the cataract with hypertonic
saline | b. | Removing the lens through the anterior
capsule | c. | The insertion of a new lens | d. | Breaking the cataract with ultrasound |
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62.
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Which complaint made by a 64-year-old patient
during a health interview would alert the nurse to the possibility of cataracts?
a. | Pain in the eyes | b. | Difficulty driving at night | c. | Loss of peripheral vision | d. | Dry eyes |
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63.
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What should a patient who has had a cataract repair
avoid?
a. | The use of eye patches | b. | The use of sunglasses | c. | The lifting of
heavy objects | d. | Reading for long
periods of time |
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64.
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What does diabetes retinopathy result
from?
a. | Capillaries in retina
hemorrhage | b. | Long-term
overdosing of insulin | c. | Retinal
detachment | d. | Aging |
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65.
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When the patient in the emergency room complains of
seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom
of which condition?
a. | Detached retina | b. | Macular degeneration | c. | Early sign of
cataract | d. | Diabetic
retinopathy |
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66.
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The nurse will assess for _____________ when the
older adult home health patient complains that the entire right side of his head hurts and he cannot
chew without pain.
a. | mumps | b. | external otitis | c. | otitis
media | d. | labyrinthitis |
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67.
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The nurse takes into consideration that the Weber
test indicated a conductive hearing loss in a patient because the patient reported hearing the
tone:
a. | equally in both ears. | b. | as a shrill noise. | c. | louder in his
affected ear. | d. | very
faintly. |
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68.
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What should the nurse remind the hearing aid wearer
to do when the nurse hears a whistling hearing aid?
a. | Reinsert the ear mold | b. | Change the battery | c. | Recharge the
hearing aid | d. | Wash the ear mold
with warm water |
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69.
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What should the nurse advise the 20-year-old to do
who has been put on cefaclor (Ceclor) for a resistant otitis media?
a. | Store suspension at room
temperature | b. | Discontinue drug
when symptoms abate | c. | Avoid alcoholic
beverages | d. | Take with meals
only |
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70.
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How should the nurse advise a patient who has
severe vertigo from labyrinthitis?
a. | Lean against a wall and not head forward until vertigo
lessens. | b. | Bend at the waist and take several deep
breaths. | c. | Drink an iced drink slowly. | d. | Lie immobile and hold the head in one position until the vertigo
lessens. |
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71.
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What do miotic eyedrops do for a patient with
glaucoma?
a. | Dilate the pupil and sharpen
vision | b. | Lubricate and moisten the dry
eye | c. | Irrigate the surface of the
eye | d. | Constrict the pupil and open the canal of
Schlemm |
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72.
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What should the nurse include in the plan of care
following a tympanoplasty?
a. | Elevating head of bed with operative side facing
upward | b. | Enforcing bed rest for 72
hours | c. | Frequent turning, coughing, and deep
breathing | d. | Continuous irrigation of the ear canal with antibiotic
solutions |
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73.
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When the patient stares at the black dot on an
Amsler grid, what should the nurse ask him to report?
a. | Any color visible on the grid | b. | Fading of the edges of the grid | c. | Any distortion of the grid | d. | Movement of the black dot |
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74.
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A patient who had an enucleation of the right eye
has been admitted PACU. What should the nurse include in the plan of care?
a. | Turn, cough, and deep breathe every 3
hours | b. | Apply a pressure dressing over the right eye
socket | c. | Document dressing assessment every 2
hours | d. | Turn on the affected
side |
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75.
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What must a patient do following a left
vitrectomy?
a. | Remain flat in bed for 48
hours | b. | Position self in a face-down position for 4 to 5
days | c. | Assume a side-lying position with the left side down for
3 days | d. | Keep head upright and cushioned with pillows for 24
hours |
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76.
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How would the nurse explain the purpose of
photocoagulation to a diabetic patient with diabetic retinopathy?
a. | The procedure will destroy the retina, which is not
getting enough blood supply. | b. | The procedure will
reduce edema in the macula of the eye. | c. | The procedure will
vaporize fatty deposits that appear in the retina. | d. | The procedure will destroy new blood vessels, seal leaking vessels, and help
prevent retinal edema. |
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77.
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What is the first indication of macular
degeneration?
a. | The loss of peripheral vision | b. | The loss of central vision | c. | The loss of color discrimination | d. | Eye fatigue |
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78.
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Which is a sign of acute angle closure glaucoma
(AACG)?
a. | Large fixed pupil | b. | Nystagmus | c. | Bluish color in
sclera | d. | Drooping eyelid |
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79.
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Why is otitis media found more frequently in
children 6 to 36 months?
a. | Eustachian tubes in children are shorter and
straighter. | b. | Infection descends
via the eustachian tube to the throat. | c. | Children’s
eustachian tubes are more vertical and longer. | d. | Otitis media is
seen equally in both children and adults. |
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80.
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Why would the nurse encourage a group of teenagers
to protect their eyes with dark sunglasses while using a UV lamp?
a. | The lamp can cause cataracts. | b. | The lamp can cause presbycusis. | c. | The lamp can cause keratitis. | d. | The lamp can cause ectropion. |
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81.
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The nurse counsels the 16-year-old boy that playing
his music at high volume can result in impairment in hearing related to:
a. | damaged tympanic membrane. | b. | protective buildup of cerumen. | c. | damage of the fine hair cells in the organ of
Corti. | d. | rupture of the oval
window. |
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