Nclex-Rn Practice Questions-Care of Adults Sensory Management
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Question 1 |
During an assessment, the nurse covers the client’s right eye and then observes a shift in the client’s gaze after the eye is uncovered. Which conclusion should the nurse make about the results of the test?
A | The client has opacity of the lens- |
B | The client has absence of the blink reflex. |
C | The client has increased intraocular pressure. |
D | The client has weakness in the extraocular muscles. |
Question 2 |
A resident of a long-term care facility tells the nurse, “I’m having a hard time hearing people talk and can’t understand the voices on TV.” Which action is most appropriate?
A | Teach the client about eliminating background noises in the room. |
B | Assess the client’s hearing and use an otoscope for examination. |
C | Schedule an appointment with the HCP for bilateral ear irrigations. |
D | Instruct the client to look at the speaker’s lips to decipher words. |
Question 3 |
The client’s daughter tells the nurse of frustration while corrununicating with her elderly mother who wears hearing aids. Which intervention should the nurse suggest to the client’s daughter?
A | Minimize oral communication to essential matters. |
B | Speak directly into her mother’s better ear. |
C | Use exaggerated mouth expressions while speaking. |
D | Attract her mother’s attention before speaking. |
Question 4 |
The client has a hearing loss from a possible acoustic neuroma. The nurse should prepare the client for which diagnostic test to confirm the presence of a tumor?
A | Tympanometry |
B | Arteriogram of the cranial vessels |
C | Magnetic resonance imaging (MRI) |
D | Auditory canal biopsy |
Question 5 |
The client receives a prescription for sodium fluoride for otosclerosis and asks the nurse, “What will this medication do for my ears?” Which response by the nurse is correct?
A | “Sodium fluoride prevents the breakdown of bone cells and hardens the bone in the ear.” |
B | “Sodium fluoride causes the breakdown of bone cells and softens the bone in the ear.” |
C | “Sodium fluoride blocks the effect of histamine and dries the fluid in the ear.” |
D | “Sodium fluoride causes the production of histamine and increases the fluid in the ear.” |
Question 6 |
The nurse is reviewing the medication list of the client with Méniére’s disease. Which medication was likely prescribed for treating the client’s vertigo?
A | Meclizine |
B | Megestrol |
C | Meropenem |
D | Metoprolol |
Question 7 |
The nurse is planning the care of the client with Meniere’s disease. With which member of the interdisciplinary team should the nurse expect a consultation?
A | Rheumatologist |
B | Otolaryngologist |
C | Physical therapist |
D | Oncologist |
Question 8 |
The client has an hordeolum of the left eye, which is painful. Which intervention, if prescribed, should the nurse implement?
A | Apply an eye patch on the left eye. |
B | Insert miotic eye drops twice daily. |
C | Apply a warm compress four times daily. |
D | Administer an antibiotic intravenously. |
Question 9 |
The nurse is caring for multiple older adult clients with age-related visual changes. Which intervention should the nurse implement?
A | Provide reading materials with boldface, normal- sized font. |
B | Lower the intensity of reading lamps to prevent glare. |
C | Provide the clients with a magnifying device for reading. |
D | Give clients printed materials that use similar, blended colors. |
Question 10 |
The nurse is caring for the client who has a visual deficit. Which approach should the nurse use?
A | Acknowledge presence by greeting the client by name. |
B | Stand directly in front of the client to speak to the client. |
C | Use a loud, clear voice to address or talk to the client. |
D | Touch to get the client’s attention before providing care. |
Question 11 |
The client with diminished sight has problems with the glare from light. Which recommendation should the nurse make?
A | Install fluorescent lighting throughout the home. |
B | Wear sunglasses and hats with brims when outdoors. |
C | Avoid going outdoors on days that are sunny. |
D | Use direct sunlight from windows rather than lights. |
Question 12 |
The client tells the nurse about being diagnosed with “wet type” macular degeneration. Which finding should the nurse expect to observe when examining the client’s eyes using an ophthalmoscope?
A | Growth of abnormal blood vessels in the macula has occurred. |
B | Structures in the macula have atrophied. |
C | The lens of the eye has become cloudy. |
D | The edge of the cornea has a thin grayish arc. |
Question 13 |
The client recently diagnosed with age-related macular degeneration (AMD) in both eyes returns to the clinic for a follow-up appointment. Which assessment will the nurse be certain to include during the visit?
A | Stools for occult blood |
B | Blood glucose levels |
C | Screening for depression |
D | Screening for hearing loss |
Question 14 |
The nurse reviews the chart of the client diagnosed with closed-angle glaucoma. Which documented finding should the nurse question with the HCP?
A | Sudden onset of eye pain |
B | Reduced central visual acuity |
C | Normal intraocular pressure |
D | Nausea and vomiting |
Question 15 |
The client is receiving treatment with gentamicin ophthalmic solution for bacterial conjunctivitis. Which symptom, described by the client, indicates that the medication is ineffective?
A | Eyes feel strained |
B | Yellowish eye drainage |
C | Twitching of the eye |
D | Unable to read small print |
Question 16 |
The client recently diagnosed with glaucoma tells the nurse, “I’m having difficulty remembering to insert my eye drops. I don’t have any pain or vision changes when I forget them.” Which statement is the best response?
A | “You should be diligent in inserting the eye drops; if not, then you will need surgery.” |
B | “You wouldn’t have pain, but untreated glaucoma will eventually lead to vision loss.” |
C | “Tell me about your day; planning a time with a daily activity often helps as a reminder.” |
D | “I know this must be hard for you; not everyone is able to remember everything.” |
Question 17 |
The nurse is concerned that the client in a long-term care facility is experiencing retinal detachment. Which intervention should the nurse implement first?
A | Flush the eye thoroughly with saline solution and apply a pressure bandage. |
B | Apply an eye shield to the affected eye and give a prescribed oral analgesic. |
C | Notify the HCP; prepare for transport to a facility for ophthalmological care. |
D | Patch both eyes and place the client in a prone position until blurring stops. |
Question 18 |
The nurse speaks with the client who recently learned that cataracts are developing in both of the client’s eyes. Which statement made by the client should the nurse correct?
A | “It is important that I schedule my surgery as soon as possible.” |
B | “Usually surgery is performed on each eye at different times.” |
C | “My own lens will be removed when I have cataract surgery.” |
D | “An intraocular lens may be inserted with the surgical procedure.” |
Question 19 |
The client with glaucoma is prescribed pilocarpine hydrochloride 1% eye drops to both eyes four times per day. The nurse knows that this medication has which expected action?
A | Increases the outflow of aqueous humor |
B | Improves vision in dimly lit environments |
C | Increases production of aqueous humor |
D | Increases ability of both pupils to dilate |
Question 20 |
The nurse is teaching the client who has otitis media. To reduce the risk of recurrent otitis media, which vaccine should the nurse recommend?
A | 1 . Varicella vaccine |
B | 2. Pneumococcal vaccine |
C | 3. Typhoid vaccine |
D | 4. Zoster vaccine |
Question 21 |
The nurse telephones the client 1 day post—cataract surgery. Which client statement necessitates an evaluation by an ophthalmologist?
A | “My eye starts hurting about 4 hours after a pain pill.” |
B | “The redness in my eye is a little less than yesterday.” |
C | “There has never been any swelling around my eye.” |
D | “I can’t see as well as I could yesterday after surgery.” |
Question 22 |
The client is one day post—surgical repair of a retinal detachment. Which assessment finding is most important for the nurse to report immediately to the HCP because it indicates a significant complication?
A | Surgical eye pain rated 2 on a 10-point scale |
B | Increased tearing from the surgical eye |
C | Blurred vision and floaters in the surgical eye |
D | Dryness and injection of the sclera in the surgical eye |
Question 23 |
The client tells the nurse, “I have something under my upper eyelid and don’t recall how it happened.” The client has no eye redness or pain and no changes in vision. Which intervention should the nurse implement?
A | Notify the client’s health care provider for guidance. |
B | Flush the client’s eye with sterile saline for 10 minutes. |
C | Evert the upper lid with a cotton-tipped applicator for examination. |
D | Place an eye patch, taping from the outside of the eye to the inside. |
Question 24 |
The nurse is reviewing the new nurse’s discharge instructions for the client following outpatient cataract surgery. Which statement should the experienced nurse remove from the discharge instructions?
A | Avoid lifting, pushing, or pulling objects heavier than 15 pounds. |
B | Clean the eye with a clean tissue; wipe from inner to outer eye. |
C | Cough and deep breathe every 2 to 3 hours while you are awake. |
D | Avoid lying on the side of the affected eye the night after surgery. |
Question 25 |
The client’s eyes, tested with the use of a Snellen chart, show 20/40 vision in the right eye and 20/30 in the left eye. How should the nurse interpret these results?
A | The client has elevated intraocular pressure in both eyes. |
B | The client needs testing for glaucoma with a tonometer. |
C | The left eye is closer to normal vision than the right eye. |
D | The client has errors of refraction indicating astigmatism. |
Question 26 |
The 60-year-old client notices a gradual decline in visual acuity and asks if it could be from a cataract. Which question will help determine whether a cataract is developing?
A | “Has your ability to perceive colors changed?” |
B | “Does your vision appear distorted or wavy?” |
C | “Does the center of your visual field appear dark?” |
D | “Do you see random flashes of bright light?” |
Question 27 |
The nurse is teaching the client with open-angle glaucoma. Which instruction should the nurse include?
A | Limit oral fluid intake to 1000 mL daily. |
B | Eat foods that are high in omega-3 fatty acids. |
C | Have annual eye exams with an eye specialist. |
D | Use timolol maleate eye drops when feeling eye pressure. |
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