Eye Problem

Situation: Mang Tomas is a 60 year old man who has just had cataract surgery performed on his right eye.
1. The physician has prescribed Cyclogel preoperatively to:
a) prevent dryness of the cornea and conjunctiva
b) reduce the inflammation of the iris and choroids
c) paralyze the ciliary muscle
d) promote drainage of aqueous humor from the chamber of the eye
2. After discharge, Mang Tomas attends the eye clinic for follow-up visits. When he receives his cataract glasses, it is important that
the nurse advise him that:
a) his peripheral vision will be increased
b) objects will appear closer than they really are
c) magnification by the lens is only about 10%
d) daily eye drops are required with these lenses
3. The nurse should instruct a client preparing for eye surgery that which of these activities will be restricted post-operatively?
a) bending with the knees flexed
b) bending from the waist
c) keeping the head in a neutral position
d) lying flat
4. Nursing care for Mang Tomas during the first 48 hours after surgery will include:
a) maintain bed rest
b) changing the dressing daily
c) encouraging coughing and deep breathing
d) lie on the unoperated side

Situation: Mang Ben is diagnosed with glaucoma and is scheduled for surgery.
5. Which symptoms are associated with acute closed-angle glaucoma?
a) diplopia and photophobia
b) episodic blindness and no pain
c) blurred vision and colored rings around lights
d) sensation of curtain drawn across the visual field
6. Which order for Mang Ben before surgery will the nurse question:
a) demerol (meperidine) 50 mg IM
b) atropine sulfate 0.4 mg IM
c) valium (diazepam) 2 mg IM
d) phenergan (promethazine) 25 mg IM
7. A physician prescribes "patching" for a child with strabismus of the right eye. A nurse instructs the motherregarding this
procedure. Which of the following statements when made by the mother indicates that she understands the instruction?
a) I will place the patch on the right eye
b) I will place the patch on both eyes
c) I will place the patch on the left eye
d) I will alternate the patch from right to left eye hourly
8. The client comments, "I frequently change my eye glasses, none of which is satisfactory and I have difficulty focusing on my
work." Which of the following disorders may the client be experiencing?
a) cataract
b) glaucoma
c) detached retina
d) myopia
9. An 85-year old woman complains of pain in her operated eye after cataract removal surgery. The nurse knows that this
symptoms is
a) expected, and she should offer analgesic
b) unexpected and may signify a detached retina
c) unexpected and may indicate hemorrhage
d) expected and she should advise the client to be on bed rest
10. The client had just undergone repair of detached retina. Which of the following should be included in thenursing care plan of the
client?
a) encourage self-care activities
b) limit movement of his eyes
c) restrict excessive talking
d) limit fluid intake
11. Which of the following is an effective technique of communicating with a hearing impaired client?
a) speak slowly in a low tone of voice
b) speak slowly in a loud voice
c) speak slowly and try to overemphasize words
d) speak slowly and directly in front of the client
12. Which of the following client statements indicates the need to postpone cataract surgery in the morning?
a) this seasonal allergy should no be a problem
b) the medications instilled into my eyes make my vision blurred
c) I feel nervous with my operation tomorrow
d) I have allergy to certain medications
13. Which of the following is done when performing Weber test?
a) place vibrating tuning fork in front of the opening of the ear
b) place the vibrating tuning fork in the middle of the head
c) place the vibrating tuning fork behind the ear
d) irrigate the ear with cold water and observe movement of the eyes
14. The client has been diagnosed to have Meniere's disease. Which of the following should be included when giving health
teachings?
a) limit carbohydrates and proteins in the diet
b) limit salt intake
c) limit fats in the diet
d) drink a lot of fluids
15. The nurse plans care for a client with acute glaucoma who reports severe pain in the eyes and rainbow colors (halos) around
lights. Which action should the nurse take first?

a) administer pain medication
b) explain to the client that with reduction in intraocular pressure, pain and other symptoms will subside
c) provide preoperative teachings to the client
d) assess the client's visual status
16. A nurse is providing instructions to a client and the family regarding home care after right eye cataract removal. Which
statement by the client would indicate an understanding of the instructions?
a) I will not sleep on my left side
b) I will not sleep on my right side
c) I will not sleep with my head elevated
d) I will not wear my glasses until my physician says it is okay
17. A day care nurse is observing a 2-year old child and suspects that the child may have strabismus. Which observation made by
the nurse might indicate this condition?
a) the child has difficulty
b) the child consistently tills the head to see
c) the child consistently turns the head to see
d) the child does not respond when spoken to
18. The mother of a 6-year old child arrives at a clinic because the child has been experiencing scratchy, red, and swollen eyes.
The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is
diagnosed. Based on this diagnosis, the nurse determines that which of the following requires further investigation?
a) possible trauma
b) possible sexual abuse
c) presence of an allergy
d) presence of a respiratory infection
19. A nurse prepares a teaching plan for a mother of a child diagnosed with bacterial conjunctivitis. Which of the following, if stated
by the mother, indicates a need for further teaching?
a) I need to wash my hands frequently
b) I need to clean the eye as prescribed
c) it is okay to share towels and washcloths
d) I need to give the eye drops as prescribed
20. A nurse provides discharge instructions to the mother of a child after myringotomy with insertion of tympanostomy tubes. The
nurse determines that the mother needs additional instructions if the mother states that:
a) swimming in deep water is prohibited
b) swimming in lake water needs to be avoided
c) she will place earplugs in the child's ears during baths and showers
d) she will be sure to give her child soft tissues to blow his nose
21. Shortly after a neonate is delivered, erythromycin is instilled into the neonates eyes. This drug is given to prevent:
a. Ophthalmia neonatorum
b. Retrolental fibroplasias
c. Corneal keratitis
d. Acute uveitis
22. An older female client confides to the visiting nurse that she is afraid she will fall while going to the bathroom at night.
Which suggestion, if made by the nurse, indicates that the nurse understands the visual changes affectingthe older client?
a) limit your fluid intake during the day
b) use a commode in your bedroom at night
c) keep a red light on the bathroom at night
d) us ea bell to call your daughter if you need to get up
23. The nurse is developing a plan of care for the client scheduled for cataract surgery. The nurse documents which most
appropriate nursing diagnosis in the plan of care?
a) anxiety
b) self-care deficit
c) nutrition, imbalanced
d0 sensory perception, disturbed
24. The nurse is performing an assessment on a client with a suspected diagnosis of cataract. The chief clinical manifestation that
the nurse would expect to note in the early stages of cataract formation is:
a) diplopia
b) eye pain
c) floating spots
d) blurred vision
25. In preparation for cataract surgery, the nurse is to administer prescribed eye drops. The nurse reviews the physician's orders,
expecting which type of eye drops to be prescribed?
a) a miotic agent
b) a thiazide diuretic
c) an osmotic diuretic
d) an mydriatic medication
26. During the early postoperative period, the client who has had a cataract extraction complains of nausea and severe eye pain
over the operative site. The initial nursing action is to:
a) call the physician
b) reassure the client that this is normal
c) turn the client on his or her operative side
d) administer the ordered pain medication and anti-emetic
27. The client is being discharged from the ambulatory care unit following cataract removal. The nurse
providesinstructions regarding home care. Which of the following, if stated by the client, indicates an understanding of
theinstructions?
a) I will take aspirin if I have any discomfort
b) I will sleep on the side that I was operated on
c) I will not lift anything if weighs more than 10 pounds
d) I will wear my eye shield at night and my glasses during the day
28. The client with glaucoma asks the nurse if complete vision will return. The most appropriate response is:
a) your vision will never return to normal
b) your vision will return soon as the medication begins to work
c) your vision loss is temporary and will return in about 3 to 4 weeks
d) although some vision has been lost and cannot be restored, further loss may be prevented by adhering to the treatment plan

29. The nurse is developing a teaching plan for the client with glaucoma. Which of the following instructions would the nurse include
in the plan of care?
a) avoid overuse of the eyes
b) decrease the amount of salt in the diet
c) eye medications will need to be administered for the client's entire life
d) decrease fluid intake to control the intraocular pressure
30. The nurse is preforming an admission assessment on a client with a diagnosis of detached retina. Which of the following is
associated with this eye disorder?
a) total loss of vision'
b) pain in the affected eye
c) a yellow discoloration of hte sclera
d) a sense of a curtain falling across the field of vision
31. The nurse is caring for a client with a diagnosis of detached retina. Which assessment sign would indicate thatbleeding has
occurred as a result of the retinal detachment?
a) total loss of vision
b) a reddened conjunctiva
c) a sudden sharp pain in the eye
d) complaints of a burst of black spots or floaters
32. The client arrives in the emergency room following an automobile accident. The client's forehead hit thesteering wheel and a
hyphema is diagnosed. The nurse places the client in which position?
a) flat on bed rest
b) semi-fowler's on bed rest
c) lateral on the affected side
d) lateral on the unaffected side
33. The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which intervention is initiated
immediately?
a) notify the physician
b) apply ice to the affected eye
c) irrigate the eye with cool water
d) accompany the client to the emergency room
34. The client arrives in the emergency room with a penetrating eye injury from wood chips that occurred while cutting wood. The
nurse assesses the eye and notes a piece of wood protruding form the eye. What is the initialnursing action?
a) apply an eye patch
b) perform visual acuity tests
c) irrigate the eye with sterile saline
d) remove the piece of wood using a sterile eye clamp
35. The client arrives in the emergency room after sustaining a chemical eye injury from a splash of battery acid. The
initial nursing action is to:
a) begin visual acuity testing
b) cover the eye with a pressure patch
c) swab the eye with antibiotic ointment
d) irrigate the eye with sterile normal saline
36. The nurse is caring for a client following enucleation. The nurse notes the presence of bright red drainage on the dressing.
Which nursing action is appropriate?
a) notify the physician
b) document the finding
c) continue to monitor the drainage
d) mark the drainage on the dressing and monitor for any increase in bleeding
37. A 55-year old woman was working in her garden. She accidentally sprayed insecticide into her right eye. She calls the
emergency room frantic and screaming for help. The nurse should instruct the woman to take which immediate action?
a) call the physician
b) irrigate the eyes with water
c) come to the emergency room
d) irrigate the eyes with diluted hydrogen peroxide
38. The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the following identifies the
accurate procedure for this visual acuity test?
a) the right eye is tested, followed by the left eye, and then both eyes are tested
b) both eyes are assessed together, followed by the assessment of the right and the left eyes
c) the client is asked to stand at a distance of 40 feet from the chart and asked to read the largest line in the chart
d) the client is asked to stand at a distance of 40 feet from the chart and read the line that can be read 200 feet away by an
individual with unimpaired vision
39. The client's vision is tested with a Snellen chart. The results of the tests are documented as 20/60. The nurse interprets this as:
a) the client is legally blind
b) the client's vision is normal
c) the client can read at distance of 60 feet what a client with normal vision can read at 20 feet
d) the client can read only at distance of 20 feet what a client with normal vision can read at 60 feet
40. The clinic nurse notes that following several eye examinations, the physician has documented a diagnosis of legal blindness in
the client's chart. The nurse reviews the results of the Snellen chart test expecting note which finding?
a) 20/20 vision
b) 20/40 vision
c) 20/60 vision
d) 20/200 vision
41. Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse analyzes the test
results as documented in the client's chart and understands that the normal intraocular pressure is:
a) 2 to 7 mm Hg
b) 10 to 21 mm Hg
c) 22 to 30 mm Hg
d) 31 to 35 mm Hg
42. The nurse is preparing a teaching plan for a client who is undergoing cataract extraction with intraocularimplantation. Which
home care measures will the nurse include in the plan? Select all that apply
a) avoid activities that require bending over
b) contact the surgeon if eye scratchiness occurs
c) place an eye shield on the surgical eye at bedtime
d) episodes of sudden severe pain in the eye are expected
e) contact the surgeon if a decrease in visual acuity occurs
f) take acetaminophen (Tylenol) for minor eye discomfort
43. The client is receiving an eye drop and eye ointment to the right eye. The nurse should:
a) administer the eye drop first, followed by the eye ointment
b) administer the eye ointment first, followed by the eye drop
c) administer the eye drop, wait 10 minutes, and administer the eye ointment
d) administer the eye ointment, wait 10 minutes, and administer the eye drop
44. The nurse is caring for a client with glaucoma. Which of the following medications, if prescribed for the client, would the nurse
question?
a) carbachol (Carboptic)
b) atropine sulfate (Isopto Atropine)
c) pilocarpine (Ocusert Pilo-20, Ocusert Pilo-40)
d) pilocarpine hydrochloride (Isopto Carpine)
45. A miotic medication has been prescribed for the client with glaucoma. The client asks the nurse about the purpose of
the medication. The nurse tells the client that:
a) the medication will help dilate the eye to prevent pressure from occurring
b) the medication will relax the muscles of the eyes and prevent blurred vision
c) the medication causes the pupil to constrict and will lower the pressure in the eye
d) the medication will help block the responses that are sent to the muscles in the eye
46. Pilocarpine hydrochloride (Isopto Carpine) is prescribed for the client with glaucoma. Which of the following medications does
the nurse plan to have available in case of systemic toxicity?
a) atropine sulfate
b) pindolol (Visken)
c) protamine sulfate
d) naloxone hydrochloride (Narcan)
47. Betaxolol hydrochloride (Betoptic) eye drops have been prescribed for the client with glaucoma. Which of the following nursing
actions is most appropriate related to monitoring for the side effects of this medication?
a) monitoring temperature
b) monitoring blood pressure
c) assessing peripheral pulses
d) assessing blood glucose level
48. In preparation for cataract surgery, the nurse to administer cyclopentolate (Cyclogyl) eye drops. The nurse a is to administer
the eye drops, knowing that the purpose of this medication is to:
a) produce miosis of the operative eye
b) dilate the pupil of the operative eye
c) provide lubrication to the operative eye
d) constrict the pupil of the operative eye
49. The home health nurse visits a client at home and instructs the client on the administration of the prescribedeye drops. Which of
the following statements by the client indicates a need for further education?
a) I can lie down, pull up the upper lid, and place the drop in the lower lid
b) I can lie down, pull down on the lower lid, and place the drop in the lower lid
c) I can sit and tilt my head back, pull down on the lower lid, and place the drop in the lower lid
d) I can lie on my side opposite to the eye I am going to place the drop, put the drop in the corner of the lid nearest my nose, and
then slowly turn to my other side while blinking
50. The nurse is providing instructions to a client who will be self-administering eye drops. To minimize the systemic effects that eye
drops can produce, the nurse instructs the client to:
a) eat before instilling the drops
b) swallow several times after instilling the drops
c) blink vigorously to encourage tearing after instilling the drops
d) occlude the nasolacrimal duct with a finger over the inner canthus for 30 to 60 seconds after instilling the drops

Hearing Problem
1. The nurse is providing instructions to a nursing assistant regarding care of an older client with hearing loss. The nurse tells the
assistant that clients with a hearing loss:
a) are often distracted
b) have middle ear changes
c) respond to low-pitched tones
d) develop moist cerumen production
2. The nurse is performing an otoscopic examination on a client with mastoiditis. On examination of the tympanicmembrane, which
of the following would the nurse expect to observe?
a) a pink-colored tympanic membrane
b) a pearly colored tympanic membrane
c) a transparent and clear tympanic membrane
d) a red, dull, thick and immobile tympanic membrane
3. The client is diagnosed with a disorder involving the inner ear. Which of the following is the most common
clientcomplaint associated with a disorder involving this part of the ear?
a) pruritus
b) tinnitus
c) hearing loss
d) burning in the ear
4. The nurse is performing a voice test to assess hearing. Which of the following describes the accurate procedure for performing
this test?
a) whisper a statement while the client blocks both ears
b) whisper a statement with the examiner's back facing the client
c) whisper a statement and ask the client to repeat it while blocking one ear
d) stand 4 feet away from the client to ensure that the client can hear at this distance
5. During a hearing assessment, the nurse notes that the sound lateralizes to the client's left ear with the Weber test. The nurse
analyzes these results as:
a) a normal finding
b) the presence of nystagmus
c) a sensorineural or conductive loss
d) a conductive loss in the right ear
6. The nurse is caring for a hearing-impaired client. Which of the following approaches will facilitate communication?
a) speak loudly
b) speak frequently
c) speak at a normal volume
d) speak directly into the impaired ear
7. A client arrives at the emergency room with a foreign body in the left ear that has been determined to be an insect. Which
intervention would the nurse anticipate to be prescribed initially?
a) irrigation of the ear
b) instillation of diluted alcohol
c) instillation of antibiotic ear drops
d) instillation of corticosteroid ointment
8. The nurse notes that the physician has documented a diagnosis of presbycusis on the client's chart. The nurse plans care
knowing that the condition is:
a) tinnitus that occurs with aging
b) nystagmus that occurs with aging
c) a conductive hearing loss that occurs with aging
d) a sensorineural hearing loss that occurs with aging
9. The nurse has conducted discharge teaching for a client who has had a fenestration procedure for the treatment of otosclerosis.
Which of the following, if stated by the client, would indicate that teaching was effective?
a) it is okay to take a shower and wash my hair
b) I can resume my tennis lessons starting next week
c) I will take stool softeners as prescribed by my doctor
d) I should drink liquids through a straw fo the next 2 to 3 weeks
10. A client with Meniere's disease is experiencing severe vertigo. Which instruction should the nurse give to the client to assist in
controlling the vertigo?
a) increase sodium in the diet
b) avoid sudden head movements
c) lie still and watch the television
d) increase fluid intake to 3L a day
11.The nurse is caring for a client following craniotomy for removal of an acoustic neuroma. Assessment of which of the following
cranial nerves would identify a complication specifically associated with this surgery?
a) cranial nerve I, olfactory
b) cranial nerve IV, trochlear
c) cranial nerve III, oculomotor
d) cranial nerve VII, facial nerve
12. The nurse assesses the client with a blunt injury sustained from a motor vehicle accident. Which assessment sign would
indicate a basal skull fracture as a result of the injury?
a) epistaxis
b) periorbital edema
c) purulent drainage from the auditory canal
d) bloody or clear drainage from the auditory canal
13. A client was just admitted to the hospital to rule out a gastrointestinal (GI) bleed. The client has brought several bottles
of medications prescribed by different specialists. During the admission assessment, the client states, "Lately, I have been hearing
some roaring sounds in my ears, especially when I am alone." Whichmedication would the nurse determine could be the cause of
the client's complaint?
a) doxycycline (Vibramycin)
b) acetazolamide (Diamox)
c) acetylsalicylic acid (aspirin)
d) diltiazem hydrochloride (Cardizem)
14. The nurse prepares the client for an ear irrigation as prescribed by the physician. In performing the procedure, the nurse:
a) warms the irrigating solution to 98F
b) position the client with the affected side up following the irrigation
c) directs a slow steady stream of irrigation solution toward the eardrum
d) assists the client to turn his or her head so that the ear to be irrigated is facing upward
15. Ear drops are prescribed for an infant with otitis media. The most appropriate method to administer the ear drops to the infant is
to:
a) pull up and back on the pinna and direct the solution onto the eardrum
b) pull down and back on the pinna and direct the solution onto the eardrum
c) pull down and back on the pinna and direct he solution toward the wall of the canal
d) pull up and back on the ear lobe and direct the solution toward the wall of the canal
16. The nurse is preparing to perform an otoscopic examination on an adult client. The nurse does which of the following to perform
this examination?
a) pulls the pinna up and back before inserting the speculum
b) pulls the earlobe down and back before inserting the speculum
c) uses the smallest speculum available to decrease the discomfort of the exam
d) tilts the clients head forward and down before inserting the speculum
17. A nurse is providing diet instructions to a client with Meniere's disease who is being discharged from the hospital
after admission for an acute attack. Which statement if made by the client indicates anunderstanding of the dietary measures to
take to prevent further attacks?
a) I need to drink at least 3 liters of fluid per day
b) I need to restrict my carbohydrates intake
c) I need to maintain a low-fat and low-cholesterol diet
d) I need to be sure to consume foods that are low in sodium
18. A nurse in the health care clinic is providing instructions to a client regarding the use of a hearing aid. Which of the
following statements would be appropriate for the nurse to include?
a) the ear mold for the hearing aid should be washed with mild soap and water once a month
b) the hearing aid should be removed from the ear at the end of the day then turned off after removal
c) the hearing aid contains a lifelong battery so you will not need to be concerned about changing batteries
d) the hearing aid should not be worn if an ear infection is present
19. A nurse is caring for a client with acute otitis media. In order to reduce pressure and allow fluid to drain, the nurse anticipates
that which of the following would most likely be recommended to the client?
a) the administration of diphenhydramine (Benadryl) capsules
b) a myringotomy
c) strict bedrest
d) a mastoidectomy
20. A nurse is developing a plan of care for a client with a diagnosis of Meniere's disease who is being admitted to the hospital. The
priority nursing intervention in the plan of care should focus on:
a) safety measures
b) self-care measures
c) knowledge about medication therapy
d) food items to avoid
21. A nurse is assigned to care for a client after a mastoidectomy. Which nursing intervention would be appropriate in the care of
this client?
a) maintain a supine position
b) position the client on the affected side to promote drainage
c) change the ear dressing daily
d) monitor for signs of facial nerve injury
22. A nurse is performing an assessment on a client with a diagnosis of Meniere's disease. The nurse anticipates that the client is
most likely to report which of the following symptoms during an acute attack?
a) tinnitus
b) headache
c) fatigue
insomnia
23. A nurse has admitted a client with a diagnosis of an acute attack of Meniere's disease to the hospital. The nurse reviews the
physician's orders for the client. Which order should the nurse question?
a) diphenhydramine (Benadryl)
b) diazepam (Valium)
c) atropine sulfate
d) ambulation 4 times daily
24. A nurse in the health care clinic is preparing to perform an otoscopic examination on adult client. In performing the examination,
the nurse should:
a) position the client lying flat on the side of the ear be examined
b) pull the ear lobe down and back before inserting the speculum
c) tilt the client's head forward before inserting the speculum
d) pull the pinna up and back before inserting the speculum

25. A nurse is providing discharge instructions to the client being discharged after a fenestration procedure for the treatment of
otosclerosis. Which statement if made by the client indicates a need for further instruction?
a) I should take stool softeners to avoid straining when having a bowel movement
b) I need to avoid washing my hair and showering for at least 1 week
c) I should avoid movements requiring bending over for at least 3 weeks
d) I should use a straw to drink liquids for the next 2 to 3 weeks
26. The clinic nurse is preparing to provide care for a client who will need an ear irrigation to remove impacted cerumen. Which
of the following will the nurse avoid when performing the irrigation?
a) position the client to turn the head so that the ear be irrigated is facing upward
b) warm the irrigating solution to a temperature that is close to body temperature
c) direct a slow steady stream of irrigation solution toward the upper wall of the ear canal
d) position the client with the affected side down after irrigation
27. A nursing student is performing an otoscopic examination in an adult client. The nursing instructor observes the student perform
this procedure. Which observation by the instructor indicates that the student is using correct technique for the procedure?
a) pulling the pinna down and back before inserting the speculum
b) pulling the earlobe down and back before inserting the speculum
c) using the smallest speculum available
d) tilting the client's head slightly away and holding the otoscope upside before inserting the speculum
28. A nurse is preparing to perform a Weber test on a client. The nurse obtains which item needed to perform this test?
a) a tongue blade
b) a stethoscope
c) a tuning fork
d) a reflex hammer
29. The home care nurse is visiting a client who was recently diagnosed with a hearing impairment. The nurse prepares to instruct
the client's spouse in which measure that will facilitate communication?
a) speak frequently to the client to provide sensory stimulation
b) speak loudly to the client to facilitate hearing
c) speak in a normal tone and face the client when speaking
d) speak directly into the impaired ear to facilitate hearing
30. A nurse is providing discharge instructions to a client who had a fenestration procedure for the treatment of otosclerosis. The
nurse instructs the client to:
a) drink liquids through a straw for the next 2 to 3 weeks
b) shower daily to prevent infection
c) avoid air travel
d) resume all normal activities in 1 week
31. A clinic nurse is preparing to perform a Romberg test on a client being seen in the clinic. The nurse performsthis test for the
purpose of determining:
a) the client's ability to ambulate
b) the functional status of the vestibular apparatus in the inner ear
c) the intactness of the retinal structure of the eye
d) the intactness of the tympanic membrane
32. A clinic nurse is performing an otoscopic examination on an adolescent who was hit in the ear with a basketball during a
neighborhood game. A perforated eardrum is suspected. Which of the following would the nurse expect to observe if the eardrum is
perforated?
a) a colony of black dots on the eardrum
b) dense white patches on the eardrum
c) a red bulging eardrum
d) a round or oval darkened area on the eardrum
33. A caloric test is ordered for a client suspected of having disease of the labyrinth. The nurse would obtain which of the following
essential items in preparation for this test?
a) an otoscope
b) an opthalmoscope
c) a tongue blade
d) an emesis basin
34. A nurse educator is conducting an in-service education session to the nurses employed in the eye and ear surgical unit of a
large trauma center. In discussing the topic of cochlear implants, the educator notes that this surgical procedure is contraindicated
in which of the following clients?
a) a client who became deaf before learning to speak
b) a client with bilateral profound hearing loss
c) a client who communicates primarily by speech
d) a client who received no benefit from conventional hearing aids
35. A nurse is observing a nursing assistant communicating with a client who is deaf. The nurse will intervene ifwhich of the
following behaviors is observed?
a) the nursing assistant is speaking directly to the client
b) the nursing assistant touches the client's arm to gain his or her attention
c) the nursing assistant faces the client when speaking to the client
d) the nursing assistant overenunciates words when speaking
36. A nurse is planning a presentation on noise prevention and ear protection for a display booth at a local health fair. The nurse
plans to incorporate which important concept regarding hearing loss in the presentation?
a) siting near loud music is not harmful
b) ear plugs or other protectors are necessary only when use of power tools
c) prolonged ringing in the ears after loud noises is normal
d) cup the hands over the ears if loud noise is expected suddenly
37. A nurse instructs a client in the use of a hearing aid. The nurse includes which of the following in the instructions?
a) check the battery to ensure that it is working before use
b) leave the hearing aid in place while showering
c) hearing aids do not require any care
d) a water-soluble lubricant is used on the hearing aid before insertion
38. A nurse has given a client at risk for motion sickness suggestions about medications that can prevent an occurrence. The nurse
determines that the client has correctly learned the information if the client states to take medication at what time before the
triggering event?
a) at least 1/2 day before
b) at least 1 hour before
c) at least the day before
d) at least 2 days before
39. An adult client makes an appointment with an ear specialist because of the frequent recurrence of middle ear infections. In
performing an intake assessment of the client, the nurse would ask about which of the following as a risk factor related
to infection of the ears?

a) exposure to loud noise
b) use of drilling and other power tools
c) congenital abnormalities
d) occupational noise
40. A nurse is planning to instruct a client with chronic vertigo about safety measures to prevent exacerbation of symptoms or injury.
Teaching for this client will include which of the following statements?
a) drive only when feelings of dizziness have not been experienced for several hours
b) go to the bedroom and lie down when vertigo is experienced
c) remove throw rugs and clutter in the home
d) turn the head slowly when spoken to
41. A nurse is preparing a plan of care for a client being admitted to the hospital with exacerbation of Meniere's disease. Which of
the following would the nurse include in the plan of care?
a) increase fluid intake to 3000 ml a day
b) tell the client to avoid moving the head suddenly
c) maintain a quiet environment, and allow the client to read and watch TV
d) increase foods high in sodium in the diet
42. A nurse is performing an assessment of a client suspected of having mastoiditis. Which finding would the nurse expect to note if
this disorder is present?
a) an elevated temperature
b) a red, dull, thick, and immobile tympanic membrane
c) a clear tympanic membrane
d) a transparent tympanic membrane
43. A nurse is performing an admission assessment of a client with a disorder involving the inner ear. Which of the following
questions will the nurse ask the client to determine if the common symptom of this type of ear disorder is present?
a) do you have any hearing loss?
b) do you have any itching around your ear?
c) do you have any ringing in the ears?
d) do you have any pain in the ear?
44. A new nursing graduate has been hired by the health care clinic to assist in conducting hearing tests in a local neighborhood.
The clinic nurse is observing the nursing graduate perform a voice test to assess hearing in a client. Which of the following
observations indicates that the graduate is performing the procedure correctly?
a) start 10 feet away from the client to determine if the client can hear clearly
b) asks the cleint to block one ear, quietly whispers a statement, and asks the client to repeat it
c) whispers a statement with the back facing the client
d) asks the client to block the ears, faces the client, verbalizes a statement, and asks the client to repeat the statement
45. A clinic nurse receives a telephone call form a client who states that an insect has somehow flown into her ear and that a
buzzing sound can be heard. The client asks the nurse how to remove the insect. Which of the following instructions should the
nurse initially provide to the client?
a) have her spouse irrigate ear to kill the insect
b) use a flashlight to try to coax the insect out of the ear
c) instill antibiotic eardrops if they are available
d) get into the shower and allow the ear to run into the ear to flush out the insect
46. A nurse is caring for a hospitalized client with an acute attack of Meniere's disease. The client verbalizes concern because the
client has experienced a hearing loss as a result of the attack. Which of the followingresponses would the nurse make to the client
regarding the hearing loss?
a) it will take several weeks before the hearing returns
b) the hearing loss will fluctuate for a period of 1 week
c) the attack leaves a hearing loss in the involved ear
d) the hearing will return to normal
47. A nurse is reviewing the physician's orders on a client admitted to the hospital with a diagnosis of an acute attack of Meniere's
disease. Which of the following orders, if noted on the client's chart, would the nurse question?
a) the administration of a sedative
b) the administration of an antihistamine
c) the administration of vasoconstrictor
d) bedrest
48. A nurse is providing discharge instructions to the client who was hospitalized for an acute attack of Meniere's disease. Which
of the following statements, if made by the client, indicates a need for further instructions?
a) I need to take the diuretics to decrease the fluid in the ear
b) I need to take antihistamine as prescribed
c) I need to take a vasodilator
d) it is not necessary to restrict salt in my diet
49. A client with a diagnosis of otosclerosis is admitted to the ambulatory care unit for stapedectomy, and the nurse prepares
instructions for the client regarding home care after the procedure. Which statement by the client indicates a need for further
instructions?
a) I need water out of the ear canal for at least 3 weeks
b) I need to avoid air travel for at least 1 year
c) I need to notify the physician if I experience any persistent dizziness
d) I need to avoid bending and lifting heavy objects for at least 3 weeks
50. A community health nurse is conducting a health-screening clinic and is scheduled to perform hearing tests on the clients who
attend the screening session. Several nurses have volunteered to assist with the screening clinic. The community health nurse
instructs the nurses to perform a voice test to assess hearing in the clients and tells the nurses to do which of the following?
a) with back to the client, whisper a statement, and determine if the client can clearly repeat it
b) face the client, and whisper a statement while the client blocks both ears
c) stand 4 feet away from the client when talking to the client, and determine if the client can hear at this distance
d) quietly whisper a statement, and ask the client to repeat it to determine the hearing ability