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Eye & Ear NCLEX practice questions
Five NCLEX-style questions on glaucoma, cataracts, retinal detachment, hearing loss and otitis. Pick your answer, then open it to see the right choice and why. New questions every week.
Question 1
A nurse is collecting data from a client who has open-angle glaucoma. Which of the following symptoms should the nurse expect the patient to report?
- A.Gradual loss of peripheral vision
- B.Gradual loss of central vision
- C.Sudden headache and nausea
- D.Cloudy blurred vision
Show answer and rationale ▾Answer and rationale ▴
Answer: A. Gradual loss of peripheral vision
Gradual loss of peripheral vision is a characteristic symptom of open-angle glaucoma, which is the most common type of glaucoma. It occurs when the drainage angle of the eye becomes blocked, causing increased intraocular pressure and damage to the optic nerve. Gradual loss of central vision is more typical of age-related macular degeneration, which is a condition that affects the macula, the central part of the retina. It is not a symptom of open-angle glaucoma. Sudden headache and nausea are signs of acute angle-closure glaucoma, which is a medical emergency that requires immediate treatment. It occurs when the drainage angle of the eye suddenly closes, causing a rapid rise in intraocular pressure and severe pain. Cloudy blurred vision is a symptom of cataract, which is a condition that causes the lens of the eye to become cloudy and opaque. It is not a symptom of open-angle glaucoma.
Question 2
A nurse is assisting with teaching a class about physiological changes to hearing in older adult clients. Which of the following should the nurse include?
- A.Decreased thickness of tympanic membranes
- B.Decreased ability to hear high-frequency sounds
- C.Decreased tinnitus
- D.Decreased ear wax
Show answer and rationale ▾Answer and rationale ▴
Answer: B. Decreased ability to hear high-frequency sounds
With aging, the tympanic membranes (eardrums) typically become thinner and less flexible, which can affect hearing. Therefore, this choice does not reflect the physiological changes that occur. One of the most common changes in hearing as people age is presbycusis, which often leads to a decreased ability to hear high-frequency sounds. This loss can significantly impact communication and quality of life for older adults. Tinnitus, which is the perception of ringing or buzzing in the ears, often does not decrease with age. In fact, many older adults experience increased tinnitus or persistent tinnitus due to age-related hearing loss or other factors, making this choice incorrect. This is not typically accurate. Older adults often have an increased build-up of ear wax (cerumen) due to changes in ear canal structure and gland function. This can lead to blockages that affect hearing, so this choice does not represent a physiological change commonly observed in older adults.
Question 3
A nurse is administering timolol eye drops to a client who has glaucoma. Which of the following actions should the nurse take?
- A.Drop prescribed amount of medication into the conjunctival sac.
- B.Protect the distal portion of the eyedropper using clean technique.
- C.Apply pressure to the bridge of the nose after administration.
- D.Wipe the eye from the outer canthus to the inner canthus before instillation.
Show answer and rationale ▾Answer and rationale ▴
Answer: A. Drop prescribed amount of medication into the conjunctival sac.
Drop prescribed amount of medication into the conjunctival sac: This is the correct action for administering eye drops. The medication should be placed in the conjunctival sac to ensure proper absorption and efficacy. Protect the distal portion of the eyedropper using clean technique: While it is important to maintain aseptic technique, protecting the distal portion is less critical compared to the correct placement of the medication. Apply pressure to the bridge of the nose after administration: This action is not necessary for timolol eye drops. Applying pressure to the inner canthus (not the bridge of the nose) can help reduce systemic absorption in certain situations, but it is not required for timolol. Wipe the eye from the outer canthus to the inner canthus before instillation: Wiping the eye from the inner to the outer canthus is the standard practice to avoid spreading any potential contaminants.
Question 4
A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is the risk for injury. This nursing problem is based on which etiology?
- A.Decreased night vision.
- B.Increased sensitivity to light.
- C.Increased frequency of lacrimation.
- D.Diminished color perception.
Show answer and rationale ▾Answer and rationale ▴
Answer: A. Decreased night vision.
Decreased night vision is a significant concern for clients receiving miotics for open-angle glaucoma. Miotics, such as pilocarpine, work by constricting the pupil (miosis), which can reduce the amount of light entering the eye. This effect is particularly problematic in low-light conditions, leading to decreased night vision and increasing the risk of injury due to poor visibility Increased sensitivity to light, also known as photophobia, can occur with the use of miotics, but it is not the primary concern related to the risk of injury. While photophobia can cause discomfort and avoidance of bright environments, it does not directly contribute to the risk of injury as significantly as decreased night vision. Increased frequency of lacrimation (tearing) can be a side effect of miotics, but it is not a major factor in the risk of injury. Excessive tearing can cause discomfort and blurred vision temporarily, but it does not pose a significant risk for injury compared to decreased night vision. Diminished color perception is not a common side effect of miotics. Miotics primarily affect the pupil size and accommodation, rather than color vision. Therefore, this choice is not relevant to the risk of injury associated with the use of miotics.
Question 5
A nurse is teaching a class about physiological changes to hearing in older adult patients.Which of the following should the nurse include?
- A.Decreased thickness of tympanic membranes
- B.Decreased tinnitus
- C.Decreased ability to hear high-frequency sounds
- D.Decreased ear wax .
Show answer and rationale ▾Answer and rationale ▴
Answer: C. Decreased ability to hear high-frequency sounds
While the thickness of the tympanic membranes can indeed change with age, it typically increases rather than decreases. Thickening of the tympanic membranes can contribute to hearing loss by reducing the ability of the ear to transmit sound vibrations. Tinnitus, or ringing in the ears, is not typically decreased in older adults. In fact, tinnitus is often more common in older individuals and can be a sign of age-related hearing loss. A decreased ability to hear high-frequency sounds is a common physiological change associated with aging. This is often one of the first signs of age-related hearing loss. Decreased ear wax is not typically associated with aging. In fact, some older adults may produce more ear wax, which can contribute to hearing problems if it becomes impacted.
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