All care plans for older adult patients include:

A. A bowel and bladder program

B. Discharge planning.
C. A fall prevention program.
D. Reminiscence therapy.
ANSWER: B

Systems theory includes which component about aging?

A. Gene regulation ideas
B. Neuroendocrine and immunological ideas
C. Nutation accumulation on aging
D. Free radical ideas
ANSWER: B

Which of the following theories on aging were introduced in the early 1900s?
A. Wear-and-tear theory and autointoxication theory
B. Evolution theory
C. Molecular theory
D. Cellular theory
ANSWER: A

Which of the following defines graying of the population?

A. Individuals getting older
B. The percentage of older population is increasing
C. The amount of stress and graying of the hair
D. The study of human population
ANSWER: B

Which of the following defines Social aging?

A. Changes in a person�s roles and relationships, both within their networks of
relatives and friends and in formal organizations such as the workplace and houses
of worship.
B. Changes involving mental functioning and personality that occur as we age.
C. The number of years the person has lived.
D. Senescence
ANSWER: A

Which of the following is an example of senescence?

A. Stiffness of the joints early in the morning due to arthritis.
B. Wrinkles around the eyes, forehead and the face.
C. Dysphagia due to esophageal varicosities.
D. Dribbling of urine.
ANSWER: B

In preparing a presentation for older adults, a nurse keeps in mind which of the
following?
A. Older adults are unlikely to participate in educational programs due to lack of
interest.
B. Older adult learners are heterogeneous due to diverse educational experiences
and learning strategies.
C. The ability to acquire knowledge from a verbal presentation decreases with age
more than the ability to acquire knowledge through reasoning.
D. The age-related decline in intellectual performance creates obstacles for
acquiring new information.
ANSWER: B

Identify which organ is responsible for drug metabolism and must be considered when
prescribing medication for an older adult?
A. Kidneys
B. Pancreas
C. Intestines
D. Liver
ANSWER: D

Which of the following choices describes the importance of understanding nursing

theory when practicing gerontologic nursing?
A. Understanding and using tested theories offer a framework on which to base
nursing practice interventions
B. Nursing theories are vague and do not offer substance in most health-care
settings
C. Theories are not proven ways on which to base nursing practice
D. Theory helps identify major concepts in nursing practice and offers a framework
for decision making
ANSWER: D

Describe the order for the nursing process as practiced by the gerontological
nurse:
A. Diagnose, implement, evaluate
B. Assess, identify expected outcomes, implement, evaluate
C. Assess, dignose along with the team, identify outcomes, plan, implement,
evaluate
D. Assess, evaluate, plan, implement, and look at outcomes
ANSWER: C

Which choice best explains the practice setting for the gerontological nurse?
A. In the home of the client
B. Only in acute care settings
C. Clinics and long-term care facilities
D. Home of the client, acute care facilities, long-term care settings, and clinics
or anywhere clients over the age of 65 seek health care and health education
ANSWER: D

A 78-year-old male resident at a long-term care facility, who is a former business

executive, has been smoking and extinguishing cigarettes in a paper cup in areas
where smoking is prohibited. He has been informed repeatedly of the designated
smoking areas. Which of the following choices explain the residents� behavior?
A. Express self-transcendence.
B. Maintain his previous professional role.
C. Maintain autonomy by exercising control.
D. React against the facility's ageism.
ANSWER: C

Home safety for an elderly patient whose mobility is impaired should include which
of the following measures?
A. Carpeting stairways
B. Installing handrails next to the tub and toilet
C. Waxing kitchen floors
D. Placing throw rugs in hallways and doorways
ANSWER: B

Which of the following physical assessment findings in an elderly patient should

the nurse report to the physician?
A. Large pupils
B. Thickened yellow lenses
C. Increased lacrimal secretions
D. Reddened sclera
ANSWER: D
Macular degeneration of aging is an important cause of what finding in the elderly
patient?
A. Poor peripheral vision
B. Poor central vision
C. Nystagmus
D. Lid lag
ANSWER: B

A nurse would expect a patient who has a cataract to report which of the following
symptoms?
A. Decreased color perception
B. Halos around lights
C. Loss of peripheral vision
D. Headaches
ANSWER: A

A nurse in a daycare program for older adults observes that the participants have
long toenails, corns, calluses, and other problems indicating a need for better
foot care. What is the nurse's best action?
A. Developing an educational program on foot health and arranging for podiatry
services at the site.
B. Establishing a regular foot care plan whereby the participants' toenails would
be cut and corns and calluses shaved.
C. Instructing competent family members in the proper methods of cutting toenails
and using commercial foot care products.
D. Recommending that the participants soak their feet for 10 minutes before cutting
their toenails using safe toenail clippers.
ANSWER: A

A nurse is caring for a patient from a different culture notices that the patient
did not eat the food on the meal tray. Which of the following comments by the nurse
demonstrates an understanding of cultural diversity?
A. �What foods do you eat at home?�
B. �You will lose weight if you do not eat.�
C. �You need to eat to keep up your strength.�
D. �Why didn�t you tell me you don�t like hospital food?�
ANSWER: A

The nurse caring for a patient from a culture not her own can increase her cultural
sensitivity by applying which of the following?
A. Being aware of the patient�s social standards
B. Paying attention to environmental cues
C. Identifying her personal reaction to the patient
D. Talking with other staff who have interacted with the patient
ANSWER: C

Which activities if applied by the nurse facilitates the benefits of life review of
an elderly patient?
A. Assisting the older adult to accept death as the inevitable last stage.
B. Changing the topic when a patient talks about his or her morbid past.
C. Encouraging reminiscence, oral histories, and storytelling.
D. Helping the older adult explore how spiritual involvement assists with stress
relief.
ANSWER: C

Reminiscence therapy promotes an older adult's sense of security by implementing

which of the following?
A. Increasing socialization skills.
B. Providing praise and recognition.
C. Meshing the past with the future.
D. Reviewing comforting memories.
ANSWER: D

The nurse is assessing the body alignment of an alert and mobile client. Which of
the following is the first action that the nurse should do?
A. Observe gait
B. Determine activity tolerance
C. Put the client at ease
D. Determine range of joint motion
ANSWER: C

An 85-year old is admitted for continuous, cramping pain as the result of

intermittent claudication. When conducting an initial physical assessment, the
nurse is unable to palpate the pedal pulses. Which of the following actions should
the nurse take first?
A. Notify the physician and anticipate emergency surgery
B. Assess the apical and radial pulses for any irregularity and notify the
physician
C. Elevate the foot of the bed and apply warm compresses
D. Obtain a Doppler and recheck the pedal pulses
ANSWER: D

The loss of lean muscle mass that occurs with aging can be diminished or reversed
by doing which of the following?
A. Anaerobic exercise.
B. Strength-training exercises.
C. High-protein diets.
D. Small doses of anabolic hormones.
ANSWER: B

Which of the following interventions should be implemented to help an older client

to prevent osteoporosis?
A. Decrease dietary calcium intake.
B. Increase sedentary lifestyles
C. Increase dietary protein intake.
D. Encourage regular exercise.
ANSWER: D

While bathing an elderly client who has limited abilities for self-care, the nurse
notices several patches of dry skin on the clients� heels, elbows, and coccyx. The
nurse cleans and dries all the areas well and applies a moisturizing lotion. The
most appropriate immediate action by the nurse to ensure appropriate nursing care
for this clients� skin is to:
A. Revise the client's care plan to show the need for the application of
moisturizing lotion
B. Assume personal responsibility to apply the moisturizing lotion daily to the
client's skin
C. Encourage the client to tell whomever bathes her to apply the moisturizing
lotion to her areas of dry skin
D. Inform the staff that the client's skin is showing signs of breakdown and
moisturizing lotion needs to be applied daily
ANSWER: A

Which client statement illustrates an understanding of a primary benefit to be

derived from moderately intense aerobic exercise?
A. �Exercise will help keep my heart strong.�
B. �When I go to Yoga class I feel more focused.�
C. �I will certainly sleep better.�
D. �I can already see a difference in my alertness.�
ANSWER: A

A 73-year-old patient is admitted to a rehabilitation facility after sustaining a

mild stroke. After three nights in the facility, the patient begins to sleep only
four to five hours a night and to awaken frequently during the night. The patient
then complains of not feeling rested and begins to nap during the day. Which is the
most appropriate nursing action?
A. Completing an assessment of the patient's sleep-wake cycle to determine
necessary interventions
B. Doing nothing since this type of sleep pattern is associated with normal aging
C. Inquiring if the patient takes a medication at bedtime and requesting that the
physician order it
D. Moving the patient further away from the nurse's station to minimize
disturbances
ANSWER: D

Which of the following instructions should a nurse give to a patient in her early
forties in order to reduce the risk of developing osteoporosis?
A. �Eliminate caffeine from your diet.�
B. �Reduce your exposure to sunlight.�
C. �Increase your physical activity.�
D. �Add iron � rich foods to your diet.�
ANSWER: C

An elderly patient who has had surgery on his right eye for cataract complains of
severe pain and nausea postoperatively. The nurse initially should carry out which
of the following measures?
A. Remove the dressing and assess for bleeding
B. Position the patient on his/her right side
C. Administer acetylsalicylic acid for pain
D. Notify the physician
ANSWER: D

A patient who has been diagnosed with osteoarthritis asks a nurse, �What does
osteoarthritis mean?� Which of the following statements if made by the nurse would
be appropriate?
A. �Many organs in your body are inflamed�
B. �You have inflammation in your joints�
C. �Your weight-bearing joints are damaged�
D. �There is shortening of your long bones�
ANSWER: C

Distinguish which of the following patients is at greatest risk for the development
of a fracture?
A. An adolescent who is entering puberty
B. A toddler who is learning to walk
C. An elderly man who has vertigo
D. A woman who is postmenopausal
ANSWER: C

Which of the following techniques would a nurse implement when interviewing a 94-
year old patient?
A. Using a low-pitched voice
B. Varying voice intonations
C. Enunciating each word slowly
D. Reinforcing the words with pictures
ANSWER: A
To promote optimal function in a patient who has rheumatoid arthritis, which of the
following instructions should a nurse include in the patient�s rehabilitation plan?
A. Apply ice to affected joints
B. Perform daily weight-bearing exercises
C. Massage joints when inflamed
D. Immobilize painful joints
ANSWER: B

A nurse is about to feed a patient with moderate dementia. The nurse will be more
effective to adequately provide nourishment to the patient if she will implement
which of the following?
A. allowing the patient to choose foods from a varied menu.
B. hand-feeding the patient's favorite foods.
C. routinely reminding the patient about the need for adequate nutrition.
D. serving soup in a mug, and offering finger foods.
ANSWER: D

You are the nursing supervisor in a long term care facility. One of the major
considerations that you apply into your practice is strict infection control
prevention measures because you are knowledgeable about the fact that the normal
aging process is associated with the deterioration of the body�s normal defenses.
Which theory of aging illustrates your belief that strict infection control
prevention measures are necessary?
A. The Programmed Longevity Theory
B. The Endocrine Theory
C. The Immunological Theory of Aging
D. The Rate of Living Theory
ANSWER: C

A bone mineral analysis reveals that a patient who is postmenopausal has severe
osteoporosis. Which of the following instructions should the nurse give to the
patient�s family to ensure a safe environment for the patient?
A. Disinfect the bathroom weekly�
B. �install handrails on hallways�
C. �Carpet floor surfaces�
D. �Keep the lights dim�
ANSWER: B

Two patient identifiers should be used before _________.

A. drawing blood
B. transporting a patient to a test or procedure
C. administering medications
D. all of the above
ANSWER: D

The picture of the Philippine Pyramid illustrates which of the following?

A. The shape of the population pyramid shows a higher population at the dependency
stage.
B. The pyramid shows an aging country.
C. The pyramid shows a thriving nation with an increase in the elderly population.
D. All of the above
ANSWER: A

With the above picture, one can infer that�

A. The country needs to invest more in school or education.
B. The country needs to invest more in the health sector.
C. The country has a good program for population control.
D. The country has a small number of young adults with stable source of income.
ANSWER: A
An 80-year old with right-sided weakness following a cerebrovascular accident (CVA)
is to ambulate with the aid of a walker. What age-related changes in this
individual will increase the risk of injury?
A. Improved muscle mass and strength
B. Increased cognitive functioning
C. Slowed response to increased stimuli
D. Development of arcus senilis
ANSWER: C

The nurse caring for a patient newly diagnosed with glaucoma should include which
of the following instructions in the discharge teaching plan?
A. Do not drive for 15 minutes after using the eyedrops
B. Keep a reserve bottle of eye drops at home
C. Discontinue eye drops when vision improves
D. Use only eye drops that dilate the pupil
ANSWER: B

Which of the following psychiatric disturbances are most common among the elderly?
A. Depression
B. Anxiety
C. Bipolar discordance
D. Personality disorders
ANSWER: A

The nurse is instructing a patient and his significant other about the diet for
dysphagia. Which of the following food choices should the nurse include in the
teaching?
A. Diced meat
B. Soft � cooked vegetables
C. Applesauce
D. Scrambled eggs
ANSWER: D

Which of the following guidelines should a nurse include in the teaching plan for a
patient who has osteoarthritis?
A. Achieve ideal body weight
B. Increase daily calcium intake to 1500 mg
C. Maintain a high-fiber diet
D. Sleep at least 10 hours each day
ANSWER: B

The nurse assessing an elderly patient should recognize which of the following
findings as a characteristic of the normal aging process?
A. Decrease in reasoning ability
B. Loss of subcutaneous tissue
C. Elevation in body temperature
D. Increase in bladder tone
ANSWER: B

The elderly client who wants to take herbal supplement for arthritis symptoms
should be advised to:
A. Read labels very carefully prior to making a selection, because they are usually
quite expensive.
B. Consult their healthcare provider about possible interactions with current
medications.
C. Verify their effectiveness with friends or family members who have taken them.
D. Reconsider the idea, because they might have serious side effects.
ANSWER: B
Which of the following is an appropriate dietary intervention for an elderly client
with dysphagia?
A. Serve smaller, more frequent meals.
B. Serve foods at room temperature.
C. Provide a full liquid diet.
D. Thicken thin liquids.
ANSWER: D

The nurse works with elderly clients in a wellness screening clinic on a weekly
basis. Which of the following statements made by the nurse is the most therapeutic
regarding their mobility?
A. "Your shoulder pain is normal for your age."
B. "Continue to exercise your joints regularly to your tolerance level."
C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you feel
next week."
D. "Don't worry about taking that combination of medications since your doctor has
prescribed them."
ANSWER: B

When answering an older client�s questions about diet, exercise, and bone
integrity, which exercise would the nurse categorize as ineffective at meeting the
need for moderately intense aerobic activity?
A. Yoga for 45 minutes twice a week
B. Jumping rope for 15 minutes daily
C. Biking 2 miles daily
D. Swimming laps for 30 minutes twice a week
ANSWER: A

A nurse in the geriatric outpatient clinic frequently receives questions from

clients about exercise. The nurse answers their questions based on the knowledge
that regular exercise:
A. Must be avoided by older adults with rheumatoid arthritis because it strains the
joints
B. Performed in excess as a young adult will lead to osteoporosis
C. Is likely to lead to increased falls and possibly fractures
D. Prevents muscle atrophy and improves mobility, thus reducing the risk of falls
ANSWER: D

Which principle is the basis for the nurse�s plan of care regarding exercise for an
older adult who is non-ambulatory?
A. Caregivers are usually unaware of the benefits of exercise for these individuals
B. Passive range of motion exercise is best suited for the needs of such a client
C. Non-ambulatory clients are usually resistant to engaging in any form of exercise
D. Appropriate exercise will positively affect the individual�s quality of life
ANSWER: D

In planning discharge teaching for a client with diabetes, which precaution related
to fall prevention is particularly important for the nurse to choose?
A. Rising slowly from the table after meals
B. Practicing stress management techniques
C. Removing newspapers and other clutter from the floor
D. Consuming recommended daily amounts of vitamin D
ANSWER: A

A patient with a diagnosis of gout is on Allopurinol (Zyloprim) therapy. Which of

the following serum laboratory values should be monitored to determine the
effectiveness of treatment?
A. Glucose
B. Calcium
C. Alkaline Phosphatase
D. Uric Acid
ANSWER: D

Which of the following statements, if made by a patient who has rheumatoid

arthritis, would indicate a correct understanding of the disease process?
A. �My bones have become brittle.�
B. �Overuse of my joints caused this problem.�
C. �Nodules may develop under my skin.�
D. �This condition is part of normal aging.�
ANSWER: C

Which of the following preoperative instructions by the nurse would be most

effective in assisting an elderly patient to adjust to the home environment
following cataract surgery?
A. Prepare meals for freezing before surgery
B. Keep your bedroom cool and dry
C. Eliminate stair-climbing after surgery
D. Elevate the head of your bed when sleeping
ANSWER: A

Which of the following actions would the nurse include when teaching a community
group about the prevention of osteoporosis?
A. Lap swimming
B. Restricting sodium intake
C. Eliminating
D. Bench Pressing
ANSWER: C

The adult children of an aging couple ask a nurse about alternative therapies or
nontraditional services to improve their parents' health. Which among the choices
is the most appropriate response if made by the nurse?
A. Discuss the benefits, risks, and limitations of various therapies.
B. Distinguish between folk and traditional medicine.
C. Give a firm warning about alternative therapies.
D. Recommend a reputable holistic health therapist.
ANSWER: A

A nurse is about to explain to a patient who is administered prednisone (Deltasone)

for the treatment of rheumatoid arthritis that the expected outcome would be to:
A. Enhance the immune system
B. Decrease inflammation
C. Increase bone density
D. Reduce peripheral edema
ANSWER: B

Select which of the following is NOT the reason for the increase in the aging
population in the Philippines.
A. The DOH extensive campaign for responsible parenthood and contraceptive use.
B. The relative increase in life expectancy at birth of Filipinos.
C. High fertility rates of the country during the 1950s to early 1970s.
D. Epidemiologic transition: long-term change in major causes of death among the
aged from infectious and acute, to degenerative.
ANSWER: A

Select which among the following statement defines social support.

A. Social support refers to the various types of support that people receive from
others and is generally classified into two categories: formal and informal.
B. It pertains to the services provided by professional, trained employees,
typically paid for their work.
C. Social support refers to support from one�s informal social network such as
family, neighbors, and friends.
ANSWER: A

Which attempt by the family to prevent an older, frail adult from falling causes
the home health nurse concern?
A. Keeping several low wattage night lights on in the evening
B. Keeping the side rails up on the client�s bed at night
C. Installing wooden railings on the stairway to the bathroom
D. Encouraging the client to use a cane when ambulating
ANSWER: B

A nurse is assessing an elderly client with reported cognitive deficits. The nurse
is aware that cognitive functioning involves intelligent, learning, attention and
memory and how well the mind is able to reason and make sound judgments. The nurse
will be able to validate cognitive deficit if the elderly will exhibit which of the
following?
A. The elderly is unable to recall the food served for breakfast this morning.
B. The elderly is able to follow the instructions during the MMSE.
C. The elderly is able to give the names of the previous presidents when asked.
D. All of the above
ANSWER: A

A nurse is planning in teaching older adult clients in the community. Choose which
of the following is the most appropriate initial strategy for the nurse to do?
A. Assess the client and individualize the teaching methods.
B. Set a slow learning pace and begin teaching simple concepts.
C. Teach slowly and use repetition.
D. Use demonstration and provide ample opportunity for practice.
ANSWER: A

Choose which among the following factor is the most crucial in the adjustment of
the elderly when relocating an elderly from a family home to a continuing care
community.
A. level of economic independence.
B. physical proximity to remaining family.
C. perceived control of the move.
D. risk-taking ability.
ANSWER: C

Choose which of the following is the most effective action that will help the
elderly to adjust?
A. Involve him in as many activities as possible so he can meet other residents.
B. Move him as quickly as possible so that he does not have time to think.
C. Restrict family visits for the first two weeks to give him time to adjust.
D. Suggest that he bring his favorite things from home to make his room seem
familiar.
ANSWER: D

A nurse in a long � term care facility noticed an elderly walking in the hall way
early in the morning. The nurse is correct in her justification that the action is
a part of typical sleep pattern changes that occur with aging which is?
A. Late-morning awakening.
B. Decreased sleep latency.
C. Longer daytime naps.
D. Diminished time in deep sleep.
ANSWER: D
An elderly patient reports a diminishing energy level. The nurse is correct in
justifying that this symptom is most likely a result of which of the following?
A. Decreased cardiac output
B. Decreased muscle mass
C. Decreased bone intensity
D. Decreased joint mobility
ANSWER: A

Which of the following nursing diagnoses is a priority for a patient with gout?
A. Pain
B. Risk of infection
C. Fatigue
D. Risk of peripheral neurovascular dysfunction
ANSWER: A

A nurse at a nursing home conducts a reminiscence therapy group for residents with
confusion. A member of the group stands up and says, "I just heard my cow. I have
to go and milk her now." The nurse's response is most therapeutic if she will make
which of the following response?
A. "All right, you may leave the group now."
B. "Please tell us about your cow."
C. "That wasn't a cow; maybe you heard a vacuum cleaner."
D. "You live here at the nursing home now, not in the farm."
ANSWER: B

A 74-year-old woman with a history of recurrent falls is seen in the clinic with
her daughter. She also has a history of mild dementia, congestive heart failure,
coronary artery disease, and hypertension. She takes furosemide, lisinopril,
aspirin, metoprolol, olanzapine, and simvastatin. She lives by herself in an
apartment she has lived in for 40 years and has help with housekeeping once a week.
Her physical examination is remarkable for decreased proximal lower-extremity
muscle strength. Which of the following is NOT an evidence based intervention for
decreasing her risk of falling?
A. Discontinuing furosemide
B. Initiating donepezil (Acetylcholinesterase inhibitor)
C. Balance and gait training exercises
D. Discontinuing olanzapine
ANSWER: B

The nurse is caring for a patient who is diagnosed with glaucoma. Which of the
following medications, if ordered for this patient should the nurse question?
A. Atropine sulfate ophthalmic solution, two drops in both eyes at hour of sleep
B. Pilocarpine ophthalmic solution, one drop every 12 hours
C. Timolol maleate (timoptic), one drop every 12 hours
D. Diamox, 250 mg, one tablet, po, every 12 hours
ANSWER: A

When the nurse enters the client's room, the nurse perceives that the client is
staring straight ahead. Which of the following is the best course of action for the
nurse to take next?
A. Hold an interdisciplinary meeting on the client's behalf promptly.
B. Consult with psychiatry.
C. Listen to the client and observe the body language.
D. Address the client by first name upon entering the room.
ANSWER: C

A 75-year-old male client has a history of macular degeneration. While he is in the

hospital, the priority nursing goal will be:
A. To provide education regarding community services for clients with adult macular
degeneration (AMD).
B. To provide health care related to monitoring his eye condition.
C. To promote a safe, effective care environment.
D. To improve vision.
ANSWER: C

Although all of the following measures might be useful in reducing the visual
disability of a client with adult macular degeneration (AMD), which measure should
the nurse teach the client primarily as a safety precaution?
A. Wear a patch over one eye.
B. Lie in bed with the unaffected side toward the door.
C. Place personal items on the sighted side.
D. Turn the head from side to side when walking.
ANSWER: D

A nurse performs an assessment of a client with a diagnosis of macular degeneration

of the eye. The nurse would expect the client to report which of the following
symptoms
A. Loss of peripheral vision
B. Increased clarity when looking at objects
C. Blurred central vision
D. Clear vision when reading
ANSWER: C

The 65-year-o is diagnosed with macular degeneration. Which statement by the client
indicates the need for more discharge teaching?
A. "I should use magnification devices as much as possible."
B. "I will look at my Amsler grid at least twice a week."
C. "I am going to use low-watt light bulbs in my house."
D. "I am going to contact a low-vision center to evaluate my home."
ANSWER: C

What nursing action is most important for the patient with age-related macular
degeneration
(AMD)?
A. Teach the patient how to use topical eyedrops for treatment of AMD.
B. Emphasize the use of vision enhancement techniques to improve what vision is
present.
C. Encourage the patient to undergo laser treatment to slow the deposit of
extracellular debris.
D. Explain that nothing can be done to save the patient's vision because there is
no treatment for AMD.
ANSWER: B

The nurse should assess an older adult with macular degeneration for:
A. Loss of central vision.
B. Total blindness.
C. Loss of peripheral vision.
D. Blurring of vision.
ANSWER: A

When developing a teaching session on glaucoma for the community, which of the
following statements would the nurse stress?
A. Glaucoma is easily corrected with eyeglasses
B. White and Asian individuals are at the highest risk for glaucoma.
C. Yearly screening for people ages 20-40 years is recommended.
D. Glaucoma can be painless and vision may be lost before the person is aware of a
problem.
ANSWER: D

A male client has just had a cataract operation without a lens implant. In
discharge teaching, the nurse will instruct the client�s wife to:
A. Feed him soft foods for several days to prevent facial movement
B. Keep the eye dressing on for one week
C. Have her husband remain in bed for 3 days
D. Allow him to walk upstairs only with assistance.
ANSWER: D

Which of the following procedures or assessments must the nurse perform when
preparing a client for eye surgery?
A. Clipping the client�s eyelashes
B. Verifying the affected eye has been patched 24 hours before surgery
C. Verifying the client has been NPO since midnight, or at least 8 hours before
surgery.
D. Obtaining informed consent with the client�s signature and placing the forms on
the chart.
ANSWER: D

Which of the following instruments is used to record intraocular pressure?

A. Goniometer
B. Ophthalmoscope
C. Slit lamp
D. Tonometer
ANSWER: D

After the nurse instills atropine drops into both eyes for a client undergoing
ophthalmic examination, which of the following instructions would be given to the
client?
A. �Be careful because the blink reflex is paralyzed.�
B. �Avoid wearing your regular glasses when driving.�
C. �Be aware that the pupils may be unusually small.�
D. �Wear dark glasses in bright light because the pupils are dilated.�
ANSWER: D

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. Both eyes are assessed together, followed by the assessment of the right and
then the left eye.
B. The right eye is tested followed by the left eye, and then both eyes are tested.
C. The client is asked to stand at a distance of 40ft. from the chart and is asked
to read the largest line on the chart.
D. The client is asked to stand at a distance of 40ft from the chart and to read
the line than can be read 200 ft away by an individual with unimpaired vision.
ANSWER: B

The clinic nurse notes that the 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�s chart test expecting to note which of the
following?
A. 20/20 vision
B. 20/40 vision
C. 20/60 vision
D. 20/200 vision
ANSWER: D

The client�s vision is tested with a Snellen�s chart. The results of the tests are
documented as 20/60. The nurse interprets this as:
A. The client can read at a distance of 60 feet what a client with normal vision
can read at 20 feet.
B. The client is legally blind.
C. The client�s vision is normal
D. The client can read only at a distance of 20 feet what a client with normal
vision can read at 60 feet.
ANSWER: D

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 normal intraocular pressure is:
A. 2-7 mmHg
B. 10-21 mmHg
C. 22-30 mmHg
D. 31-35 mmHg
ANSWER: B

The nurse is developing a plan of care for the client scheduled for cataract
surgery. The nurse documents which more appropriate nursing diagnosis in the plan
of care?
A. Self-care deficit
B. Disturbed sensory perception
C. Imbalanced nutrition
D. Anxiety
ANSWER: B

The nurse is performing an assessment in 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. Eye pain
B. Floating spots
C. Blurred vision
D. Diplopia
ANSWER: C

In preparation for cataract surgery, the nurse is to administer prescribed eye

drops. The nurse reviews the physicians orders, expecting which type of eye drops
to be instilled?
A. An osmotic diuretic
B. A miotic agent
C. A mydriatic medication
D. A thiazide diuretic
ANSWER: C

During the early postoperative period, the client who 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. Administer the ordered main medication and antiemetic
C. Reassure the client that this is normal.
D. Turn the client on his or her operative side
ANSWER: A

The client is being discharged from the ambulatory care unit following cataract
removal. The nurse provides instructions regarding home care. Which of the
following, if stated by the client, indicates an understanding of the instructions?
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 wear my eye shield at night and my glasses during the day.�
D. �I will not lift anything if it weighs more that 10 pounds.�
ANSWER: C

The client with glaucoma asks the nurse is complete vision will return. The most
appropriate response is:
A. �Although some vision as been lost and cannot be restored, further loss may be
prevented by adhering to the treatment plan.�
B. �Your vision will return as soon as the medications begin to work.�
C. �Your vision will never return to normal.�
D. �Your vision loss is temporary and will return in about 3-4 weeks.�
ANSWER: A

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. Decrease fluid intake to control the intraocular pressure
B. Avoid overuse of the eyes
C. Decrease the amount of salt in the diet
D. Eye medications will need to be administered lifelong.
ANSWER: D