NCLEX Review about Ear Infection (11-15)

NCLEX Review about Ear Infection

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." Which medication 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

NCLEX Review about Ear Infection:

11) D
- Treatment for acoustic neuroma is surgical removal via a craniotomy. Extreme care is taken to preserve remaining hearing and preserve the function of the facial nerve. Acoustic neuromas rarely recur following surgical removal.

12) D
- Bloody or clear watery drainage from the auditory canal indicates a cerebrospinal fluid leak following trauma and suggests a basal skull fracture. This warrants immediate attention. Options A, B, and C are not specific to a basal skull fracture.

13) C
- Aspirin is contraindicated for gastrointestinal bleed and is potentially ototoxic. The client should be advised to notify the prescribing physician so the medication can be discontinued and/or a substitute that is less toxic to the ear can be taken instead. Options A, B, and D do not have side effects that are potentially associated with hearing difficulties.

14) A
- Irrigation solutions that are not close to the client’s body temperature can be uncomfortable and may cause injury, nausea, and vertigo. The client is positioned so that the ear to be irrigated is facing downward, because this allows gravity to assist in the removal of the ear wax and solution. Following the irrigation, the client is to lie on the affected side to finish draining the irrigating solution. A slow steady stream of solution should be directed toward the upper wall of the ear canal and not toward the eardrum. Too much force could cause the tympanic membrane to rupture.

15) C
- In a child younger than 3 years, the pinna is pulled down and straight back. The infant should be turned on the side with the affected ear uppermost. With the nondominant hand, the pinna is pulled down and back. The medication is administered by aiming it at the wall of the canal rather than directly onto the eardrum. The infant should remain with the affected ear uppermost for 10 to 15 minutes to retain the solution. In the adult or a child older than 3 years, the pinna is pulled up and back to straighten the auditory canal.

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    NCLEX Review about Ear Infection (6-10)

    NCLEX Review about Ear Infection

    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

    Online Nursing Practice Test about Ear Disorders (1-5)

    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 tympanic membrane, 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

    NCLEX Review about Skin and Integumentary Disorders (46-50)

    NCLEX Review about Skin and Integumentary Disorders

    46. A community health nurse is providing a teaching session to firefighters in a small community regarding care of a burn victim at the scene of injury. The nurse instructs the firefighters that in the event of a tar burn, the immediate action should be:

    a) cooling the injury with water
    b) removing all clothing immediately
    c) removing the tar from the burn injury
    d) leaving any clothing that is saturated with tar in place

    47. An industrial nurse is providing instructions to a group of employees regarding care to a client in the event of a chemical burn injury. The nurse instructs the employees that the first consideration in immediate care is:

    a) leaving all clothing in place until the client is brought to the emergency department
    b) removing all clothing including gloves and shoes
    c) lavaging the skin with water and avoiding brushing powdered chemicals off the clothing to prevent further spread of the injury
    d) determining the antidote for the chemical and placing the antidote on the burn site

    NCLEX Review about Skin and Integumentary Disorders (41-45)

    NCLEX Review about Skin and Integumentary Disorders

    41. An emergency department nurse is caring for a client who has sustained chemical burns to the esophagus after ingestion of lye. The nurse reviews the physician's orders and plans to question an order for which of the following?

    a) nothing by mouth (NPO) status
    b) gastric lavage
    c) intravenous fluid therapy
    d) preparation for barium swallow

    42. A home care nurse is visiting a client with a skin infection who is receiving amoxicillin (Amoxil) 500 mg every 8 hours. Which of the following would indicate to the nurse that the client is experiencing a frequent side effect related to the medication?

    a) severe abdominal cramps
    b) vaginal drainage
    c) fever
    d) severe watery diarrhea

    Online Nursing Practice Test about Skin (Integumentary Disorder 36-40)

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    36. When caring for a client with extensive burns, the nurse anticipates that pain medication will be administered via which route?

    a) oral
    b) intravenous
    c) intramuscular
    d) subcutaneous

    37. The nurse is caring for a client following an autograft and grafting to a burn wound on the right knee. Which of the following would the nurse anticipate to be prescribed for the client?

    a) out of bed
    b) bathroom privileges
    c) immobilization of the affected leg
    d) placing the affected leg in a dependent position

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    Online Nursing Practice Test about Skin (Integumentary Disorder 31-35)

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    31. The client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. The appropriate response by the nurse is:

    a) there is no pain associated with this procedure
    b) the local anesthesia may cause a burning or stinging sensation
    c) a preoperative medication will be given so you will be sleeping and will not feel any pain
    d) there is some pain, but the physician will prescribe an opioid analgesic following the procedure

    32. The nurse prepares to assist the physician to examine the client's skin with a Wood light. The nurse includes which of the following in the plan for this procedure?

    a) prepare a local anesthetic
    b) obtain an informed consent
    c) darken the room for the examination
    d) shave the skin and scrub with povidine-iodine solution

    NCLEX Review Respiratory Questions (51-55)

    51. A nurse is caring for a client immediately after removal of the endotracheal tube. The nurse reports which of the following signs immediately if experienced by the client?

    a) stridor
    b) occasional pink-tinged sputum
    c) a few basilar lung crackles on the right
    d) respiratory rate of 24 bpm

    52. A nurse is assessing the functioning of a chest tube drainage system in a client who has just returned from the recovery room following a thoracotomy with wedge resection. Select all expected assessment findings

    a) excessive bubbling in the water seal chamber
    b) vigorous bubbling in the suction control chamber
    c) 50 ml of drainage in the drainage collection chamber
    d) drainage system maintained below the client's chest
    e) occlusive dressing in place over the chest tube insertion site
    f) fluctuation of water in the tube in the water seal chamber during inhalation and exhalation

    NCLEX Renal Questions (46-50)

    Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

    Online Nursing Practice Test about Renal Disorders (1-7)

    Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck

    46. The client is admitted to the emergency department following a motor vehicle accident. The client was wearing a lap seat belt when the accident occurred and now the client has hematuria and lower abdominal pain. To assess further whether the pain is caused by bladder trauma, the nurse asks the client if the pain is referred to which of the following area?

    a) hip
    b) shoulder
    c) umbilicus
    d) costovertebral angle

    47. The female client is admitted to the emergency department following a fall from a horse and the physician orders insertion of a foley catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should:

    a) notify the physician
    b) use a smaller size of catheter
    c) administer pain medication before inserting the catheter
    d) use extra povidone-iodine solution in cleansing the meatus

    NCLEX Renal Questions (41-45)

    NCLEX Renal Questions

    41. The client with an external arteriovenous shunt in place for hemodialysis is at risk for bleeding. The priority nurse action would be to:

    a) check the shunt for the presence of bruit and thrill
    b) observe the site once as time permits during the shift
    c) check the results of the prothrombin time as they are determined
    d) ensure that small clamps are attached to the arteriovenous shunt dressing

    42. The nurse develops a post-procedure plan of care for a client who had a renal biopsy. The nurse avoids documenting which intervention in the plan?

    a) administering analgesics as needed
    b) encouraging fluids to at least 3L in the first 24 hours
    c) testing serial urine samples with dipstick for occult blood
    d) ambulating the client in the room and hall for short distances

    Online Nursing Practice Test about Renal Disorders (36-40)

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    36. The client with acute renal failure has a serum potassium of 6.0 mEq/L. The nurse would plan which of the following as a priority action?

    a) check the sodium level
    b) place the client on a cardiac monitor
    c) encourage increased vegetables in the diet
    d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration

    37. The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication:

    a) during dialysis
    b) just before dialysis
    c) the day after dialysis
    d) on return form dialysis

    Online Nursing Practice Test about Renal Disorders (31-35)

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    31. Which of the following should be considered in the diet of the client with end-stage-renal-disease (ESRD)?

    a) limit fluid intake during anuric phase
    b) limit phosphorus and vitamin D-rich food
    c) limit calcium-rich food
    d) limit carbohydrates

    32. A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen level drops to:

    a) 3 mg/dL
    b) 15 mg/dL
    c) 29 mg/dL
    d) 35 mg/dL

    NCLEX Secrets: Musculoskeletal Injuries (51-55)

    NCLEX Secrets about Musculoskeletal Injuries

    51. A client has a fiberglass (nonplaster) cast applied to the lower leg. The client asks the nurse when the client will be able to walk using the casted leg. The nurse replies that the client will be able to bear weight on the casted leg:

    a) in 48 hours
    b) in 24 hours
    c) in about  hours
    d) within 20 to 30 minutes of application

     52. A nurse has given a client with a leg cast instructions on cast care at home. The nurse would evaluate that the client needs further instruction if the client makes which of the following statements?

    a) I should avoid walking on wet, slippery floors
    b) I'm not supposed to scratch the skin underneath the cast
    c) it's okay to wipe dirt off the top of the cast with a damp cloth
    d) if the cast gets wet, I can dry it with a hair dryer turned to the warmest setting