Eye Health Questions (NCLEX 51-55)

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Complete NCLEX Study Materials

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51. The nurse has an order to administer two opthalmic medications to the client who has undergone eye surgery. The nurse waits how many minutes after administering the first medication before giving the second?

a) 1 to 2
b) 3 to 5
c) 8 to 10
d) it is not necessary to wait; the second medication can be administered immediately

52. The nurse is assigned to care for a client who has just undergone cataract surgery. The nurse plans to instruct the client that which of the following activities is permitted in the postoperative period?

a) bending over
b) lifting objects
c) coughing exercises
d) watching television

53. During a routine visit to the physician's office for monitoring of diabetic control, an older client with diabetes mellitus complains to the nurse of vision changes. The client describes blurring of vision with difficulty in reading and with driving at night. Given the history, the nurse interprets that the client is probably developing:

a) cataracts
b) glaucoma
c) papilledema
d) detached retina

54. A client arrives at the emergency room with a chemical burn of the left eye. The nurse immediately:

a) applies a light bandage to the eye
b) performs an assessment on the client
c) applies a cold compress to the injured eye
d) flushes the eye continuously with a sterile solution

55. The home care nurse visits an older client with arthritis. The client complains of difficulty instilling glaucoma eye drops because of shaking hands caused by the arthritis. Which instruction should the nurse plans to provide to the client to alleviate this problem?

a) tilt the head back to instill the eye drops
b) lie down on a bed or sofa to instill the eye drops
c) a family member will have to instill the eye drops
d) keep the eye drops in the refrigerator so that they will thicken and be easier to instill

Eye Health Questions
Answers and Rationale

51) B
- The nurse waits 3 to 5 minutes between administration of the two separate ophthalmic medications. This allows for adequate ocular absorption of the medication and prevents the second medication from flushing out the first.

52) D
- The client is taught to avoid activities that raise intraocular pressure and could cause complications in the postoperative period. The client is also taught to avoid activities that cause rapid eye movements that are irritating in the presence of postoperative inflammation. For these reasons, the client is taught to avoid bending over, lifting heavy objects, straining, sneezing, coughing, making sudden movements, or reading. Watching television is permissible because the eye does not need to move rapidly with this activity, and it does not increase the intraocular pressure.

53) A
- Although the incidence of cataracts increases with age, the older client with diabetes mellitus is at greater risk for developing cataracts. The most frequent complaint is blurred vision that is not accompanied by pain. The client may also experience difficulty with reading, night driving, and glare. Options B, C, and D are not directly associated with this client's history or complaints.

54) D
- When the client has suffered a chemical burn of the eye, the nurse immediately flushes the site with a sterile solution continuously for 15 minutes. If a sterile eye irrigation solution is not available, running water may be used. Performing an assessment may be helpful but is not the priority action. Applying compresses or bandages is incorrect, because they do not rid the eye of the damaging chemical. Cold compresses are used for blows to the eye, whereas light bandages may be placed over cuts of the eye or eyelid.

55) B
- Older clients with arthritis or shaking hands have difficulty instilling their own eye drops. The older client is instructed to lie down on a bed or sofa to instill the eye drops. Tilting the head back can lead to a loss of balance. Eye drop regimens for glaucoma require accurate timing, and it is unreasonable to expect a family member to instill the eye drops. Additionally, this discourages client independence. Placing the eye drops in the refrigerator should not be done unless specifically prescribed.

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Eye Health Questions (1-6)

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Eye Health Questions (56-60)

Endocrine NCLEX Questions (76-80)

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

76. A client with a diagnosis of Cushing's syndrome is undergoing a dexamethasone suppression test. The nurse plans to implement which steps during this test?

a ) collect a 24-hour urine specimen to measure serum cortisol levels
b) administer 1 mg of dexamethasone orally at night and obtain serum cortisol levels the next morning
c) draw blood samples before and after exercise to evaluate the effect of exercise on serum cortisol levels
d) administer an injection of adrenocorticotropic hormone (ACTH) 30 minutes before drawing blood to measure serum cortisol levels

77. The nurse is caring for a client with type 1 diabetes mellitus. Which of the following laboratory results would indicate a potential complication associated with this disorder?

a) ketonuria
b) potassium: 4.2 mEq
c) blood glucose: 112 mg/dL
d) blood urea nitrogen (BUN): 18 mg/dL

78. Endocrine NCLEX Questions about the nurse who is employed in a diabetes mellitus clinic is caring for a client on insulin pump therapy. Which statement by the client indicates that a knowledge deficit exists regarding insulin pump therapy?

a) if my blood glucose is elevated, I can bolus myself with additional insulin as ordered
b) I'll need to check my blood glucose before meals in case I need a premeal insulin anymore
c) I still need to follow a diet and exercise plan even though I don't inject myself daily anymore
d) now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis ever happening again

79. A client with Grave's disease has exopthalmos and is experiencing photophobia. Which of the following nursing interventions would best assist the client with this problem?

a) obtain dark glasses for the client
b) lubricate the eyes with tap water every 2 to 4 hours
c) administer methimazole (Tapazole) every 8 hours around the clock
d) instruct the client to avoid straining or heavy lifting because this can increase eye pressure

80. The nurse is completing a health history on a client with diabetes mellitus who has been taking insulin for many years. At present the client states that he is experiencing periods of hypoglycemia followed by periods of hyperglycemia. The most likely cause for this occurrence is which of following?

a) eating snacks between meals
b) initiating the use of the insulin pump
c) injecting insulin at a site of lipodystrophy
d) adjusting insulin according to blood glucose levels

Endocrine NCLEX Questions
Answers and Rationale

76) B
- The dexamethasone suppression test is performed to evaluate the function of the adrenal cortex. The procedure for this test is to administer 1 mg of dexamethasone at 11:00 PM to suppress ACTH formation and then to obtain 8:00 AM serum cortisol levels on the following day.

77) A
- Ketonuria is an abnormal finding in the client with diabetes mellitus indicating ketosis. Ketosis is a metabolic effect from the lack of insulin on fat metabolism and occurs in type 1 diabetes mellitus. It is associated with the severe complication of diabetic ketoacidosis (hyperglycemia, ketosis, and acidosis). Options B, C, and D are all normal laboratory findings.

78) D
- Endocrine NCLEX Questions Rationale: Hypoglycemic reactions can occur if there is an error in calculating the insulin dose or if the pump malfunctions. Ketoacidosis can occur if too little insulin is used or if there is an increase in metabolic need. The pump does not have a built-in blood glucose monitoring feedback system, so the client is subject to the usual complications associated with insulin administration without the use of a pump. Options A, B, and C are accurate regarding the use of the insulin pump.

79) A
- Medical therapy for Graves' disease does not help alleviate the clinical manifestation of exophthalmos. Because photophobia (light intolerance) accompanies this disorder, dark glasses are helpful in alleviating the problem. Tap water, which is hypotonic, could actually cause more swelling around the eye because it could pull fluid into the interstitial space. In addition, the client is at risk for developing an eye infection because the solution is not sterile. Methimazole inhibits the synthesis of thyroid hormone and is used to treat hyperthyroidism but will not alleviate exophthalmos or photophobia. There is no need to avoid straining with exophthalmos.

80) C
- Lipodystrophy, specifically lipohypertrophy, involves swelling of the fat at the site of repeated injections. This can interfere with the absorption of insulin, resulting in erratic blood glucose levels. Because the client has been on insulin for many years, this is the most likely cause of poor control. Options A, B, and D are appropriate techniques to use in order to regulate blood glucose levels.

After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Endocrine NCLEX Questions (1-7)