Jefferson State Community College / NUR 114
NUR 114 Exam Elimination NCLEX Questions
Which nursing actions are appropriate when administering beta-blocker eye drops to a patient with glaucoma?
26
Select all that apply.
A. Wash hands before and after administration.
B. Instruct the patient to close the eyes gently after instillation.
20
C. Apply pressure to the inner canthus for 1-2 minutes.
D. Administer into the lower conjunctival sac.
E. Apply multiple drops quickly into the eye to increase absorption.
s
Answers: A, B, C, D
am
• Rationale: Proper administration includes hand hygiene (A), gentle eye closure
(B), punctal occlusion (C), and correct drop placement (D). Multiple drops (E)
increase systemic absorption and waste the medication. Ex
A nurse is caring for a child diagnosed with acute glomerulonephritis. Which of the following is the priority nursing
intervention?
A. Encourage increased fluid intake
s
B. Monitor blood pressure frequently
rt
C. Administer potassium supplements
pe
D. Restrict physical activity
Correct Answer: B. Monitor blood pressure frequently
Rationale: Hypertension is a major complication of glomerulonephritis due to fluid retention. Monitoring BP helps detect
Ex
and manage this risk early.
A nurse is teaching a patient about timolol eye drops. Which information should be included?
se
Select all that apply.
A. "These drops help lower the pressure inside your eye."
ur
B. "You may feel burning or stinging for a short time after use."
C. "We will monitor your pulse and blood pressure while on this medication."
D. "These drops may make your eyelashes grow longer and thicker."
N
E. "Do not stop taking the drops suddenly without consulting your provider."
Answers: A, B, C, E
• Rationale: Timolol lowers IOP (A), can cause mild stinging (B), may cause systemic beta-blocker effects (C), and should
not be stopped suddenly (E). Eyelash growth (D) is seen with prostaglandin analogs (like latanoprost), not beta- blockers.
A patient with glaucoma is receiving timolol eye drops. Which findings should the nurse report to the provider
immediately?
Select all that apply.
A. Heart rate of 48 bpm
,B. Blood pressure 90/58 mmHg
C. Audible wheezing on auscultation
D. Mild burning sensation in the eyes after instillation
E. Patient reports dizziness and syncope
Answers: A, B, C, E
• Rationale: Systemic absorption may cause bradycardia (A), hypotension (B), bronchospasm (C), and syncope/dizziness
(E). Mild burning (D) is expected and not urgent.
A patient with open-angle glaucoma is prescribed timolol eye drops. The nurse understands the primary purpose of this
26
medication is to:
A. Constrict the pupil to improve aqueous humor drainage
20
B. Increase aqueous humor production to nourish the cornea
C. Reduce aqueous humor production to lower intraocular pressure
D. Relax the ciliary muscles to improve lens accommodation
Answer: C
s
• Rationale: Beta-blocker eye drops (timolol) reduce aqueous humor production, which lowers IOP in glaucoma.
am
A patient with glaucoma is prescribed timolol eye drops. Which assessment finding would require the nurse to
question the prescription?
Ex
A. History of hypertension
B. History of asthma with frequent wheezing
C. History of cataracts
s
D. History of mild myopia (nearsightedness)
rt
Answer: B
• Rationale: Beta-blocker eye drops can cause bronchospasm if absorbed systemically, so they are contraindicated in
pe
asthma/COPD.
Ex
The nurse is teaching a patient how to administer timolol eye drops. Which statement indicates correct understanding?
A. "I should press on the inside corner of my eye after putting in the drop."
B. "I should blink rapidly after instilling the eye drop."
se
C. "I should rinse my eyes with water right after applying the drop."
D. "I can stop using the eye drops once my vision improves."
Answer: A
ur
• Rationale: Pressing the nasolacrimal duct (punctal occlusion) prevents systemic absorption and reduces side effects.
N
,6. The nurse is caring for a pediatric patient recovering Correct Answers: A, C, D, F
from post-streptococcal glomerulonephritis. What Rationale:
nursing interventions are appropriate?
Select all that apply. A. Diuretics reduce fluid overload.
C. Weight tracking helps monitor fluid status.
A. Administer prescribed diuretics D. I&O helps assess kidney function and fluid balance.
B. Encourage high fluid intake F. Preventing future strep infections can prevent recurrence.
C. Monitor daily weights B. Fluid intake is often restricted.
D. Maintain strict I&O E. Protein is usually limited if kidney function is impaired.
E. Provide a high-protein diet
F. Educate parents about avoiding future strep infections
26
7. A nurse is assessing a client with acute pyelonephritis. Correct Answers: A, B, C, E
Which of the following findings should the nurse expect?
20
(Select all that apply): Rationale: Pyelonephritis typically presents with systemic signs of infection (fever,
chills), urinary symptoms (dysuria), and flank pain due to kidney inflammation. CVA
A. Flank pain tenderness is a hallmark sign. Bradycardia and hypoglycemia are not typical.
B. Fever and chills
s
C. Dysuria
am
D. Bradycardia
E. Costovertebral angle tenderness
F. Hypoglycemia Ex
8. The nurse is educating a patient with a history of Correct Answers: B, E
recurrent pyelonephritis on prevention strategies. Which
statements indicate a need for further teaching? (Select Rationale: B and E indicate a need for further education. Patients should urinate
s
all that apply): after intercourse to reduce bacterial entry into the urethra. Frequent bubble baths
rt
can irritate the urethra and increase the risk of infections.
A. "I will wipe from front to back after using the
pe
bathroom."
B. "I should avoid urinating after intercourse to reduce the
risk of infection."
C. "Drinking more fluids will help flush bacteria from my
Ex
system."
D. "I'll finish my antibiotics even if I start feeling better."
E. "Taking bubble baths frequently will help soothe
se
urinary symptoms."
9. A nurse is reviewing the laboratory results of a client Correct Answer: B
ur
with suspected pyelonephritis. Which finding is most
indicative of this condition? Rationale: WBC casts in the urine are highly suggestive of kidney infection
N
(pyelonephritis). The other options are unrelated.
A. Elevated serum amylase
B. Presence of white blood cell casts in the urine
C. High serum calcium levels
D. Positive stool occult blood
10. A client is admitted with acute pyelonephritis. Which of Correct Answer: C
the following is the priority nursing intervention?
Rationale: IV antibiotics are the first-line treatment for acute pyelonephritis to
A. Encourage the client to increase dietary fiber prevent sepsis or worsening kidney damage. The other options are not
B. Begin bladder training appropriate priorities.
C. Initiate IV antibiotic therapy as prescribed
D. Administer antacids to relieve nausea
, 15. A nurse is caring for a client with advanced Correct Answer: C
nephrosclerosis. Which clinical finding indicates
progression to end-stage kidney disease (ESKD)? Rationale: A GFR below 15 mL/min is indicative of ESKD. Hematuria and polyuria
may occur earlier, and a creatinine of 1.0 mg/dL is within normal range.
A. Hematuria
B. Polyuria
C. GFR less than 15 mL/min
D. Creatinine level of 1.0 mg/dL
16. The nurse is teaching a client with benign Correct Answer: B
nephrosclerosis. Which statement by the client indicates a
26
correct understanding of the disease? Rationale: Blood pressure control is key in managing nephrosclerosis and slowing
disease progression. It is not caused by infection and dialysis is not immediately
A. "This condition is caused by a bacterial infection." necessary in benign cases.
20
B. "Managing my blood pressure can help slow kidney
damage."
C. "I'll need to start dialysis immediately."
D. "It mainly affects the bladder, not the kidneys."
s
am
17. Which of the following pathophysiological processes Correct Answers: A, C, E
are directly associated with nephrosclerosis? (Select all
that apply): Rationale: Nephrosclerosis is characterized by vascular fibrosis, thickening, and
hardening of the renal arteries and arterioles, leading to decreased renal
Ex
A. Vascular fibrosis in the renal arterioles perfusion and kidney ischemia. Hyperplasia of tubular cells and the formation of
B. Increased glomerular filtration rate (GFR) thrombi are not primary features of nephrosclerosis.
C. Decreased renal perfusion due to vessel narrowing
s
D. Hyperplasia of the renal tubular cells
rt
E. Thickening and hardening of the renal arteries
F. Formation of intrarenal thrombi
pe
Which of the following factors contribute to the Correct Answers: A, B, C, D, E
development of vascular changes in nephrosclerosis?
Ex
(Select all that apply): Rationale: Hypertension, hyperglycemia, hyperlipidemia, and atherosclerosis
contribute to vascular changes, including vessel narrowing and sclerosis. Plasma
A. Chronic hypertension renin levels may be elevated due to the compensatory response in hypertension.
B. Hyperglycemia Low sodium intake is not a direct factor in nephrosclerosis development.
se
C. Increased plasma renin levels
D. Hyperlipidemia
E. Atherosclerosis
ur
F. Low sodium intake
N
19. In nephrosclerosis, which of the following mechanisms Correct Answer: C
primarily leads to kidney damage?
Rationale: Chronic reduction in renal blood flow due to arterial sclerosis is the
A. Inflammation of renal parenchyma hallmark mechanism in nephrosclerosis. This leads to renal ischemia, fibrosis, and
B. Increased permeability of the glomerular filtration eventually progressive kidney dysfunction.
barrier
C. Chronic reduction in renal blood flow due to arterial
sclerosis
D. Formation of urinary calculi obstructing renal tubules
NUR 114 Exam Elimination NCLEX Questions
Which nursing actions are appropriate when administering beta-blocker eye drops to a patient with glaucoma?
26
Select all that apply.
A. Wash hands before and after administration.
B. Instruct the patient to close the eyes gently after instillation.
20
C. Apply pressure to the inner canthus for 1-2 minutes.
D. Administer into the lower conjunctival sac.
E. Apply multiple drops quickly into the eye to increase absorption.
s
Answers: A, B, C, D
am
• Rationale: Proper administration includes hand hygiene (A), gentle eye closure
(B), punctal occlusion (C), and correct drop placement (D). Multiple drops (E)
increase systemic absorption and waste the medication. Ex
A nurse is caring for a child diagnosed with acute glomerulonephritis. Which of the following is the priority nursing
intervention?
A. Encourage increased fluid intake
s
B. Monitor blood pressure frequently
rt
C. Administer potassium supplements
pe
D. Restrict physical activity
Correct Answer: B. Monitor blood pressure frequently
Rationale: Hypertension is a major complication of glomerulonephritis due to fluid retention. Monitoring BP helps detect
Ex
and manage this risk early.
A nurse is teaching a patient about timolol eye drops. Which information should be included?
se
Select all that apply.
A. "These drops help lower the pressure inside your eye."
ur
B. "You may feel burning or stinging for a short time after use."
C. "We will monitor your pulse and blood pressure while on this medication."
D. "These drops may make your eyelashes grow longer and thicker."
N
E. "Do not stop taking the drops suddenly without consulting your provider."
Answers: A, B, C, E
• Rationale: Timolol lowers IOP (A), can cause mild stinging (B), may cause systemic beta-blocker effects (C), and should
not be stopped suddenly (E). Eyelash growth (D) is seen with prostaglandin analogs (like latanoprost), not beta- blockers.
A patient with glaucoma is receiving timolol eye drops. Which findings should the nurse report to the provider
immediately?
Select all that apply.
A. Heart rate of 48 bpm
,B. Blood pressure 90/58 mmHg
C. Audible wheezing on auscultation
D. Mild burning sensation in the eyes after instillation
E. Patient reports dizziness and syncope
Answers: A, B, C, E
• Rationale: Systemic absorption may cause bradycardia (A), hypotension (B), bronchospasm (C), and syncope/dizziness
(E). Mild burning (D) is expected and not urgent.
A patient with open-angle glaucoma is prescribed timolol eye drops. The nurse understands the primary purpose of this
26
medication is to:
A. Constrict the pupil to improve aqueous humor drainage
20
B. Increase aqueous humor production to nourish the cornea
C. Reduce aqueous humor production to lower intraocular pressure
D. Relax the ciliary muscles to improve lens accommodation
Answer: C
s
• Rationale: Beta-blocker eye drops (timolol) reduce aqueous humor production, which lowers IOP in glaucoma.
am
A patient with glaucoma is prescribed timolol eye drops. Which assessment finding would require the nurse to
question the prescription?
Ex
A. History of hypertension
B. History of asthma with frequent wheezing
C. History of cataracts
s
D. History of mild myopia (nearsightedness)
rt
Answer: B
• Rationale: Beta-blocker eye drops can cause bronchospasm if absorbed systemically, so they are contraindicated in
pe
asthma/COPD.
Ex
The nurse is teaching a patient how to administer timolol eye drops. Which statement indicates correct understanding?
A. "I should press on the inside corner of my eye after putting in the drop."
B. "I should blink rapidly after instilling the eye drop."
se
C. "I should rinse my eyes with water right after applying the drop."
D. "I can stop using the eye drops once my vision improves."
Answer: A
ur
• Rationale: Pressing the nasolacrimal duct (punctal occlusion) prevents systemic absorption and reduces side effects.
N
,6. The nurse is caring for a pediatric patient recovering Correct Answers: A, C, D, F
from post-streptococcal glomerulonephritis. What Rationale:
nursing interventions are appropriate?
Select all that apply. A. Diuretics reduce fluid overload.
C. Weight tracking helps monitor fluid status.
A. Administer prescribed diuretics D. I&O helps assess kidney function and fluid balance.
B. Encourage high fluid intake F. Preventing future strep infections can prevent recurrence.
C. Monitor daily weights B. Fluid intake is often restricted.
D. Maintain strict I&O E. Protein is usually limited if kidney function is impaired.
E. Provide a high-protein diet
F. Educate parents about avoiding future strep infections
26
7. A nurse is assessing a client with acute pyelonephritis. Correct Answers: A, B, C, E
Which of the following findings should the nurse expect?
20
(Select all that apply): Rationale: Pyelonephritis typically presents with systemic signs of infection (fever,
chills), urinary symptoms (dysuria), and flank pain due to kidney inflammation. CVA
A. Flank pain tenderness is a hallmark sign. Bradycardia and hypoglycemia are not typical.
B. Fever and chills
s
C. Dysuria
am
D. Bradycardia
E. Costovertebral angle tenderness
F. Hypoglycemia Ex
8. The nurse is educating a patient with a history of Correct Answers: B, E
recurrent pyelonephritis on prevention strategies. Which
statements indicate a need for further teaching? (Select Rationale: B and E indicate a need for further education. Patients should urinate
s
all that apply): after intercourse to reduce bacterial entry into the urethra. Frequent bubble baths
rt
can irritate the urethra and increase the risk of infections.
A. "I will wipe from front to back after using the
pe
bathroom."
B. "I should avoid urinating after intercourse to reduce the
risk of infection."
C. "Drinking more fluids will help flush bacteria from my
Ex
system."
D. "I'll finish my antibiotics even if I start feeling better."
E. "Taking bubble baths frequently will help soothe
se
urinary symptoms."
9. A nurse is reviewing the laboratory results of a client Correct Answer: B
ur
with suspected pyelonephritis. Which finding is most
indicative of this condition? Rationale: WBC casts in the urine are highly suggestive of kidney infection
N
(pyelonephritis). The other options are unrelated.
A. Elevated serum amylase
B. Presence of white blood cell casts in the urine
C. High serum calcium levels
D. Positive stool occult blood
10. A client is admitted with acute pyelonephritis. Which of Correct Answer: C
the following is the priority nursing intervention?
Rationale: IV antibiotics are the first-line treatment for acute pyelonephritis to
A. Encourage the client to increase dietary fiber prevent sepsis or worsening kidney damage. The other options are not
B. Begin bladder training appropriate priorities.
C. Initiate IV antibiotic therapy as prescribed
D. Administer antacids to relieve nausea
, 15. A nurse is caring for a client with advanced Correct Answer: C
nephrosclerosis. Which clinical finding indicates
progression to end-stage kidney disease (ESKD)? Rationale: A GFR below 15 mL/min is indicative of ESKD. Hematuria and polyuria
may occur earlier, and a creatinine of 1.0 mg/dL is within normal range.
A. Hematuria
B. Polyuria
C. GFR less than 15 mL/min
D. Creatinine level of 1.0 mg/dL
16. The nurse is teaching a client with benign Correct Answer: B
nephrosclerosis. Which statement by the client indicates a
26
correct understanding of the disease? Rationale: Blood pressure control is key in managing nephrosclerosis and slowing
disease progression. It is not caused by infection and dialysis is not immediately
A. "This condition is caused by a bacterial infection." necessary in benign cases.
20
B. "Managing my blood pressure can help slow kidney
damage."
C. "I'll need to start dialysis immediately."
D. "It mainly affects the bladder, not the kidneys."
s
am
17. Which of the following pathophysiological processes Correct Answers: A, C, E
are directly associated with nephrosclerosis? (Select all
that apply): Rationale: Nephrosclerosis is characterized by vascular fibrosis, thickening, and
hardening of the renal arteries and arterioles, leading to decreased renal
Ex
A. Vascular fibrosis in the renal arterioles perfusion and kidney ischemia. Hyperplasia of tubular cells and the formation of
B. Increased glomerular filtration rate (GFR) thrombi are not primary features of nephrosclerosis.
C. Decreased renal perfusion due to vessel narrowing
s
D. Hyperplasia of the renal tubular cells
rt
E. Thickening and hardening of the renal arteries
F. Formation of intrarenal thrombi
pe
Which of the following factors contribute to the Correct Answers: A, B, C, D, E
development of vascular changes in nephrosclerosis?
Ex
(Select all that apply): Rationale: Hypertension, hyperglycemia, hyperlipidemia, and atherosclerosis
contribute to vascular changes, including vessel narrowing and sclerosis. Plasma
A. Chronic hypertension renin levels may be elevated due to the compensatory response in hypertension.
B. Hyperglycemia Low sodium intake is not a direct factor in nephrosclerosis development.
se
C. Increased plasma renin levels
D. Hyperlipidemia
E. Atherosclerosis
ur
F. Low sodium intake
N
19. In nephrosclerosis, which of the following mechanisms Correct Answer: C
primarily leads to kidney damage?
Rationale: Chronic reduction in renal blood flow due to arterial sclerosis is the
A. Inflammation of renal parenchyma hallmark mechanism in nephrosclerosis. This leads to renal ischemia, fibrosis, and
B. Increased permeability of the glomerular filtration eventually progressive kidney dysfunction.
barrier
C. Chronic reduction in renal blood flow due to arterial
sclerosis
D. Formation of urinary calculi obstructing renal tubules
