NUR 210 – Final Exam Questions With
Correct Verified Solutions.
What is the normal response to the accommodation test?
a. Convergence of the axis of the eyes and constriction of the pupils
b. A direct light reflex and consensual light reflex
c. Conjugate movement of the eyes in all 6 cardinal positions of gaze
d. Symmetrical dilation of bilateral pupils - Answer a. Convergence of the axis of the eyes and
constriction of the pupils
How will the nurse assess the peripheral vision of an adult patient who was admitted to the
hospital with a possible stroke?
a. Perform the Snellen alphabet test
b. Perform the diagnostic positions test
c. Perform the corneal light reflex test
d. Perform the confrontation test - Answer d. Perform the confrontation test
Which cranial nerves are being tested when the nurse has a patient perform the diagnostic
positions test?
a. Cranial nerves III, IV and VI
b. Cranial nerves II, III and IV
c. Cranial nerves IV, V and VI
d. Cranial nerves III, IV and V - Answer a. Cranial nerves III, IV and VI
What is the best nursing response when asymmetric corneal light reflex is observed in a 3 year
old child?
a. Look for other signs of Bell's palsy
b. Refer the patient to the appropriate specialist due to strabismus
c. No action is needed, because this is a normal finding in children under the age of 6
,What is the nursing priority for an African-American patient with small brown macules on the
sclera?
a. Refer the patient to an ophthalmologist for further testing.
b. Notify the patient that he may have liver disease and should have it checked.
c. Proceed with the examination as planned because this is a normal finding.
d. Instruct the patient to wear sunglasses when outdoors to prevent further macule formation. -
Answer c. Proceed with the examination as planned because this is a normal finding.
How will the nurse document assessment of the eyes in an adult patient that has drooping of
the left eye lid with a smaller distance between the upper and lower lids on the left?
a. Exophthalmos of the right eye
b. Ptosis of the left eye lid
c. Anisocoria of the left eye lid
d. Nystagmus of the left eye - Answer b. Ptosis of the left eye lid
What is the priority nursing intervention when the nurse observes that an elderly patient
cannot move the eyes past the midline to the left when performing the diagnostic positions
test?
a. Perform the Snellen eye test and pupillary light reflex to further test cranial nerve II.
b. Document dysfunction of cranial nerves II and III and proceed with the assessment.
c. Continue the assessment, because this is a normal finding in elderly patients.
d. Refer patient for further testing due to possible dysfunction of cranial nerves III, IV and VI. -
Answer d. Refer patient for further testing due to possible dysfunction of cranial nerves III, IV
and VI.
What type of vision loss does the nurse expect in a patient that has experienced an infarct
involving the left cerebral optic tract (left hemispheric stroke)?
a. Visual field loss in the right temporal and left nasal fields
b. Visual field loss in the right nasal and left nasal fields
c. Visual field loss in the right temporal and left temporal fields
d. Visual field loss in right nasal and left temporal fields - Answer a. Visual field loss in the right
,a.
"It is unusual for a small child to have frequent ear infections unless something else is wrong."
b.
"We need to check the immune system of your son to determine why he is having so many ear
infections."
c.
"Ear infections are not uncommon in infants and toddlers because they tend to have more
cerumen in the external ear."
d.
"Your son's eustachian tube is shorter and wider than yours because of his age, which allows for
infections to develop more easily." - Answer d. "Your son's eustachian tube is shorter and
wider than yours because of his age, which allows for infections to develop more easily."
How does the nurse interpret the following information: an adult patient states that he has the
sensation that everything around him is spinning?
a.
Dizziness caused by cranial nerve VIII dysfunction
b.
Vertigo and the middle ear is responsible for this sensation
c.
Near syncope caused by dysfunction of the organ of Corti
d.
Vertigo and the inner ear is responsible for this sensation - Answer d. Vertigo and the inner ear
is responsible for this sensation
What is the nursing priority when the family of a 2 year old child states that he cannot produce
any intelligible speech and is inattentive in conversation?
a.
Refer the patient to the appropriate specialist due to possible hearing loss
b.
Note the placement of the ears, to assess for possible Down syndrome.
, Refer the patient to the appropriate specialist due to possible hearing loss
How does the nurse interpret the following assessment findings; painful movement of the pinna
and tragus with redness and swelling of the pinna and canal?
a. Otitis media (middle ear infection)
b. Otitis Externa (swimmer's ear)
c. Inner ear infection (Labyrinthitis)
d. Meniere disease ( inner ear disorder) - Answer b. Otitis Externa (swimmer's ear)
How will the nurse facilitate communication with a 35 year old patient with otosclerosis?
a.
Use a louder volume
b.
Use a lower tone of voice
c.
Eliminate background noise
d.
Place emphasis on consonants - Answer a.
Use a louder volume
Which of the following are potential etiologies of conductive hearing loss? (Select all that apply.)
a. Presbycusis
b. Impacted cerumen
c. Otitis media with effusion
d. Otosclerosis
e. Perforated tympanic membrane - Answer c. Otitis media with effusion
d. Otosclerosis
e. Perforated tympanic membrane
Correct Verified Solutions.
What is the normal response to the accommodation test?
a. Convergence of the axis of the eyes and constriction of the pupils
b. A direct light reflex and consensual light reflex
c. Conjugate movement of the eyes in all 6 cardinal positions of gaze
d. Symmetrical dilation of bilateral pupils - Answer a. Convergence of the axis of the eyes and
constriction of the pupils
How will the nurse assess the peripheral vision of an adult patient who was admitted to the
hospital with a possible stroke?
a. Perform the Snellen alphabet test
b. Perform the diagnostic positions test
c. Perform the corneal light reflex test
d. Perform the confrontation test - Answer d. Perform the confrontation test
Which cranial nerves are being tested when the nurse has a patient perform the diagnostic
positions test?
a. Cranial nerves III, IV and VI
b. Cranial nerves II, III and IV
c. Cranial nerves IV, V and VI
d. Cranial nerves III, IV and V - Answer a. Cranial nerves III, IV and VI
What is the best nursing response when asymmetric corneal light reflex is observed in a 3 year
old child?
a. Look for other signs of Bell's palsy
b. Refer the patient to the appropriate specialist due to strabismus
c. No action is needed, because this is a normal finding in children under the age of 6
,What is the nursing priority for an African-American patient with small brown macules on the
sclera?
a. Refer the patient to an ophthalmologist for further testing.
b. Notify the patient that he may have liver disease and should have it checked.
c. Proceed with the examination as planned because this is a normal finding.
d. Instruct the patient to wear sunglasses when outdoors to prevent further macule formation. -
Answer c. Proceed with the examination as planned because this is a normal finding.
How will the nurse document assessment of the eyes in an adult patient that has drooping of
the left eye lid with a smaller distance between the upper and lower lids on the left?
a. Exophthalmos of the right eye
b. Ptosis of the left eye lid
c. Anisocoria of the left eye lid
d. Nystagmus of the left eye - Answer b. Ptosis of the left eye lid
What is the priority nursing intervention when the nurse observes that an elderly patient
cannot move the eyes past the midline to the left when performing the diagnostic positions
test?
a. Perform the Snellen eye test and pupillary light reflex to further test cranial nerve II.
b. Document dysfunction of cranial nerves II and III and proceed with the assessment.
c. Continue the assessment, because this is a normal finding in elderly patients.
d. Refer patient for further testing due to possible dysfunction of cranial nerves III, IV and VI. -
Answer d. Refer patient for further testing due to possible dysfunction of cranial nerves III, IV
and VI.
What type of vision loss does the nurse expect in a patient that has experienced an infarct
involving the left cerebral optic tract (left hemispheric stroke)?
a. Visual field loss in the right temporal and left nasal fields
b. Visual field loss in the right nasal and left nasal fields
c. Visual field loss in the right temporal and left temporal fields
d. Visual field loss in right nasal and left temporal fields - Answer a. Visual field loss in the right
,a.
"It is unusual for a small child to have frequent ear infections unless something else is wrong."
b.
"We need to check the immune system of your son to determine why he is having so many ear
infections."
c.
"Ear infections are not uncommon in infants and toddlers because they tend to have more
cerumen in the external ear."
d.
"Your son's eustachian tube is shorter and wider than yours because of his age, which allows for
infections to develop more easily." - Answer d. "Your son's eustachian tube is shorter and
wider than yours because of his age, which allows for infections to develop more easily."
How does the nurse interpret the following information: an adult patient states that he has the
sensation that everything around him is spinning?
a.
Dizziness caused by cranial nerve VIII dysfunction
b.
Vertigo and the middle ear is responsible for this sensation
c.
Near syncope caused by dysfunction of the organ of Corti
d.
Vertigo and the inner ear is responsible for this sensation - Answer d. Vertigo and the inner ear
is responsible for this sensation
What is the nursing priority when the family of a 2 year old child states that he cannot produce
any intelligible speech and is inattentive in conversation?
a.
Refer the patient to the appropriate specialist due to possible hearing loss
b.
Note the placement of the ears, to assess for possible Down syndrome.
, Refer the patient to the appropriate specialist due to possible hearing loss
How does the nurse interpret the following assessment findings; painful movement of the pinna
and tragus with redness and swelling of the pinna and canal?
a. Otitis media (middle ear infection)
b. Otitis Externa (swimmer's ear)
c. Inner ear infection (Labyrinthitis)
d. Meniere disease ( inner ear disorder) - Answer b. Otitis Externa (swimmer's ear)
How will the nurse facilitate communication with a 35 year old patient with otosclerosis?
a.
Use a louder volume
b.
Use a lower tone of voice
c.
Eliminate background noise
d.
Place emphasis on consonants - Answer a.
Use a louder volume
Which of the following are potential etiologies of conductive hearing loss? (Select all that apply.)
a. Presbycusis
b. Impacted cerumen
c. Otitis media with effusion
d. Otosclerosis
e. Perforated tympanic membrane - Answer c. Otitis media with effusion
d. Otosclerosis
e. Perforated tympanic membrane
