,NU 185 Exam 4 | Medical-Surgical II | Questions &
Verified Answers | 2026 Edition | Galen College
1. Which of the following best describes the pathophysiology of open-angle glaucoma?
A) Increased intraocular pressure due to obstruction of aqueous humor outflow through the trabecular
meshwork
B) Sudden blockage of the angle by the iris
C) Inflammation of the uveal tract
D) Separation of the retina from the choroid
Correct Answer: Increased intraocular pressure due to obstruction of aqueous humor outflow through
the trabecular meshwork
Rationale: In open-angle glaucoma, the anterior chamber angle remains open but the trabecular
meshwork becomes less permeable, causing a gradual rise in intraocular pressure that damages the
optic nerve. Acute angle closure is sudden and painful. Retinal detachment is separate.
2. The nurse is teaching a patient after cataract surgery. Which statement indicates a need for further
instruction?
A) “I will wear my eye shield at night.”
B) “I can bend over to tie my shoes starting tomorrow.”
C) “I will avoid rubbing my eye.”
D) “I will use my eye drops as prescribed.”
Correct Answer: “I can bend over to tie my shoes starting tomorrow.”
Rationale: Activities that increase intraocular pressure such as bending, lifting heavy objects, and
straining must be avoided after cataract surgery to protect the incision and prevent complications. The
other statements reflect correct postoperative care.
3. A patient reports sudden, painless vision loss in one eye described as “a curtain coming down.” The
nurse suspects
,A) central retinal artery occlusion
B) retinal detachment
C) cataract formation
D) acute angle-closure glaucoma
Correct Answer: Retinal detachment
Rationale: The classic presentation of retinal detachment is a painless loss of vision often described as a
curtain or veil descending over the visual field, frequently preceded by flashes and floaters. It is a
medical emergency requiring prompt surgical repair.
4. The nurse is caring for a patient with Ménière disease during an acute attack. Which intervention is
the priority?
A) Apply warm compresses to the ear
B) Encourage ambulation to stimulate vestibular function
C) Place the patient on a low-sodium diet
D) Administer prescribed meclizine and provide a quiet, darkened environment
Correct Answer: Administer prescribed meclizine and provide a quiet, darkened environment
Rationale: During an acute Ménière attack, vertigo is severe. Antiemetics and vestibular suppressants
such as meclizine reduce symptoms. A quiet, darkened room with minimal stimuli helps reduce vertigo.
Fall precautions are essential. Sodium restriction is preventive, not acute.
5. The nurse is assessing a patient with dry age-related macular degeneration. Which finding is most
characteristic?
A) Gradual loss of central vision and presence of drusen
B) Sudden onset of peripheral vision loss
C) Cloudy, opaque lens
D) Increased intraocular pressure
, Correct Answer: Gradual loss of central vision and presence of drusen
Rationale: Dry macular degeneration is characterized by the accumulation of drusen under the retina
and gradual deterioration of the macula, causing painless, progressive loss of central vision. Peripheral
vision is retained. Cloudy lens indicates cataract; elevated IOP indicates glaucoma.
6. The nurse is assessing a patient with acute otitis media. Which finding is expected on otoscopic
examination?
A) A pearly gray, translucent tympanic membrane
B) A red, bulging tympanic membrane with obscured landmarks
C) A retracted tympanic membrane with a visible fluid level
D) A blue-black discoloration behind the tympanic membrane
Correct Answer: A red, bulging tympanic membrane with obscured landmarks
Rationale: Acute otitis media presents with a hyperemic, bulging tympanic membrane due to purulent
fluid accumulation in the middle ear. A pearly gray membrane is normal. Retraction with fluid suggests
serous otitis. Blue-black discoloration suggests hemotympanum.
7. When teaching a patient about preventing noise-induced hearing loss, which statement indicates
understanding?
A) “I will clean my ears daily with cotton swabs.”
B) “I only need hearing protection at rock concerts.”
C) “I will wear earplugs when using power tools or mowing the lawn.”
D) “Hearing loss from loud noise is reversible with medication.”
Correct Answer: “I will wear earplugs when using power tools or mowing the lawn.”
Rationale: Consistent use of hearing protection during exposure to loud noises, including power tools
and lawn equipment, prevents permanent sensorineural hearing loss. Cotton swabs should not be
inserted into the ear canal. Noise-induced hearing loss is irreversible.
Verified Answers | 2026 Edition | Galen College
1. Which of the following best describes the pathophysiology of open-angle glaucoma?
A) Increased intraocular pressure due to obstruction of aqueous humor outflow through the trabecular
meshwork
B) Sudden blockage of the angle by the iris
C) Inflammation of the uveal tract
D) Separation of the retina from the choroid
Correct Answer: Increased intraocular pressure due to obstruction of aqueous humor outflow through
the trabecular meshwork
Rationale: In open-angle glaucoma, the anterior chamber angle remains open but the trabecular
meshwork becomes less permeable, causing a gradual rise in intraocular pressure that damages the
optic nerve. Acute angle closure is sudden and painful. Retinal detachment is separate.
2. The nurse is teaching a patient after cataract surgery. Which statement indicates a need for further
instruction?
A) “I will wear my eye shield at night.”
B) “I can bend over to tie my shoes starting tomorrow.”
C) “I will avoid rubbing my eye.”
D) “I will use my eye drops as prescribed.”
Correct Answer: “I can bend over to tie my shoes starting tomorrow.”
Rationale: Activities that increase intraocular pressure such as bending, lifting heavy objects, and
straining must be avoided after cataract surgery to protect the incision and prevent complications. The
other statements reflect correct postoperative care.
3. A patient reports sudden, painless vision loss in one eye described as “a curtain coming down.” The
nurse suspects
,A) central retinal artery occlusion
B) retinal detachment
C) cataract formation
D) acute angle-closure glaucoma
Correct Answer: Retinal detachment
Rationale: The classic presentation of retinal detachment is a painless loss of vision often described as a
curtain or veil descending over the visual field, frequently preceded by flashes and floaters. It is a
medical emergency requiring prompt surgical repair.
4. The nurse is caring for a patient with Ménière disease during an acute attack. Which intervention is
the priority?
A) Apply warm compresses to the ear
B) Encourage ambulation to stimulate vestibular function
C) Place the patient on a low-sodium diet
D) Administer prescribed meclizine and provide a quiet, darkened environment
Correct Answer: Administer prescribed meclizine and provide a quiet, darkened environment
Rationale: During an acute Ménière attack, vertigo is severe. Antiemetics and vestibular suppressants
such as meclizine reduce symptoms. A quiet, darkened room with minimal stimuli helps reduce vertigo.
Fall precautions are essential. Sodium restriction is preventive, not acute.
5. The nurse is assessing a patient with dry age-related macular degeneration. Which finding is most
characteristic?
A) Gradual loss of central vision and presence of drusen
B) Sudden onset of peripheral vision loss
C) Cloudy, opaque lens
D) Increased intraocular pressure
, Correct Answer: Gradual loss of central vision and presence of drusen
Rationale: Dry macular degeneration is characterized by the accumulation of drusen under the retina
and gradual deterioration of the macula, causing painless, progressive loss of central vision. Peripheral
vision is retained. Cloudy lens indicates cataract; elevated IOP indicates glaucoma.
6. The nurse is assessing a patient with acute otitis media. Which finding is expected on otoscopic
examination?
A) A pearly gray, translucent tympanic membrane
B) A red, bulging tympanic membrane with obscured landmarks
C) A retracted tympanic membrane with a visible fluid level
D) A blue-black discoloration behind the tympanic membrane
Correct Answer: A red, bulging tympanic membrane with obscured landmarks
Rationale: Acute otitis media presents with a hyperemic, bulging tympanic membrane due to purulent
fluid accumulation in the middle ear. A pearly gray membrane is normal. Retraction with fluid suggests
serous otitis. Blue-black discoloration suggests hemotympanum.
7. When teaching a patient about preventing noise-induced hearing loss, which statement indicates
understanding?
A) “I will clean my ears daily with cotton swabs.”
B) “I only need hearing protection at rock concerts.”
C) “I will wear earplugs when using power tools or mowing the lawn.”
D) “Hearing loss from loud noise is reversible with medication.”
Correct Answer: “I will wear earplugs when using power tools or mowing the lawn.”
Rationale: Consistent use of hearing protection during exposure to loud noises, including power tools
and lawn equipment, prevents permanent sensorineural hearing loss. Cotton swabs should not be
inserted into the ear canal. Noise-induced hearing loss is irreversible.
