Download 3280 patho 2026 paractice questions and more Quizzes Pathophysiology in PDF only on Docsity!
NSG 3280 Unit 6: Eye & Ear Conditions PRACTICE
QUESTIONS
1. Select All That Apply (SATA) A nurse is reviewing the chart of a 45- year-old White woman recently diagnosed with otosclerosis. Which findings are consistent with the known pathophysiology and clinical manifestations of this condition? A. The hearing loss started in one ear but has the potential to affect both. B. Normal bone is destroyed and replaced with spongelike bone on the ossicles. C. The primary hearing loss is sensorineural due resulting from damage to the organ of Corti. D. The client may experience tinnitus. E. The condition is associated with ossicle fixation, especially the stapes bone foot plate. 2. A client reports that over the last several years, they have gradually struggled to hear conversations and higher-pitched sounds. This hearing loss is bilateral. The nurse recognizes these characteristics are most indicative of which condition? A. Meniere Disease. B. Otosclerosis. C. Trauma Hearing loss. D. Presbycusis. 3. A patient is experiencing an acute exacerbation of Meniere disease. The patient reports sudden-onset vertigo, which reached maximum intensity within minutes. Which nursing intervention is the priority based on these symptoms? A. Administering a PRN medication for buzzing tinnitus. B. Documenting the duration of the low tone hearing loss. C. Implementing fall precautions. D. Assessing for nystagmus directed toward the affected ear.
4. A client is diagnosed with hearing loss caused by chronic, repeated exposure to sounds greater than 85 decibels. The nurse understands that this type of hearing loss involves injury to which inner ear structure? A. Ossicles and middle ear fluid. B. The Eustachian tube and middle ear space. C. Cochlear hair cells and the Organ of Corti. D. The stapes bone foot plate. 5. A patient is prescribed a new aminoglycoside antibiotic. The nurse teaches the patient that this medication can cause sensorineural hearing loss through which mechanism? A. Causing Eustachian tube dysfunction and inflammation. B. Inducing atrophy of the cochlear wall. C. Disrupting the structure and fixation of the ossicles. D. Damaging or destroying the cochlear hair cells. 6. Select All That Apply (SATA) The nurse is educating the parent of a child with a history of recurrent acute otitis media (AOM). The nurse should recommend reducing exposure to which risk factors associated with AOM? A. Pacifiers. B. Second hand smoke. C. Loud noises. D. Propped milk bottles. E. Daycare attendance. 7. A client presents with symptoms including purulent ear drainage that has lasted longer than 12 weeks, as well as some conductive hearing loss. The client denies current pain. The nurse suspects: A. Acute otitis media. B. Ototoxicity.
D. Otitis media.
12. A nurse is assessing a young child suspected of having acute otitis media. Which finding would specifically support this diagnosis? A. Purulent ear drainage that has lasted over three months. B. An eardrum that is red and appears to bulge. C. Complaints of being unable to hear high-pitched sounds. D. A report of ringing or buzzing in the ear (tinnitus). 13. A client with hyperopia has trouble seeing objects up close because the eye is shorter than normal, causing the image to fall behind the retina. To correct this error, the nurse anticipates the client will need which type of lens? A. Concave lenses. B. Convex lenses. C. Reading glasses only D. Lenses to correct an irregular cornea shape. 14. In a client diagnosed with cataracts, the nurse understands that the primary pathological process leading to blurred vision involves: A. Mechanical detachment of the lens due to scar tissue. B. Oxidative stress damaging the avascular lens tissue causing clouding and loss of opacity. C. Increased intraocular pressure leading to cell death in the optic nerve. D. Hyperglycemia causing diseased capillaries and eye tissue ischemia. 15. Select All That Apply (SATA) A client is diagnosed with amblyopia. The nurse understands that this condition is characterized by: A. Ocular misalignment due to poor muscle control. B. Poor vision in one or both eyes even with corrective glasses. C. Being harder to treat the later it is caught. D. Being caused by visual development alterations. E. Requiring reading glasses during middle age.
16. A client with an opacity in the center of the lens reports difficulty seeing at night while driving but notes that their vision seems clearer when they are in a dimly lit environment, such as a theater. The nurse explains this is due to: A. The light being focused directly on the retina by the clouded lens. B. Pupil dilation in dim light allowing light to enter around the central opacity. C. Altered color perception caused by the cataract. D. The decreased ability to see near, characteristic of presbyopia. 17. A client with a history of myopia reports a sudden onset of seeing floating spots and describes a "curtain-like vision" in one eye. The nurse understands this is an acute sign of which condition requiring immediate intervention? A. Closed-angle glaucoma. B. Wet macular degeneration. C. Retinal detachment. D. Proliferative diabetic retinopathy. 18. Which pathology correctly identifies the mechanical cause of spontaneous (rhegmatogenous) retinal detachment? A. Serous fluid accumulation behind the retina due to hypertension. B. Scar tissue pulling the retina away from the underlying structures. C. The vitreous humor shrinking with age and creating traction that pulls the retina away. D. Neovascular growth attaching to the retina and causing leakage. 19. A nurse is counseling a patient diagnosed with diabetic retinopathy. The nurse explains that the progression of the disease is initially characterized by: A. The eye becoming shorter than normal (hyperopia). B. Diseased capillaries, tissue ischemia, and macular edema. C. An increase in intraocular pressure causing optic disc atrophy.
A. Steamy cornea (corneal edema) and a dilated pupil nonreactive to light. B. Difficulty distinguishing colors and persistent dull eye pain. C. Floating spots and flashes of light with eye movement. D. Squinting and headaches following close work.
24. Open-angle glaucoma results in progressive peripheral vision loss primarily because of: A. Oxidative stress causing degeneration of the retinal epithelium. B. Increased endolymphatic fluid pressure damaging the scala media. C. An increase in intraocular pressure (IOP) leading to retinal ganglion cell death and optic disc atrophy. D. Scar tissue pulling the retina away from the back of the eye. 25. Select All That Apply (SATA) The nurse is screening a client for Glaucoma risk factors. Which findings from the client's history increase the likelihood of developing the condition? A. History of Myopia. B. History of Diabetes. C. Caucasian ethnicity. D. Advanced age. E. Use of steroid medications. 26. A client with strabismus (crossed eyes) is exhibiting squinting, frowning, and headaches. These symptoms occur because the ocular misalignment results in: A. Fluid collection behind the retina. B. Loss of lens accommodation. C. The eyes being unable to work together. D. The eye being shorter than normal. 27. A 60-year-old client reports recent difficulty distinguishing colors and a persistent, dull pain in their eyes. Which diagnosis does the nurse suspect?
A. Cataracts. B. Open-angle glaucoma. C. Closed-angle glaucoma. D. Presbyopia.
28. A client with high myopia who had cataract removal surgery one week ago reports new symptoms of blurred vision and black floating spots. The nurse’s primary concern is the client's predisposition to which complication? A. Astigmatism. B. Sudden increase in intraocular pressure. C. Retinal detachment. D. Wet macular degeneration. 29. Which statement accurately compares Myopia and Hyperopia? A. Both conditions require concave lenses for correction. B. Myopia is due to an elongated eye causing the image to fall in front of the retina. C. Hyperopia is due to loss of lens accommodation. D. Both conditions involve the image falling behind the retina. 30. Select All That Apply (SATA) Which conditions are related to a known or suspected excess accumulation of fluid in sensory structures? A. Otitis media. B. Meniere Disease. C. Otosclerosis D. Closed-angle glaucoma E. Wet Macular Degeneration. 31. The nurse explains that the pathology of chronic otitis media involves irreversible damage, often resulting in retractions of the eardrum due to: A. Cholesteatoma formation.
NSG 3280 Unit 6: Eye & Ear Conditions ANSWERS
1. Select All That Apply (SATA) A nurse is reviewing the chart of a 45- year-old White woman recently diagnosed with otosclerosis. Which findings are consistent with the known pathophysiology and clinical manifestations of this condition? A. The hearing loss started in one ear but has the potential to affect both. B. Normal bone is destroyed and replaced with spongelike bone on the ossicles. C. The primary hearing loss is sensorineural due resulting from damage to the organ of Corti. D. The client may experience tinnitus. E. The condition is associated with ossicle fixation, especially the stapes bone foot plate. Answer: A, B, D, E Rationale: Otosclerosis typically starts in one ear but can affect both. It involves the destruction of normal bone and replacement with spongelike bone, particularly on the stapes foot plate, which leads to decreased sound wave transmission. Tinnitus is a common clinical manifestation. Otosclerosis primarily causes conductive hearing loss, although stapes fixation can lead to sensorineural loss as well. Sensorineural loss alone is more characteristic of issues like ototoxicity or loud noise exposure. 2. A client reports that over the last several years, they have gradually struggled to hear conversations and higher-pitched sounds. This hearing loss is bilateral. The nurse recognizes these characteristics are most indicative of which condition? A. Meniere Disease. B. Otosclerosis. C. Trauma Hearing loss. D. Presbycusis. Answer: D Rationale: Presbycusis is the most common hearing loss in older adults, characterized by being gradual and bilateral. Patients with Presbycusis struggle the most with higher pitched sounds and conversations. Meniere disease causes unilateral low-tone loss. Otosclerosis starts in one
ear and is primarily conductive loss. Trauma hearing loss is bilateral sensorineural loss, but the gradual, specific struggle with high pitches and conversations points strongly toward Presbycusis.
3. A patient is experiencing an acute exacerbation of Meniere disease. The patient reports sudden-onset vertigo, which reached maximum intensity within minutes. Which nursing intervention is the priority based on these symptoms? A. Administering a PRN medication for buzzing tinnitus. B. Documenting the duration of the low tone hearing loss. C. Implementing fall precautions. D. Assessing for nystagmus directed toward the affected ear. Answer: C Rationale: Meniere disease causes sudden-onset vertigo which lasts for hours and can lead to unsteadiness for days. Implementing fall precautions immediately is the highest priority to ensure patient safety.
Nystagmus is directed to the side of the unaffected ear, not the affected ear.
4. A client is diagnosed with hearing loss caused by chronic, repeated exposure to sounds greater than 85 decibels. The nurse understands that this type of hearing loss involves injury to which inner ear structure? A. Ossicles and middle ear fluid. B. The Eustachian tube and middle ear space. C. Cochlear hair cells and the Organ of Corti. D. The stapes bone foot plate. Answer: C Rationale: Trauma hearing loss caused by chronic loud sounds injures the hair cells and the organ of Corti in the inner ear, leading to bilateral sensorineural hearing loss. Issues with the ossicles and middle ear fluid cause conductive loss. 5. A patient is prescribed a new aminoglycoside antibiotic. The nurse teaches the patient that this medication can cause sensorineural hearing loss through which mechanism? A. Causing Eustachian tube dysfunction and inflammation. B. Inducing atrophy of the cochlear wall. C. Disrupting the structure and fixation of the ossicles.
C. Ossicle disruption. D. Cerumen impaction. E. Excess fluid in inner ear structures. Answer: A, B, E Rationale: Sensorineural hearing loss occurs when sound processing in the cochlea or vestibulocochlear nerve is impaired. Causes include neural Presbycusis, ototoxic meds like salicylates, and excess fluid in inner ear structures (Meniere’s). Ossicle disruption and cerumen impaction cause conductive hearing loss.
9. A nurse is comparing the pathological effects of otosclerosis and presbycusis. Which statement accurately describes a shared underlying mechanism that leads to hearing loss in both conditions? A. Both conditions are primarily caused by long-term loud noise exposure. B. Both can eventually involve conductive hearing loss due to changes in the middle ear. C. Both are triggered exclusively by genetic factors. D. Both result in bilateral sensorineural loss involving degeneration of the cochlear hair cells. Answer: B Rationale: Otosclerosis is primarily conductive due to ossicle stiffness/fixation (middle ear issue). Presbycusis is usually sensorineural but mechanical causes involve changes in the middle ear that lead to conductive hearing loss. 10. A client with Meniere disease is seeking ways to prevent cochlear degeneration. The nurse explains that the degeneration is caused by: A. The atrophy of the cochlear wall. B. An infection of the middle ear space. C. Distension and damage to the scala media. D. A foreign body causing obstruction and cerumen impaction. Answer: C Rationale: The pathophysiology of Meniere disease involves increased endolymphatic fluid in the inner ear, which leads to distension and damage to the scala media (duct inside the cochlea), ultimately causing cochlear degeneration.
11. A client reports hearing loss that is temporary, but that is specific to low tones. The nurse understands this finding is characteristic of: A. Presbycusis. B. Otosclerosis. C. Meniere disease. D. Otitis media. Answer: C Rationale: Meniere disease is characterized by unilateral low tone hearing loss, which is temporary during an exacerbation but can become permanent. 12. A nurse is assessing a young child suspected of having acute otitis media. Which finding would specifically support this diagnosis? A. Purulent ear drainage that has lasted over three months. B. An eardrum that is red and appears to bulge. C. Complaints of being unable to hear high-pitched sounds. D. A report of ringing or buzzing in the ear (tinnitus). Answer: B Rationale: Acute otitis media comes on suddenly with an URI, pain, fever, and the eardrum may be red and may bulge. Purulent drainage lasting over 12 weeks suggests chronic otitis media. 13. A client with hyperopia has trouble seeing objects up close because the eye is shorter than normal, causing the image to fall behind the retina. To correct this error, the nurse anticipates the client will need which type of lens? A. Concave lenses. B. Convex lenses. C. Reading glasses only D. Lenses to correct an irregular cornea shape. Answer: B Rationale: Hyperopia (farsightedness) is corrected using convex lenses. Concave lenses are needed for myopia (nearsightedness). 14. In a client diagnosed with cataracts, the nurse understands that the primary pathological process leading to blurred vision involves:
Answer: B Rationale: If the opacity is in the center of the lens, vision may be better in dim light because the pupil dilates to let light in around the opacity.
17. A client with a history of myopia reports a sudden onset of seeing floating spots and describes a "curtain-like vision" in one eye. The nurse understands this is an acute sign of which condition requiring immediate intervention? A. Closed-angle glaucoma. B. Wet macular degeneration. C. Retinal detachment. D. Proliferative diabetic retinopathy. Answer: C Rationale: Sudden onset, floating spots, blurred vision, and "curtain-like vision" are characteristic manifestations of a retinal detachment. Myopia is a predisposing factor. This condition can rapidly worsen to complete blindness. 18. Which pathology correctly identifies the mechanical cause of spontaneous (rhegmatogenous) retinal detachment? A. Serous fluid accumulation behind the retina due to hypertension. B. Scar tissue pulling the retina away from the underlying structures. C. The vitreous humor shrinking with age and creating traction that pulls the retina away. D. Neovascular growth attaching to the retina and causing leakage. Answer: C Rationale: Spontaneous (rhegmatogenous) detachment occurs when the vitreous humor shrinks with age, and traction develops, pulling the retina away. A is exudative, and B is tractional detachment. D is proliferative diabetic retinopathy. 19. A nurse is counseling a patient diagnosed with diabetic retinopathy. The nurse explains that the progression of the disease is initially characterized by: A. The eye becoming shorter than normal (hyperopia). B. Diseased capillaries, tissue ischemia, and macular edema. C. An increase in intraocular pressure causing optic disc atrophy.
D. Oxidation and inflammation leading to degeneration of the retinal epithelium. Answer: B Rationale: The pathophysiology of Diabetic Retinopathy begins with hyperglycemia leading to diseased capillaries, decreased blood flow, tissue ischemia, and the eventual possibility of vessel leakage and macular edema. Oxidation and inflammation (D) are characteristic of Macular Degeneration.
20. Select All That Apply (SATA) A client is diagnosed with non- proliferative diabetic retinopathy. The nurse expects which clinical findings? A. Cotton wool spots. B. Blurred vision. C. Darkened vision. D. New blood vessels growing into the vitreous. E. Small hemorrhage spots. Answer: A, B, C, E Rationale: Non-proliferative retinopathy is characterized by small hemorrhage spots and cotton wool spots (nerve fiber death). As the disease progresses, patients may experience general manifestations like blurred or darkened vision. New vessel growth (D) occurs in the proliferative stage. 21. The nurse is providing education to a client diagnosed with dry macular degeneration. Which statement indicates the client understands their condition? A. “I should expect my central vision loss to become progressively worse over time.”. B. “I need to be aware that my vision loss may be sudden, resulting from hemorrhage.”. C. “This condition primarily affects my peripheral vision, leading to tunnel vision.”. D. “I will need less light for close work since the opacity in my eye is central.”. Answer: A Rationale: Dry macular degeneration involves the progressive worsening of central vision loss. Sudden vision loss from hemorrhage (B) is characteristic of wet macular degeneration. Loss of peripheral vision (C) is
death, loss of axons in the optic nerve, optic disc atrophy, and ultimately, peripheral vision loss (tunnel vision).
25. Select All That Apply (SATA) The nurse is screening a client for Glaucoma risk factors. Which findings from the client's history increase the likelihood of developing the condition? A. History of Myopia. B. History of Diabetes. C. Caucasian ethnicity. D. Advanced age. E. Use of steroid medications. Answer: A, B, D, E Rationale: Glaucoma risk factors include increased age, Myopia, Diabetes, and steroids. African American ethnicity is listed as a risk factor, while Caucasian ethnicity is a risk factor for otosclerosis. 26. A client with strabismus (crossed eyes) is exhibiting squinting, frowning, and headaches. These symptoms occur because the ocular misalignment results in: A. Fluid collection behind the retina. B. Loss of lens accommodation. C. The eyes being unable to work together. D. The eye being shorter than normal. Answer: C Rationale: Strabismus is ocular misalignment due to poor muscle control, meaning the eyes cannot work together. Clinical manifestations include squinting, frowning, dizziness, and headaches. 27. A 60-year-old client reports recent difficulty distinguishing colors and a persistent, dull pain in their eyes. Which diagnosis does the nurse suspect? A. Cataracts. B. Open-angle glaucoma. C. Closed-angle glaucoma. D. Presbyopia.
Answer: B Rationale: Open-angle glaucoma manifestations include persistent dull eye pain and issues distinguishing colors, along with progressive peripheral vision loss. Closed-angle glaucoma involves sudden, severe pain and halos around lights.
28. A client with high myopia who had cataract removal surgery one week ago reports new symptoms of blurred vision and black floating spots. The nurse’s primary concern is the client's predisposition to which complication? A. Astigmatism. B. Sudden increase in intraocular pressure. C. Retinal detachment. D. Wet macular degeneration. Answer: C Rationale: Retinal detachment is a major complication. Predisposing factors include myopia and cataract removal. The symptoms of blurred vision and floating spots are clinical manifestations of detachment. 29. Which statement accurately compares Myopia and Hyperopia? A. Both conditions require concave lenses for correction. B. Myopia is due to an elongated eye causing the image to fall in front of the retina. C. Hyperopia is due to loss of lens accommodation. D. Both conditions involve the image falling behind the retina. Answer: B Rationale: Myopia (nearsightedness) results from an elongated eye where the image falls in front of the retina. Hyperopia is a shorter eye where the image falls behind the retina. Presbyopia is the loss of lens accommodation. 30. Select All That Apply (SATA) Which conditions are related to a known or suspected excess accumulation of fluid in sensory structures? A. Otitis media. B. Meniere Disease. C. Otosclerosis D. Closed-angle glaucoma E. Wet Macular Degeneration.
