MERU UNIVERSITY OF SCIENCE AND TECHNOLOGY

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Website: www.must.ac.ke Email: [email protected]
University Examinations 2021/2022

THIRD YEAR, SECOND SEMESTER EXAMINATION FOR THE DEGREE OF

BACHELOR OF NURSING
NND 3321: ENT & OPHTHALMIC NURSING

DATE: JUNE 2022 TIME: 3 HOURS

INSTRUCTIONS: Answer all questions

SECTION A: MCQ (20MARKS)

1. A client with an eye injury to the left eye wears a patch over the injured eye. The
nurse identifies which chief visual disturbance the client will experience while
wearing the eye patch?
a. Inability to focus on very near or far away objects
b. Difficulty judging the distance of objects
c. Impaired accommodation to darkness
d. Floating spots seen in the affected eye
2. A client is scheduled for extra-capsular cataract removal. It is most important for the
nurse to include which information during preoperative teaching?
a. Postoperative activities and restrictions
b. The proper use of dark glasses
c. Signs and symptoms of a detached retina
d. Symptoms of eye hemorrhage
3. The nurse provides care for clients in the outpatient clinic. A client comes in stating,
“I think I have a piece of glass in my eye”. Which action does the nurse take first?
a. Attempts to remove the impaled glass using tweezers
b. Douses the affected eye with artificial tears
c. Assesses visual losses in the affected eye
d. Covers the eye with a protective shield
4. The nurse identifies which environmental factor is most helpful to maintain
independence for a client who is legally blind?
a. A radio on the bedside table
b. A nurse call light that is easy to reach
c. The furniture in the room consistently arranged
d. A room with a private bathroom

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5. The nurse identifies which symptoms are characteristics of acute (closed-angle)
glaucoma?
a. Eye fatigue, photophobia, loss of peripheral vision
b. Blurred visio, headache, rainbows around lights
c. Tunnel vision, malaise, flashing lights
d. Nausea, orbital edema, blindness
6. The nurse teaches a client diagnosed with an infection of both the left and right eye
how to care for the eyes. It is most important for the nurse to include which
instruction?
a. Touch the eyes with the medication dropper when instilling eye drops
b. Put firm pressure on the eyeball when wiping or cleaning the eye
c. Clean each eye with a separate tissue to prevent cross-contamination between the
eyes
d. Wash the hands after completing each eye care
7. When performing preoperative care for a client diagnosed with a detached retina, the
nurse should?
a. Apply ice packs to the affected eye
b. Irrigate the eye with warm normal saline
c. Maintain the client on bed rest
d. Instruct the client to lie on the affected side
8. An adolescent is brought to the emergency department after being hit on the head
while playing ball. After examination, a diagnosis of detached retina of the left eye is
made. Which sign and symptom does the nurse expect to observe?
a. The client reports quick flashes of light are seen
b. The client reports severe pain in the affected eye
c. The client has decreased peripheral vision
d. The nurse observes periorbital edema
9. The Snellen chart is used for which purpose?
a. Assess visual acuity
b. Measure eye pressure
c. Determine client’s ability to read
d. Test peripheral vision
10. The nurse identifies which of the following as the proper technique for eye drop
administration?
a. Instruct the client to look down, retract the lower eyelid, and instill drops
b. Instruct the client to look up, retract the lower eyelid, and instill drops
c. Instruct the client to look down, retract the lower eyelid, and instill drops then
apply pressure
d. Instruct the client to look sideways, and instill the drops then apply pressure
11. A patient complaining of blurred vision is describing a symptom that is:
A. Objective
B. Prodromal
C. Functional
D. Subjective

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12. A pre-schooler is returned to his room following a tonsillectomy. He remains sleepy
from the anesthesia but is easily awakened. The nurse should place the child in which
of the following positions?
A. Sim’s
B. Side-lying
C. Supine
D. Prone
13. Cataract surgery results in aphakia. Which following statements best describes the
term?
A. Loss of accommodation
B. Retinal detachment
C. Absence of the crystalline lens
D. A keyhole pupil
14. Mr. C’s visual acuity is 20/50. This means that he:
A. Can see 50% what the average person sees at 20 feet
B. Has perfect vision when tested at 50 feet
C. Can see 20% of the letters on the chart’s 20/50 line
D. Can read letters while standing 20 feet from the chart that the average person
could read at 50 feet
15. An allergy can cause the conjunctiva to have:
A. Cobblestone pattern
B. Dry surface
C. Subconjuctival hemorrhage
D. Rust-coloured pigment
16. When assessing the turbinate’s of a healthy patient, the practitioner would expect
which of the following findings?
A. Mucosa that is brighter in color than oral tissues
B. Similar in appearance to oral buccal mucosa\
C. Soft, boggy and pale pink in appearance
D. Translucent pearly gray with definite landmarks visible
17. A nurse is preparing to administer eye drops to a client. To which of the following site
should the nurse administer it?
A. Conjunctival sac
B. Pupil
C. Inner canthus
D. Outer canthus
18. The junction between the bulbar and palpebral conjunctiva is referred to as:
A. Limbus
B. Fornix
C. Sclera
D. Ptergium
19. Opacities of the red reflex may indicate the presence of:
A. Hypertension
B. Pupillary light reflex
C. Cataracts
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 D. Myopia
20. Which precaution is most important for the nurse to teach a 62-year-old patient newly
diagnosed with early-stage dry age-related macular degeneration?
A. Quit smoking
B. Quit drinking alcoholic beverages
C. Eat more dark green, red and yellow vegetables
D. Wear dark glasses whenever in bright lighting

SECTION B: SHORT ANSWER QUESTIONS (30MARKS)

1. Identify 4 priority nursing diagnosis for a patient with epiglottitis (4 marks)

2. Describe how to perform the Weber test on a patient (5marks)
3. State 4 patient teachings on self-care on prevention of epistaxis on discharge (4marks)
4. Outline 4 patient education after a tonsillectomy to help prevent complications
(4marks)
5. List 8 ways that can be used in assisting a client with visual deficits (8marks)
6. Identify 5 nursing interventions for a client who is hearing impaired (5marks)

SECTION C: LONG ANSWER QUESTIONS (20MARKS)

1. A 70year-old patient is diagnosed with Menieere’s disease at the outpatient setting

and admitted for further management. Formulate a nursing care plan for the patient,
include 3 assessment data for each nursing diagnosis, 2 nursing diagnosis with 1 goal
and 1 expected outcome, 2 priority intervention for each nursing diagnosis with 2
rationales each (20marks)
Assessment Nursing Goals and Interventions rationales
data diagnosis expected
outcomes
3 1 1 goal 2 2
1 expected
outcome
3 1 1 goal 2 2
1 expected
outcome

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