EAQ Module 13 Quiz

For which contraindication would the nurse assess the patient before administering a new prescription for timolol (Timoptic; Istalol) eyedrops as treatment of glaucoma?

Chronic obstructive pulmonary disease (COPD)

When interviewing a patient with a new diagnosis of glaucoma, which question is most relevant to the patient's condition?

"Do you have a history of cardiac or pulmonary disease?" ***Because glaucoma is often treated with beta-adrenergic blockers

When interviewing a patient experiencing visual impairment, which elimination question would the nurse ask to determine intraocular pressure changes?

"Do you have to strain when having a bowel movement?"

While completing a health history, the nurse learns that a patient has symptoms of tinnitus. Which follow-up question would the nurse ask?

"Do you routinely take aspirin, or have you increased your aspirin intake lately?"

The nurse is educating a patient with Ménière's disease about care management after discharge. Which statement by the patient indicates effective teaching? -"I should limit alcohol intake to 2 ounces a day." -"I should choose solid foods over liquids." -"I should eat a low-sodium diet." -"I should exercise in the evening."

"I should eat a low-sodium diet." ***This reduces the risk of water retention

For glaucoma discharge instructions, which patient statement indicates understanding of the nurse's teachings? -"I'll limit my fluid intake each day." -"I'll change positions very slowly." -"I'll use my eyedrops until my vision clears." -"I'll check the labels on my nonprescription drugs."

"I'll check the labels on my nonprescription drugs." ***Nonprescription drugs, even caffeine, may increase IOP

A nurse is assessing a patient with chronic tinnitus. Which question is appropriate to ask when exploring the patient's sleep habits?

"Is your sleep disturbed by ringing in your ears?"

The nurse suspects a patient is experiencing nystagmus. Which statement made by the patient supports the nurse's suspicion?

"My vision blurs when I move my head."

A patient comes to the clinic reporting a ringing sensation in the ears. Which questions would the nurse ask to find out more about the patient's problem? Select all that apply. -"Can you describe the type of ringing?" -"When do you usually have this sensation?" -"Have you ever collapsed due to dizziness?" -"Do you get ear pain if you strain while defecating?" -"What measures have you taken to resolve this complaint?"

-"Can you describe the type of ringing?" -"When do you usually have this sensation?" -"What measures have you taken to resolve this complaint?"

A patient is advised to undergo a caloric-test stimulus. Which information would the nurse include when explaining the test to the patient? Select all that apply. -"You will be in a standing position for the test." -"You will be sitting or lying down for the test." -"The test involves pouring cold or warm solution into your ears." -"The test is performed to determine conductive or sensorineural hearing loss." -"The test may result in nausea and vertigo after stimulation of semicircular canals."

-"You will be sitting or lying down for the test." -"The test involves pouring cold or warm solution into your ears." -"The test may result in nausea and vertigo after stimulation of semicircular canals." ***This test is used to diagnose diseases of the labyrinth and vestibular systems

Which actions would the nurse take when performing a focused assessment on the auditory system? Select all that apply. -Ask whether the patient wears earrings. -Ask whether the patient is feeling any ear pain. -Assess whether the patient can hear a clock ticking. -Determine whether the patient can hear loud noises. -Check the external auditory meatus for any discharge.

-Ask whether the patient is feeling any ear pain. -Assess whether the patient can hear a clock ticking. -Check the external auditory meatus for any discharge.

Which actions would the nurse implement when using the sighted-guide technique to assist a patient who is blind?

-Describe the environment to the patient while walking -Stand slightly in front and to one side of the patient; provide an elbow for support -Help the patient to sit by placing the patient's hand on the seat of the chair

When planning the discharge of a patient after eye surgery, which activities would the nurse instruct the patient to avoid?

-Lifting -Coughing -Bending over

Which gerontological findings related to assessment of the visual system would the nurse anticipate when planning care for an older adult patient?

-Loss of hair pigment -Increased rigidity of the lens -Atrophy of the corneal nerves

When documenting a patient's health assessment, the nurse utilized the abbreviation PERRLA. Which findings did the nurse document? Select all that apply. -Pupils are round. -The retina responds to light bilaterally. -Lacrimal apparatus is functioning in both eyes. -Intraocular pressure is even and within normal parameters. -Pupils constrict when the patient focuses on a nearer object.

-Pupils are round -Pupils constrict when the patient focuses on a nearer object ***PERRLA = pupils are equal, round, reactant to light, & accommodation (pupil constricts when focusing on a nearer object)

During a patient's assessment of pupillary function, which steps would the nurse perform when assessing accommodation? Select all that apply. -Request that the patient focus on the nurse's identified finger. -Ask the patient to focus on any distant object within the examination room. -Place an index finger at a distance of 20 feet from the patient's nose. -Identifies one finger and locates it 3 inches from the patient's nose. -Identifies a personal finger and locates it at a distance of 6 meters from the patient's nose.

-Request that the patient focus on the nurse's identified finger. -Ask the patient to focus on any distant object within the examination room. -Identifies one finger and locates it 3 inches from the patient's nose.

Which medications would the nurse ask a patient with hearing loss about directly? Select all that apply. -Salicylates -Herbal drugs -Aminoglycosides -Antimalarial agents -Vitamin supplements

-Salicylates -Aminoglycosides -Antimalarial agents

Which interventions would the nurse implement to prevent postoperative complications of the patient scheduled for cataract surgery? Select all that apply. -Administer antiviral medications to prevent infections. -Teach the patient to instill medicine utilizing aseptic techniques. -Teach the patient about proper hygiene and eye care techniques. -Instruct the patient to discontinue all prescribed medicine two days after surgery. -Advise the patient to avoid actions that can increase their intraocular pressures.

-Teach the patient to instill medicine utilizing aseptic techniques. -Teach the patient about proper hygiene and eye care techniques. -Advise the patient to avoid actions that can increase their intraocular pressures.

While completing a health history, the nurse suspects that a patient could have hearing loss. Which findings may have led the nurse to this suspicion? Select all that apply. -The patient tries to lip read the nurse's words. -The patient blinks often and answers questions rapidly. -The patient requests that questions be repeated frequently. -The patient misses out on words when not looking at the nurse. -The patient doesn't look at the nurse and answers questions while looking down.

-The patient tries to lip read the nurse's words. -The patient requests that questions be repeated frequently. -The patient misses out on words when not looking at the nurse.

When performing an eye examination, which patient clinical manifestations would the nurse document as ABNORMAL? Select all that apply. -The pupils are equal and round. -The right pupil is slightly smaller than the left one. -The pupils dilate when introducing a light stimulus. -The pupils constrict when introducing a light stimulus. -The right pupil constricts faster than the left when subjected to a light.

-The right pupil is slightly smaller than the left one. -The pupils dilate when introducing a light stimulus. -The right pupil constricts faster than the left when subjected to a light.

Which age-related changes does the nurse anticipate in the auditory system when assessing older patients? Select all that apply. -Tinnitus -Collapsed ear canal -Increase in cerumen moisture -Increased sensitivity to loud sounds -Diminished sensitivity to low-pitched sounds

-Tinnitus -Collapsed ear canal -Increased sensitivity to loud sounds

For which health conditions would the nurse question the patient with acute-angle glaucoma when teaching about their new eyedrop prescription?

A history of heart or lung disease ***Medications to treat glaucoma can slow HR, decrease BP, and exacerbate asthma or (COPD)

What does the tympanic membrane do?

Acts as an instrument of sound transmission between the external auditory canal and the tympanic membrane

The nurse assesses a bulging, red eardrum on an otoscopic examination with a middle ear filled with pus and blood. Which would the nurse infer from this finding? -Eustachian tube blockage -Serous otitis media -Seborrheic dermatitis -Acute otitis media

Acute otitis media

Which intervention would the nurse implement when providing care for a patient who lost an eye after an industrial accident yesterday?

Assist the patient with the same grieving process associated with other losses.

Which refractive error would the nurse associate with a patient's uneven cornea and complaints of visual distortion?

Astigmatism

The patient with Ménière's disease had decompression of the endolymphatic sac. Which instruction would the nurse include in the discharge teaching for this patient?

Avoid sudden head movements or position changes.

Which clinical manifestation would the patient experience when a health care provider identifies smaller and stiffer than normal ciliary muscles during an ophthalmic examination?

Decrease in near vision

Which action would the nurse implement when a patient with a history of asthma receives a prescription for timolol to treat chronic glaucoma?

Do not administer timolol, and notify the health care provider. ***Timolol causes bronchospasms

Which instruction is most important for the nurse to include in the discharge teaching of a patient being discharged home after cataract surgery?

Do not bend, stoop, cough, or lift.

Which initial assessment question would the nurse ask when a college student reports to the infirmary complaining of eye pain during finals week?

Do you wear contacts?

For which clinical manifestation would the nurse teach discharge interventions when a patient's prescription includes alternating patching of one eye at a time for treatment of diplopia?

Dryness in the patched eye

The nurse understands that which structure located in the middle ear may cause a middle-ear infection when it is blocked?

Eustachian tubes

Which intervention would the nurse employ to lessen anxiety and discomfort associated with an otoscopic examination for a patient who has been treated for an ear infection?

Gently palpate the tragus and move the auricle, noting sensitive areas.

Which auditory system change would the nurse suspect in a patient who has alterations in balance and body orientation?

Inner ear

An older patient reports not being able to hear very well. Which would the nurse do first to determine the cause of the hearing loss?

Look for cerumen in the ear.

The neighbor of a nurse states, "While I was walking, I got something in my eye." Which intervention would the nurse implement for a suspected foreign object in the patient's eye?

Loosely cover the eye with a sterile patch and refer the patient to emergency care.

Which action would the nurse implement immediately when visiting a patient who is two days post-cataract surgery and reporting intense eye pain?

Notify the surgeon. ***It may indicate hemorrhage, infection, or increased IOP

A patient is due for rotary chair testing to assess vestibular function. Which action by the nurse is most appropriate?

Observe the patient for vomiting.

Which nonverbal aids would the nurse adopt to effectively communicate with a patient with hearing loss?

Refraining from covering the mouth or face with hands

Which initial clinical manifestation would a patient report with a retinal detachment?

Seeing flashes of light and floaters

The nurse is performing an otoscopic assessment and notes that the patient has hairline fluid level in the tympanum and yellowish bubbles above the fluid level. The nurse recognizes which condition is most likely present?

Serous otitis media ***This middle ear condition is characterized by inflammation of the middle ear and is accompanied by fluid-like discharge

When observing the tympanic membrane during an otoscopic examination, what would the nurse anticipate documenting if considered normal?

Shiny, pearl gray in color and translucent ***Tympanic membrane (ear drum) should appear white, pink, or pearly gray in color & should be shiny and translucent

When assessing a patient's dilator muscle atrophy of the eye, which clinical manifestation would the nurse expect to identify?

Slow recovery of pupil size after light stimuli. ***This is because dilator muscle atrophy or weakness affects the ability of the pupils to contract and relax.

When completing an otoscopic examination, the nurse notes discharge in the canal, and the patient reports pain with the examination. Which would the nurse assess the patient for next?

Swimmer's ear (external ear infection)

A patient tells a nurse, "I take an aspirin every two days because I'm always getting headaches." Which ear abnormality would the nurse expect?

Tinnitus

A patient tells the nurse, "I always need my fan on while I'm sleeping." Which ear abnormality may be indicated?

Tinnitus ***Patients with chronic tinnitus often use a fan, radio, TV, or other source of background noise to drown out the tinnitus to help achieve peaceful sleep

Which rationale would the nurse associate with the health care provider's order of cycloplegics for a patient preparing for surgical intervention of a visual disorder?

To block the effect of acetylcholine on ciliary body muscles

For the patient recently blinded from a motor vehicle accident, which patient goal has the highest priority? -Use suitable coping strategies to reduce stress. -Identify the patient's strengths and support system. -Verbalize feelings related to visual impairment. -Transition successfully to the sudden vision loss.

Verbalize feelings related to visual impairment.

The nurse observes a patient ambulating with a stumbling gait. Which condition would the nurse note to be a possible cause of this patient's condition?

Vertigo