Visual Problems /Auditory Problems

Question 9 of 9 The nurse is caring for a patient with age-related macular degeneration (AMD) and refers the patient to a psychologist. Which responses by the nurse are appropriate when the patient questions the reason for the referral? Select all that apply. "The permanent loss of central vision can be very difficult." "This is done to discuss the need for additional support systems." "Safety issues are a top priority in patients who have sight problems." "This is done to determine if you will still be able to care for yourself after this diagnosis." "This is done to evaluate your understanding of the disease process and treatment."

"The permanent loss of central vision can be very difficult." The patient may need to see a psychologist to help deal with the vision loss and the implications to his or her lifestyle. Correct "This is done to discuss the need for additional support systems." The psychologist will help the patient deal with his or her own issues regarding loss of vision and discuss whether any additional support systems are needed.

Question 6 of 9 The patient with acute angle-closure glaucoma is preparing for surgery. The nurse notes that the patient consented for a lens removal procedure. How should the nurse proceed? Administer topical apraclonidine drops Administer the preoperative cholinergic agents Contact the surgeon for revision of the consent form Explain to the patient that the surgery will not provide a cure

Contact the surgeon for revision of the consent form Either laser peripheral iridotomy or surgical iridectomy is the surgery of choice for acute angle-closure glaucoma. Lens removal is a surgery to correct cataracts. The nurse identifies this error and should consult the HCP to have the consent revised.

Question 4 of 6 The student nurse is caring for a patient with an acute attack of Ménière's disease. Which finding indicates a need for further teaching of the student nurse? The patient's urine output is measured. An emesis basin is kept on the bedside table. The patient is placed in the dayroom to watch a favorite action movie. Three side rails on the patient's bed are placed in the upright position.

The patient is placed in the dayroom to watch a favorite action movie. When caring for a patient with an acute attack of Ménière's disease, the nurse should plan interventions that minimize vertigo and provide for patient safety. Avoiding fluorescent or flickering lights or a television will minimize the attack and/or symptoms.

Question 1 of 3 A patient in the emergency department is diagnosed with Ménière's disease after an acute episode and asks the nurse how long the attack will last. What is the nurse's correct response? "You should start to feel better soon." "These attacks can last for hours to days." "You may feel like this for the rest of your life." "It can be several months before you feel better."

These attacks can last for hours to days." Attacks of Ménière's disease can last for hours or days and may occur several times a year.

Question 4 of 9 A nurse is caring for a patient who reports loss of peripheral vision that developed over time. Which diagnostic tests would the nurse anticipate the patient to undergo? Select all that apply. Tonometry Gonioscopy Glare testing IV angiography Amsler grid test

Tonometry The patient presents with a sign of glaucoma, which results from increased intraocular pressure. Tonometry, or measurement of intraocular pressure, is important to diagnosing glaucoma. Correct Gonioscopy The patient presents with a sign of glaucoma, which results from increased intraocular pressure due to decreased drainage. Gonioscopy allows the examiner to view the irideocorneal angle to evaluate whether drainage can occur.

Question 6 of 6 A nurse is teaching a group of new nurses about working with patients with profound hearing loss. Which statement made by a new nurse requires correction? "I should speak at a normal volume." "I should avoid using hand movements." "I should make sure that there is good lighting in the room." "I should avoid chewing gum when speaking with a patient with hearing loss."

"I should avoid using hand movements." A nonverbal aid such as hand movements would help the patient understand what the nurse is trying to communicate and should not be avoided. This statement requires correction.

Question 5 of 9 A nurse is counseling a patient about to undergo cataract surgery. The patient will have cataracts removed from both eyes, but just the poorest eye will be operated on initially. Which statement demonstrates that the patient understands the procedure? "The surgery will allow the abnormal blood vessels to be sealed." "The eye with poorer vision is at greater risk for permanent damage." "Permanent damage in the poorer eye could be caused by increased IOP." "If a complication arises in the eye with poorest vision, I will still have some vision in the better eye."

"If a complication arises in the eye with poorest vision, I will still have some vision in the better eye." Surgery must first be performed on the eye with lowest level of acuity because if surgery is unsuccessful, the patient will have some vision left in the other eye.

Question 2 of 3 A nurse is caring for a patient with hearing loss. The patient asks the nurse what it means to have sensorineural hearing loss. Which response from the nurse is correct? "It is just a normal part of aging." "It is a type of mixed hearing loss." "It may be caused by a psychological issue, so you may need to see a psychiatrist." "It is an impairment of one of your cranial nerves that affects the function of your ear." NOT SURE

"It is an impairment of one of your cranial nerves that affects the function of your ear." Sensorineural hearing loss is caused by impairment of function of the inner ear or the vestibulocochlear nerve (CN VII).

Question 3 of 3 A nurse is caring for a patient newly diagnosed with open-angle glaucoma. The patient asks, "How could I possibly have glaucoma? I haven't noticed a thing." What is an appropriate response by the nurse? "Glaucoma can be precipitated by exposure to bright lights." "Glaucoma is usually caused by trauma. Have you been in an accident recently?" "Let me start your assessment, and your provider will be able to tell you based on the results." "People with glaucoma often don't have symptoms right away, and are not aware of the disease until they are evaluated by a health care provider."

"People with glaucoma often don't have symptoms right away, and are not aware of the disease until they are evaluated by a health care provider." Glaucoma develops slowly and without symptoms of pain or pressure and may not be noticed until there is visual field loss.

Question 2 of 9 The nurse is caring for a patient with a family history of age-related macular degeneration (AMD), a medical history of high blood pressure, and a social history including daily cigar smoking. The patient asks if there is any way to prevent development of the disease. Which responses by the nurse are correct? Select all that apply. "Protect your eyes from trauma." "Reduce or quit smoking cigars." "Keep your blood pressure under control." "AMD is not genetic; you have nothing to worry about." "If you have the gene for the disease, then there is no way to prevent development."

"Reduce or quit smoking cigars." Smoking is a major risk factor for AMD. Reducing or, ideally, quitting smoking tobacco can reduce the risk. Correct "Keep your blood pressure under control." Hypertension is a risk factor for AMD, and keeping blood pressure under control, either through diet and exercise or medication, can lower the risk for AMD.

Question 1 of 3 Which patient does the nurse identify as being at risk for developing cataracts? A newborn with an unsuccessful vision examination A 45-year-old with blue eyes experiencing eye pain A 30-year-old who irregularly takes vitamin supplements A 20-year-old who sustained an injury to the right eye after a car accident

A 20-year-old who sustained an injury to the right eye after a car accident Eye injuries are a risk factor for the development of cataracts. This patient is at risk.

Question 5 of 6 A nurse receives orders for a patient with an acute attack of Ménière's disease. Which drug order should the nurse question? Antiemetics ACE inhibitors Anticholinergics Benzodiazepines

ACE inhibitors This is an angiotensin-converting enzyme inhibitor and normally used for cardiac disease, not Ménière's disease. Calcium channel blockers may be used for the treatment of acute attacks.

Question 1 of 3 The nurse is preparing a patient for surgery to correct an age-related cataract of the left eye. Which nursing assessments are appropriate for this patient? Select all that apply. Pain levels Anxiety levels Visual acuity in the right eye Presence of metamorphopsia Knowledge of different therapeutic options

Anxiety levels Visual acuity in the right eye Knowledge of different therapeutic options

Question 7 of 9 During an education session for a patient with a chronic visual sensory perception problem, which information should the nurse ensure the patient knows? Select all that apply. Details of the treatment regimen Long-term effects of the disease process How to recognize emergency care needs How to do regular self-eye examinations That food preferences and nutritional habits can affect eyesight

Details of the treatment regimen Long-term effects of the disease process How to recognize emergency care needs That food preferences and nutritional habits can affect eyesight

Question 2 of 3 The nurse is preparing a teaching plan for a patient with mild hearing loss who was fitted with an in-canal hearing aid. Which information should the nurse include in the teaching? Normal hearing should be restored within 2 weeks. Ensure the hearing aid fits properly inside the ear canal. Use the highest amplification setting when in crowded places. If the hearing aid becomes uncomfortable, it can be moved to the ear.

Ensure the hearing aid fits properly inside the ear canal. For mild hearing loss, the type of hearing aid needed is one that fits completely inside the ear canal. The nurse should teach the patient how to insert the hearing aid to ensure optimal function.

Question 1 of 9 The health care provider is educating a 65-year-old patient on a new diagnosis of primary open-angle glaucoma (POAG). Which statement by the patient shows an understanding of the discussion? "I will have an ophthalmologic examination every 2 to 4 years." "I should consider getting a service dog since I am going to go blind." "I will need to follow my treatment plan to prevent damage to the optic nerve." "This is related to the car accident that I had last week and nothing can be done."

I will need to follow my treatment plan to prevent damage to the optic nerve." Once diagnosed, the priority for glaucoma is to keep the intraoptic pressure (IOP) low in order to prevent optic nerve damage.

Question 3 of 3 A nurse is caring for a patient with a new diagnosis of primary open-angle glaucoma (POAG). When reviewing the health care provider's orders, which prescription should the nurse question? Ibuprofen Betaxolol Dipivefrin Brinzolamide

Ibuprofen Nonsteroidal antiinflammatory drugs, such as ibuprofen, may be used preoperatively for patients undergoing cataract surgery, but they are not indicated for a patient with POAG.

Question 2 of 3 The nurse is developing a nutritional plan for a patient at risk for age-related macular degeneration (AMD). Which food item should the nurse encourage in the patient's diet? Skim milk Kale salad Lean protein Carrots and sweet potatoes

Kale salad Eating dark-green and leafy vegetables, which are rich in lutein, may aid in reducing the risk of AMD in people at higher risk.

Question 1 of 3 The nurse is caring for a patient with cataracts. The health care provider informs the nurse that the patient will be undergoing surgery to replace the affected lens. The nurse anticipates preparing the patient for which procedure? Gonioscopy IV angiography Indirect ophthalmoscopy Keratometry and A-scan ultrasound

Keratometry and A-scan ultrasound If surgery is planned, keratometry may be performed to assess the curvature of the cornea, and an A-scan ultrasound may be done to obtain measurements for an artificial replacement lens.

Question 3 of 9 A nurse is caring for a patient who has prolonged pupil dilation related to ophthalmic medication usage. The nurse will monitor the patient for which signs of acute PACG? Acute vision loss Nausea, vomiting, and acute eye pain Ocular redness, hypertension, and headaches Growth of new blood vessels in an abnormal location

Nausea, vomiting, and acute eye pain An acute attack of PACG can result in excruciating pain in or around the eye that may be accompanied by nausea and vomiting.

Question 2 of 6 A patient has central and functional hearing loss. The nurse understands that which finding may have contributed to this disorder? Impacted cerumen History of ototoxic medication use History of multiple ear infections as a child No physical reason for hearing loss can be identified

No physical reason for hearing loss can be identified Central and functional hearing loss is caused by an emotional or psychological factor, where no physical reason for hearing loss can be identified.

Question 3 of 3 While caring for a patient with hearing loss, the nurse notes a deficit of 75 decibels on the audiogram. The nurse understands this is consistent with which type of hearing loss? Profound deafness Severe impairment Moderate impairment Moderately severe impairment

Severe impairment Severe impairment is represented by a loss of 71-90 decibels on the audiogram.

Question 1 of 6 The nurse is assessing a patient with Ménière's disease. The patient presents with complaints of vertigo. What additional sign or symptom would the nurse suspect? Ear pain Sudden hearing loss Significant inability to function Difficulty understanding speech

Significant inability to function Patients with Ménière's disease may experience significant instability because of sudden, severe attacks of vertigo.

Question 2 of 3 While educating a patient with age-related macular degeneration (AMD), the nurse discusses modifiable risk factors. Which modifiable risk factor should the nurse include in the teaching? Smoking Alcohol use Hypotension White ethnicity

Smoking Smoking is a modifiable risk factor that is a predisposing factor for AMD. The patient should be educated on the importance of smoking cessation.

Question 1 of 3 The wife of an older adult patient states, "If I don't speak loudly to my husband, he can't hear me. It's been getting much worse these past few months." When planning care for this patient, which recommendation should the nurse include? Recommend the patient be fitted for a hearing aid Encourage the patient to schedule an appointment with an audiologist Suggest the patient have his hearing evaluated by his primary care provider immediately Remind the wife that hearing changes are common in older adult men and likely no action is necessary

Suggest the patient have his hearing evaluated by his primary care provider immediately The primary care provider should do an initial assessment and collect health data to determine the problem, and if the patient needs to see the audiologist.

Question 3 of 3 A patient presents with mixed hearing loss. What should the nurse keep in mind when assessing the patient? Speak directly with the sign language interpreter Interview the patient's caregiver in another room Have a family member present during the assessment to provide additional information Take a careful medical and family history, especially assessing for deafness in the family

Take a careful medical and family history, especially assessing for deafness in the family The nurse would want to assess the patient's medical and family history. Having a history of deafness in the family may give insight into the patient's medical condition.

Question 8 of 9 A patient with a visual impairment is being admitted to the hospital after abdominal surgery. As the nurse prepares the room for the patient, which action must be taken? Take note of the furniture placement in the room Begin discharge planning to a rehabilitation facility Ensure that the bed is placed next to the window to maximize light exposure Place a bedpan on the bedside table so the patient doesn't need to find the bathroom

Take note of the furniture placement in the room The nurse should implement fall precautions because the patient is at risk since he or she cannot see well. Part of the nursing interventions for a patient with visual impairment is to notify the patient if furniture or wastebaskets are moved. A careful review of the furniture placement can facilitate this action.

Question 3 of 3 The nurse is preparing to assess a patient with an eye condition. What is the primary reason for the nurse to include the patient's family in the assessment process? The family may become the primary care provider. So that the family can verify information that the patient has provided. To determine how long the patient has had a visual impairment. To have an additional source of information about how the patient is coping.

The family may become the primary care provider. Ask about the patient's support system and always include the patient's caregiver in the assessment process, because some families may become the primary care providers.

Question 2 of 3 The nurse is preparing teaching materials for a patient who is newly diagnosed with glaucoma. What information is appropriate for this patient? The need to avoid sun exposure That the treatment will be curative The importance of eating green vegetables The importance of compliance with taking medications

The importance of compliance with taking medications Being compliant with medications will assist with maintenance of a lower intraocular pressure. This should be included in the discharge teaching.

Question 3 of 6 A patient calls the office and reports that his 78-year-old spouse has suddenly lost hearing in one ear. Which recommendation by the nurse is correct? Bring his spouse in to be evaluated immediately Suggest gently cleaning out the ears to remove impacted cerumen Monitor the patient's hearing and call back the next day with an update Advise that this is normal with aging, and suggest facing his spouse when speaking

Bring his spouse in to be evaluated immediately Sudden hearing loss is a medical emergency, and the patient should see the health care provider immediately.