Chapter 63 and 64 (eyes and ears)
It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye? a) 20/100 b) 20/50 c) 20/200 d) 20/150
20/200
When undergoing testing of visual acuity with a Snellen chart, the client can read the line labeled 20/50 but misses three letters on the line. The nurse documents this finding as which of the following? a) 20/20/50 b) 20/50 c) 20/50-3 d) 20/20 + 30
20/50-3
A 6-year-old child is brought to the pediatric clinic for the assessment of redness and discharge from the eye and is diagnosed with viral conjunctivitis. What is the most important information to discuss with the parents and child? A) Handwashing can prevent the spread of the disease to others. B) The importance of compliance with antibiotic therapy C) Signs and symptoms of complications, such as meningitis and septicemia D) The likely need for surgery to prevent scarring of the conjunctiva
A
A nurse is teaching a patient with glaucoma how to administer eye drops to achieve maximum absorption. The nurse should teach the patient to perform what action? A) Instill the medication in the conjunctival sac. B) Maintain a supine position for 10 minutes after administration. C) Keep the eyes closed for 1 to 2 minutes after administration. D) Apply the medication evenly to the sclera
A
A patient comes to the ophthalmology clinic for an eye examination. The patient tells the nurse that he often sees floaters in his vision. How should the nurse best interpret this subjective assessment finding? A) This is a normal aging process of the eye. B) Glasses will minimize this phenomenon. C) The patient may be exhibiting signs of glaucoma. D) This may be a result of weakened ciliary muscles.
A
A patient got a sliver of glass in his eye when a glass container at work fell and shattered. The glass had to be surgically removed and the patient is about to be discharged home. The patient asks the nurse for a topical anesthetic for the pain in his eye. What should the nurse respond? A) "Overuse of these drops could soften your cornea and damage your eye." B) "You could lose the peripheral vision in your eye if you used these drops too much." C) "I'm sorry, this medication is considered a controlled substance and patients cannot take it home." D) "I know these drops will make your eye feel better, but I can't let you take them home."
A
A patient has had a sudden loss of vision after head trauma. How should the nurse best describe the placement of items on the dinner tray? A) Explain the location of items using clock cues. B) Explain that each of the items on the tray is clearly separated. C) Describe the location of items from the bottom of the plate to the top. D) Ask the patient to describe the location of items before confirming their location.
A
A patient with glaucoma has presented for a scheduled clinic visit and tells the nurse that she has begun taking an herbal remedy for her condition that was recommended by a work colleague. What instruction should the nurse provide to the patient? A) The patient should discuss this new remedy with her ophthalmologist promptly. B) The patient should monitor her IOP closely for the next several weeks. C) The patient should do further research on the herbal remedy. D) The patient should report any adverse effects to her pharmacist.
A
A patient's ocular tumor has necessitated enucleation and the patient will be fitted with a prosthesis. The nurse should address what nursing diagnosis when planning the patient's discharge education? A) Disturbed body image B) Chronic pain C) Ineffective protection D) Unilateral neglect
A
The nurse has taken shift report on her patients and has been told that one patient has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the patient? A) Ensure adequate lighting in the patient's room. B) Provide a dimly lit room to aid vision by limiting contrast. C) Carefully point out color differences for the patient. D) Carefully point out fine details for the patient.
A
The nurse is admitting a 55-year-old male patient diagnosed with a retinal detachment in his left eye. While assessing this patient, what characteristic symptom would the nurse expect to find? A) Flashing lights in the visual field B) Sudden eye pain C) Loss of color vision D) Colored halos around lights
A
The nurse should recognize the greatest risk for the development of blindness in which of the following patients? A) A 58-year-old Caucasian woman with macular degeneration B) A 28-year-old Caucasian man with astigmatism C) A 58-year-old African American woman with hyperopia D) A 28-year-old African American man with myopia
A
A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common causes of blindness and visual impairment among adults over the age of 40? Select all that apply. A) Diabetic retinopathy B) Trauma C) Macular degeneration D) Cytomegalovirus E) Glaucoma
A,C,E
A patient is scheduled for enucleation and the nurse is providing anticipatory guidance about postoperative care. What aspects of care should the nurse describe to the patient? Select all that apply. A) Application of topical antibiotic ointment B) Maintenance of a supine position for the first 48 hours postoperative C) Fluid restriction to prevent orbital edema D) Administration of loop diuretics to prevent orbital edema E) Use of an ocular pressure dressing
A,E
When a cataract is extracted, and an intraocular lens implant is not used.
Aphakia
Which of the following terms refers to the absence of the natural lens? a) Hyphema b) Keratoconus c) Scotoma d) Aphakia
Aphakia
A nurse is performing an eye examination. Which of the following questions would not be included in the examination? a) "Have you experienced blurred, double, or distorted vision?" b) "Are you able to raise both eyebrows?" c) "Do any family members have any eye conditions?" d) "What medications are you taking?"
Are you able to raise both eyebrows?
an irregularity in the curve of the cornea, which can affect both near and distant vision.
Astigmatism
An eight-grade boy tells the school nurse that the eye doctor told him he had astigmatism and that meant his eyeball wasn't shaped right. The boy says he went home and looked in the mirror and both eyes looked just alike. What is the school nurse's best response? a) "Astigmatism means that the lens of the eye is more of an oval shape than the lens in most eyes." b) "Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes." c) "Astigmatism means that the eye is shaped more like an olive than most eyes." d) "Astigmatism means that the inside of the eye is shaped differently than the inside of most eyes."
Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes
A patient has had cataract extractions and the nurse is providing discharge instructions. What should the nurse encourage the patient to do at home? a) Maintain bed rest for 1 week. b) Avoid bending the head below the waist. c) Lift weights to increase muscle strength. d) Lie on the stomach while sleeping.
Avoid bending the head below the waist
A hospitalized patient with impaired vision must get a picture in his or her mind of the hospital room and its contents in order to mobilize independently and safely. What must the nurse monitor in the patient's room? A) That a commode is always available at the bedside B) That all furniture remains in the same position C) That visitors do not leave items on the bedside table D) That the patient's slippers stay under the bed
B
A patient has been diagnosed with glaucoma and the nurse is preparing health education regarding the patient's medication regimen. The patient states that she is eager to "beat this disease" and looks forward to the time that she will no longer require medication. How should the nurse best respond? A) "You have a great attitude. This will likely shorten the amount of time that you need medications." B) "In fact, glaucoma usually requires lifelong treatment with medications." C) "Most people are treated until their intraocular pressure goes below 50 mm Hg." D) "You can likely expect a minimum of 6 months of treatment."
B
A patient has just returned to the surgical floor after undergoing a retinal detachment repair. The postoperative orders specify that the patient should be kept in a prone position until otherwise ordered. What should the nurse do? A) Call the physician and ask for the order to be confirmed. B) Follow the order because this position will help keep the retinal repair intact. C) Instruct the patient to maintain this position to prevent bleeding. D) Reposition the patient after the first dressing change
B
A patient has lost most of her vision as a result of macular degeneration. When attempting to meet this patient's psychosocial needs, what nursing action is most appropriate? A) Encourage the patient to focus on her use of her other senses. B) Assess and promote the patient's coping skills during interactions with the patient. C) Emphasize that her lifestyle will be unchanged once she adapts to her vision loss. D) Promote the patient's hope for recovery.
B
A patient presents at the ED after receiving a chemical burn to the eye. What would be the nurse's initial intervention for this patient? A) Generously flush the affected eye with a dilute antibiotic solution. B) Generously flush the affected eye with normal saline or water. C) Apply a patch to the affected eye. D) Apply direct pressure to the affected eye.
B
A patient who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The patient asks the nurse what these numbers specifically mean. What is a correct response by the nurse? A) "A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away." B) "A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away." C) "A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away." D) "A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away."
B
During discharge teaching the nurse realizes that the patient is not able to read medication bottles accurately and has not been taking her medications consistently at home. How should the nurse intervene most appropriately in this situation? A) Ask the social worker to investigate alternative housing arrangements. B) Ask the social worker to investigate community support agencies. C) Encourage the patient to explore surgical corrections for the vision problem. D) Arrange for referral to a rehabilitation facility for vision training.
B
The nurse is providing discharge education to an adult patient who will begin a regimen of ocular medications for the treatment of glaucoma. How can the nurse best determine if the patient is able to self-administer these medications safely and effectively? A) Assess the patient for any previous inability to self-manage medications. B) Ask the patient to demonstrate the instillation of her medications. C) Determine whether the patient can accurately describe the appropriate method of administering her medications. D) Assess the patient's functional status.
B
The nurse is providing health education to a patient newly diagnosed with glaucoma. The nurse teaches the patient that this disease has a familial tendency. The nurse should encourage the patient's immediate family members to undergo clinical examinations how often? A) At least monthly B) At least once every 2 years C) At least once every 5 years D) At least once every 10 years
B
The nurse on the medical-surgical unit is reviewing discharge instructions with a patient who has a history of glaucoma. The nurse should anticipate the use of what medications? A) Potassium-sparing diuretics B) Cholinergics C) Antibiotics D) Loop diuretics
B
The nurse's assessment of a patient with significant visual losses reveals that the patient cannot count fingers. How should the nurse proceed with assessment of the patient's visual acuity? A) Assess the patient's vision using a Snellen chart. B) Determine whether the patient is able to see the nurse's hand motion. C) Perform a detailed examination of the patient's external eye structures. D) Palpate the patient's periocular regions.
B
A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography? a) Platelet count b) BUN and creatinine c) AST and ALT d) Hemoglobin and hematocrit
BUN and creatinine
A client, diagnosed with a cataract, comes into the clinic. What assessment should the nurse observe in this client? a) A burning sensation and the sensation of an object in the eye b) Blurred or cloudy visual image c) A swollen lacrimal caruncle d) Inability to produce sufficient tears
Blurred or cloudy visual image
Choice Multiple question - Select all answer choices that apply. A patient has been brought to the emergency room after being hit in the head with a baseball. The nurse should be alert to which of the following clinical manifestations of a detached retina? Select all that apply. a) Sensation of a curtain coming across vision of one eye b) Sudden onset of floaters c) Cobwebs d) Bright flashing lights e) Pain
Bright flashing lights • Sudden onset of floaters • Cobwebs • Sensation of a curtain coming across vision of one eye
A 56-year-old patient has come to the clinic for his routine eye examination and is told he needs bifocals. The patient asks the nurse what change in his eyes has caused his need for bifocals. How should the nurse respond? A) "You know, you are getting older now and we change as we get older." B) "The parts of our eyes age, just like the rest of us, and this is nothing to cause you to worry." C) "There is a gradual thickening of the lens of the eye and it can limit the eye's ability for accommodation." D) "The eye gets shorter, back to front, as we age and it changes how we see things."
C
A patient has informed the home health nurse that she has recently noticed distortions when she looks at the Amsler grid that she has mounted on her refrigerator. What is the nurse's most appropriate action? A) Reassure the patient that this is an age-related change in vision. B) Arrange for the patient to have her visual acuity assessed. C) Arrange for the patient to be assessed for macular degeneration. D) Facilitate tonometry testing.
C
A patient has just arrived to the floor after an enucleation procedure following a workplace accident in which his left eye was irreparably damaged. Which of the following should the nurse prioritize during the patient's immediate postoperative recovery? A) Teaching the patient about options for eye prostheses B) Teaching the patient to estimate depth and distance with the use of one eye C) Assessing and addressing the patient's emotional needs D) Teaching the patient about his post-discharge medication regimen
C
A patient with low vision has called the clinic and asked the nurse for help with acquiring some low-vision aids. What else can the nurse offer to help this patient manage his low vision? A) The patient uses OTC NSAIDs. B) The patient has a history of stroke. C) The patient has diabetes. D) The patient has Asian ancestry.
C
An older adult patient has been diagnosed with macular degeneration and the nurse is assessing him for changes in visual acuity since his last clinic visit. When assessing the patient for recent changes in visual acuity, the patient states that he sees the lines on an Amsler grid as being distorted. What is the nurse's most appropriate response? A) Ask if the patient has been using OTC vasoconstrictors. B) Instruct the patient to repeat the test at different times of the day when at home. C) Arrange for the patient to visit his ophthalmologist. D) Encourage the patient to adhere to his prescribed drug regimen.
C
Cytomegalovirus (CMV) is the most common cause of retinal inflammation in patients with AIDS. What drug, surgically implanted, is used for the acute stage of CMV retinitis? A) Pilocarpine B) Penicillin C) Ganciclovir D) Gentamicin
C
The nurse is teaching a patient to care for her new ocular prosthesis. What should the nurse emphasize during the patient's health education? A) The need to limit exposure to bright light B) The need to maintain a low Fowler's position when removing the prosthesis C) The need to perform thorough hand hygiene before handling the prosthesis D) The need to apply antiviral ointment to the prosthesis daily
C
When administering a patient's eye drops, the nurse recognizes the need to prevent absorption by the nasolacrimal duct. How can the nurse best achieve this goal? A) Ensure that the patient is well hydrated at all times. B) Encourage self-administration of eye drops. C) Occlude the puncta after applying the medication. D) Position the patient supine before administering eye drops.
C
edema of the conjunctiva.
Chemosis
Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? a) Prednisone b) Lasix c) Glucophage d) Coumadin
Coumadin
A patient is being discharged home from the ambulatory surgical center after cataract surgery. In reviewing the discharge instructions with the patient, the nurse instructs the patient to immediately call the office if the patient experiences what? A) Slight morning discharge from the eye B) Any appearance of redness of the eye C) A "scratchy" feeling in the eye D) A new floater in vision
D
A patient is exploring treatment options after being diagnosed with age-related cataracts that affect her vision. What treatment is most likely to be used in this patient's care? A) Antioxidant supplements, vitamin C and E, beta-carotene, and selenium B) Eyeglasses or magnifying lenses C) Corticosteroid eye drops D) Surgical intervention
D
A patient is ready to be discharged home after a cataract extraction with intraocular lens implant and the nurse is reviewing signs and symptoms that need to be reported to the ophthalmologist immediately. Which of the patient's statements best demonstrates an adequate understanding? A) "I need to call the doctor if I get nauseated." B) "I need to call the doctor if I have a light morning discharge." C) "I need to call the doctor if I get a scratchy feeling." D) "I need to call the doctor if I see flashing lights."
D
A patient with a diagnosis of retinal detachment has undergone a vitreoretinal procedure on an outpatient basis. What subject should the nurse prioritize during discharge education? A) Risk factors for postoperative cytomegalovirus (CMV) B) Compensating for vision loss for the next several weeks C) Non-pharmacologic pain management strategies D) Signs and symptoms of increased intraocular pressure
D
A patient with chronic open-angle glaucoma is being taught to self-administer pilocarpine. After the patient administers the pilocarpine, the patient states that her vision is blurred. Which nursing action is most appropriate? A) Holding the next dose and notifying the physician B) Treating the patient for an allergic reaction C) Suggesting that the patient put on her glasses D) Explaining that this is an expected adverse effect
D
Several residents of a long-term care facility have developed signs and symptoms of viral conjunctivitis. What is the most appropriate action of the nurse who oversees care in the facility? A) Arrange for the administration of prophylactic antibiotics to unaffected residents. B) Instill normal saline into the eyes of affected residents two to three times daily. C) Swab the conjunctiva of unaffected residents for culture and sensitivity testing. D) Isolate affected residents from residents who have not developed conjunctivitis.
D
The nurse is administering eye drops to a patient with glaucoma. After instilling the patient's first medication, how long should the nurse wait before instilling the patient's second medication into the same eye? A) 30 seconds B) 1 minute C) 3 minutes D) 5 minutes
D
The public health nurse is addressing eye health and vision protection during an educational event. What statement by a participant best demonstrates an understanding of threats to vision? A) "I'm planning to avoid exposure to direct sunlight on my next vacation." B) "I've never exercised regularly, but I'm going to start working out at the gym daily." C) "I'm planning to talk with my pharmacist to review my current medications." D) "I'm certainly going to keep a close eye on my blood pressure from now on."
D
The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient? A) Provide instructions in simple, clear terms. B) Introduce herself in a firm, loud voice at the doorway of the room. C) Lightly touch the patient's arm and then introduce herself. D) State her name and role immediately after entering the patient's room.
D
refers to normal eyesight in which the image focuses precisely on the retina
Emmetropia
A patient has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the patient tells the nurse that she has stopped using the medication because her vision did not improve. Which of the following is the appropriate action to be taken by the nurse? a) Explain the therapeutic effect and expected outcome of the medication. b) Refer the patient to the ED. c) Administer the medication immediately. d) Talk with the doctor about switching to a different glaucoma medication.
Explain the therapeutic effect and expected outcome of the medication
The nurse asks a client to follow the movement of a pencil up, down, right, left, and both ways diagonally. The nurse is assessing which of the following? a) Pupillary reaction b) Eyelid drooping c) Eyeball oscillation movements d) Extraocular muscle function
Extraocular muscle function
A patient is brought into the emergency department with chemical burns to both eyes. What is the priority action of the nurse for this patient's care? a) Applying hot compresses at 15-minute intervals b) Flushing the lids, conjunctiva, and cornea with tap water or normal saline c) Cleansing the conjunctiva with a small cotton-tipped applicator d) Administering local anesthetics and antibacterial drops for 24 to 36 hours
Flushing the lids, conjunctiva, and cornea with tap water or normal saline
The nurse should monitor for which of the following manifestations in a patient who has had LASIK surgery? a) Halos and glare b) Cataract formation c) Stye formation d) Excessive tearing
Halos and glare
Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry red in color? a) Xanthelasma b) Milia c) Molluscum contagiosum d) Hemangioma
Hemangioma
vascular capillary tumors that may be bright, superficial, strawberry-red lesions or bluish and purplish deeper lesions.
Hemangioma
refers to the client's ability to see distant objects clearly, but sees near objects as blurry.
Hyperopia (farsightedness)
blood in the anterior chamber of the eye
Hyphema
A patient presents to the ED complaining of a chemical burn to both eyes. Which of the following is the priority nursing intervention? a) Irrigate both eyes. b) Assess the pH of the corneal surface. c) Assess visual acuity. d) Obtain the Material Safety Data Sheet (MSDS).
Irrigate both eyes
A client comes to the eye clinic for a routine check-up. The client tells the nurse they think they are color blind. What screening test does the nurse know will be performed on this client to assess for color-blindness? a) Rosenbaum b) Snellen c) Ishihara d) Jaeger
Ishihara
Following an ophthalmologic exam, an anxious client asks the nurse, "How serious is a refraction error?" Which of the following is the best response from the nurse? a) "It is nothing serious." b) "Simple surgery can fix this problem." c) "This is normal for anyone your age." d) "It means corrective lenses are required."
It means corrective lenses are required
a cone-shaped deformity of the cornea.
Keratoconus
A 15-year-old baseball player was fielding a ground ball when it bounced and struck him in the left eye, leaving a large ecchymosis and edema. In your client education, after applying an ice pack, you explain to the client the functions of the various structures of the eye. What glands, contained in the eyelids, produce tears? a) Sebaceous b) Lacrimal c) Sweat d) Olfactory
Lacrimal
Which of the following surgical procedures involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? a) Photorefractive keratectomy (PRK) b) Keratoconus c) Keratoplasty d) Laser-assisted stromal in situ keratomileusis (LASIK)
Laser-assisted stromal in situ keratomileusis (LASIK)
small, white, slightly elevated cysts of the eyelid that may occur in multiples.
Milia
used to cause the pupil to constrict.(medication)
Miotics
lesions flat symmetric growths along the lid margin caused by a virus that can result in conjunctivitis and keratitis if the lesion grows into the conjunctival sac
Molluscum contagiosum
cause the pupil to dilate. (medication)
Mydriatics
Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? a) Astigmatism b) Myopia c) Hyperopia d) Emmetropia
Myopia
refers to the condition in which the client can see near objects but has blurred distant vision.
Myopia (nearsightedness)
Choice Multiple question - Select all answer choices that apply. When an impaled object is in the eye, which of the following steps should be taken to ensure that no further damage occurs? Select all that apply. a) Protect object from jarring b) Apply gentle pressure to the eye c) Apply a patch to the eye d) No attempt should be made to remove the object e) Use metal shield
No attempt should be made to remove the object Use metal shield Protect object from jarring
To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treating inflammatory conditions of the eyes? a) Miotics b) Nonsteroidal anti-inflammatory drugs (NSAIDs) c) Mydriatics d) Cycloplegics
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A 63-year-old client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend? a) Oculomotor nerve b) Trigeminal nerve c) Optic nerve d) Trochlear nerve
Optic nerve
Which is the term for swelling of the optic disc due to increased intraocular pressure (IOP)? a) Papilledema b) Chemosis c) Photophobia d) Ptosis
Papilledema
An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? a) Cataract b) Presbyopia c) Macular degeneration d) Myopia
Presbyopia
The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? a) Hyperopia since age 20 years b) History of respiratory disease c) Prolonged use of corticosteroids d) Age younger than 40 years
Prolonged use of corticosteroids
a drooping eyelid.
Ptosis
Which of the following is an accurate statement regarding refractive surgery? a) Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea. b) Refractive surgery may be performed on patients with an abnormal corneal structure as long as they have a stable refractive error. c) Refractive surgery may be performed on all patients, even if they have underlying health conditions. d) Refractive surgery will alter the normal aging of the eye.
Refractive surgery is an elective, cosmetic surgery performed to reshape the cornea
a blind or partially blind area in the visual field
Scotoma
The nurse is instructing a nursing student when a new client comes to the eye clinic. The client explains that he thinks he has a corneal abrasion. The nurse should explain what to the student nurse? a) "To detect corneal abrasions, a slit lamp is used." b) "To detect corneal abrasions, an ophthalmoscope is used." c) "To detect corneal abrasions, retinal angiography is used." d) "To detect corneal abrasions, ultrasonography is used."
To detect corneal abrasions, a slit lamp is used
A client is scheduled to have a cataract removed and an artificial lens implanted. What test would the nurse know would be useful in measuring for an intraocular lens implant in this client? a) Slit lamp b) Retinal angiography c) Visual field d) Ultrasonography
Ultrasonography
Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection? a) Allergic b) Toxic c) Viral d) Vernal
Viral
The school nurse is testing the kindergarten class with the Snellen chart. What is the nurse testing the children for? a) Near vision b) Color vision c) Hearing d) Visual acuity
Visual acuity
yellowish, lipoid deposits on both lids near the inner angle of the eye that commonly appear as a result of skin aging or a lipid disorder.
Xanthelasma
Which of the following types of glaucoma presents an ocular emergency? a) Chronic open-angle glaucoma b) Ocular hypertension c) Acute angle-closure glaucoma d) Normal tension glaucoma
acute angle-closure glaucoma
James Robertson, a 62-year-old retired customer service agent, is awaiting elective surgery in the hospital unit where you practice nursing. Mr. Robertson is blind. What would you do to promote Mr. Robertson's control over his hospital environment? a) Ask Mr. Robertson where to store his self-care items. b) Arrange Mr. Robertson's tray in a way that's easiest for you to assist him. c) Open all containers without prompting to be helpful. d) Keep personal care items where you know their location.
ask Mr. Robertson where to store his self-care items.
Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? a) Avoid washing face and eyes for first 24 hours. b) Apply protective patch to both eyes at bedtime. c) Avoid any activity that can increase intraocular pressure. d) Only sleep on back.
avoid any activity that can increase intraocular pressure
The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient? a) It has a lower concentration than eye drops. b) Blurred vision results after application. c) It has more side effects than eye drops. d) It does not work as rapidly as eye drops do.
blurred vision results after appilication
What patient activity indicates to the nurse that a patient understands how to correctly instill ophthalmic medications? a) Client allows the tip of the container to touch the eyelid while administering the medication. b) Client wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. c) Client pulls the tissue near the cheek downward to instill medication. d) Client rubs the eye after administering medication.
client pulls the tissue near the cheek downward to instill medication
A client is color blind. The nurse understands that this client has a problem with: a) aqueous humor. b) lens. c) cones. d) rods.
cones
cause paralysis of the iris sphincter. (medication
cycloplegics
A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: a) provide instructions on eye patching. b) demonstrate eyedrop instillation. c) assess the client's visual acuity. d) teach about intraocular lens cleaning.
demonstrate eyedrop instillation
A 13-year-old client is visiting the ophthalmologist after severe eye injuries. The client suffered trauma to her sclera and is being treated for a subsequent infection. During your client education, you indicate where the sclera is attached. Which of the following structures would you NOT include? a) Eyelids b) Iris c) Cornea d) Pupil
eyelids
Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis? a) "It feels like there is something stuck in my eye." b) "My eyes hurt when I'm in the bright sunlight." c) "My eyelids were stuck together this morning." d) "My eyes feel like they are on fire."
my eyelids were stuck together this morning
swelling of the optic disc due to increased IOP.
papilledema
ocular pain on exposure to light.
photophobia
