Ear and ophthalmic conditions wk 10

2. The nurse is obtaining a visual history from a client who has noted an increased glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis?

Identification of opacities on the lens

62. A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure?

Improve outflow drainage

16. The client is having a Weber test. During a Weber test, where should the tuning fork be placed?

In the midline of the client's skull or in the center of the forehead

19. Which of the following teaching items would be a priority in maintaining normal pressure range in the eye?

Increase fiber in the diet.

57. A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear?

Instillation of mineral oil

39. The nurse is teaching a parent how to instill drops in their 12-year-old son's eyes. Which action would the nurse teach the parent is accomplished first?

Tilt the head slightly backward.

22. During a pharmacology class, the students are told that some drugs need to be closely monitored. What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides?

Tinnitus and sensorineural hearing loss

50. A client has undergone enucleation. What complication of enucleation should be addressed by the nurse?

hemorrhage

25. The nurse is assisting the client in planning care during exacerbations of Ménière's disease. Which diet would the nurse identify as appropriate at this time?

low-sodium diet

47. The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern?

meningitis

26. The nurse is assisting with the administration of a caloric stimulation test. Which client response would the nurse document as an expected response?

nystagmus

21. The nurse is assisting in providing coordination of services between the physician's office and vision specialist's office for a client who is being referred for potential retinal surgery. Which eye care specialist will the nurse make the referral to?

ophthalmologist

51. The nurse is assisting the eye surgeon in completing an examination of the eye. Which piece of equipment would the nurse provide to the physician to examine the optic disc under magnification?

ophthalmoscope

80. What is located in the cochlea of the inner ear?

organ of Corti

91. The nurse is caring for a client ordered multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal?

retinal angiography

83. The client has been diagnosed with objective vertigo. Which symptom would the nurse relate to the tentative diagnosis?

sensation of things moving

11. The nurse is obtaining a history from a client who indicates hearing loss due to drug toxicity. Which type of hearing loss is noted?

sensorineural

20. A client states having difficulty noting details on faces or television. Which of the following structures of the eye allows for detailed vision?

the macula lutea

wear pop-bottle lenses after surgery?" Which is the most appropriate response from the 73. An elderly client is scheduled for cataract surgery and asks the nurse, "Will I need to nurse?

"An implanted lens has replaced the need for corrective glasses.

60. 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?

"Astigmatism means that the cornea of the eye is shaped differently than the cornea in most eyes."

58. At morning report, the nurse learns the assigned client is blind. Which question should the nurse ask the client upon initial assessment?

"Can you perceive light and motion?"

56. A client presents to the emergency room with symptoms of blurred vision. Which type of question would be best to ask first?

"Have you ever had these symptoms before?"

38. The nurse is employed in an ear, nose, and throat (ENT) physician's office, obtaining a client history. The nurse documents the following client statements. Which symptoms may indicate a diagnosis of otosclerosis? Select all that apply.

"I can hear best when you put the tuning fork behind my ear."

63. 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?

"It means corrective lenses are required."

59. The nurse is supervising a family member who is instilling ear drops into the client's ear. Which of the following statements, made by the family member, would require further nursing instruction?

"These drops are cold from being on the window seal."

87. 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?

"To detect corneal abrasions, a slit lamp is used."

85. The nurse is conducting hearing tests at the local junior high school. Which of the following indicates normal hearing in a child?

A client who first perceives sound at 20 dB

81. While cleaning gutters, a client reports getting debris in the eyes. On inspection, no obvious foreign object is noted. Which of the following diagnostic evaluation techniques would be most beneficial for this client?

Administer fluorescein dye.

29. Which technique would be most beneficial for ambulation of a client who is visually impaired?

Allow client to follow your lead.

30. The occupational nurse is advising a customer service representative client on assistive devices for hearing because the client has progressive hearing loss. In discussing the options with the client, which type would be the last option offered by the nurse?

American Sign Language

68. A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client?

Amsler grid

49. A client is diagnosed with uveitis. Which assessment finding is most important in determining likelihood of recurrence?

Ankylosing spondylitis

12. The nurse is obtaining a history on a client stating the inability to read the newspaper and even seeing detail when looking at an image. Which assessment test would add additional data for a diagnosis?

Assess peripheral vision.

34. The nurse is caring for a client who is post-stapedectomy. What would the nurse include in the nursing care?

Assesst the facial nerve.

84. The nurse is instructing a client's family members on the most incapacitating symptom of Ménière's disease. Which nursing instruction associated with the symptom is most helpful?

Assist the client when ambulating.

61. A client, diagnosed with a cataract, comes into the clinic. What assessment should the nurse observe in this client?

Blurred or cloudy visual image

90. The nurse is caring for a client with open-angle glaucoma. The nurse knows that this disease causes which of the following? Select all that apply.

Degeneration of the optic nerve Atrophy of nerve fibers in the peripheral areas of the retina Edema of the cornea

9. Immediately following cataract removal, which symptom would be most alarming to the nurse?

Dry, tickling cough

53. A nurse is doing preoperative and postoperative teaching with a client who is undergoing cataract surgery. What is an important teaching point the nurse should teach the client about?

Eat soft, easily chewed food until healing is complete

48. The nurse is caring for a client who just returned from a trip requiring an airline flight. The client commented on how his ears hurt upon descent. The nurse is correct in stating which site as being the pressure equalizer in the ear?

Eustachian tube

86. The nursing student is taking an anatomy and physiology class. What anatomical structure equalizes air pressure in the middle ear?

Eustachian tube

3. A middle-aged client reports increasing difficulty reading the newspaper print. Which of the following nursing explanations best describes this type of refractive error?

Loss of elasticity of the lens

36. A client has just been diagnosed with glaucoma. What teaching should the nurse include with this client?

Maintain regular bowel habits

71. A nursing student is presenting a report on Ménière's disease to other members of the class. What symptom would the student list?

Nystagmus of the eyes

18. The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception?

Once symptoms occur, they will always be present.

75. A client is diagnosed with blepharitis. What symptoms should a nurse monitor in this client?

Patchy flakes clinging to the eyelashes

15. The nurse is teaching the family member how to instill ear drops to the client to remove impacted cerumen. What is important to teach this woman?

Place the container in warm water before instillation.

64. The nurse is caring for an 8-year-old and anticipates that the client has otitis externa from symptoms stated on the history. Which symptoms, from the history and physical examination, would confirm the diagnosis?

Pus noted in the ear canal

13. The nurse is assessing a client's hearing using the Rinne test. When providing instruction to elicit client feedback, which instruction is essential?

Raise your hand when you no longer hear sound.

72. What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids?

Serous otitis media

69. The nurse is obtaining subjective data from a client with difficulty hearing. In order to assist the client in hearing the nurse's voice, which adjustments are made? Select all that apply.

Speak in a lower tone Speak in a clear voice Clearly articulate Face the client when speaking

41. A 24-year-old female client is diagnosed with otosclerosis. Which teaching is most accurate?

Symptoms may be accelerated by pregnancy.

5. When caring for a client with a foreign object removed from the eye, the nurse is most correct to assess the eye protective functions of which structures? Select all that apply.

Tears Eyelids and lashes

42. A nurse is assessing a client for a fracture to the bony orbit. What would the nurse document if her assessment for fracture was positive?

The client has diplopia.

1. When caring for a client with progressive macular degeneration, which teaching measure is primary for client safety?

Turn head side to side when walking.

79. A client is diagnosed with keratitis. What advice should the nurse give this client?

Use dark glasses.

77. A client has exhibited repeated return of hordeolum (sty). Which assessment finding is most important in determining care for this client?

Use of mascara

46. The nurse is caring for a client who underwent surgery for a retinal detachment. The surgery included the injection of an air bubble to promote contact between the retina and choroids. What position should the nurse keep the client in?

With the face parallel to the floor

78. Audiometry is testing that measures hearing acuity precisely. Who does the nurse know can perform audiometric testing?

audiologist

92. The nurse is caring for a client with increased fluid accumulation in the eye. When assessing the client, which structure within the eye is noted to drain fluid from the anterior chamber?

canals of Schlemm

76. The nurse is instructing a client on the benefits of a cochlear implant. The client asks, "How am I able to interpret sound?" The nurse credits which of the following as significant in the production of hearing?

Auditory nerve

40. Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important?

Avoid any activity that can increase intraocular pressure.

52. An elderly client is admitted with the diagnosis of retinal detachment and is scheduled for laser surgery and scleral buckling procedure. The nurse anticipates which of the following symptoms to be exhibited in this client? Select all that apply.

Flashing lights Cobwebs in vision field

66. The nurse is obtaining a history from a client complaining of ear pain and dizziness. Which assessment finding is the best evidence that the client has a perforated eardrum?

Fluid draining in the external canal

33. Which of the following assessment findings is least helpful in identifying a cause of Ménière's disease?

Food intolerance

28. Which assessment finding would contraindicate the use of atropine in a client scheduled for general anesthesia?

Glaucoma

54. The nurse is working in the triage section of a walk-in clinic. Which triad of common symptoms, when placed together, indicate Ménière's disease?

Hearing loss, vertigo, tinnitus

67. The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at home methods of cerumen removal is discouraged?

Removing the cerumen by means of a cotton tip applicator

37. The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand?

20-feet distance

17. The nurse is assessing client's eyes as part of the inspection part of the assessment process. For which reason does the nurse identify a normal variation in the angle of the lateral and medial canthus?

Ethnic differences

44. An elderly client with macular degeneration has received injections of angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening?

Central vision impairment

35. The nurse is caring for geriatric clients stating that they are prescribed reading glasses. Some individuals state needing assistance with seeing writing far away, and others need assistance with closer vision. The nurse is correct to understand that the aging visual changes relate to which of the following?

Changes in accommodation

70. Which nursing goal is a priority when caring for a client newly diagnosed with vertigo?

Client will remain safe while ambulating in the home.

65. Miotic eye solutions are often ordered in the treatment of glaucoma. Which is the best nursing rationale for the use of this medication?

Constricts pupil

23. A client is having problems with dizziness and complains of the "room spinning." The physician performs the caloric stimulation test. The nurse knows that a diminished response in one eye during the caloric stimulation test is indicative of what?

Inner ear disorder

4. The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working?

Intraocular pressure 15 mm Hg

10. Which nursing suggestion would be most helpful to the client with recurrent otitis externa?

Place ear plugs into the ears before swimming.

27. The nurse is working in a long-term care facility. Which clues does the nurse note which suggests that the client is not hearing what the nurse said? Select all that apply.

The client does not want to be social. The client responds inappropriately. The client nods the head and smiles. The client withdraws from activity.

6. The nurse is assessing a client for objective symptoms of hearing difficulties. Which symptom leads the nurse to take alternate measures to ensure client understanding of teaching?

The client leans foward and turns the head

43. The nurse is evaluating the independent care of a client recovering from a stapedectomy. Which action, made by the client, indicates a need for further teaching?

The client uses clean technique to clean the wound.

14. The nurse is caring for a client with symptoms of ototoxicity from aminoglycoside administration. On which structure does the medication produce the ototoxic effect?

The eighth cranial nerve

89. The nurse is completing a corneal light reflex test using a penlight. Which result would indicate a normal test result?

The light reflection is in the same spot on each eye.

55. The nurse is evaluating the client while taking the color vision test. Which response would the nurse anticipate when caring for a client with normal color vision?

The nurse would anticipate the client identifying numbers and shapes.

8. The nurse is working in the emergency department when a physician asks for help as the client is undergoing a Romberg test. In which position would the nurse stand to be most helpful?

The nurse would stand laterally to the client, opposite side to where the physician is standing.

82. A client comes to the occupational health nurse complaining of eye irritation. The client works in a dusty, outdoor environment. Why should the nurse advise periodic blinking to this client?

clear the dust and particles from the surface of the eyes

74. The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate?

conductive

88. There are several types of hearing loss. Which type of hearing loss benefits most from the use of a hearing aid?

conductive

32. A nurse is assessing a pediatric client in a public health clinic. The parent states that the client has been sneezing and rubbing the eyes. The nurse looks at the client's eyes and documents objective symptoms of watery and red eyes. When reporting to the physician the assessment findings, which word is appropriate?

conjunctivitis

7. The nurse is caring for a client being treated for Ménière's disease. Which medication is monitored closely due to its addictive properties?

diazepam

45. The client is consulting with a physician regarding a potential diagnosis Ménière's disease. The nurse is assisting in positional testing and documentation. Which diagnostic test would the nurse anticipate to obtain a more precise evaluation of vestibular function?

electronystamography

24. The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis?

progressive, bilateral loss of hearing

31. A nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about Ménière's disease?

referred to as endolymphatic hydrops. /