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The nurse is assigned to care for a client with a detached retina. Which finding should the nurse expect to be documented in the client's record?

A sense of a curtain falling across the field of vision

A nursing instructor asks a student about cochlear implants. The student understands that which clients are candidates for such a procedure? Select all that apply.

A client who has a profound hearing loss in both ears 4. A client who has received no benefit from conventional hearing aids

A client with a diagnosis of otosclerosis is admitted to the ambulatory care unit for stapedectomy, and the nurse reinforces instructions to the client regarding home care following the procedure. Which statement by the client indicates a need for further teaching?

"I need to avoid air travel for at least 6 months."

A clinic nurse is reinforcing home care instructions to a client with a diagnosis of glaucoma. Which statement by the client indicates an understanding of the treatment plan for glaucoma?

"I need to take my eye drops for the rest of my life."

A client has been diagnosed with a hearing loss caused by age-related changes in the ear. The nurse reinforces information about obtaining and learning to use a hearing aid. Which statement by the client indicates understating of the information?

"I should obtain a hearing aid as soon as possible."

A client diagnosed with primary open-angle glaucoma has been prescribed pilocarpine ophthalmic drops. The nurse has given the client instructions on how to administer the eye drops. Which client statement indicates a need for further teaching?

"I will drop the eye drop in the middle of my eye."

The nurse is reinforcing discharge instructions to a client following right eye corneal transplantation surgery. The nurse determines that the client understands the instructions if the client makes which statement?

"I will lie on my back or left side."

The nurse interprets that a client diagnosed with glaucoma needs additional information about the expected effects of this condition when the client makes which statement?

"Taking my daily walk right around dusk each evening has proven to be so enjoyable."

The nurse is assisting a client who has just been given a hearing aid to wear for the first time. When reinforcing client teaching, the nurse should include which instruction?

"The hearing aid should not be worn if an ear infection is present."

A client with glaucoma has suffered significant eye damage before diagnosis and now has impaired vision. The nurse determines that the client needs further assistance in adapting to this situation if the client makes which statement?

"There is no difficulty driving at dusk.

The nurse notes that the primary health care provider (PHCP) has documented a diagnosis of presbycusis on the client's chart. Which explanation should the nurse give to the client to explain this condition?

A sensorineural hearing loss that occurs with aging

The nurse is reinforcing instructions to a client with a diagnosis of hordeolum regarding the treatment plan. Which instruction should the nurse include in the teaching plan for the client?

Apply a warm compress for 15 minutes 4 times daily.

A client arrives in the emergency department with a foreign body in the eye. Which action should the nurse plan to perform first?

Apply an eye patch to both eyes.

The nurse should check for vision loss in a client with which condition?

Diabetes mellitus

The nurse is collecting data from a client who has a history of untreated cataracts. The nurse checks the client for which associated manifestation?

Difficulty with driving a car at night

The nurse in a health care clinic is assisting in testing the client for accommodation. Arrange the actions and observations in the order that they should occur. All options must be used.

Focus on distant object. Pupils dilate. Focus on close object. Pupils constrict. Document findings.

The nurse is reinforcing home-care instructions to a client and family regarding care after left cataract surgery with lens implant. Which statements made by the client indicate an understanding of the instructions? Select all that apply.

I will not sleep lying on my left side." 3. "I will sit at the table to eat breakfast." 4. "I will sit in my recliner with my feet elevated." 5. "I will not lift anything heavier than 10 pounds."

The nurse is reinforcing education to a client who has just obtained a hearing aid about its use and maintenance. The nurse tells the client that it is helpful to follow which practice?

Keep an extra battery readily available

A client has sought treatment in the ambulatory care clinic after an insect has become trapped in the external ear canal. The nurse prepares to assist the primary health care provider to instill which acceptable solutions into the ear to remove the insect? Select all that apply.

Lidocaine 2. Mineral oil 3. Ether solution

Which nursing interventions are appropriate for a client recovering from surgery for retinal detachment? Select all that apply.

Monitor for hemorrhage. 2. Administer eye medications. 3. Maintain the eye patch or shield. 4. Assist with activities of daily living. 6. Educate regarding symptoms of retinal detachment.

Betaxolol hydrochloride eye drops have been prescribed for the client with glaucoma. Which nursing action is most appropriate related to monitoring for the side/adverse effects of this medication?

Monitoring blood pressure

An adult client has increased fluid in the middle ear that is causing vertigo. The nurse checks this client for which associated signs and symptoms of this condition?

Nausea and vomiting

The nurse is assisting the primary health care provider in performing a caloric test on a client. Following instillation of cool water into the ear, the nurse observes the presence of nystagmus. The nurse should document the findings of this test as indicative of which result?

Normal

A client has been diagnosed with glaucoma. The nurse who is teaching the client principles of self-care should encourage the client to limit or refrain from which usual activity on a repeated basis?

Picking objects up off the floor

Which are age-related changes to the eyes? Select all that apply.

Presbyopia 2. Arcus senilis 3. Yellow-tinged sclera 6. Decreased ability to see in dim light

During the early postoperative stage, the client who had a cataract extraction complains of nausea and severe eye pain over the operative site. Which action should the nurse implement?

Report the client's complaints.

The nurse assigned to care for a hearing-impaired client should use which approach to communication in order to enhance communication and preserve the client's self-esteem? Select all that apply.

Speaking slowly and clearly 3. Standing directly in front of the client while speaking 5. Turning down the volume on the radio or TV when talking

The nurse is inserting soft contact lenses into the eyes of a client. Which direction does the nurse tell the client to look?

Straight ahead

A client is being discharged from the ambulatory care unit following cataract removal. Which instruction from the discharge teaching plan should the nurse reinforce?

Take acetaminophen if any discomfort occurs.

The nurse is assisting in performing a confrontation test on a client seen in the clinic. The nurse understands that this test is performed to determine what?

The ability to demonstrate effective peripheral vision

The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of an acute attack of Ménière's disease. Which prescription noted on the client's chart should the nurse question?

The administration of a vasoconstrictor

The nurse notes that the client's physical examination record states the client's eyes moved normally through the six cardinal fields of gaze. The nurse makes which interpretation?

The client has normal ocular movements.

When reinforcing information to a client regarding how to appropriately care for a new hearing aid, the nurse should provide the client with which instruction?

To check the battery regularly to ensure that it is working before use

Which instruction is appropriate for the nurse to provide to a client who reports via telephone that he is certain an insect has flown into his ear because he can hear it "buzzing"?

Use a flashlight to coax the insect out of the ear.

While at home, the nurse receives a telephone call from a neighbor who reports that while accidentally breaking a mirror, a piece of glass flew into her eye. Which is the appropriate initial nursing action after observing that the large glass shard is protruding from the neighbor's eye?

ecure a paper cup over the affected eye.

The nurse is attempting to communicate with a hearing-impaired client. Which strategy by the nurse would be least helpful when talking to this client?

miling continuously during conversation

The nurse is assisting in developing a plan of care for a client following the surgical removal of an acoustic neuroma. Which assessment will be included in the plan of care for this specific intervention?

ssessment of cranial nerve VII (facial)

The nurse is providing discharge instructions for a client who has had a fenestration procedure for the treatment of otosclerosis. Which statement by the client indicates an understanding of the instructions?

will take stool softeners as prescribed by my doctor

The nurse determines that the client diagnosed with Ménière's disease understands the reinforced dietary instructions when the client states that which food will be avoided in the diet?

Hot dogs

A miotic medication has been prescribed for the client with glaucoma. The client asks the nurse about the purpose of the medication. The nurse should tell the client which purpose?

"The medication causes the pupil to constrict and will lower the pressure in the eye."

Prescriptive glasses are prescribed for a client with bilateral aphakia, and the nurse reinforces instructions to the client regarding the use of the glasses. Which statement by the client indicates the need for further teaching?

"The prescriptive glasses will correct my visual field of sight." 4.

A client has bilateral aphakia. When reinforcing teaching instructions regarding the prescribed eyeglasses, the nurse determines the need for further teaching when the client makes which statement?

"My peripheral vision will not be distorted."

The nurse is providing client and family instructions for a client who has been recently diagnosed with glaucoma. Which statement indicates that the client's family member needs further teaching regarding the eye drop application of pilocarpine hydrochloride? Select all that apply.

"I should apply the eye drops directly over my family member's pupil." 3. "I have to contact the prescriber if my family member develops a small pupil." 5. "I need to wipe off the tip of the eye drop bottle with a tissue between administrations."

The nurse is reviewing the record of a client with mastoiditis. The nurse should expect to note which signs and symptoms? Select all that apply.

Headache 2. Swelling directly behind the ear 5. Red and immobile tympanic membrane

The nurse is reviewing the medication list for an assigned client. Which medication is the only one on the client's prescription sheet that does not have an ototoxic effect?

Acetaminophen

A nursing student is caring for a client in the health care clinic who has been diagnosed with glaucoma. The client has a history of heart disease. The nursing instructor asks the student about group of medications used to treat glaucoma that would be contraindicated?

Alpha2-adrenergic agonist

Which diagnostic test would verify the diagnosis of macular degeneration?

Amsler grid test

A client sustains a contusion of the eyeball after a traumatic injury with a blunt object. The nurse should take which immediate action?

Apply ice to the affected eye.

A client has been admitted to the telemetry unit with a diagnosis of bradycardia. The nurse is reviewing the client's prescriptions with the registered nurse. The client has a history of open-angle glaucoma. Which prescription should the nurse suggest should be questioned?

Atropine intravenously

A client is diagnosed with hyphema after experiencing a traumatic blow to the eye. The nurse explains to the client that which activity limitation needs to be implemented following this type of injury?

Bed rest with the head in semi-Fowler's position

A client is brought to the emergency department by the ambulance team after collapse at home. Cardiopulmonary resuscitation is attempted but is unsuccessful. The wife of the client tells the nurse that the client is an organ donor and that their eyes are to be donated. Which action should the nurse take next?

Close the eyes, elevate the head of the bed, and place a small ice pack on the eyes.

The nurse caring for a client in the postoperative period following an enucleation notes bloody staining on the surgical eye dressing. Which is the appropriate nursing action?

Contact the registered nurse.

The nurse is reinforcing home care instructions to a client who has a hordeolum (sty) of the right eye. Which statement by the client indicates an understanding of the instructions?

I should apply antibiotic ointment as prescribed."

Which medications cause ototoxicity? Select all that apply.

Ibuprofen 3. Furosemide 4. Vancomycin

The nurse is reinforcing home care instructions to a client following a fenestration procedure for the treatment of otosclerosis. Which instruction should the nurse give the client?

Increase fluids and take a stool softener daily.

A client arrives at the emergency department with a foreign body in the left ear that has been determined to be an insect. Which initial intervention should the nurse anticipate to be prescribed?

Instillation of mineral oil or diluted alcohol

The nurse is caring for a client who will be undergoing surgical treatment for Ménière's disease. The nurse plans care based on which expected outcome?

The surgery relieves pressure from accumulation of inner ear fluid in the endolymphatic sac.

The nurse is reinforcing discharge instructions to a client going home after same-day eye surgery. During the postoperative period, the nurse stresses that the client may safely perform which activity?

Watch television.

The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops? Select all that apply.

Wash hands. 2. Put on gloves. 3. Place the drop in the conjunctival sac. 4. Pull the lower lid down against the cheekbone.

A client with a history of ear problems telephones the ambulatory care nurse to cancel an appointment because he will be away on business. The client mentions that he will be flying during this trip. The nurse advises the client to engage in which activities to prevent barotrauma during takeoff and landing? Select all that apply.

Chewing gum 2. Yawning occasionally 3. Swallowing a few times 5. Sucking on a piece of hard candy

The nurse administers meclizine hydrochloride to a client diagnosed with an attack of Ménière's disease. Which observations demonstrate to the nurse that the medication is effective? Select all that apply.

Decrease in nausea 3. Decrease in vertigo

A client who has undergone cataract removal without an intraocular lens implant is visibly upset because his vision is still blurry. Which action should the nurse perform to provide realistic reassurance to this client?

Explain that vision will improve with adjustment to aphakic lenses.

The nurse is assisting with developing a teaching plan for the client with glaucoma. Which instruction should the nurse suggest to include in the plan of care?

Eye medications may need to be administered for the rest of your life.

The nurse is reviewing the health care record of a client suspected of having mastoiditis. Which documented findings should the nurse expect to note if this disorder is present? Select all that apply.

Headache 3. Elevated white blood cell count 4. Diminished hearing on affected side 5. Swelling behind the ear on affected ear

A clinic nurse is reviewing the record of a client recently diagnosed with a cataract. Which clinical manifestations associated with this disorder should the nurse expect to be documented in the client's record? Select all that apply.

Increasing nearsightedness 4. Need for more light when reading 5. Painless progressive loss of vision

A client arrives in the emergency department with a chemical eye injury. The nurse immediately performs which action?

Irrigates the eye with copious amounts of sterile normal saline

The nurse is gathering data from a client with a history of untreated cataracts. The nurse asks the client about the presence of which sign of a cataract?

Difficulty with driving at night and blurred vision

The nurse in the outpatient unit is preparing a client who is scheduled for a laser trabeculoplasty for the treatment of primary open-angle glaucoma. Which instructions should the nurse reinforce to the client?

"You may return to work 1 or 2 days following the procedure."

The nurse is reinforcing discharge instructions with a client who is being discharged following a fenestration procedure for the treatment of otosclerosis. Which should be included on the list of instructions prepared for the client?

"You need to avoid air travel."

A client arrives at the emergency department for treatment of an injury to the eye after being hit by a baseball bat. On data collection, the nurse notes that the eye is bleeding. Which nursing action is appropriate?

Cover the eye with cold, sterile saline gauze.

A client sustains a chemical eye injury from a splash of battery acid. The nurse should prepare the client for which immediate measure?

Irrigating the eye with sterile normal saline

A client who sustained an eye injury arrives at the emergency department. Which is the initial nursing action?

Obtain a history regarding the cause of the injury.

The nurse in the recovery room area is preparing to care for a client following cataract extraction of the right eye. Which position does the nurse prepare to place the client?

On the left side with the head of the bed elevated

The nurse is assigned to care for a client following a cataract extraction. The nurse plans to place the client in which position?

On the nonoperative side

A client has been diagnosed with cataracts. Which signs and symptoms should the nurse expect to note? Select all that apply.

Photophobia 3. Blurred vision 4. Decreased color perception

The nurse is caring for a client after enucleation and notes the presence of bright red drainage on the dressing. The nurse should take which appropriate action?

Report the finding to the registered nurse (RN).

The nursing student is developing information for use in a clinical conference about hearing disorders. In the presentation, the student plans to include the statement that the ear is housed in which bones of the skull?

Temporal

A client has had same-day surgery to insert a ventilating tube in the tympanic membrane. The nurse reinforces to the client to be sure to perform which action until the postoperative assessment by the primary health care provider?

Use a shower cap to protect the ears if taking a shower.

The nurse is speaking with a client with a hearing impairment. The nurse refrains from doing which least likely helpful action when communicating with this client?

Using many exaggerated hand gestures while talking

The nurse is reinforcing preoperative instructions to a client scheduled for cataract surgery and prepares a written list of instructions for the client. Which statement by the client indicates a need for further teaching?

"I can drink any liquids that I want to on the morning of the surgery."

The nurse is caring for a client following craniotomy for removal of an acoustic neuroma. The nurse understands that assessment of which cranial nerve should identify a complication specifically associated with this surgery?

Cranial nerve VII, facial nerve

After a routine eye examination, a client has been told there are refractive errors in both eyes. The nurse explains to the client that this problem is primarily treated with which intervention?

Prescription of corrective lenses

The nurse is preparing to instill an otic solution into the adult client's right ear. The nurse should include which action while performing this procedure? Select all that apply.

Pulling the auricle of the right ear upward Pulling the auricle of the right ear backward Warming the solution to room temperature Placing the client in a left side-lying position

The nurse is preparing to administer eardrops to an adult client. The nurse administers the eardrops by which technique?

Pulling the pinna up and back

The nurse is reviewing the plan of care developed by a nursing student for a client scheduled for keratoplasty. The nurse discusses the plan with the student if which incorrect intervention is listed in the plan?

Administering medications that will dilate the pupil

The nurse is providing discharge instructions to a client following a keratoplasty. Which statement by the client indicates the need for further teaching?

"Sutures are removed in 2 weeks."

A client was just admitted to the hospital to rule out a gastrointestinal bleed. The client has brought several bottles of medications prescribed by different specialists. During the admission assessment, the client states, "Lately, I have been hearing some roaring sounds in my ears, especially when I am alone." Which medication should the nurse determine to be the cause of the client's complaint?

Acetylsalicylic acid


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