Saunders

Surgery has been recommended for the client with otosclerosis. The client tells the nurse she would. not prefer to have surgery and asks the nurse about alternative methods to improve hearing. The nurse should take which appropriate response to the client

A hearing aid may improve your hearing.

To administer eye medications, the nurse would wash hands and put on gloves. The client is instructed to tilt the head backward, open the eyes, and look up. The nurse pulls the lower lid down against the cheekbone and holds the bottle like a pencil, with the tip downward. Holding the bottle, the nurse gently rests the wrist of the hand on the client's cheek and squeezes the bottle gently to allow the drop to fall into the conjunctival sac. The client is instructed to close the eyes gently and not to squeeze the eyes shut to prevent the loss of medication.

Acetylsalicylic acid Rationale Aspirin is contraindicated for gastrointestinal bleeding and is potentially ototoxic. The client should be advised to notify the prescribing PHCP so that the medication can be discontinued and/or a substitute that is less toxic to the ear can be taken instead. Options 1, 2, and 4 do not have side effects that are potentially associated with hearing difficulties.

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."

The nurse is reinforcing discharge teaching to a client following right eye cataract surgery. The nurse determines that the client needs further teaching about about ways to avoid to strain on operative eye when the client makes which statements? SATA

-I can lie on my right side -I will wear my eye shield only during the daytime

The nurse collects data from a client with a diagnosis of macular degeneration of the eye. The nurse should expect the client to report which symptoms

Blurred central vision Bending of straight lines Inability to see color vividness Objects that appear to be the wrong size

A client who had previously undergone cataract surgery tells a nurse that she has begun seeing flashing light and gloaters in the eye. Based on the clients history the nurse interprets that the client is at risk for which?

Detached retina

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 indicated a need for further teaching?

I will drop the eye drop in the middle of the eye

The nurse is giving home care instructions to a client with conjunctivitis. Which client statement indicates need for further teaching?

I will use a sterile gauze to rub any matter from my eye

The nurse is attempting to inspect the lacrimal apparatus of a client's eye. Because of its anatomical location, the nurse should do which action?

Retract the upper eye lid and ask the client to look down

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

An adult client with a history of ear infections reports a right earache accompanied by a sensation of fullness. the client also reports nausea and has a temp of 100.6 F the nurse questions the client about which aspect of the clients history

Whether the client has had a recent upper respiratory infection (URI)

Which medications cause ototoxicity? Select all that apply.

-Ibuprofen -Furosemide -Vancomycin

A client who frequently experiences hearing loss due to built-up cerumen in the ears asks the nurse about ways to deal with the problem including irrigating the ears. Which information is correct for the nurse to include in the teaching plan? Select all that apply.

-Irrigate the ear canal with lukewarm tap water around 98° F. -The ear irrigation should be stopped if the client becomes dizzy or nauseous. -Instill drops of mineral oil and hydrogen peroxide for several days to soften dried cerumen before irrigation.

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

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

The client is receiving an eye drip and an eye ointment ti there right eye. Which action should the nurse take?

Administer the eye drops first followed by the eye ointment. Rationale When an eye drop and an eye ointment is scheduled to be administered at the same time, the eye drop is administered first. Options 2, 3, and 4 are incorrect.

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 when driving a car at night

The PHCP will preform a caloric test. Which is the priority order of the actions to preform this test.

Explain the procedure Note is the has had CNS depressants alcohol to barbiturates Check for the presence of nystagmus postural deviation and past pointing Examine and clean the ear canal Place emesis basin under the ear to be tested Irrigate until the client complains of nausea and dizziness or nystagmus is observed

After an eye examination, a client has been diagnosed with acute angle-closure glaucoma. The nurse collecting data from the client asks the client about an accompanying history of which sign/symptom?

Eye Pain

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

Irrigating the eye with sterile normal saline. Rationale Emergency care after a chemical burn to the eye includes irrigating the eye immediately with sterile normal saline or ocular irrigating solution. The irrigation should be maintained for at least 10 minutes. After this emergency treatment, visual acuity is assessed. Options 2 and 3 are not immediate measures.

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

My peripheral vision will not be distorted

The nurse is providing instructions to a client who will be self-administering eye drops. To minimize the systemic effects that eye drops can produce the client is instructed to preform which action?

Occlude the nasolacrimal duct with the finger over the canthus for 30-60 seconds after instilling the drops

The nurse is assisting a PHCP in preforming a caloric test on a client. Following instillation of warm water into the ear, the nurse notes that nystagmus does not occur. The nurse should document the findings of this test as indicative of which result?

Positive

Which are age related changes to the eyes? SATA

Presbyopia Arcus senilis Yellow tinged sclera Decreased ability to see in dim light

After a routine eye examination a client had been told there are refractive errors in both eye. The nurse explains to there client that this problem is primary treated with which intervention

Prescription of corrective lenses

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

Pulling the pinna up and back Rationale For an adult, the nurse tilts the client's head slightly away and pulls the pinna up and back. Asking the client to stand and lean to one side is inappropriate and unsafe.

A client susceptible to motion sickness asks the nurse about the use of medication to prevent an occurrence. The nurse plans to incorporate into the discussion that the medication works effectively if it is taken at least:

Taking the medication 1 hour before triggering event

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

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

The surgery relieves pressure fro accumulation of inner ear fluid and endolyphatic sac

In preparation for cataract surgery the nurse is to administer cyclopentolate eye drops. The nurse administers the eye drops knowing that which is the purpose of the medication?

To dilate the pupil of the operative eye Rationale Cyclopentolate is a rapidly acting mydriatic and cycloplegic medication. Cyclopentolate is effective in 25 to 75 minutes, and accommodation returns in 6 to 24 hours. Cyclopentolate is used for preoperative mydriasis.

The nurse is explaining how sound is conducted from the middle ear to the inner ear in teaching a client who is experiencing hearing loss. What is the order of structures conducting sound waves from the middle ear to the inner ear? Arrange the structures in the order that they should occur. All options must be used.

Tympanic membrane Malleus incus stapes Oval window Cochlea Organ of Corti

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

Monitoring blood pressure Hypotension, dizziness, nausea, diaphoresis, headache, fatigue, constipation, and diarrhea are systemic effects of the medication. Nursing interventions include monitoring the blood pressure for hypotension and assessing the pulse for strength, weakness, irregular rate, and bradycardia. Options 1, 3, and 4 are not specifically associated with this medication.

The nurse is assisting the PHCP ointment preforming the caloric test on a client. Following instillation of warm water into the ear, the client complains of vertigo. the nurse documents the finding of this test as indicative of which results?

Normal

The nurse is asserting in preforming a confrontation test on a client seen in the clinic. The nurse understands that this test is preformed to determine what ?

The ability to demonstrate effective peripheral vision

A client with glaucoma and an acute exacerbation of chronic obstructive pulmonary disease (COPD) has a new prescription to receive carteolol HCl eye drops. Which action by the nurse is most appropriate?

With hold the mediation and notify the RN

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

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

The nurse is reviewing the heath record of a client diagnosed with a cataract. Which are signs and symptoms of cataract formation? SATA

-Floaters in visual field -Difficulty in night vision -Decreased color perception Ratioanale Signs and symptoms of a cataract include hazy, blurred, or double vision (diplopia), and floaters in visual field. There is increasing nearsightedness, complaints that colors are faded or appear yellowish or brownish, and difficulty with night vision. Uncomplicated cataracts are usually painless, but the client may have photophobia (intolerance of light).

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 clients record? SATA

-Increasing nearsightedness -Need for more light when reading -Painless progressive loss of vision

A client has sought treatment in the ambulatory care clinic after an insect had become trapped in the external ear canal. The nurse prepares to assist the PHCP to instill which acceptable solution into the ear to remove the insect?

-Lidocaine -Mineral oil -Ether soultion

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 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 in the Semi-Fowlers position

A client diagnosed with glaucoma. Which data gathered by the nurse indicate a risk factor associated with glaucoma?

Cardiovascular disease Rationale Hypertension, cardiovascular disease, diabetes mellitus, and obesity are associated with the development of glaucoma. Smoking, ingestion of caffeine or large amounts of alcohol, illicit drugs, corticosteroids, altered hormone levels, posture, and eye movements may cause varying transient increases in intraocular pressure.

A client with a history if 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 prevent barotrauma during takeoff and landing

Chewing gum Yawing occasionally Swallowing a few times Sucking on a piece of hard candy

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

You ay return to work 1-2 days following the procedure

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 and 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 preform to provide realistic reassurance to this client

Explain that vision will improve with adjustment to aphakic.

A client reports to the health care clinic for an eye examination, and a diagnosis of primary open angle glaucoma is suspected. Which questions will elicit information regarding the signs/symptoms associated with this disorder

Have you had difficulty with peripheral vision

The nurse reinforces instructions to a client with glaucoma regarding measures that will prevent an increase in intraocular pressure in the eyes. Which statement by the client indicates a need for further teaching

I can tie my shoelaces by bending over slowly

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

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

The nurse is reinforcing instructions to a client regarding the use of a hearing aid. Which statement by the client indicates a need for further teaching?

I should turn the hearing aid off after removing it from my ear Rationale Nurses should have a basic knowledge of the care of a hearing aid to assist the client in its use. The client should be instructed to turn the hearing aid off before removing it from the ear to prevent squealing feedback. The hearing aid should be turned off when not in use, and the client should keep an extra battery available at all times. The client should wash the ear mold frequently with mild soap and water using a pipe cleaner to cleanse the cannula. The client should not wear the hearing aid during an ear infection.

The nurse is reinforcing discharge instructions to a client following right eye corneal transportation 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 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

I will take stool softeners as prescribed by my doctor Rationale Following ear surgery, clients need to avoid straining when having a bowel movement. Clients need to be instructed to avoid drinking with a straw for 2 to 3 weeks, air travel, and coughing excessively. Clients need to avoid getting their head wet, washing their hair, and showering for 1 week. Clients need to avoid rapidly moving the head, bouncing, and bending over for 3 weeks.

The nurse is assisting the PHCP in preforming a caloric test on a client. Following instillation of cool water into the ear, the nurse observes the presences of nystagmus. the nurse should document the findings of this test s indicative of which result?

Normal

The client arrives in the emergency department after an automobile crash. The clients forehead hit the steering wheel and a hyphema has been diagnosed. Which position should the nurse prepare to position the client?

On ben rest in the semi-Fowler position Rationale A hyphema is the presence of blood in the anterior chamber. It is produced when a force is sufficient to break the integrity of the blood vessels in the eye. It can be caused by direct injury, such as a penetrating injury from a BB pellet, or indirectly, such as from striking the forehead on a steering wheel during an accident. The client is treated by bed rest in a semi-Fowler's position to assist gravity in keeping the hyphema away from the optical center of the cornea.

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 Rationale Postoperatively, cataract extraction clients should be positioned on their backs in a semi-Fowler's position or on the nonoperative side to prevent edema in the surgical site. The remaining positions are incorrect and will cause swelling at the surgical site.

A client is experiencing blockage of the eustachian tubes. The nurse teaches the client that which activities by the client may forcibly open the eustachian tube?

Performing the Valsalva maneuver

A client has been diagnosed with cataracts Which sign and symptoms should the nurse expect to notes? SATA

Photophobia Blurred vision Decreased color perception

The nurse is preparing a plan of care for a client admitted to the hospital with a diagnosis of retinal detachment. Which measure should the nurse include in the plan of care?

Place an eye patch over the affected eye

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

Temporal

A client arrives in the emergency department following an eye injury from a chemical solution. Which is the initial nursing action

Test the eye pH with litmus paper

The nurse is observing an unlicensed assistive personnel (UAP) talk to a client who is hearing impaired. The nurse should intervene if which actions are performed by the UAP during communication with the client? Select all that apply.

The UAP speaks in a very loud voice. The UAP speaks while cleaning the room. The UAP speaks directly into the impaired ear.

Immediately following cataract repair, the client's affected conjunctiva and eyelids are edematous. Which statement by the nurse accurately characterizes these findings for the client?

The edema is normal and should subside within 3 days

The nurse is reviewing the results of an eye examination on a client. Which tests can detect glaucoma?

Tonometry Visual field check

The nurse is reviewing the preoperative prescriptions of a client scheduled for a keratoplasty. Which prescriptions noted in the clients chart should the nurse question?

Administer medication to dilate the affected pupil

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 a group of medications used to treat glaucoma that would be contraindicated?

Alpha 2 adrenal antagonist

Which diagnostic test would verify the diagnosis of macular degeneration?

Amsler grid test

A caloric test is prescribed for a client suspected of having a disease of the labyrinth. The nurse obtains which essential item in preparation for this test?

An otoscope

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 IV

The nurse is caring for a client with glaucoma. Which medication prescribed for the client should the nurse question?

Atropine Sulfate Rationale Options 1, 2, and 4 are miotic agents used to treat glaucoma. Option 3 is a mydriatic and cycloplegic medication, and its use is contraindicated in clients with glaucoma. Mydriatic medications dilate the pupil and can cause an increase in intraocular pressure in the eye.

The nurse is assisting in preparing a teaching plan for a client with Menieres disease. The nurse places highest priority on teaching the client information related to which infomation

safety

Tonometey is preformed on a client with a suspected diagnosis of glaucoma. The nurse reviews the test and determines that the intraocular pressure is normal if which result is noted?

15 mm Hg Rationale Tonometry is the method of measuring intraocular fluid pressure using a calibrated instrument that indents or flattens the corneal apex. Pressures between approximately 10 and 21 mm Hg are considered within the normal range; therefore, the other options are incorrect.

The myringotomy is preformed on a client in the ambulatory care center. the ambulatory care nurse calls the client 24 hours after the procedure to evaluate the status of the client. The client reports to the nurse that a small amount of brownish drainage has been coming from the ear Which instruction should the nurse provide to the client

Continue to monitor the drainage because this is normal and ay occur for 24-48 hours following the surgery.

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

Apply ice to the affected eye Rationale Treatment for a contusion begins at the time of injury. Ice is applied immediately. The client should receive a thorough eye examination to rule out the presence of other eye injuries. Eye irrigation is not indicated in a contusion. Options 3 and 4 will delay immediate treatment. After the application of ice, the PHCP would be notified.

A nurse is reinforcing discharge instructions to a client who has had ocular surgery of the left eye. Which statement by the client indicates a need for further teaching?

I need to call the doctor if I develop a fever

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

-Headache -Swelling directly behind the ear -Red and immobile tympanic membrane Rationale Otoscopic examination in a client with mastoiditis reveals a red, dull, thick, and immobile tympanic membrane with or without perforation. Signs and symptoms of mastoiditis include mastoid swelling (directly behind the ear) and soreness, headache, malaise, and an elevated white blood cell (WBC) count. Thick, purulent drainage from the ear may be seen.

The nurse is preparing to reinforce teaching plan for a client who is undergoing cataract extraction with intraocular implant. Which home care measures should the nurse include in the plan.

-To avoid activities that require bending over -To take acetaminophen for minor eye discomfort -To place an eye shield on the surgical eye at bedtime -To contact the surgeon if a decrease of visual acuity occurs Rationale After eye surgery, some scratchiness and mild eye discomfort may occur in the operative eye and is usually relieved by mild analgesics. If the eye pain becomes severe, the client should notify the surgeon because this may indicate hemorrhage, infection, or increased intraocular pressure. The nurse would also instruct the client to notify the surgeon of purulent drainage, increased redness, or any decrease in visual acuity. The client is instructed to place an eye shield over the operative eye at bedtime to protect the eye from injury during sleep and to avoid activities that increase intraocular pressure such as bending over.

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

Apply an eye patch to both eyes

A client has been diagnosed with open angle glaucoma. Which signs and symptoms are found in open angle glaucoma

Blurred or hazy vision Colored rings around lights Tonmetry reading 30 mm Hg

The nurse is providing client teaching regarding glaucoma Which instructions are important to include in the teaching plan? SATA

Follow low sodium minimal caffeine diet with plenty of fiber Be sure to report halos of light or increased eye pain to your PHCP

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 client reporting recent right eye discomfort is diagnosed with chalazion of the right eye. The nurse reinforces instructions to the client regarding care to the eye. Which statement by the client indicates an understanding of the measures?

I should apply warm packs to my eye

The nurse is providing discharge instructions to a client who is postoperative cataract surgery on the left eye Which statement indicated the need for further teaching

If I have severe eye pain I will take the narcotic pain pill that my doctor will prescribe for me Rationale After cataract surgery the most important thing is to prevent strain on the operative eye. The client should not lift more than 5 pounds. The client should protect the eye during the day with glasses and use sunglasses for outside wear. The client should wear a protective eye shield at night. A mild analgesic is usually ordered as needed. Postoperative clients with cataract surgery should not have severe pain. If a client complains of severe pain, the surgeon is notified. Severe pain may indicate hemorrhage or rising pressure within the eye.

The nurse is caring for a client with acute otitis media. The nurse plans care knowing which treatment for this problem is likely to be included?

Myringotomy

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

Report the clients complaints. Rationale Severe pain or pain accompanied by nausea is an indicator of increased intraocular pressure and should be reported to the registered nurse and primary health care provider immediately. The remaining options are incorrect.

The nurse assists with preparing the client for ear irrigation as prescribed by the PHCP. Which actions should the nurse plan take?

Warm the irrigating solution to 98 F Rartionale Irrigation solutions that are not close to the client's body temperature can be uncomfortable and may cause injury, nausea, and vertigo. The client is positioned so that the ear to be irrigated is facing downward, because this allows gravity to assist with the removal of the ear wax and solution. After the irrigation, the client is to lie on the affected side to finish draining the irrigating solution. A slow, steady stream of solution should be directed toward the upper wall of the ear canal and not toward the eardrum. Too much force could cause the tympanic membrane to rupture.

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

A client is diagnosed with labyrinthitis. Which are signs and symptoms of labyrinthitis. SATA

-Severe dizziness -Nausea and Vomiting -Abnormal jerking movement of the eye Rationale Signs and symptoms of labyrinthitis include vertigo, nausea, vomiting, headache, anorexia, nystagmus, and sensorineural hearing loss on the affected side. The client may also experience anorexia.

The nurse is reviewing the health care record of a client with a diagnosis of otosclerosis. Which signs and symptoms should the nurse note? SATA

-Tinnitus -Difficulty hearing voices of others -Bone conduction better than air conduction Rationale Otosclerosis involves the formation of spongy bone in the capsule of the labyrinth of the ear often causing the auditory ossicles to become fixed and less able to vibrate when sound enters the ear. The primary symptom of otosclerosis is slowly progressive hearing loss in the absence of infection. In the early stages, the client may report tinnitus. The Rinne test reveals bone conduction to be greater than air conduction. The client often complains of difficulty hearing the voices of others, yet his own voice sounds unusually loud. In response to this, he may lower his voice to the point that he can scarcely be heard by others.

A nursing student is preparing to assist with an ear irrigation on an assigned client who has a buildup of cerumen in the left ear. The nursing instructor asks the student about the procedure for the irrigation. The student nurse should perform the procedure in which correct order? Arrange the actions in the order that they should be used. All options must be used.

-Warm the solution to body temp -Have the client sit up holding an emesis basin under the ear -Straighten the external canal of an adult by pulling the auricle up and back -Select and irrigating syringe or bulb syringe with a tip that is smaller than the canal -Direct the solution toward the top of the canal in a steady stream not toward the eardrum

The nurse is reviewing the health care record of a client suspected of having mastoiditis. Which documented findings should the nurse expect. to not if this disorder is present? SATA

Headache Elevated WBC Swelling behind the ear on affected ear

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

Apply a warm compress for 15 min 4 times daily

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

Difficulty with driving at night and blurred vision

The instructor is quizzing the student nurse concerting the care of a. visually impaired client. Which statement indicates the need for further teaching?

I will take the clients arm to lead while we are walking Rationale Measures to support the client with impaired vision and to prevent injury include announcing yourself when entering or leaving the room and speaking in a normal tone of voice. People tend to act as if those who cannot see also cannot hear, so a tendency exists to raise one's voice when talking to the visually impaired. Advise the client what to expect during procedures. Keep doors either open or closed so that the ambulatory client does not run into a partially closed door. To lead a blind person, have him or her take your arm.

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 stool softeners daily.

A client is brought to the ambulatory care department by the spouse 1 day following a cataract extraction procedure. A diagnosis of hyphema is made, which occurred as a result of the surgical procedure. The nurse reinforces instructions to the client and spouse regarding the treatment for the complication and makes which statement?

Maintain bed rest and patching of both eyes

The nurse in the recovery room area is preparing 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

T he 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 reviewing the primary health care provides prescriptions for a client admitted to the hospital with a diagnosis for an acute attack of Meniere's disease. Which prescription noted on the clients chart should the nurse question?

The administration of a vasoconstrictor

A client has been newly diagnosed with glaucoma. As part of the discharge instructions, the nurse should plan to reinforce which information?

The need for lifelong medication therapy

The 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 preform which action until the postoperative assessment bu the PCHP

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

The nurse is assigned to administer the prescribed eye drops for a client preparing for a cataract surgery. Which type of eye drops should the nurse expect to be prescribed?

A mydriatic medication Rationale A mydriatic medication produces mydriasis or dilation of the pupil. Mydriatic medications are used preoperatively in the cataract client. These medications act by dilating the pupils. They also constrict blood vessels. A miotic agent would constrict the pupil. An osmotic agent would act to decrease intraocular pressure. A thiazide diuretic would promote the excretion of body fluid. A thiazide diuretic is not likely to be prescribed for a client with a cataract.

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 record?

A sense of a curtain falling across the field of vision. Rationale A characteristic clinical manifestation of retinal detachment described by clients is the feeling that a shadow or curtain is falling across the field of vision. There is no pain associated with detachment of the retina. A retinal detachment is an ophthalmic emergency and even more so if visual acuity is still normal. Options 1 and 3 are not specifically associated with a detached retina.

Pilocarpine hydrochloride is prescribed for the client with glaucoma. Which medication should the nurse plan to have available in the even of systemic toxicity?

Atropine sulfate Rationale Systemic absorption of pilocarpine hydrochloride can produce toxicity and includes manifestations of vertigo, bradycardia, tremors, hypotension, and seizure. Atropine sulfate must be available in the event of systemic toxicity. Pindolol, timolol maleate, and carteolol hydrochloride are ß-blockers.

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 taken for the rest of your life. Rationale The administration of eye drops is a critical component of the treatment plan for the client with glaucoma. The client needs to be instructed that medications may need to be taken for the rest of his or her life. Limiting fluids and reducing salt will not decrease intraocular pressure. Option 3 is not necessary.

The 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. Rationale Insects are killed before removal unless they can be coaxed out by a flashlight or a humming noise. Mineral oil or diluted alcohol is instilled into the ear to suffocate the insect, which is then removed by using ear forceps. When the foreign object is vegetable matter, irrigation is not used because this material expands with hydration and the impaction becomes worse. Options 1, 2, and 3 may be prescribed after the initial treatment if necessary and if inflammation or infection is a concern.

The nurse provides discharge instructions to the client who was hospitalized for an acute attack of Meniere's disease. Which statement by the client indicates the need for further teaching?

It is not necessary to restrict salt in my diet. Rationale Management during remission of Ménière's disease includes diuretics to decrease the fluid and thereby decrease pressure in the endolymphatic system. Antihistamines, vasodilators, and diuretics may be prescribed for the client. A low-salt diet may also be prescribed for the client to reduce fluid retention. The major goal of treatment is to preserve the client's hearing; careful medical management helps achieve this in most clients with Ménière's disease.

A client with retinal detachment is admitted to the outpatient nursing unit in preparation for a scleral buckling procedure. Which of the following would the nurse anticipate to be prescribed?

Placing an eye path over the clients affected eye Rationale The nurse places an eye patch over the client's affected eye to reduce eye movement. Some clients may need bilateral patching. Depending on the location and size of the retinal break, activity restrictions, including watching television, may be needed immediately. These restrictions are necessary to prevent further tearing or detachment and to promote drainage of any subretinal fluid. The nurse positions the client as prescribed by the primary health care provider.

The nurse is caring for a client hospitalized with an acute attack from Meniere's disease. The client verbalizes concern because the client has experienced hearing loss as the result of the attack. Which response should the nurse make to the client regarding the hearing loss

The attack leaves the hearing loss in the involved ear.

The miotic medication has been prescribed fort 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. Rationale Miotics cause pupillary constriction and are used to treat glaucoma. They lower the intraocular pressure, thereby increasing blood flow to the retina and decreasing retinal damage and loss of vision. Miotics cause a contraction of the ciliary muscle and a widening of the trabecular meshwork. Options 1, 2, and 4 are incorrect.

The nurse in a health care clinic is assisting in testing for accommodation Arrange the actions and observations in the order that they should occur?

Focus on distant object Pupils dilate Focus on close object Pupils constrics Document findings

The nurse is caring for a client who is hearing impaired and should take which approach to facilitate communication?

Speak in a normal tone Rationale It is important to speak in a normal tone to the client with impaired hearing and avoid shouting. The nurse should talk directly to the client while facing the client and should speak clearly. If the client does not seem to understand what is said, the nurse should express it differently. Moving closer to the client and toward the better ear may facilitate communication, but it is important to avoid talking directly into the impaired ear.

The nurse is reinforcing discharge instructions to a client going home after same day eye surgery. During the postoperative period the nurse stress that the client may safely preform which activity

Watch television

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 with Meniere's disease is experiencing severe vertigo. The nurse reinforces instructions to the client to do which to assist with controlling the vertigo

Avoid sudden head movements. Rationale The nurse instructs the client to make slow head movements to prevent worsening of the vertigo. Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid are sometimes prescribed. Watching television can increase the vertigo.

The nurse is reviewing the medical record of a client diagnosed with conjunctivitis. Which signs and symptoms should the nurse expect to be noted? Select all that apply.

Itching Redness Sensation of foreign object

These are signs and symptoms of glaucoma. Which sign or symptom is found only in narrow angle glaucoma?

Severe pain in and around the eye

The nurse is preparing to communicate with an older client who is hearing impaired. Which intervention should be implemented initially?

Stand in front of the client Rationale The nurse should ensure that the hearing-impaired client can see the nurse when the nurse is speaking by providing adequate lighting and standing in front of the client. The nurse should enunciate words clearly, but not exaggerate lip movements. If the client is profoundly hearing impaired and uses signing, a sign-language interpreter should be obtained. If a client cannot understand by reading lips, the nurse should try using gestures, pantomiming, or writing notes.

The nurse in 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

-I will not sleep lying on my left side -I will sit at the table to eat my breakfast -I will sit in my recliner with my feet elevated -I will not lift anything heavier than 10 lbs Rationale After cataract surgery, the client should not assume positions that will increase the intraocular pressure. This could lead to injury to the surgical site and damage the lens implant. The client should not sleep on the side of the body that was operated on. The client may resume activities such as sitting upright at a table or sitting in a recliner with the feet elevated. The client should not lift anything heavier than 10 lbs. The client should not perform activities that would increase the pressure within the eye, such as bending over to tie shoes or performing pushups.

The nurse is preparing to instill an otic solution into the adult clients right ear. The nurse should include which action while preforming this procedure? SATA

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

The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops. SATA

-Wash hands -Put on gloves -Place drop in the conjunctival sac -Pull the lower lid down against the cheekbone Rationale To administer eye medications, the nurse would wash hands and put on gloves. The client is instructed to tilt the head backward, open the eyes, and look up. The nurse pulls the lower lid down against the cheekbone and holds the bottle like a pencil, with the tip downward. Holding the bottle, the nurse gently rests the wrist of the hand on the client's cheek and squeezes the bottle gently to allow the drop to fall into the conjunctival sac. The client is instructed to close the eyes gently and not to squeeze the eyes shut to prevent the loss of medication.

The nurse is assisting the PHCP with preforming a Rinne tuning fork test on a client. The nurse expects that the steps of the testing will be preformed in which priority order

-tap the tuning fork to activate -Place base of tuning fork on the mastoid bone -Have client indicate when sound disappears -Move the tuning fork close to the ear canal -Ask the client if he or she hears the sound and to indicate when the sound disappears. Document whether bone or air conduction is better

The nurse is assigned to care for a client with a diagnosis of detached retina. Which finding would indicate that bleeding has occurred as a result of renal detachment.

-Vision many be cloudy -Complaints of a burst of black spots or floaters Rationale Complaints of a sudden burst of black spots or floaters indicate that bleeding has occurred as a result of the detachment. Vision may also be cloudy. Options 1, 3, 4 and 6 are not specifically associated with bleeding as a result of detached retina.

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

A sensoineural hearing loss that occurs with aging Rationale Presbycusis is a type of hearing loss that occurs with aging. It is a gradual sensorineural loss caused by nerve degeneration in the inner ear or auditory nerve. Options 1, 2, and 3 are not accurate descriptions.

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 SATA

I should apply the eye drops directly over y family members pupil I have to contact the prescriber if my family member develops a small pupil I need to wipe off the tip of the eye drop bottle with a tissue between administrations

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

Smiling continuously during conversation Rationale Hearing-impaired clients rely on visual cues to help them comprehend the conversation of others. Smiling continuously is the least helpful strategy, because the smile distorts the appearance of the mouth if the client is trying to read lips. When beginning the conversation, it helps to reduce background noise such as turning off or lowering the volume of the television. Facing the client and standing so there is light on the nurse's face are helpful strategies, because it assists the client with lip-reading. Taking care not to show frustration or annoyance with the client's impairment is also helpful to preserve their self-esteem.

A client is being discharged from the ambulatory care unit following cataract removal, and the nurse provides instructions regarding home care. Which statement by the client indicates an understanding of the instructions?

I will wear my eye shield at night and my glasses during the day Rationale The client is instructed to wear a metal or plastic shield to protect the eye from accidental injury and is instructed not to rub the eye. Glasses may be worn during the day. Aspirin or medications containing aspirin are not to be administered or taken by the client, and the client is instructed to take acetaminophen as needed for pain. The client is instructed not to sleep on the same side of the body that underwent surgery. The client is not to lift more than 5 pounds.

The nurse has reinforced instructions to a client following a right keratoplasty. Which statement bu the client indicates a need for further teaching?

In 1 week I'll return to have the sutures removed

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 RN Rationale If the nurse notes the presence of bright red drainage on the dressing, it must be reported to the registered nurse because this can indicate hemorrhage. Options 1, 2, and 4 will delay necessary treatment.

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

Cranial nerve VII facial nerve Rationale Treatment for acoustic neuroma is surgical removal via a craniotomy. Extreme care is taken to preserve remaining hearing and preserve the function of the facial nerve. Acoustic neuromas rarely reoccur following surgical removal.

The nurse is assigned to care for a client hospitalized with Meniere's disease. The nurse expects which would most likely be prescribed for the client?

Low sodium diet Rationale Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid are sometimes prescribed. Options 1, 3, and 4 are not specific dietary prescriptions for this condition.

Which actions should be preformed when communicating with a client with prebycusis? SATA

Speak slowly and distinctly Face the client when speaking Use short sentences and phrases

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.