Chapter 20 the book

What surgical choices are available for correction of a refractive error (select all that apply)? a. LASIK b. Contact lenses c. Corrective lenses d. Intraocular lens implantation e. Photorefractive keratectomy (PRK) ADE

A,D,E

To determine the presence of corneal abrasions or defects in a patient with an eye injury, what would the nurse provide? a. A tonometer b. Fluorescein dye c. Pocket penlight d. An ophthalmoscope

B

When the patient describes inflammation of the cornea, what does the nurse know this is called? a. Keratitis b. Blepharitis c. Hordeolum d. Conjunctivitis

A

In which patients should the nurse expect to find a yellow cast to the sclera? a. Infants b. Older persons c. Persons with brown irises d. Patients with eye infections

B

Which tissue nourishes the ciliary body, iris, and part of the retina? a. Pupil b. Cones c. Choroid d. Canal of Schlemm

C

What is in the posterior cavity of the eye? a. Zonules b. Cornea c. Aqueous humor d. Vitreous humor

D

A patient with bilateral cataracts is scheduled for an extracapsular cataract extraction with an intraocular lens implantation of 1 eye. What should be done by the nurse preoperatively? a. Assess the visual acuity in the unoperated eye to plan the need for postoperative assistance. b. Inform the patient that the operative eye will need to be patched for 3 to 4 days postoperatively. c. Assure the patient that vision in the operative eye will be improved to near normal on the first postoperative day. d. Teach the patient routine coughing and deep-breathing techniques to use postoperatively to prevent respiratory complications.

A

Following a pneumatic retinopexy, what does the nurse need to know about the postoperative care for the patient? a. Specific positioning and activity restrictions are likely to be required for days or weeks. b. The patient is frequently hospitalized for 7 to 10 days on bed rest until healing is complete. c. Patients experience little or no pain, and development of pain indicates hemorrhage or infection. d. Reattachment of the retina commonly fails, and patients can be expected to grieve for loss of vision.

A

Priority Decision: When obtaining a health history from a patient with cataracts, it is most important for the nurse to ask about the patient's use of which drug? a. Corticosteroids b. Oral hypoglycemic agents c. β-Adrenergic blocking agents d. Antihistamines and decongestants

A

To determine if an unconscious patient has contact lenses in place, what should the nurse do? a. Use a penlight to shine a light obliquely over the eyeball. b. Apply drops of fluorescein dye to the eye to stain the lenses yellow. c. Touch the cornea lightly with a dry cotton ball to see if the patient reacts. d. Tense the lateral canthus to cause a lens to be ejected if it is present in the eye.

A

Endophthalmitis can be a complication of intraocular surgery or penetrating ocular injury. What manifestations are expected when the nurse assesses a patient with this disorder (select all that apply)? a. Ocular pain b. Photophobia c. Eyelid edema d. Reddened sclera e. Bleeding conjunctiva f. Decreased visual acuity ABF

A,B,F

What are possible abnormal assessment findings when assessing the eyelid (select all that apply)? a. Ptosis b. Strabismus c. Blepharitis d. Anisocoria e. Swollen pinna A,C

A,C

Which characteristics of glaucoma are associated with only acute primary angle-closure glaucoma (PACG) (select all that apply)? a. Caused by lens blocking papillary opening b. Treated with trabeculoplasty or trabeculectomy c. Causes loss of central vision with corneal edema d. Treated with β-adrenergic blockers, such as betaxolol (Betoptic) e. Causes sudden, severe eye pain associated with nausea and vomiting f. Treated with hyperosmotic oral and IV fluids to lower intraocular pressure ACEF

A,C,E,F

For the patient with a retinal break, what extraocular techniques may be used with sclera buckling to seal the break by creating an inflammatory reaction that causes a chorioretinal adhesion or scar (select all that apply)? a. Cryopexy b. Vitrectomy c. Pneumatic retinopexy d. Laser photocoagulation e. Penetrating keratoplasty A,D

A,D

Myopia is present in 30% of Americans. Which characteristics are associated with myopia (select all that apply)? a. Excessive light refraction b. Abnormally short eyeball c. Unequal corneal curvature d. Corrected with concave lens e. Image focused in front of retina ADE

A,D,E

When teaching the patient about the new diagnosis of glaucoma, which characteristics relate only to primary open-angle glaucoma (POAG) (select all that apply)? a. Gradual loss of peripheral vision b. Treated with iridotomy or iridectomy c. Causes loss of central vision with corneal edema d. May be caused by increased production of aqueous humor e. Treated with cholinergic agents, such as pilocarpine (Pilocar) f. Resistance to aqueous outflow through trabecular meshwork ADF

A,D,F

Priority Decision: What nursing action is most important for the patient with age-related dry macular degeneration (AMD)? a. Teach the patient how to use topical eyedrops for treatment of AMD. b. Emphasize the use of vision enhancement techniques to improve what vision is present. c. Encourage the patient to undergo laser treatment to slow the deposit of extracellular debris. d. Explain that nothing can be done to save the patient's vision because there is no treatment for AMD.

B

To prepare a patient for a fluorescein angiography, what should the nurse explain about the test? a. Measures curvature of the cornea b. Involves IV dye injection to evaluate blood flow through retinal blood vessels c. Includes application of eyedrops containing a dye that will localize arterial abnormalities in the retina d. Anesthetizes the eye so that probes can be inserted into the anterior chamber to measure intraocular pressure

B

What best describes pink eye? a. Blindness b. Acute bacterial conjunctivitis c. Epidemic keratoconjunctivitis d. Chronic inflammation of sebaceous glands

B

A 60-year-old patient is being prepared for outpatient cataract surgery. When obtaining admission data from the patient, what would the nurse expect to find in the patient's history? a. A painless, sudden, severe loss of vision b. Blurred vision, colored halos around lights, and eye pain c. A gradual loss of vision with abnormal color perception and glare d. Light flashes, floaters, and a "cobweb" in the field of vision with loss of central or peripheral vision

C

A patient with wet AMD is treated with photodynamic therapy. What does the nurse instruct the patient to do after the procedure? a. Maintain the head in an upright position for 24 hours. b. Avoid blowing the nose or causing jerking movements of the head. c. Completely cover all the skin to avoid a thermal burn from sunlight. d. Expect to experience blind spots where the laser has caused retinal damage.

C

Priority Decision: A patient is admitted to the emergency department with a wood splinter imbedded in the right eye. Which intervention by the nurse is most appropriate? a. Irrigate the eye with a large amount of sterile saline. b. Carefully remove the splinter with a pair of sterile forceps. c. Cover the eye with a dry sterile patch and a protective shield. d. Apply light pressure on the closed eye to prevent bleeding or loss of aqueous humor.

C

What accurately describes the conjunctiva? a. Junction of the upper and lower eyelids b. Point where the optic nerve exits the eyeball c. Transparent mucous membrane lining the eyelids d. Drains tears from the surface of the eye into the lacrimal canals

C

What is an important health promotion nursing intervention for a middle-aged adult related to glaucoma? a. Teach people at risk for glaucoma about early signs and symptoms of the disease. b. Prepare patients with glaucoma for lifestyle changes necessary to adapt to eventual blindness. c. Promote measurements of intraocular pressure every 2 to 4 years for early detection and treatment of glaucoma. d. Inform patients that glaucoma is curable if eye medications are administered before visual impairment has occurred.

C

What is the function of the sclera? a. Secrete aqueous humor b. Focus light rays on the retina c. Protective outer layer of the eyeball d. Photoreceptor cells stimulated in dim environments

C

When examining the patient's eye with an ophthalmoscope, the nurse would consider which finding to be of most concern? a. No blood vessels in the macula b. Depression at the center of the optic disc c. A break in the retina at the site of the macula d. Pieces of liquefied vitreous in the vitreous chamber

C

When the patient has a diagnosis of hyperthyroidism, which abnormal assessment of the eye could be found? a. Light intolerance b. Unequal pupil size c. Protrusion of eyeball d. Deviation of eye position

C

A patient tells the nurse on admission to the health care facility that he has finally been classified as legally blind. What does the nurse understand about the patient's vision? a. Has lost usable vision but has some light perception b. Will need time for grieving and adjusting to living with total blindness c. Will be dependent on others to ensure a safe environment for functioning d. May be able to perform many tasks and activities with vision enhancement techniques

D

A patient with early cataracts tells the nurse that he is afraid cataract surgery may cause permanent visual damage. What should the nurse teach the patient? a. The cataracts will only worsen with time and should be removed as early as possible to prevent blindness. b. Cataract surgery is very safe, and with the implantation of an intraocular lens, the need for glasses will be eliminated. c. Progression of the cataracts can be prevented by avoidance of ultraviolet (UV) light and good dietary management. d. Vision enhancement techniques may improve vision until surgery becomes an acceptable way to maintain desired activities.

D

The nurse documents PERRLA following assessment of a patient's eyes. What assessment finding supports this statement? a. A slightly oval shape of the pupils b. The presence of nystagmus on far lateral gaze c. Dilation of the pupil when a light is shined in the opposite eye d. Constriction of the pupils when an object is brought closer to the eyes

D

The patient is diagnosed with presbyopia. When he asks the nurse what that is, what is the best explanation the nurse can give to the patient? a. Absence of the lens b. Abnormally long eyeballs c. Correctable with cylinder lens d. Loss of accommodation associated with age

D

What should the nurse teach all patients with conjunctival infections to use? a. Artificial tears to moisten and soothe the eyes b. Dark glasses to prevent the discomfort of photophobia c. Iced moist compresses to the eyes to promote comfort and healing d. Frequent and thorough hand washing to avoid spreading the infection

D