N310 Ch 22 practice questions

The patient calls the clinic about a "sty" that she has had for some time on her upper eyelid. She says she has used warm moist compresses, but it is no better. What should the nurse tell her to do? "Go to the pharmacy to get some eye drops." "Come in so the ophthalmologist can remove the lesion for you." "The health care provider will need to inject it with an antibiotic." "Wash the lid margins with baby shampoo to remove the crusting."

"Come in so the ophthalmologist can remove the lesion for you." A chalazion may evolve from a "sty" or hordeolum as it did for this patient. Initial treatment is with warm compresses, but when they are ineffective, the lesion may be surgically removed or injected with corticosteroids. Washing the lid margins with baby shampoo is done with blepharitis.

When performing teaching with a patient with glaucoma while administering a scheduled dose of pilocarpine, the nurse would include which statement? "Prolonged eye irritation is an expected adverse effect of this medication." "This medication will help to raise intraocular pressure to a near normal level." "This medication needs to be continued for at least 5 years after your initial diagnosis." "It is important not to do activities requiring visual acuity immediately after administration."

"It is important not to do activities requiring visual acuity immediately after administration." Pilocarpine causes blurred vision and difficulty in focusing, so it is important not to engage in any activities requiring visual acuity until the vision clears.

You are providing care for a 73-year-old male patient who has sought care because of a loss in his hearing acuity over the past several years. Which statement by the nurse is most accurate? "This is often due to an infection that will resolve on its own." "Many people experience an age-related decline in their hearing." "This is likely an effect of your medications. Try stopping them for a few days." "You can likely accommodate for your hearing loss with a few small changes in your routine."

"Many people experience an age-related decline in their hearing." Presbycusis is a loss of hearing that is both common and age-related. Infections are most often accompanied by different symptoms. It would be inappropriate to counsel the patient to stop his medications. It would be simplistic to advise the patient to accommodate the hearing loss rather than seek intervention.

When teaching a patient about the pathophysiology related to open-angle glaucoma, which statement is most appropriate? "The retinal nerve is damaged by an abnormal increase in the production of aqueous humor." "There is decreased draining of aqueous humor in the eye, causing pressure damage to the optic nerve." "The lens enlarges with normal aging, pushing the iris forward, which then covers the outflow channels of the eye." "There is a decreased flow of aqueous humor into the anterior chamber by the lens of the eye blocking the papillary opening."

"There is decreased draining of aqueous humor in the eye, causing pressure damage to the optic nerve." With primary open-angle glaucoma, there is increased intraocular pressure because the aqueous humor cannot drain from the eye. This leads to damage to the optic nerve over time. Primary angle-closure glaucoma is caused by the lens bulging forward and blocking the flow of aqueous humor into the anterior chamber.

Which statement is most appropriate when teaching a patient about timolol (Timoptic) eye drops in the treatment of glaucoma? "You may feel some palpitations after instilling these eye drops." "You should withhold this medication if your blood pressure becomes elevated." "You may have some temporary blurring of vision after instilling these eye drops." "You should keep your eyes closed for 15 minutes after instilling these eye drops."

"You may have some temporary blurring of vision after instilling these eye drops." It is common for patients to have a temporary blurring of vision for a few minutes after instilling eye drops. This should not cause concern to the patient. Because timolol is a β-blocker, heart rate may slow, and blood pressure is more likely to decrease if absorbed systemically.

Which finding related to primary open-angle glaucoma would the nurse expect to find when reviewing a patient's history and physical examination report? Absence of pain or pressure Blurred vision in the morning Seeing colored halos around lights Eye pain accompanied with nausea and vomiting

Absence of pain or pressure Primary open-angle glaucoma is typically symptom-free, which explains why patients can have significant vision loss before a diagnosis is made unless regular eye examinations are being performed. Primary angle-closure glaucoma manifestations include sudden, excruciating pain in or around the eye, seeing colored halos around lights, and nausea and vomiting.

When using the otoscope, the nurse is unable to see the landmarks or light reflex of the tympanic membrane. The tympanic membrane is bulging and red. What does the nurse think is most likely occurring in the patient's ear? Swimmer's ear Acute otitis media Impacted cerumen Chronic otitis media

Acute otitis media The manifestations of inability to see the landmarks or light reflex of the tympanic membrane and the bulging and redness of the tympanic membrane are those of acute otitis media. With swimmer's ear and chronic otitis media, there is frequently drainage in the external auditory canal. Impacted cerumen would block the visualization of the tympanic membrane.

A patient with poor visual acuity is diagnosed with age-related macular degeneration (AMD). Which nursing intervention should be the nurse's priority? Teach about visual enhancement techniques. Teach nutritional strategies to improve vision. Assess coping strategies and support systems. Assess impact of vision on normal functioning.

Assess impact of vision on normal functioning. The most important nursing intervention is to assess the patient's ability to function with the visual impairment. The nurse will use this information to plan nursing care including assessment of the patient's coping strategies and teaching about vision enhancement techniques and nutrition.

The patient with Ménière's disease had decompression of the endolymphatic sac to reduce the frequent and incapacitating attacks she was experiencing. What should the nurse include in the discharge teaching for this patient? Airplane travel will be more comfortable now. Avoid sudden head movements or position changes. Cough or blow the nose to keep the Eustachian tube clear. Take antihistamines, antiemetics, and sedatives for recovery.

Avoid sudden head movements or position changes. After ear surgery the patient should avoid sudden head movements or position changes. The patient should not cough or blow the nose because this increases pressure in the Eustachian tube and middle ear cavity and may disrupt healing. Airplane travel should be avoided at first as increased pressure and ear popping is normally experienced, which will disrupt healing. Antihistamines, antiemetics, and sedatives are used to decrease the symptoms of acute attacks of Ménière's disease

Before administrating timolol (Timoptic) eye drops for treatment of glaucoma, the nurse would assess the patient for which contraindication for the use of this medicine? Sinusitis Migraine headaches Chronic urinary tract infection Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease Timolol is a nonselective β-adrenergic blocker that could lead to bronchoconstriction and bronchospasm. For this reason, it should not be used in patients with COPD. Timolol may be used to treat migraine headaches, and it does not affect sinusitis or chronic urinary tract infections.

Which instruction is most appropriate for a patient using contact lenses who is diagnosed with bacterial conjunctivitis? Discard all opened or used lens care products. Disinfect contact lenses by soaking in a cleaning solution for 48 hours. Put all used cosmetics in a plastic bag for 1 week to kill any bacteria before reusing. Disinfect all lens care products with the prescribed antibiotic drops for 1 week after infection.

Discard all opened or used lens care products. The patient who wears contact lenses and develops infections should discard all opened or used lens care products and cosmetics to decrease the risk of reinfection from contaminated products. The risk of conjunctivitis is increased with not disinfecting lenses properly, wearing contact lenses too long, or using water or homemade solutions to store and clean lenses.

When planning care for a patient with disturbed sensory perception related to increased intraocular pressure caused by primary open-angle glaucoma, what should the nurse focus on? Recognizing that eye damage caused by glaucoma can be reversed in the early stages Giving anticipatory guidance about the eventual loss of central vision that will occur Encouraging compliance with drug therapy for the glaucoma to prevent loss of vision Managing the pain experienced by patients with glaucoma that persists until the optic nerve atrophies

Encouraging compliance with drug therapy for the glaucoma to prevent loss of vision Drug therapy is necessary to prevent the eventual vision loss that may occur as a consequence of glaucoma. For this reason, encourage the patient to remain compliant with drug therapy.

An acoustic neuroma is removed from a patient, and the nurse instructs the patient about tumor recurrence. What should the nurse instruct the patient to monitor (select all that apply)? Episodes of dizziness Lack of coordination Worsening of hearing Inability to close the eye Clear drainage from the nose

Episodes of dizziness Worsening of hearing Inability to close the eye An acoustic neuroma is a unilateral benign tumor that occurs where the vestibulocochlear nerve (CN VIII) enters the internal auditory canal. Clinical manifestations of tumor recurrence including facial nerve (CN VII) paralysis can be manifested by intermittent vertigo, hearing loss, and inability to close the eye. Lack of coordination and clear nasal drainage do not manifest with acoustic neuroma.

When administering eye drops to a patient with glaucoma, which nursing measure is most appropriate to minimize systemic effects of the medication? Apply pressure to each eyeball for a few seconds after administration. Have the patient close the eyes and move them back and forth several times. Have the patient put pressure on the inner canthus of the eye after administration. Have the patient try to blink out excess medication immediately after administration.

Have the patient put pressure on the inner canthus of the eye after administration. Systemic absorption can be minimized by applying pressure to the inner canthus of the eye. The other options will not minimize systemic effects of the medication.

When administering a scheduled dose of pilocarpine, in which area should the nurse place the drops? Inner canthus Outer canthus Center of the eyeball Lower conjunctival sac

Lower conjunctival sac Ocular medications such as pilocarpine should be instilled into the lower conjunctival sac. Never apply eye drops directly to the cornea. Applying the drops to the inner canthus will cause them to be distributed systemically.

A patient has severe myopia. Which type of correction is the patient planning to have if she tells you, "I can't wait to be able to see after they implant a contact lens over my lens"? Photorefractive keratectomy (PRK) Phakic intraocular lenses (phakic IOLs) Refractive intraocular lens (refractive IOL) Laser-assisted in situ keratomileusis (LASIK)

Phakic intraocular lenses (phakic IOLs) Phakic intraocular lenses (phakic IOLs) is the implantation of a contact lens in front of the natural lens. PRK is used with low to moderate amounts of myopia, and the epithelium is removed and the laser sculpts the cornea to correct the refractive error. Refractive IOL is also for patients with a high degree of myopia or hyperopia and involves removing the natural lens and implanting an intraocular lens. LASIK surgery is similar to PRK except that the epithelium is replaced after surgery.

he patient needs, but does not want, a corneal transplant because of the difficulty with vision that may last for up to 12 months after the transplant. What can the nurse teach the patient about this? If the transplant is done soon after the donor dies, there will not be as much trouble recovering vision. The astigmatism the patient is experiencing may be corrected with glasses or rigid contact lenses. Increasing the amount of light and using a magnifier to read will be helpful if a transplant is not wanted. There are newer procedures where only the damaged cornea epithelial layer is replaced, and they have a faster recovery.

There are newer procedures where only the damaged cornea epithelial layer is replaced, and they have a faster recovery. The new procedures are called Descemet's stripping endothelial keratoplasty (DSEK) and Descemet's membrane endothelial keratoplasty (DMEK). Corneal transplants should be done as soon as possible, but this does not affect the rate of visual recovery. Astigmatism is not experienced with corneal scars and opacities requiring a corneal transplant. Increasing light and magnification helps a person with cataracts to read.

A patient with septic shock is receiving multiple medications. Which IV medication is most likely to cause a hearing loss? Dopamine (Intropin) Ampicillin (Principen) Aspirin (Bayer Aspirin) Vancomycin (Vancocin)

Vancomycin (Vancocin) The IV medication in use that is most likely to cause a hearing loss is vancomycin (Vancocin) because it is an ototoxic medication. For that reason, serum drug levels are monitored to maintain therapeutic levels and reduce the risk of ototoxicity. Aspirin can also cause hearing loss, but it is not administered IV. Neither dopamine nor ampicillin is likely to cause hearing loss.

A male patient is recovering from a motor vehicle accident that left him blind. He is withdrawn and refuses to get out of bed. What is the nurse's priority goal for this patient? Use suitable coping strategies to reduce stress. Identify patient's strengths and support system. Verbalize feelings related to visual impairment. Transition successfully to the sudden vision loss.

Verbalize feelings related to visual impairment. The nurse's priority is to help the patient express his feelings about his vision loss because he is not coping effectively with his situation. Until the patient expresses how he feels, he will be unable to progress in his rehabilitation process.