prepU ch 63 Assessment and Management of Patients With Hearing and Balance Disorders

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After surgery for removal of cataract, a client is being discharged, and the nurse has completed discharge instruction. Which client statement indicates that the outcome of the teaching plan has been met?

"I should avoid pulling or pushing any object that weighs more than 15 lbs."

The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer?

"This test measures peripheral vision and detects gaps in the visual field."

A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate?

"You'll need to use the drops for the rest of your life to control the glaucoma."

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye?

20/200

A patient comes to the clinic with a suspected eye infection. The nurse recognizes that the patient most likely has conjunctivitis, as evidenced by what symptom?

A mucopurulent ocular discharge

The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform?

Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

A nurse is working with a client in an optometrist office. What is the role of the nurse with a client who is undergoing an eye examination and tests? Select all that apply.

Assuring that the client receives eye care to preserve eye function and prevent further visual loss Assessing and obtaining an accurate baseline of the function and structure of the eyes Explaining the temporary inability to maintain visual focus after mydriatic eye medications

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient?

Blurred vision results after application.

A patient has been diagnosed with bacterial conjunctivitis that was sexually transmitted. The nurse informs the patient that the isolated organism is which of the following?

Chlamydia trachomatis

Which of the following is the main refracting surface of the eye?

Cornea

What type of medication would the nurse use in combination with mydriatics to dilate the patient's pupil?

Cycloplegics

The nurse is assessing a client's visual acuity using a Snellen chart. The client states he cannot read the letter at the top of the chart. What action should the nurse do next?

Determine whether the client can count fingers.

A client has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the client tells the nurse that she has stopped using the medication because her vision did not improve. Which action by the nurse is appropriate?

Explain the therapeutic effect and expected outcome of the medication.

The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client?

Face the client when speaking directly to him.

The nurse should monitor for which manifestation in a client who has undergone LASIK?

Halos and glare

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry red in color?

Hemangioma

The upper eyelid normally covers the uppermost portion of the iris and is innervated by which cranial nerve?

III

A client presents to the ED reporting a chemical burn to both eyes. Which is the prioritynursing intervention?

Irrigate both eyes.

A nurse conducted a history and physical for a newly admitted patient who states, "My arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing:

Loss of accommodative power in the lens.

During a routine eye examination, a patient complains that she is unable to read road signs at a distance when driving her car. What should the patient be assessed for?

Myopia

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory conditions of the eyes?

NSAIDs

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treating inflammatory conditions of the eyes?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A 68-year-old client reports a change in vision when driving during the night. Which strategies would the nurse recommend to mitigate this problem?

Recommend contrast sensitivity testing measures to determine visual function.

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

Retinal Angiography

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?

Scleral buckle

Which of the following occurs when there is deviation from perfect ocular alignment?

Strabismus

The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment?

The power of the lens to accommodate will be decreased.

When conducting an eye exam, the nurse practitioner is aware that a diagnostic clinical manifestation of glaucoma is:

The presence of halos around lights.

A client accidentally splashes chemicals into one eye. The nurse knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first aid treatment?

To prevent vision loss

To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it:

Up and backward.

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection?

Viral

A client is in the ED after being struck in the left eye with a baseball, leaving a large ecchymosis and edema. In client education, the nurse explains to the client the functions of the various structures of the eye. What are functions of the eyelids? Select all that apply.

impact ocular light spread tears

The most common site of metastasis in clients diagnosed with rhabdomyosarcoma is the

lungs

A nurse is obtaining a history from a new client with glaucoma. The client indicates having read about the diagnosis and understanding that this type of glaucoma is due to the degeneration and obstruction of the trabecular meshwork, whose original function is to absorb the aqueous humor. The loss of absorption will lead to an increased resistance, and thus a chronic, painless buildup of pressure in the eye. Which type of glaucoma has the client described?

open angle

A client with multiple sclerosis is being seen by a neuro-ophthalmologist for a routine eye exam. The nurse explains to the client that during the examination, the client will be asked to maintain a fixed gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when the object becomes visible The nurse further explains that the test being performed is called a:

perimetry test

A client has noticed needing to hold printed material at arms length to make the print readable. What is the term used to describe this visual condition?

presbyopia

A nurse notices that a client's left upper eyelid is drooping. The nurse has observed:

ptosis

After a fall at home, a client hits their head on the corner of a table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms?

retinal detachment

When the client tells the nurse that his vision is 20/200 and then asks what that means, the nurse informs the client that a person with 20/200 vision

sees an object from 20 feet away that a person with normal vision sees from 200 feet away.


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