Nur165 Sensorineural Comprehensive Study

Legal blindness defined as BCVA that does not exceed __/__ in the better eye or whose widest visual field diameter is __ degrees or less.

20 200 20

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

20, 200

target IOP for patient undergoing treatment for high IOP is typically ____% lower than their current IOP.

30 (IE, the goal of treatment is to lower IOP by 30%)

The ________ test is a hearing test, primarily for evaluating loss of hearing in one ear (unilateral hearing loss). It compares perception of sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid. Thus, one can quickly screen for the presence of conductive hearing loss.

Rinne

an ______ is a branch of medicine concerned with care and diseases of the eye. ophthalmologist optometrist optician

a

which meds dilate the pupil? mydriatics beta blockers sympathomimetics miotics

a

which of the following describes a condition characterized by abnormal spongy bone formation around the stapes? otosclerosis chronic otitis media otitis externa middle ear effusion

a

which of the following is inconsistant with acute otitis media? it is a relatively uncommon childhood infection a purulent exudate is usually present in the middle ear conductive hearing loss may occur the infection usually lasts less than 6 weeks

a

which of the following is the overall aim of glaucoma treatment? prevent optic nerve damage reattach the retina reverse optic nerve damage optimize the patient's remaining vision

a

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 pneumatic retinopexy pars plana vitrectomy phacomulsification

a

which of the manifestations is the most problematic for a patient diagnosed with Meniere's disease? vertigo tinnitus diaphoresis hearing loss

a

which medication might cause ototoxicity? Garamycin (gentamicin) Amoxacillin (erythromycin) Rocephin (ceftriaxone) Sulfazine

a (Aminoglycosides are useful primarily in infections involving aerobic, Gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some Mycobacteria, including the bacteria that cause tuberculosis, are susceptible to aminoglycosides. Since they are not absorbed from the gut, they are administered intravenously and intramuscularly. the second is a penicillin, the third is a cephalosporin, and the fourth is a sulfonamide)

which of the following classification of medications is the most common cause of ototoxicity? aminoglycosides sulfonamides cephalosporin penicillan

a (IV meds, especially aminoglycosides, are the most common cause of ototoxicity)

A patient has a normal sensory change that results in diminished sense of taste. How would this be documented? Hypogeusia Odynophagia Xerostomia Arthralgia

a (Rationale: A diminished sense of taste is referred to as hypogeusia. Odynophagia refers to pain upon swallowing. Xerostomia refers to dry mouth that occurs with salivary gland dysfunction. Arthralgia refers to pain in a joint.)

When the visiting nurse is teaching the family of a patient with acute conjunctivitis regarding the disease process, the nurse emphasizes which of the following statements as most important? Wash hands before and after instilling eye drops. Cleanse the patient's contact lenses twice each day. Ask patient to gently rub eyes to circulate the eye drops after instillation. Use a cotton-tipped swab to cleanse the right eye and then the left eye.

a (Rationale: Acute conjunctivitis is highly contagious. Teach the family to wash hands thoroughly before and after instilling eye medication. Contact lens use should be avoided until the infection has cleared. Rubbing the eyes increases the risk of corneal trauma. Using a new swab between eyes prevents cross-contamination.)

A 78-year-old client is admitted to the Emergency Department (ED) via emergency medical service (EMS) with complaints of severe diarrhea with resultant weakness and signs of dehydration. Discussion with the significant other reveals that the patient continually eats spoiled foods. Which of the following might be most directly related to this patient's behavior? Damage to cranial nerve I Damage to cranial nerve II Damage to cranial nerve III Damage to cranial nerve IV

a (Rationale: Although hyposmia (impaired sense of smell) might be due to age-related changes, it might also be the result of olfactory nerve damage (cranial nerve I), since this nerve is the sole innervation for smell. Cranial nerve II is responsible for constriction of the pupils, and IV the superior oblique muscle. Cranial II would affect vision, but an intact CN I would allow the individual to identify the odor of spoiled food accurately.)

A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on: Encouraging compliance with drug therapy to prevent loss of vision. Recognition that damage to the eye caused by glaucoma can be reversed until the late stages of the disease. Management of the severe pain experienced until the optic nerve atrophies. Anticipatory guidance, since with or without treatment, the patient eventually will lose peripheral vision.

a (Rationale: Management of glaucoma involves lowering the intraocular pressure to cease drainage to the optic nerve and further vision loss. Therapy involves medications to decrease intraocular pressure. It is critical that the patient understand the importance of compliance with the medication regimen. Glaucoma needs to be controlled to prevent damage that cannot be reversed. Pain is considered an emergency, so if it was identified, the patient would need immediate intervention. Loss of peripheral vision is a concern, but the priority is to encourage the patient to be compliant with medications to prevent further damage to the vision.)

Which of the following statements by a patient with newly prescribed contact lenses indicates a need for additional teaching? "I think it is so cool that my best friend, Taylor, and I have the same prescription. She has blue lenses and I have brown lenses, so we'll be able to trade to see what we would look like with different eyes." "If I run out of cleaning and wetting solution, I'll have to wait until I get a new supply before I'll be able to wear my lenses again." "I'll follow the manufacturer's guide to tell me when I need to take them out." "If I have eye redness or pain in my eyes, I'll take out my lenses and call the ophthalmologist first thing."

a (Rationale: Manufacturer's recommendations indicate to the wearer proper length of time for wear, cleaning, and storing. Patients are instructed to use cleaning and wetting solutions recommended by the optometrist, ophthalmologist, or lens manufacturer. Patients are instructed not to use water or homemade solutions for wetting or cleaning lenses. If eye redness, tearing, vision loss, or pain occurs, the patient should remove the lenses and contact the eye care professional as soon as possible. Lenses should not be shared or "tried on" by another person.)

Which of the following physical assessment maneuvers will allow the nurse to differentiate the ear pain of a patient with otitis externa from the ear pain of a patient with otitis media? Manipulation of the auricle Irrigating the ear canal with cool water Rinne and Weber tests Whisper test

a (Rationale: The pain of otitis externa can be differentiated from that associated with otitis media by the manipulation of the auricle. In external otitis, this maneuver increases pain, whereas the patient with otitis media experiences no change in pain perception. Rinne and Weber tests are used to diagnose sensorineural hearing loss. The caloric test (irrigation with cool water) evaluates vestibulo-ocular reflex. The whisper test evaluates hearing loss.)

Which test uses a tuning fork shifted between two locations to assess hearing? Rinne's Whisper test Watch Tick Weber's

a (Weber's is on top of the head)

________ occurs when there is a deviation from perfect ocular alignment: strabismus nystagmus chemosis ptosis

a (nystagmus is involuntary oscillation of the eyeball, chemosis is edema of the conjunctiva)

which of the following would be an inaccurate clinical manifestation of retinal detachment? pain cobwebs sudden onset of a greater number of floaters bright flashing lights

a (patients do not complain of pain with this condition)

_______ is the altered sensation of orientation in space. dizziness vertigo tinnitus nystagmus

a (vertigo would be the illusion of movement)

which test distinguishes between conductive and sensorineural hearing loss? Rinne's Whisper test Watch Tick Weber's

a (weber test assesses bone conduction and lateralization of sound.)

Which of the following drugs are associated with hearing impairment? Select all that apply. Gentamicin (Garamycin) Cis-platinum (Platinol) Furosemide (Lasix) Digoxin (Lanoxin)

a b c (Rationale: Digoxin (Lanoxin) causes vision changes, but does not affect hearing. Aminoglycosides such as gentamicin, antineoplastics such as cis-platinum, diuretics such as furosemide, antispasmodics such as baclofen, and propranolol cause changes in hearing ability.)

Which of the following is true of presbycusis? (Select all that apply.) Dysfunction with the cochlea and auditory nerve Ménière's disease and tumors Changes due to accumulation of cerumen Infections of the inner ear

a b d (Rationale: Presbycusis is hearing loss associated with aging, and affects approximately 75% of people over the age 60. Loss of hair cells in the cochlea (sensory loss) and degradation of neurons (neural loss) result in this form of hearing loss. Presbycusis occurs gradually, and usually is bilateral. Answer 3 describes a conductive hearing loss.)

a _______ conduct eye test and prescribe corrective lenses. ophthalmologist optometrist optician

b

most common cause of visual loss in those over 60? glaucoma macular degeneration cataracts retinal detachment

b

what portion of the middle ear equalizes pressure? ossicles tympanic membrane auricle cochlea

b

which meds decrease production of aqueous humor? mydriatics beta blockers sympathomimetics miotics

b

which of the following is a correct rationale for encouraging a patient to eat soft foods when suffering from otitis externa? chewy foods, such as red meat, may interact with prescribed analgesics and antibiotics chewing may cause discomfort chewing may cause excessive drainage chewing may lead to further complications such as otitis externa

b

You are the nurse assigned to care for an elderly client. While assessing the ears of the patient, you observed dry, hard cerumen developing in the ear canal. Which of the following actions should you take? Do nothing, since this a normal finding in the older adult. Document finding and report your concern to the physician. Irrigate the ear canal with a mixture of hydrogen peroxide and normal saline. Ask the patient if he is experiencing any discomfort.

b (Rationale: Cerumen or earwax produced by the ceruminous glands is a normal finding in the ear canal. However, in the older adult, cerumen tends to be dryer and harder, and accumulates in the ear canal due to decreased activity of the apocrine glands. Hearing will become impaired if the cerumen accumulates to impact the canal. Irrigation should be tried after other attempts fail. Therefore, documentation and reporting to the primary care provider will help avoid unnecessary alteration in hearing.)

A client has noticed a decrease in taste sensation. Which of the following cranial nerves are most likely involved? CN V and CN VII CN IX and CN VII CN VIII and CN V CN VI and CN X

b (Rationale: Cranial nerves VII and IX supply sensation to the tongue.)

The nurse's first action for a patient who presents to the Emergency Department with manifestations of corneal perforation is to: Contact the patient's ophthalmologist. Place the patient in a supine position. Cover the eye with gauze. Administer tears for dry eyes.

b (Rationale: If corneal perforation is suspected, the nurse should first place the patient in the supine position, then close the eye, and cover it with a dry, sterile dressing. Thereafter, the nurse should notify either the patient's ophthalmologist or an on-call ophthalmologist to see the patient. The complications of corneal perforation include infection of deep eye structures and loss of ocular contents. Nothing should be placed in the eye.)

A spry 77-year-old female patient has been diagnosed with simple glaucoma. She lives alone, takes medications for asthma, is on a fixed income, and walks to Catholic Mass on Sunday mornings. The nurse must be certain that the ophthalmologist is aware of which of the aforementioned facts about the patient? Lives alone. Takes medications for asthma. Lives on a fixed income. Walks to Catholic Mass on Sundays.

b (Rationale: Living alone and a fixed income should be concerns addressed through a Social Services consultation. The patient could be listed on a clergy visit list if hospitalized. Most importantly, the nurse wants to be certain that the patient takes medications for asthma because beta-adrenergic blockers are used topically to treat glaucoma. In asthmatic patients, beta-adrenergic blockers can cause bronchospasm, and are contraindicated)

Which of the following physiologic changes would be expected in a patient with presbyopia? Degeneration of the cornea Loss of lens elasticity Decreased distance vision abilities Decreased adaptation to darkness

b (Rationale: The lens loses elasticity or pliability, decreasing its ability to change shape in order to accommodate for near vision. Response 4 is indicative of cataracts, 3 is myopia, and 1 is due to corneal changes.)

edema of the conjunctiva is termed: proptosis chemosis papilledema strabismus

b (chemosis is edema of the conjunctiva, papilledema refers to swelling of the optic disk due to increased intracranial pressure, strabismus is a deviation from perfect ocular alignment.)

_______ is the illusion of movement. dizziness vertigo tinnitus nystagmus

b (dizziness is a sense of altered orientation in space)

people with hyperopia have ______ nearsighted far sighted astigmatism normal vision

b (normal vision is emetropia)

which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color? nevi hemangioma Xanthelasma milia

b (xanthelasma are small, yellowish lipoid deposits near the inner corner of the eye)

The nurse is caring for a patient who has a hearing deficit. Which of the following techniques should be implemented by the nurse to improve communication? (Select all that apply.) Keep the patient's face in full light. Use a low voice pitch with normal loudness. Speak at a slower rate than usual. Use short sentences.

b d (Rationale: Techniques to improve communication with a patient with a hearing loss include keeping one's face in full light-placing light in the patient's face will prevent patient from seeing the speaker; using a low voice pitch with normal loudness; speaking at a normal rate, and not overarticulating; and using short sentences, and pausing at the end of each sentence.)

A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry? "If the eyeball is too long for the power of the lens, it is called hypermetropia." "A shortened eyeball is called myopia." "The lens is normally transparent." "Refraction is when the eyes adjust to seeing objects at various distances."

c

a _______ is a fitter or supplier of glasses and contact lenses who does not examine eyes. ophthalmologist optometrist optician

c

acoustic neuromas are benign tumors of which of the following cranial nerves? VI VII VIII V

c

clinical manifestations of motion sickness are caused by over stimulation in what system? GI cochlear vestibular cardiovascular

c

normal IOP is between 11-26 mmhg 10-20 mmhg 10-21 mmhg 45-60 mmhg

c

which of the following is the leading cause of blindness in the united states? macular degeneration retinal detachment glaucoma cataracts

c

A 76-year-old client tells the nurse that she notices that she is having trouble hearing, especially in large groups. She continues, saying she cannot always tell where the sound is coming from, and the words often sound "mixed up." The nurse should suspect which of the following as the cause for this change? Atrophy of the apocrine glands Cilia in the ear becoming coarse and stiff Nerve degeneration in the inner ear Scarring of the tympanic membrane

c (Rationale: Hearing loss is common in older adults. Changes in the inner ear involve atrophy of the organ of corti and cochlear, and degeneration of the stria vascularis. This is a gradual hearing loss that affects the auditory nerve, which makes words sound garbled, and the ability to localize sound is also impaired. The result is that communication dysfunction is accentuated when background noise is present. Responses 1, 2, and 4 would not affect the sensorineural component of hearing.)

In evaluating the functioning of a client's anterior spinothalamic tract, the nurse is testing for: Hot and cold sensation. Pain sensation. Light touch sensation. Sense of position.

c (Rationale: It is the spinothalamic tract that transmits light (crude) touch sensation.)

A preschool-age child is undergoing bilateral myringotomy with tubes for the treatment of recurrent otitis media. The mother asks the nurse what the tubes will do. The nurse's best response is that the tubes will: Provide for drainage. Prevent future episodes of otitis media. Equalize pressures between the middle ear and the environment. Prevent the spread of infection to the mastoid bone.

c (Rationale: Myringotomy (an incision of the tympanic membrane) is performed to relieve pressure caused by the edema and swelling of otitis media, which impairs the eustachian tubes' ability to equalize pressures between the middle ear and the environment. Without relief of pressure, the tympanic membrane can rupture, the delicate structures of the middle ear can be damaged, and infection can spread to adjoining tissues and structures. Infection can still occur and spread despite myringotomy.)

Which of the following suggestions should be taught by the nurse to the patient with tinnitus to assist the patient with coping with the symptom to promote concentration and sleep? Earplugs Sleeping medication Hearing aid that produces a tone to mask tinnitus Bedtime use of nasal decongestant spray

c (Rationale: Options for masking tinnitus to promote concentrate and sleep include ambient noise from a radio or sound system; masking device or white noise machine; hearing aid that produces a tone to mask the tinnitus; and hearing aid that amplifies ambient sound. Earplugs will focus the patient's attention on the sound. The patient's issue is the noise, not a sleeping disorder; hence, sleeping medications are not indicated. The tinnitus is a result of neurosensory damage, not of congestion.)

You are the nurse assigned to perform an eye assessment on an 80-year-old client. Which of the following findings during the assessment is considered normal? Absence of the red reflex Edematous eyelids with matted eyelashes Equal pupillary constriction in response to light Inflamed conjunctiva

c (Rationale: Pupils are small in old age, and the pupillary light reflex can be slowed, but pupillary constriction should be symmetrical. There should be a red reflex, and the eyelids and conjunctivae should not be edematous or inflamed.)

Which of the following aspects for health teaching regarding acute and chronic conjunctivitis is the most important information to be emphasized to a group of preschool parents? Preventable cause of blindness Importance of early medical diagnosis Mode of transmission Pain management

c (Rationale: The nurse should emphasize to the group ways to prevent the transmission of the infection. Conjunctivitis is highly contagious, and can be transmitted by direct contact with contaminated fomites (e.g., hands, tissues, towels, pillow cases), and some forms can be transmitted to an infant during vaginal delivery. Prevention is the most important aspect of conjunctivitis to be communicated to the group. Pain with acute conjunctivitis is not common.)

When the patient who has undergone cataract extraction is preparing to go home, the nurse reinforces which of the following instructions? Remove the dressing at bedtime. A headache for the first few days after surgery should be expected. Avoid sleeping on the operative side. Set a new appointment with the surgeon for 1 month from today.

c (Rationale: The nurse should reinforce any limitation, such as avoiding reading, lifting, and strenuous activity, and sleeping on the operative side. The patient also needs to understand the importance of not disturbing the eye dressing, of follow-up appointments, and of manifestations of complications such as eye pain, change in vision, headache, or nausea.)

Which of the following nursing diagnoses is the priority diagnosis for a patient with Ménière's disease? Disturbed Sensory Perception: Auditory Disturbed Sleep Pattern Risk for Trauma Social Isolation

c (Rationale: The risk for trauma in patients with inner ear disorders, such as Ménière's disease, is great. Disturbed Sensory Perception: Auditory is a priority nursing diagnosis for patients with hearing loss. Sleep Pattern Disturbance is a priority nursing diagnosis for patients with tinnitus. Risk for Trauma is the priority nursing diagnosis for patients with inner ear disturbances causing balance disorders. Social Isolation is a priority diagnosis for patients with otosclerosis or presbycusis.)

During a hearing assessment, the nurse finds that sound lateralizes to the client's left ear with the Weber and Rinne tests. What should the nurse conclude from this finding? The patient has: A conductive hearing loss in the right ear. Lateralization is a normal finding with the Weber test. Either a sensorineural or conductive hearing loss. The steps in assessing the patient's hearing were done incorrectly.

c (Rationale: When caring for the older person, a thorough history and physical of the person's hearing is important to help determine the cause of hearing loss, which can be conductive, due to external aspect of the ear, or sensorineural, from an inner ear problem. Both tests determine the degree of hearing loss, if any.)

Which of the following should a nurse observe during an ophthalmic assessment? visual acuity IOP external eye appearance internal eye function

c (a qualified examiner assesses the rest)

the red reflex results from shining light on the ______ optic disk eyelid pupil iris

c (absence of this may indicate lens opacity, which may indicate detached retina, cataract, or retinoblastoma)

which of the following preattack symptoms would a person with Miniere's disease report? nystagmus low blood pressure full feeling in the ear photosensitivity

c (also headache)

swelling of the optic disk due to increased intracranial pressure is termed: proptosis chemosis papilledema strabismus

c (chemosis is edema of the conjunctiva, papilledema refers to swelling of the optic disk due to increased intracranial pressure, strabismus is a deviation from perfect ocular alignment.)

Which group of meds cause pupillary constriction? beta blockers adrenergic agonists miotics mydriatics

c (mydriatics cause pupillary dilation, beta blockers decrease production of aqueous humor, adrenergic agonists decrease aqueous humor production and increase outflow.)

which of the following would be a negative result in the cover-uncover test? lack of movement in the uncovered eye lack of color vision in the uncovered eye movement in the uncovered eye inability to identify letters of decreasing size in the uncovered eye

c (this test assesses extraocular muscle function. Movement may indicate weakness in the muscle.)

which meds decrease the size of the pupil, facilitating the outflow of aquous humor and thus decrease IOP? (select all that apply) mydriatics beta blockers sympathomimetics miotics

c, d

the macula is responsible for _______ vision.

central

part of the retina responsible for central vision: optic disk fundus sclera macula

d

people with emetropia have _______ nearsighted far sighted astigmatism normal vision

d

which of the following describes a condition characterized by fluid in the middle ear without evidence of infection? otosclerosis chronic otitis media otitis externa middle ear effusion

d

An 84-year-old client is admitted to the hospital for treatment of diabetes mellitus. On initial interview, the patient reports having difficulty hearing, and informs the nurse that she has too much ear wax. Because of the patient's age, which of the following questions is most important for the nurse to ask the client in relation to her hearing problem? "Have you noticed a change in the color of the ear wax?" "Do you have an upper respiratory tract infection?" "What type of diabetes mellitus do you have?" "Have you ever experienced impacted cerumen?"

d (Rationale: Because the hairs in the ear become coarser during the aging process, retention of wax is more of a cause of hearing loss in older clients. Cerumen, if dry and hard, can impact the ear canal and interfere with hearing.)

The nurse providing postoperative teaching for a patient who has undergone LASIK surgery advises the patient to contact the office if he experiences: Dry eyes. Undercorrection of visual acuity. Decreased night vision with halos. Drainage from the eye.

d (Rationale: Following surgery, patients can experience a temporary loss of sharpness, over- or undercorrection of visual acuity, dry eyes, or temporarily decreased night vision with halos, glare, and starbursts. Bleeding or drainage could indicate a surgical complication, and should be reported immediately.)

The public health nurse is preparing to teach the members of the local swim club about care of the ears. Which of the following statements would be appropriate for the nurse to include? Use a clean cotton swab to dry the ear canal after swimming. A tight-fitting swim cap is preferred to earplugs for keeping water out of the ear. If there is debris in the ear canal, irrigate the ear with cold water. After an episode of acute inflammation, the swimmer should wait 7-10 days before returning to the water.

d (Rationale: Guidelines include: Stay out of the water until the acute inflammatory process is completely resolved-ideally, 7-10 days before resuming water activities; and use silicone earplugs, and dry the outer ear with a towel, then use a hair dryer on the lowest setting several inches from the ear to dry the canal. Do not insert cotton swabs or other objects into the ear canal to dry it. A tight-fitting swim cap does not keep water out of the ear. Repeated exposure to cold water encourages the growth of exostoses in the ear canal.)

The patient with glaucoma has been prescribed travoprost (Travatan), a prostaglandin analog, to improve the outflow of aqueous humor and reduce ocular pressure. Of the following signs or symptoms, which will the nurse teach the patient to report immediately to the eye doctor? Burning in the eye when the eye drops are used Tearing in the eye when the eye drops are used Changes in the color of the eyes Intolerable pain in the eyes after the drops are used

d (Rationale: Prostaglandin analogs have some adverse effects, such as blurred vision and stinging, and, when used long-term, cause permanent darkening of the iris of the eye and eyebrows, increased growth of eyelashes, and conjunctival redness.)

The 77-year-old male smoker has developed cataracts on both eyes, and is awaiting surgery. The cataracts have prevented the patient from driving, reading, and seeing television. Which of the following statements would be appropriate for the nurse in the preoperative holding area to communicate to the patient? "Did your eye doctor explain to you that you could choose to use eye drops six times a day to dissolve the cataract?" "You are wise to have both eyes done at the same time." "If you were a non-smoker, you would never have developed cataracts." "Most patients undergoing cataract surgery do well and enjoy the improved vision."

d (Rationale: Surgical removal is the only treatment used at this time for cataracts; no medical treatment is available to prevent or treat them. Surgical removal of the cataract and lens is indicated when the cataract has developed to the point that vision and activities of daily living are affected. If the patient presents with bilateral cataracts, surgery is only performed on one eye at a time. Complications from cataract surgery are unusual, and occur in less than 1% of the surgeries.)

The patient is in the preoperative holding area, having been brought to surgery from the Emergency Department because of a detached retina. The tear has occurred in the right posterior aspect of the retina. The nurse places the patient in which of the following positions? At a 45-degree angle (semi-Fowler's position) At a 90-degree angle (high Fowler's position) Prone Supine

d (Rationale: The patient's head is positioned so that gravity pulls the detached portion of the retina into closer contact with the choroid. In this example, the patient's head should be flat and turned slightly to the right.)

A client comes to the office with a tentative diagnosis of glaucoma, and is to have testing to determine whether the anterior angle of the eye is open or closed. The patient will require education for which of the following examinations? Tonometry Computed axial tomography Retinography Slit-lamp inspection

d (Rationale: The slit-lamp inspection of the iris is done to assess whether the anterior angle of the eye is open or closed. This is part of a complete dilated examination to inspect the optic nerve and retina. Tonometry measures only the pressure within the eye. Response 2 would be used to take multiple x-rays of the eye tissue, and retinography records the electrical activity of the eye.)

A patient with glaucoma has medication prescribed to decrease intraocular pressure. Which of the following medication should be questioned by the nurse? Timolol maleate (Timoptic) Levobunolol (Betagan) Pilocarpine HCl (Isopto) Artificial tears

d (Rationale: Timoptic, levobunolol, and pilocarpine are drugs usually prescribed for patients with glaucoma and increased intraocular pressure (IOP). Artificial tears are usually prescribed for persons with "dry eyes.")

which test assesses lateralization of sound? Rinne's Whisper test Watch Tick Weber's

d (Rinne's distinguishes between conductive and sensorineural hearing loss)

a deviation from perfect ocular alignment is termed: proptosis chemosis papilledema strabismus

d (chemosis is edema of the conjunctiva, papilledema refers to swelling of the optic disk due to increased intracranial pressure, strabismus is a deviation from perfect ocular alignment.)

unequal pupils = _____: nystagmus strabismus diploplia anisocoria

d (diploplia is double vision)

which of the following medications need to be withheld 5-7 days prior to cataract surgery? lasix prednisone glucophage coumadin

d (prevents retrobulbar hemorrhage)

which of the following is correct advice regarding food for a patient who underwent cataract surgery? eat greens 2-4 times per week eat red meat 2- 4 times per week increase A and C vitamins eat soft, easily chewed foods

d (this prevents excessive facial movements)

The ______ of the _______ is important in determining refractive error.

depth eyeball

people who are far sighted are known in the medical community as having _________

hyperopia

when a patient has shallow eyeballs, they will likely suffer from (myopia or hyperopia?) which is (nearsighted or farsighted?)

hyperopia, farsighted

when a patient is given the Weber test and hears noise louder in one ear than the other, it is known as ________. For example, when this happens in the left ear, it would mean the RIGHT ear had either sensorineural or conductive hearing loss.

laterilization

____ vision is defined as best corrected visual acuity (BCVA) of 20/70 to 20/200

low

people who are near sighted are known in the medical community as having _________

myopia

when a patient has deeper eyeballs, they will likely suffer from (myopia or hyperopia?) which is (nearsighted or farsighted?)

myopia, nearsighted

For the Rinne test, a vibrating tuning fork (typically 512 Hz) is placed initially on the mastoid process behind each ear until sound is no longer heard. Then, the fork is then immediately placed just outside the ear with the patient asked to report when the sound caused by the vibration is no longer heard. A normal or positive Rinne test is when the sound heard outside of the ear (air conduction or AC) is louder than that heard of the initial sound heard when the tuning fork end was placed against the skin on top of the mastoid process behind the ear (bone conduction or BC). Therefore, AC > BC; which is how it is reported clinically for a normal or positive Rinne result. In conductive hearing loss, bone conduction is better than air or BC > AC, a negative Rinne.

okay

In a normal patient, the Weber tuning fork sound is heard equally loud in both ears with no one ear hearing the sound louder than the other (lateralization). Similarly, a patient with symmetrical hearing loss will hear the Weber tuning fork sound equally as well with diagnostic utility only in asymmetric (one-sided) hearing losses. In a patient with hearing loss, the Weber tuning fork sound is heard louder in one ear (lateralization) versus the other. This clinical finding should be confirmed by repeating the procedure and having the patient occlude one ear with a finger; the sound should be heard best in the occluded ear.

okay

Nursing considerations in Eye assessments Assess family history of eye problems Current medications and eye drops, also OTC meds Ask about accidents, injuries, & surgeries Diet history- Vitamin A deficiency can cause conjunctival dryness, and blindness Work Current health problems

okay

Physical assessment of Eyes Observe for .... -head tilt -squinting -noticeable action that offers clues for compensation. Check for.... -redness -lesions -drainage -scleral color -blink reflex

okay

Physical assessment of Eyes Observe for head tilt, squinting, or noticeable action that offers clues for compensation. Check for redness, lesions, drainage, scleral color, blink reflex

okay

The nurse is examining the external eye in an ____________ assessment.

ophthalmic

an _________ practices in a branch of medicine concerned with care and diseases of the eye

ophthalmologist

an _________ is a fitter or supplier of glasses and contact lenses who does not examine eyes

optician

an ________conduct eye test and prescribe corrective lenses

optometrist

________ is associated with several disorders, including migraines, Menniere's disease, otosclerosis, acoustic neuroma, & thyroid disease.

tinnitus

what eye test is done on those older than 40 years to assess IOP?

tonometry

refractive surgery is considered a cosmetic surgery to reshape the cornea (true or false)

true (it also helps fix refractive errors and will not alter the normal aging process of the eye)

The ______ test is a quick screening test for hearing. It can detect unilateral (one-sided) conductive hearing loss (middle ear hearing loss) and unilateral sensorineural hearing loss (inner ear hearing loss)

weber