Ear and eye disorders

When teaching a community group of older adults, what information will the nurse include regarding normal hearing changes associated with aging? Select all that apply. A- Hair in the ear thins and falls out. B- Hearing acuity changes in all older adults. C- Cerumen dries and becomes impacted more easily. D- The ability to hear low frequency pitches diminishes first. E- Sounds such as f, s, sh, and pa may be more difficult to discern.

A- Hair in the ear thins and falls out. B- Hearing acuity changes in all older adults. D- The ability to hear low frequency pitches diminishes first. E- Sounds such as f, s, sh, and pa may be more difficult to discern.

Which client statement regarding a new diagnosis of tinnitus requires nursing teaching? Select all that apply. A- I am so glad this condition will go away permanently B- It is important that I do not drive when I have tinnitus C- Watching my diet will make a difference in my condition. D- Surgery is the only treatment that is available for tinnitus. E- I have found a coupe of support groups that I like to attend.

A- I am so glad this condition will go away permanently C- Watching my diet will make a difference in my condition. D- Surgery is the only treatment that is available for tinnitus.

Which supplement will the nurse recommend to a client who wants to enhance eye health? A- Lutein B- Vitamin D C- Magnesium D- Saw palmetto

A- Lutein

Which client statement affirms that nurse teaching about the instillation of eyedrops has been effective? Select all that apply. A- It will be very easy for me to instill all of the drops at one time. B- A schedule will help me remember when to instill the eyedrops C- If I have trouble instilling the drops, there are devices that can be helpful. D- I can label the eyedrops by color to help me easily distinguish which one is which E- I will not touch the dropper to my eyes as this can cause contamination and infection

B- A schedule will help me remember when to instill the eyedrops C- If I have trouble instilling the drops, there are devices that can be helpful. D- I can label the eyedrops by color to help me easily distinguish which one is which E- I will not touch the dropper to my eyes as this can cause contamination and infection

When caring for four clients, which client does the nurse report to the health care provider who should NOT receive an otoscopic examination? A- 25 year-old with throat and ear pain B- 39 year old experiencing dizziness C- 48 year-old who has type II diabetes D- 60 year-old experiencing delirium

D- 60 year-old experiencing delirium

What teaching will the nurse provide to a client who has just been fitted for new hearing aides? A- Turn off the hearing aid when not using it. B- Immerse the ear mold in alcohol to fully clean it. C- Store the hearing aid in a warm, humid bathroom when not in use. D- Avoid using hairspray, makeup, and personal care products around the devices.

D- Avoid using hairspray, makeup, and personal care products around the devices.

Which tasks are appropriate to assign to an LPN/LVN who is functioning under the supervision of an RN? Select all that apply. 1. Administering sulfacetamide sodium 10% to a child with conjunctivitis 2. Reviewing hand-washing and hygiene practices with clients who have eye infections 3. Showing clients how to gently cleanse eyelid margins to remove crusting 4. Assessing nutritional factors for a client with age-related macular degeneration 5. Reviewing the health history of a client to identify risk for ocular manifestations 6. Performing a routine check of a client's visual acuity

1. Administering sulfacetamide sodium 10% to a child with conjunctivitis 2. Reviewing hand-washing and hygiene practices with clients who have eye infections 3. Showing clients how to gently cleanse eyelid margins to remove crusting 6. Performing a routine check of a client's visual acuity

The nurse is working in a community health clinic and a client needs instructions for the care of a hordeolum (stye) on the right upper eyelid. What is the first intervention that the client should try 1. Apply warm compresses four times per day. 2. Gently perform hygienic eyelid scrubs. 3. Obtain a prescription for antibiotic drops. 4. Contact the ophthalmologist.

1. Apply warm compresses four times per day.

Phenylephrine, an adrenergic agonist, has been prescribed as a topical application for a client as an aid to intraocular surgery. Although systemic toxicity is unlikely, which adverse physiologic response is the greatest concern? 1. Cardiovascular response, such as hypertension or ventricular dysrhythmia 2. Renal response, such as urinary retention or urinary incontinence 3. Respiratory response, such as bronchospasm or mucus plugs 4. Musculoskeletal response, such as bone pain or joint stiffness

1. Cardiovascular response, such as hypertension or ventricular dysrhythmia

Which clients would be best to assign to the most experienced nurse in an ambulatory care center that specializes in vision problems and eye surgery? Select all that apply. 1. Client who requires postoperative instructions after cataract surgery 2. Client who needs an eye pad and a metal shield a applied 3. Client who requests a home health referral for dressing changes and eye drop instillation 4. Client who needs teaching about self-administration Of eyedrops 5. Client who requires an assessment for recent and sudden loss of sight 6. Client who requires preoperative teaching for laser trabeculoplasty

1. Client who requires postoperative instructions after cataract surgery 3. Client who requests a home health referral for dressing changes and eye drop instillation 5. Client who requires an assessment for recent and sudden loss of sight 6. Client who requires preoperative teaching for laser trabeculoplasty

The client reports tinnitus. The nurse decides to review the client's medication list to determine if any medical effect. Which combination of drugs is cause for greatest concern? 1. Gentamycin and ethacrynic acid 2. Furosemide and metoprolol 3. Vancomycin and nitroglycerin patch 5. Aspirin and calcium supplement

1. Gentamycin and ethacrynic acid

Which tasks are appropriate to assign to an LPN/L VN who is functioning under the supervision of a team leader or RN? Select all that apply. 1. Irrigating the ear canal to loosen impacted cerumen 2. Administering amoxicillin to a child with otitis media 3. Reminding the client not to blow the nose after tympanoplasty 4. Counseling a client with Ménière disease 5. Suggesting communication techniques for the family of a hearing-impaired older adult 6. Assessing a client with labyrinthitis for headache and level of consciousness

1. Irrigating the ear canal to loosen impacted cerumen 2. Administering amoxicillin to a child with otitis media 3. Reminding the client not to blow the nose after tympanoplasty

The nurse is interviewing an older adult client who reports that "lately there has been a roaring sound in my ears." What additional assessments should the nurse include? Select all that apply. 1. Obtain a medication history. 2. Ask about exposure to loud noises. 3. Observe the canal for earwax or foreign body. 4. Assess for signs and symptoms of ear infection. 5. Ask about method of ear hygiene. 6. Ask about diet and nutrition.

1. Obtain a medication history. 2. Ask about exposure to loud noises. 3. Observe the canal for earwax or foreign body. 4. Assess for signs and symptoms of ear infection. 5. Ask about method of ear hygiene.

A nursing student is preparing the equipment to irrigate a client's ear canal. In which circumstances would the supervising nurse intervene before the student starts the irrigation? Select all that apply. 1.Client has a probable perforated eardrum. 2. Client has a foreign body, probably a bean, in the a ear canal! 3. Client has a foreign body, probably an insect, in the ear canal. 4. Client has hearing loss related to impacted cerumen. 5. Client is currently being treated for acute otitis media 6. Client has used ear candles in the past to remove ear wax.

1.Client has a probable perforated eardrum. 2. Client has a foreign body, probably a bean, in the a ear canal! 3. Client has a foreign body, probably an insect, in the ear canal. 5. Client is currently being treated for acute otitis media

The nurse is working in a clinic that specializes in the care of clients with ear disorders. A client tells the nurse that he has been taking meclizine. Which question is the nurse most likely to ask to evaluate the effectiveness of the medication 1. Has the medication helped to relieve the pain in the ear canal? 2. Are you still experiencing the whirling and turning sensations? 3. Have you been able to hear better since you started the medication 4. Are you still having the itching and discomfort in the outer ear?

2. Are you still experiencing the whirling and turning sensations?

The nurse is supervising a new nurse who has just finished assessing a client for redness and discomfort to the right eye. The new nurse documents "visual acuity N/A." What should the supervising nurse do? 1. Do nothing; the documentation is minimal but acceptable 2. Ask her to explain the rationale for the documentation 3. Reassess the client's eye and vision to validate findings. 4. Suggest contacting the clinical educator for documentation tips.

2. Ask her to explain the rationale for the documentation

In the care of a client who has sustained recent blindness, which tasks would be appropriate to delegate to unlicensed assistive personnel (UAP)? Select all that apply. 1. Counseling the client to express grief or loss 2. Assisting the client with ambulating in the hall 3. Orienting the client to the surroundings 4. Encouraging independence 5. Obtaining supplies for hygienic care Storing personal items to reduce clutter

2. Assisting the client with ambulating in the hall 5. Obtaining supplies for hygienic care Storing personal items to reduce clutter

An older client tells the home health nurse that several days ago, he had ranibizumab injected into his eye for treatment of wet age-related macular degeneration. He is now experiencing redness, light sensitivity, and pain. What should the nurse tell the client 1. These are common side effects that should pass after a few more days. 2. Contact the health care provider (HCP) immediately for possible eye infection. 3. Rest eyes as much as possible and wear sunglasses if lights are too bright. 4. Inform the HCP before next the treatment so that the dosage can be adjusted.

2. Contact the health care provider (HCP) immediately for possible eye infection.

A cheerful older widow comes to the community clinic her annual checkup. She is in reasonably good but she has a hearing loss of 40 dB. She confides, "I don't get out much. I used to be really active, but the older I get, the more trouble I have hearing. It can be really embarrassing." What is the priority nursing concept to consider in planning care for this client. 1. Cognition 2. Sensory perception 3. Mood and affect 4. Anxiety

2. Sensory perception

A nursing student is assisting an older client who is alert, conversant, and cognitively intact. The client has decreased vision related to macular degeneration. When would the supervising nurse intervene? 1. Student puts call bell and personal items within reach and locates each item by guiding the client's hand. 2. Student closes the curtains and turns off all of the lights at the end of the shift to encourage rest and sleep. 3. Student talks to the client about family and asks, "So, when was the last time that you saw your uncle." 4. Student assists during mealtime by opening packages and describing location of foods by using clock coordinates.

2. Student closes the curtains and turns off all of the lights at the end of the shift to encourage rest and sleep.

The nurse is interviewing an older woman and discovers that she has been taking her glaucoma eyedrops by mouth for the past week. What should the nurse do first? 1. Obtain a prescription for tonometry so that her intraocular pressure can be checked. 2. Try to determine how frequently and how much she has been ingesting. 3. Ask her how she decided to take the drops orally instead of instilling them as eyedrops. 4. Call the Poison Control Center and be prepared to describe untoward side effects.

2. Try to determine how frequently and how much she has been ingesting.

The nurse performed postoperative stapedectomy teaching several days ago for a client. Which comment by the client is cause for greatest concern? 1. "I'm going to take swimming lessons in a couple of months.' 2. "I have to take a long overseas flight in several weeks. 3. "I can't wait to get back to my regular weightlifting class. 4. "I have been coughing a lot with my mouth open.

3. "I can't wait to get back to my regular weightlifting class.

The nurse is working in an ambulatory care clinic. A client calls to report redness of the sclera, itching the eyes, and increased lacrimation for several hours. What should the nurse direct the caller to do first. 1. "Please call your health care provider" (e.g., decline to advise). 2. "Apply a cool compress to your eyes. 3. "If you are wearing contact lenses, remove them. 4. "Take an over-the-counter antihistamine.

3. "If you are wearing contact lenses, remove them.

The nurse is reviewing medications that have been prescribed for several clients who have disorders of the eye. Which medication prescription is the most important to discuss with the health care provider? 1. Timolol for open-angle glaucoma 2. Cromolyn sodium for allergic conjunctivitis 3. Atropine for acute angle-closure glaucoma 4. Ranibizumab for wet age-related macular degeneration

3. Atropine for acute angle-closure glaucoma

Which physical assessment findings should be reported to the health care provider? 1. Pearly gray or pink tympanic membrane 2. Dense whitish ring at the circumference of the tympanum 3. Bulging red or blue tympanic membrane 4. Cone of light at the innermost part of the tympanum

3. Bulging red or blue tympanic membrane

A client reports a sudden excruciating pain in the left eye with the visual change of colored halos around lights and blurred vision. Which interventions should the nurse expect and perform for this emergency condition? Select all that apply. 1. Prepare the client for photodynamic therapy. 2. Instill a mydriatic agent, such as phenylephrine. 3. Instill a miotic agent, such as pilocarpine. 4. Administer an oral hyperosmotic agent, such as isosorbide. 5. Apply a cool compress to the forehead. 6. Provide a darkened, quiet, and private space for the a client.

3. Instill a miotic agent, such as pilocarpine. 4. Administer an oral hyperosmotic agent, such as isosorbide. 5. Apply a cool compress to the forehead. 6. Provide a darkened, quiet, and private space for the a client.

For a client who has multiple risk factors for primary а open-angle glaucoma (POAG), which sign or symptom should be investigated as an early sign of POAG? 1. Loss of central visual field 2. Seeing halos around lights 3. Mild eye aching 4. Loss of peripheral vision

3. Mild eye aching

At a community health clinic, the nurse is teaching a community group about the prevention of accidental eye injuries. What is the most important thing to stress? 1. Workplace policies for handling chemicals should be followed. 2. Children and parents should be cautious about aggressive play. 3. Protective eyewear should be worn during sports or hazardous work 4. Emergency eyewash stations should be established in the workplace.

3. Protective eyewear should be worn during sports or hazardous work

The nurse is on a camping trip. A man is chopping wood and gets struck in the eye with a piece of debris. On examination, a wood splinter is protruding from his eyeball. What should the nurse do first? 1. Have the man lie in the back seat of the car and drive him to the emergency department. 2. Gently remove the piece of wood and place a sterile dressing over the eye. 3. Stabilize the area by carefully resting a plastic cup on the orbital rim and taping it in place. 4. Flush the eye with copious amounts of clean tepid water; then check visual acuity.

3. Stabilize the area by carefully resting a plastic cup on the orbital rim and taping it in place.

Which description by a client reporting vertigo is cause a for greatest concern? 1. Dizziness with hearing loss 2. Episodic vertigo 3. Vertigo without hearing loss 4. "Merry-go-round" vertigo

3. Vertigo without hearing loss

The nurse is preparing to administer a beta-adrenergic blocking glaucoma agent. Which statement made by the client warrants additional assessment and notification of the health care provider? 1. "My blood pressure runs a little high if I gain too much weight." 2. "Occasionally, I have palpitations, but they pass very quickly 3. "My joints feel stiff today, but that's just my arthritis 4. "My pulse rate is a little low today because I take digoxin.

4. "My pulse rate is a little low today because I take digoxin.

Which finding should be immediately reported to the health care provider 1. A change in color vision 2. Crusty yellow drainage on the eyelashes 3. Increased lacrimation 4. A curtainlike shadow across the visual field

4. A curtainlike shadow across the visual field

After examining the client's ear canal with an otoscope, the health care provider instructs the nurse to irrigate the ear canal. Place the following steps for ear irrigation in the correct order. 1. Place the tip of the syringe at an angle in the external canal. 2. Watch for fluid return and signs of cerumen. 3. If cerumen does not appear, wait 10 minutes and repeat the irrigation. 4. Fill a syringe with warm irrigating solution. 5. After completion of the irrigation, have the client turn the head to the side to facilitate drainage. 6. Apply gentle but continuous pressure to the syringe plunger.

4. Fill a syringe with warm irrigating solution. 1. Place the tip of the syringe at an angle in the external canal. 6. Apply gentle but continuous pressure to the syringe plunger. 2. Watch for fluid return and signs of cerumen. 3. If cerumen does not appear, wait 10 minutes and repeat the irrigation. 5. After completion of the irrigation, have the client turn the head to the side to facilitate drainage.

After cataract surgery, the client experiences all of the symptoms listed below. Which symptoms need to be immediately reported to the health care provider? 1. A scratchy sensation in the operative eye 2. Loss of depth perception with the patch in place 3. Poor vision 6 to 8 hours after patch removal 4. Pain not relieved by prescribed medication

4. Pain not relieved by prescribed medication

The nurse is caring for several clients who are having problems with their ears. Which client condition is cause for greatest concern? 1. Has discomfort of the ear preceded by a viral infection; the tympanic membrane is erythematous 2. Has been treated with antibiotics for recurrent acute otitis media four times within the past 6 months 3. Reports rapid onset ear pain with pruritis and a sensation of fullness that started after cleaning the ear canal with a finger 4. Reports progressive severe otic pain with purulent discharge and is positive for human immunodeficiency virus

4. Reports progressive severe otic pain with purulent discharge and is positive for human immunodeficiency virus

Place the following steps for eyedrop administration in correct order. 1. Gently press on the lacrimal duct for 1 minute. 2. Gently pull tissue underneath eye downward to expose lower conjunctival sac. 3. Have the client gently close the eye and move it around. 4. Have the client look up and instill the number of prescribed drops. 5. Hold the dropper and stabilize hand on the client's forehead. 6. Have the client sit down and tilt his or her head slightly backward.

6. Have the client sit down and tilt his or her head slightly backward. 2. Gently pull tissue underneath eye downward to expose lower conjunctival sac. 5. Hold the dropper and stabilize hand on the client's forehead. 4. Have the client look up and instill the number of prescribed drops. 3. Have the client gently close the eye and move it around. 1. Gently press on the lacrimal duct for 1 minute.

Which assessment data does the nurse anticipate when a client presents to the emergency department reporting the sensation of a foreign body in the eye? Select all that apply. A- Pain B- Fever C- Tearing D- Photophobia E- Blurred vision

A- Pain C- Tearing D- Photophobia E- Blurred vision

Which symptom will the nurse teach the client who just had surgery to correct a retinal detachment to immediately report to the eye care provider? Select all that apply. A- Pain in the affected eye B- Pus in the affected eye C- Decreased visual acuity D- Temp of 99.0 E- Pupil that constricts in response to light

A- Pain in the affected eye B- Pus in the affected eye C- Decreased visual acuity

What client teaching will the nurse provide to a client who continues to experience more frequent episodes of Meniere Disease? Select all that apply. A- Reducing activity can reduce frequency of episodes. B- Episodes will eventually decrease in severity and number. C- Reducing sodium, caffeine, and alcohol intake can be beneficial. D- The only treatment that is effective is to undergo a labyrinthectomy. E- When moving from sitting to standing, be cautious and take your time.

A- Reducing activity can reduce frequency of episodes. C- Reducing sodium, caffeine, and alcohol intake can be beneficial. E- When moving from sitting to standing, be cautious and take your time.

Which communication method is appropriate when interacting with a client who is deaf? A- Use pictures and writing B- Speak with enunciated words C- Ask client to read the nurses lips D- Dialogue with the clients caregivers

A- Use pictures and writing

Which client statement regarding a new diagnosis of tinnitus requires nursing teaching? Select all that apply. A. "I am so glad this condition will go away permanently. B. "It is important that I do not drive when I have tinnitus. C. "Watching my diet will make a difference in my condition. D. "Surgery is the only treatment that is available for tinnitus. E. "I have found a couple of support groups that I like to attend."

A. "I am so glad this condition will go away permanently. C. "Watching my diet will make a difference in my condition. D. "Surgery is the only treatment that is available for tinnitus.

2. When teaching a community group of older adults, what information will the nurse include regarding normal hearing changes associated with aging? Select all that apply. A. Hair in the ear thins and falls out B. Hearing acuity changes in all older adults C. Cerumen dries and becomes impacted more easily D. The ability to hear low-frequency pitches diminishes first E. Sounds such as f, s, sh, and pa may be more difficult to discern

A. Hair in the ear thins and falls out B. Hearing acuity changes in all older adults D. The ability to hear low-frequency pitches diminishes first E. Sounds such as f, s, sh, and pa may be more difficult to discern

What teaching will the nurse provide to a client who continues to experience frequent episodes associated with Ménière disease? Select all that apply. A. Reducing activity can reduce frequency of episodes. B. Episodes will eventually decrease in severity and number. C. Reducing sodium, caffeine, and alcohol intake can be beneficial. D. The only treatment that is effective is to undergo labyrinthectomy. E. When moving from sitting to standing, be cautious and take your time.

A. Reducing activity can reduce frequency of episodes. C. Reducing sodium, caffeine, and alcohol intake can be beneficial. E. When moving from sitting to standing, be cautious and take your time.

Which communication method is appropriate when the nurse is interacting with a client who is deaf? A. Use pictures and writing B. Speak with enunciated words C. Ask client to read the nurse's lips D. Dialogue with the client's caregivers

A. Use pictures and writing

What finding does the nurse anticipate when assessing a client with a new diagnosis of glaucoma? A- Seeing "shooting stars" B- Decrease in central vision C- Gradual loss of visual fields D- Abrupt onset of excruciating pain

C- Gradual loss of visual fields

When caring for four clients, which client does the nurse report to the health care provider who should not receive an otoscopic examination? A. 25-year-old with throat and ear pain B. 39-year-old experiencing dizziness C. 46-year-old who has type 2 diabetes D. 60-year-old experiencing delirium

D. 60-year-old experiencing delirium

3. What teaching will the nurse provide to a client who has just been fitted for new hearing aids? A. Turn off the hearing aid when not using it. B. Immerse the ear mold in alcohol to fully clean it. C. Store the hearing aid in a warm, humid bathroom when not in use. D. Avoid using hair spray, makeup, and personal care products around the device.

D. Avoid using hair spray, makeup, and personal care products around the device.