Wk 6 Day 4 Ch 53, 55 Practice questions

579. The nurse is assigned to care for a client hospitalized with Ménière's disease. The nurse expects that which would most likely be prescribed for the client?

2. Low-sodium diet

A client arrives in the emergency department after an automobile crash. The client's forehead hit the steering wheel and a hyphema has been diagnosed. Which position should the nurse prepare to position the client?570

2. On bed rest in a semi-Fowler's position

A client sustains a contusion of the eyeball after a traumatic injury with a blunt object. The nurse should take which immediate action?571

1. Apply ice to the affected eye.

580. A client is diagnosed with glaucoma. Which data gathered by the nurse indicate a risk factor associated with glaucoma?

1. Cardiovascular disease

The nurse is assigned to care for a client with a diagnosis of detached retina. Which findings would indicate that bleeding has occurred as a result of retinal detachment?569

2. Vision may be cloudy 5. Complaints of a burst of black spots or floaters.

574. The nurse is preparing to administer eardrops to an adult client. The nurse administers the eardrops by which technique?

1. Pulling the pinna up and back

The nurse is preparing to reinforce a teaching plan for aclient who is undergoing cataract extraction with intraocular implan. Which home care measures should the nurse include in the plan?566

1. To avoid activities that require bending over. 4. To place an eye shield on the surgical eye at bedtime. 6. To contact the surgeon if a decrease in visual acuity occurs. 3. To take acetaminophen for minor eye discomfort. Rationale:

The nurse is assisting with developing a teaching plan for the client with glaucoma. Which instruction should the nurse suggest to include in the plan of care?567

3. Avoid reading the newspaper and watching television.. correct: 4. Eye medications may need to be administered for lthe rest of your life.

578. A client with Ménière's disease is experiencing severe vertigo. The nurse reinforces instructions to the client to do which to assist with controlling the vertigo?

3. Avoid sudden head movements

573. The nurse is caring for a client after enucleation and notes the presence of bright red drainage on the dressing. The nurse should take which appropriate action?

3. Report the finding to the registered nurse (RN)

575. The nurse is caring for a client who is hearing-impaired and should take which approach to facilitate communication?

3. Speak in a normal tone.

The nurse is assigned to care for a client with a detached retina. Which finding should the nurse expect to be documented in the client's record?568

4. A sense of a curtain falling across the field of vision

577. The nurse notes that the primary health care provider (PHCP) has documented a diagnosis of presbycusis on the client's chart. Which explanation should the nurse give to the client to explain this condition?

4. A sensorineural hearing loss that occurs with aging

576. A client arrives at the emergency department with a foreign body in the left ear that has been determined to be an insect. Which initial intervention should the nurse anticipate to be prescribed?

4. Instillation of mineral oil or diluted alcohol

572. A client sustains a chemical eye injury from a splash of battery acid. The nurse should prepare the client for which immediate measure?

4. Irrigating the eye with sterile normal saline

Chapter 53, Eyes and ears.

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