Deck 64: Caring for the Patient With Visual Disorders

Question 1

A patient's eye examination reveals limited central vision. The nurse would conduct further assessment for problems with which structure?

A) Sclera
B) Lens
C) Macula
D) Extraocular muscles

Answer 1

Macula

Question 2

A patient has been diagnosed with primary glaucoma. What information would the nurse provide about this condition?

A) It was probably caused by a congenital anomaly in the structure of the eye.
B) Primary glaucoma is not as serious as other forms of glaucoma.
C) The disorder has no relation to other ocular conditions.
D) This condition is the result of conjunctival infections in childhood.

Answer 2

The disorder has no relation to other ocular conditions.

Question 3

The nurse is caring for a patient newly diagnosed with glaucoma. The patient is asymptomatic except for increased intraocular pressure detected during a routine eye examination. When developing a plan of care, which intervention should have the highest priority?

A) Assess for fall injuries.
B) Discuss risk factors for developing glaucoma.
C) Consider home maintenance issues.
D) Stress the importance of compliance with the glaucoma eyedrop regimen.

Answer 3

Stress the importance of compliance with the glaucoma eyedrop regimen.

Question 4

Which instructions would be appropriate for the nurse to give a patient with acute viral conjunctivitis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "You should wash your hands before cleansing the eye and using eyedrops."
B) "You can soak your lids with warm saline to soften crusts and exudates."
C) "You should not share towels or makeup with anyone else."
D) "Do not return to work for at least 2 weeks."
E) "You can use warm compresses to relieve eye discomfort."

Question 5

Which patient statement would the nurse evaluate as indicating problems with accommodation?

A) "I feel blinded by sunlight."
B) "I can't tell the difference between colors as well as I once did."
C) "I have trouble seeing at night."
D) "I am having trouble reading the newspaper."

Question 6

The nurse is performing the corneal light reflex as part of an eye assessment. Which actions are necessary? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Shine a penlight into the patient's eyes.
B) Observe the location of a light reflection in the patient's pupils.
C) Touch the cornea lightly with a cotton wisp.
D) Observe for blinking.
E) Look for a whitening of the red reflex.

Question 7

The nurse is teaching a community education class on the prevention of eye injuries and caring for someone with an eye injury. What should be included in this presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Eye protection devices should be worn when participating in high-risk sports or occupations.
B) Most eye injuries are self-limited and do not require medical intervention.
C) Immediately flush the eye with copious amounts of water if a chemical splash occurs.
D) Loose, visible objects can be removed using a clean, moistened cotton-tipped swab.
E) If an object appears to penetrate the eye, gently remove it using sterile gauze and seek medical attention.

Question 8

A nurse is teaching a diabetic education class. One of the patients asks, "What can I do to prevent going blind due to my diabetes?" What is the best response by the nurse?

A) "The risk of developing blindness is related to how long you've had diabetes, and how well your blood sugar and hypertension are controlled."
B) "Diabetic retinopathy is caused by changes in the small blood vessels of the eye."
C) "This is only a problem with type 2 diabetes, so you won't have this problem."
D) "Laser photocoagulation surgery will treat any problems that develop and cure the diabetic retinopathy."

Question 9

The nurse is conducting assessment of a patient's eye. Which instrument would the nurse obtain to measure intraocular pressure?

A) Snellen chart
B) Ophthalmoscope
C) Tonometer
D) Penlight

Question 10

Phenylephrine Neo-Synephrine) is administered to a patient before a diagnostic procedure. What should patient education about this medication include?

A) Driving may be difficult.
B) The eyes may be red for one or two days.
C) Tears will be yellow.
D) Sunlight will improve vision.

Question 11

An elderly patient is being discharged after having a cataract removed during same-day surgery. The nurse's priority is to assess the patient for which ability?

A) Ability to administer eyedrops postprocedure
B) Ability to read discharge instructions
C) Ability to drive
D) Ability to ambulate safely

Question 12

A patient comes into the clinic complaining of sudden onset of "black spots and a curtain dropping" in the right eye. The nurse would conduct additional assessment for which condition?

A) Detached retina
B) Conjunctivitis
C) Endophthalmitis
D) Cataract

Question 13

A patient complains that sometimes there appears to be gnats in the field of vision. The nurse would interpret this statement to mean that the patient has which visual change?

A) Conjunctivitis
B) Floaters
C) Strabismus
D) Nystagmus

Question 14

A patient is being discharged after cataract surgery. The nurse evaluates that the patient understands discharge instructions when the patient says, "I should not pick up anything that weighs more than _______ pounds."

Question 15

A patient has just returned from surgery for removal of a cataract. Which nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Position the patient with the head of the bed up at 30 degrees.
B) Have the patient lie on the affected side.
C) Assess the operative eye for drainage.
D) Keep the eye patch in place.
E) Monitor the patient's pain level.

Question 16

A patient with an ectropion continues to experience eye dryness and corneal abrasions. The nurse would reinforce teaching about which treatment option?

A) Corrective surgery
B) Corrective lenses
C) UV protective sunglasses
D) Corneal transplant

Question 17

A patient reports having difficulty discriminating colors after being prescribed hydroxychloroquine Plaquenil). What information should the nurse provide?

A) Keratometry can be done to diagnose color blindness.
B) The Ishihara test is simple and can reveal color blindness.
C) Invasive testing will be required to assess cones and rods.
D) A picture of the ocular fundus will be necessary to make this diagnosis.

Question 18

The nurse providing community education would discuss which techniques to reduce the risk of cataract development? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Smoking cessation
B) Wearing sunglasses
C) Well-balanced diet
D) Maintaining a healthy weight
E) Avoidance of alcohol

Question 19

The nurse is assessing a patient who had cataract surgery several weeks ago. Which patient statement would alert the nurse that the most common complication of cataract surgery is occurring in this patient?

A) "My eye itches at night."
B) "My vision has not been as clear as I thought it would be."
C) "I think my cataract is growing back."
D) "I have pus in the corner of my eye."

Question 20

The nurse is reviewing discharge orders in preparation for teaching patients diagnosed with open-angle glaucoma. Which order would the nurse question?

A) Timolol Timoptic), a beta-adrenergic blocker, for a 60-year-old with congestive heart failure CHF)
B) Dorzolamide Trusopt), a carbonic anhydrase inhibitor, for a patient with asthma and chronic obstructive pulmonary disease COPD)
C) Brinzolamide Azopt) for a 20-year-old male
D) Brimonidine Alphagan), an adrenergic agonist, for a healthy 40-year-old on no other drugs

Question 21

A patient who has a history of dry eye syndrome says, "My eyes don't bother me as long as I put artificial tears in about every 4 hours while I am awake." How should the nurse respond?

A) "You should not use artificial tears that often."
B) "Try to lengthen the time to at least 6 hours between instillations."
C) "If this schedule is giving you relief, try to follow it consistently every day."
D) "Try using the drops every 2 hours and see if your eyes feel better."

Question 22

A patient with a corneal abrasion is being discharged after treatment with fluorescein and proparacaine drops. Looking in the mirror, the patient says, "My eye is yellow! What happened?" How should the nurse respond?

A) "Unfortunately, corneal abrasion treatment can cause discoloration of the eye for several weeks."
B) "The color helps us see the abrasion and will be washed away by your normal tears."
C) "I have not seen this reaction before. I will contact the health care provider."
D) "When you get home, put a hot compress on the eye. If the color doesn't clear in an hour, call us back."

Question 23

A patient with severe diabetic retinopathy is nearly blind despite years of various treatments. Which patient statements would the nurse evaluate as indicating this patient is coping with the disability? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "I went to a luncheon at church this week."
B) "My husband put some Velcro on my washing machine so I could tell which setting to use."
C) "I don't get out of doors very often, so it is fun to come to the doctor."
D) "My daughters found a new low-carbohydrate recipe to try for my birthday cake this year."
E) "I would so love to really be able to see my new grandson's face."

Question 24

Glaucoma is the second leading cause of blindness in the United States. The nurse providing health promotion materials should focus information on which issues contributing to that statistic? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Delayed recognition of glaucoma
B) Noncompliance in using eyedrops once diagnosed
C) Lack of understanding of the seriousness of the disorder
D) Difficulty achieving normal pressure readings once glaucoma is established
E) Reluctance to seek treatment due to social stigma of the disease

Question 25

A patient is scheduled for photodynamic therapy to treat wet age-related macular degeneration. Which instruction should the nurse provide?

A) Wear comfortable shoes for this procedure.
B) Wear a shirt with short sleeves for easy IV placement access.
C) Bring gloves to wear home.
D) Plan to wear regular glasses home after the procedure.

Question 26

The nurse is teaching a patient about dietary considerations associated with the diagnosis of glaucoma. Which foods should the nurse teach the patient to avoid? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Citrus fruits
B) Cheese
C) White dinner rolls
D) Gas-producing foods such as beans and broccoli
E) Beef

Question 27

A 63-year-old African woman is seen in the clinic for an eye examination. The woman has diabetes, smokes a pack of cigarettes a day, and drinks "a pot" of coffee each day. The nurse identifies which findings from this history as increasing the patient's risk of glaucoma? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Ethnic origin
B) Age
C) Caffeine intake
D) Comorbidity
E) Smoking

Question 28

A patient is prescribed ranibuizumag Lucentisz) as treatment for age-related macular degeneration. The nurse would assess this patient for which expected adverse reaction?

A) Sudden increase in urine output
B) Petechiae across the patient's chest
C) Thickened bronchial secretions
D) Photophobia

Question 29

A patient diagnosed with glaucoma says, "I can't believe this is happening to me and that I can't change it. Everything I do requires that I see well." Which nursing questions will address the issue reflected in this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "What time is good for you to return to the clinic tomorrow for a recheck?"
B) "Did you bring someone to drive you home?"
C) "Which pharmacy location do you want me to call with your new prescription?"
D) "Is someone staying with you until your vision is clearer?"
E) "Do you want black sunglasses or red ones?"

Question 30

The nurse has provided discharge instructions to a patient who had cataract surgery. The nurse is satisfied that the patient understands these instructions when the patient makes which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "I will ask my wife to tie my shoes for a few days."
B) "I will wear my eye shield all the time."
C) "I should expect to see bright flashes of light as my eye heals."
D) "I will avoid reading at least until my follow-up appointment next week."
E) "I will sleep on my back or on my nonoperative side."

Question 31

A patient is admitted to the emergency department with complaints that indicate possible retinal detachment. Which nursing actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Contact the health care provider immediately.
B) Record what the patient has eaten today and the time of consumption.
C) Ask the patient to bear down to see if there are changes in vision.
D) Give the patient oral pain medications as ordered.
E) Keep the patient as quiet as possible.

Question 32

Which patient statement would the nurse evaluate as indicating that further instruction is needed regarding precautions following photodynamic therapy?

A) "I may need to use my special halogen lamp to do hand sewing."
B) "I plan to go to the movies with my family this weekend."
C) "My spouse and I are going to watch the football play-offs on television this weekend."
D) "I will not go outside until after sundown."

Question 33

The nurse is admitting a patient for laser photocoagulation treatment of diabetic retinopathy. The nurse would immediately contact the health care provider if the patient's diastolic blood pressure is above _______ mmHg.

Question 34

A patient's laser photocoagulation procedure was delayed 2 weeks until the patient's blood glucose was consistently below 300 mg/dL. The surgery was performed today, and the nurse is providing discharge instructions. Which instruction should be provided regarding new glasses?

A) "We made an appointment for you to be fitted with new glasses tomorrow."
B) "As soon as your eye has healed, you should call for an appointment to be fitted for new glasses."
C) "Once your blood glucose is below 200 mg/dL, you should get new glasses."
D) "Wait until your blood glucose is at your optimal level for at least 6 to 9 weeks before you get new glasses."

Question 35

A patient with dry macular degeneration is being treated conservatively with dietary management. Which foods in particular should the nurse encourage the patient to include in the daily diet?

A) Salad made with dark-green leafy vegetables
B) Lean proteins
C) Baked or steamed white potatoes
D) Whole-grain cereal