Question 1

A patient who has bacterial endophthalmitis in the left eye is restless,frequently asking whether the eye is healing,and whether removal of the eye will be necessary.Based on the assessment data,which nursing diagnosis is most appropriate at this time?

Accepted Answer

The patient's restlessness and questioning of the nurse indicate anxiety about the future possible loss of vision.Because the patient can see with the right eye,functional vision is relatively intact.There is no indication of impaired self-esteem at this time.

Question 2

A 72-year-old patient with age-related macular degeneration (AMD)has just had photodynamic therapy.Which statement by the patient indicates that the discharge teaching has been effective?

Accepted Answer

The photosensitizing drug used for photodynamic therapy is activated by exposure to bright light and can cause burns in areas exposed to light for 5 days after the treatment.There are no restrictions on the use of facial lotions,medications to keep the pupils dilated would not be appropriate,and bright lights would increase the risk for damage caused by the treatment.

Question 3

A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection?

Accepted Answer

Hordeolum (styes)are commonly caused by Staphylococcus aureus,which may be present in cosmetics that the patient is using.Warm compresses are recommended to treat hordeolum.Antiseborrheic shampoos are recommended for seborrheic blepharitis.Patients with adult inclusion conjunctivitis,which is caused by Chlamydia trachomatis,should be referred for sexually transmitted infection (STI)testing.

Question 4

The nurse is completing the admission database for a patient admitted with abdominal pain and notes a history of hypertension and glaucoma.Which prescribed medications should the nurse question?

Accepted Answer

Scopolamine is a parasympathetic blocker and will relax the iris,causing blockage of aqueous humor outflow and an increase in intraocular pressure.The other medications are appropriate for this patient.

Question 5

A nurse should instruct a patient with recurrent staphylococcal and seborrheic blepharitis to

Accepted Answer

Baby shampoo is used to soften and remove crusts associated with blepharitis.The other interventions are not used in treating this disorder.

Question 6

To determine whether treatment is effective for a patient with primary open-angle glaucoma (POAG),the nurse can evaluate the patient for improvement by

Accepted Answer

POAG develops slowly and without symptoms except for a gradual loss of visual fields.Acute closed-angle glaucoma may present with excruciating pain,colored halos,and blurred vision.Problems with depth perception are not associated with POAG.

Question 7

Which topic will the nurse teach after a patient has had outpatient cataract surgery and lens implantation?

Accepted Answer

Antibiotic and corticosteroid eye drops are commonly prescribed after cataract surgery.The patient should be able to administer them using safe technique.Pain is not expected after cataract surgery and opioids will not be needed.Coughing and deep breathing exercises are not needed because a general anesthetic agent is not used.There is no bed rest restriction after cataract surgery.

Question 8

Which teaching point should the nurse plan to include when caring for a patient whose vision is corrected to 20/200?

Accepted Answer

Various types of magnifiers can enhance the remaining vision enough to allow the performance of many tasks and activities of daily living (ADLs).Audio books,Braille instruction,and canes usually are reserved for patients with no functional vision.

Question 9

The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the right ear.Which finding is a priority to report to the health care provider?

Accepted Answer

The fever indicates that the infection may not be resolved and the patient might need further antibiotic therapy.A feeling of fullness,"popping" of the ear,and decreased hearing are symptoms of otitis media with effusion.These symptoms are normal for weeks to months after an episode of acute otitis media and usually resolve without treatment.

Question 10

A patient with glaucoma who has been using timolol (Timoptic)drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration.The best response to the patient's statement is

Accepted Answer

Patients should be instructed that eye discomfort and visual blurring are expected side effects of the ophthalmic drops but that the drops must be used to prevent further visual-field loss.The temporary burning and visual blurriness might not lessen with ongoing use,are not relieved by avoiding systemic absorption,and are not symptoms of glaucoma.

Question 11

A patient diagnosed with external otitis is being discharged from the emergency department with an ear wick in place.Which statement by the patient indicates a need for further teaching?

Accepted Answer

Insertion of instruments such as cotton-tipped applicators into the ear should be avoided.The other patient statements indicate that the teaching has been successful.

Question 12

The nurse is developing a plan of care for an adult patient diagnosed with adult inclusion conjunctivitis (AIC)caused by Chlamydia trachomatis.Which action should be included in the plan of care?

Accepted Answer

Patients with AIC have a high risk for concurrent genital Chlamydia infection and should be referred for sexually transmitted infection (STI)testing.AIC is treated with antibiotics.Antiviral and corticosteroid medications are not appropriate therapies.Although some types of Chlamydia infection do cause blindness,AIC does not lead to blindness,so referral for visual rehabilitation is not appropriate.

Question 13

A patient who has undergone a left tympanoplasty should be instructed to

Accepted Answer

Coughing or blowing the nose increases pressure in the eustachian tube and middle ear cavity and disrupts postoperative healing.There is no postoperative need for prolonged bed rest,elevation of the head,or continuous antibiotic irrigation.

Question 14

A 42-year-old woman with Ménière's disease is admitted with vertigo,nausea,and vomiting.Which nursing intervention will be included in the care plan?

Accepted Answer

A darkened,quiet room will decrease the symptoms of the acute attack of Ménière's disease.Because the patient will be nauseated during an acute attack,fluids are administered IV.Position changes will cause vertigo and nausea.The head of the bed can be positioned for patient comfort.

Question 15

The nurse evaluates that wearing bifocals improved the patient's myopia and presbyopia by assessing for

Accepted Answer

The lenses are prescribed to correct the patient's near and distant vision.The nurse may also assess for cloudiness of the lenses,increased intraocular pressure,and eye movement,but these data do not evaluate whether the patient's bifocals are effective.

Question 16

The nurse developing a teaching plan for a patient with herpes simplex keratitis should include which instruction?

Accepted Answer

The best way to avoid the spread of infection from one eye to another is to avoid rubbing or touching the eyes and to use careful hand washing when touching the eyes is unavoidable.Occlusive dressings are not used for herpes keratitis.Herpes simplex is a virus and antibiotic drops will not be prescribed.Topical corticosteroids are immunosuppressive and typically are not ordered because they can contribute to a longer course of infection and more complications.

Question 17

To decrease the risk for future hearing loss,which action should the nurse who is working with college students at the on-campus health clinic implement?

Accepted Answer

The nurse should discuss the impact of amplified music on hearing with young adults and discourage listening to very amplified music,especially for prolonged periods.Tympanometry measures the ability of the eardrum to vibrate and would not help prevent future hearing loss.Although students are at risk for the influenza virus,being vaccinated does not help prevent future hearing loss.Otoscopic examinations are not necessary for all patients.

Question 18

A patient with a right retinal detachment had a pneumatic retinopexy procedure.Which information will be included in the discharge teaching plan?

Accepted Answer

Following pneumatic retinopexy,the patient will need to position the head so the air bubble remains in contact with the retinal tear.The dark lenses and bilateral eye patches are not required after this procedure.Saturation of any eye dressings would not be expected following this procedure.

Question 19

In reviewing a 55-year-old patient's medical record,the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg.The nurse will plan to assess

Accepted Answer

The patient's increased intraocular pressure indicates glaucoma,which decreases peripheral vision.Because central visual acuity is unchanged by glaucoma,assessment of visual acuity could be normal even if the patient has worsening glaucoma.Color perception and pupil reaction to light are not affected by glaucoma.

Question 20

When assisting a blind patient in ambulating to the bathroom,the nurse should

Accepted Answer

When using the sighted-guide technique,the nurse walks slightly in front and to the side of the patient and has the patient hold the nurse's elbow.The other techniques are not as safe in assisting a blind patient.

Quiz 18: Nursing Management: Visual and Auditory Problems