Question 1

A client is taking timolol (Timoptic)eyedrops.The nurse assesses the client's pulse at 48 beats/min.What action by the nurse is the priority?&#10;A) Ask the client about excessive salivation.&#10;B) Assess the client for shortness of breath.&#10;C) Give the drops using punctal occlusion.&#10;D) Hold the eyedrops and notify the provider.

Accepted Answer

The nurse should hold the eyedrops and notify the provider because beta blockers can slow the heart rate.Excessive salivation can occur with cholinergic agonists.Shortness of breath is not related.If the drops are given,the nurse uses punctal occlusion to avoid systemic absorption.

Question 2

A client is in the preoperative holding area waiting for cataract surgery.The client says &#34;Oh,yeah,I forgot to tell you that I take clopidogrel,or Plavix.&#34; What action by the nurse is most important?&#10;A) Ask the client when the last dose was.&#10;B) Check results of the prothrombin time (PT) and international normalized ratio (INR).&#10;C) Document the information in the chart.&#10;D) Notify the surgeon immediately.

Accepted Answer

Clopidogrel is an antiplatelet aggregate and could increase bleeding.The surgeon should be notified immediately.The nurse should find out when the last dose of the drug was,but the priority is to notify the provider.This drug is not monitored with PT and INR.Documentation should occur but is not the priority.

Question 3

A client had cataract surgery.What instructions should the nurse provide? (Select all that apply.)&#10;A) Call the doctor for increased pain.&#10;B) Do not bend over from the waist.&#10;C) Do not lift more than 10 pounds.&#10;D) Sexual intercourse is allowed.&#10;E) Use stool softeners to avoid constipation.

Accepted Answer

The client should be taught to call the physician for increased pain as this might indicate infection or other complication.To avoid increasing intraocular pressure,clients are taught to not lift more than 10 pounds,to avoid bending at the waist,to avoid straining at stool,and to avoid sexual intercourse for a time after surgery.

Question 4

A nurse has delegated applying a warm compress to a client's eye.What actions by the unlicensed assistive personnel (UAP)warrant intervention by the nurse? (Select all that apply.)&#10;A) Heating the wet washcloth in the microwave&#10;B) Holding the cloth on the client using an Ace wrap&#10;C) Turning the cloth so it remains warm on the client&#10;D) Using a clean washcloth for the compress&#10;E) Washing the hands on entering the client's room

Accepted Answer

The washcloth should be warmed under running warm water.Microwaving it can lead to burns.Gentle pressure is used to hold the compress in place.The other actions are correct.

Question 5

A client who is near blind is admitted to the hospital.What action by the nurse is most important?&#10;A) Allow the client to feel his or her way around.&#10;B) Let the client arrange objects on the bedside table.&#10;C) Orient the client to the room using a focal point.&#10;D) Speak loudly and slowing when talking to the client.

Accepted Answer

Using a focal point,orient the client to the room by giving descriptions of items as they relate to the focal point.Letting the client arrange the bedside table is a good idea,but not as important as orienting the client to the room for safety.Allowing the client to just feel around may cause injury.Unless the client is also hearing impaired,use a normal tone of voice.

Question 6

An older client has decided to give up driving due to cataracts.What assessment information is most important to collect?&#10;A) Family history of visual problems&#10;B) Feelings related to loss of driving&#10;C) Knowledge about surgical options&#10;D) Presence of family support

Accepted Answer

Loss of driving is often associated with loss of independence,as is decreasing vision.The nurse should assess how the client feels about this decision and what its impact will be.Family history and knowledge about surgical options are not related as the client has made a decision to decline surgery.Family support is also useful information,but it is most important to get the client's perspective on this change.

Question 7

A nurse is seeing clients in the ophthalmology clinic.Which client should the nurse see first?&#10;A) Client with intraocular pressure reading of 24 mm Hg&#10;B) Client who has had cataract surgery and has worsening vision&#10;C) Client whose red reflex is absent on ophthalmologic examination&#10;D) Client with a tearing, reddened eye with exudate

Accepted Answer

After cataract surgery,worsening vision indicates an infection or other complication.The nurse should see this client first.The intraocular pressure is slightly elevated.An absent red reflex may indicate cataracts.The client who has the tearing eye may have an infection.

Question 8

A client has been taught about retinitis pigmentosa (RP).What statement by the client indicates a need for further teaching?&#10;A) &#34;Beta carotene, lutein, and zeaxanthin are good supplements.&#34;&#10;B) &#34;I might qualify for a retinal transplant one day soon.&#34;&#10;C) &#34;Since I'm going blind, sunglasses are not needed anymore.&#34;&#10;D) &#34;Vitamin A has been shown to slow progression of RP.&#34;

Accepted Answer

Sunglasses are needed to prevent the development of cataracts in addition to the RP.The other statements are accurate.

Question 9

A client's intraocular pressure (IOP)is 28 mm Hg.What action by the nurse is best?&#10;A) Educate the client on corneal transplantation.&#10;B) Facilitate scheduling the eye surgery.&#10;C) Plan to teach about drugs for glaucoma.&#10;D) Refer the client to local Braille classes.

Accepted Answer

This increased IOP indicates glaucoma.The nurse's main responsibility is teaching the client about drug therapy.Corneal transplantation is not used in glaucoma.Eye surgery is not indicated at this time.Braille classes are also not indicated at this time.

Question 10

A client has a foreign body in the eye.What action by the nurse takes priority?&#10;A) Administering ordered antibiotics&#10;B) Assessing the client's visual acuity&#10;C) Obtaining consent for enucleation&#10;D) Removing the object immediately

Accepted Answer

To prevent infection,antibiotics are provided.Visual acuity in the affected eye cannot be assessed.The client may or may not need enucleation.The object is only removed by the ophthalmologist.

Question 11

A client has been prescribed brinzolamide (Azopt).What assessment by the nurse requires consultation with the provider?&#10;A) Allergy to eggs&#10;B) Allergy to sulfonamides&#10;C) Use of contact lenses&#10;D) Use of beta blockers

Accepted Answer

The answer of A client has been prescribed brinzolamide (Azopt).What...

Question 12

A client is seen in the ophthalmology clinic with bacterial conjunctivitis.Which statements by the client indicate a good understanding of home management of this condition? (Select all that apply.)&#10;A) &#34;As long as I don't wipe my eyes, I can share my towel.&#34;&#10;B) &#34;Eye irrigations should be done with warm saline or water.&#34;&#10;C) &#34;I will throw away all my eye makeup when I get home.&#34;&#10;D) &#34;I won't touch the tip of the eyedrop bottle to my eye.&#34;&#10;E) &#34;When the infection is gone, I can use my contacts again.&#34;

Accepted Answer

The answer of A client is seen in the ophthalmology...

Question 13

A client has a corneal ulcer.What information provided by the client most indicates a potential barrier to home care?&#10;A) Chronic use of sleeping pills&#10;B) Impaired near vision&#10;C) Slightly shaking hands&#10;D) Use of contact lenses

Accepted Answer

The answer of A client has a corneal ulcer.What information...

Question 14

The nurse working in the ophthalmology clinic sees clients with eyelid and eye problems.What information should the nurse understand about these disorders? (Select all that apply.)&#10;A) A chalazion is an inflammation of an eyelid sebaceous gland.&#10;B) An ectropion is the eyelid turning inward.&#10;C) An entropion is the eyelid turning outward.&#10;D) A hordeolum is an infection of the eyelid sweat gland.&#10;E) Keratoconjunctivitis sicca is caused by drugs or diseases.

Accepted Answer

The answer of The nurse working in the ophthalmology clinic...

Question 15

A client had a retinal detachment and has undergone surgical correction.What discharge instruction is most important?&#10;A) &#34;Avoid reading, writing, or close work such as sewing.&#34;&#10;B) &#34;Dim the lights in your house for at least a week.&#34;&#10;C) &#34;Keep the follow-up appointment with the ophthalmologist.&#34;&#10;D) &#34;Remove your eye patch every hour for eyedrops.&#34;

Accepted Answer

The answer of A client had a retinal detachment and...

Question 16

A client does not understand why vision loss due to glaucoma is irreversible.What explanation by the nurse is best?&#10;A) &#34;Because eye pressure was too high, the tissue died.&#34;&#10;B) &#34;Glaucoma always leads to permanent blindness.&#34;&#10;C) &#34;The traumatic damage to your eye was too great.&#34;&#10;D) &#34;The infection occurs so quickly it can't be treated.&#34;

Accepted Answer

The answer of A client does not understand why vision...

Question 17

A client had proxymetacaine (Ocu-Caine)instilled in one eye in the emergency department.What discharge instruction is most important?&#10;A) Do not touch or rub the eye until it is no longer numb.&#10;B) Monitor the eye for any bleeding for the next day.&#10;C) Rinse the eye with warm saline solution at home.&#10;D) Use all the eyedrops as prescribed until they are gone.

Accepted Answer

The answer of A client had proxymetacaine (Ocu-Caine)instilled in one...

Question 18

A client is brought to the emergency department after a car crash.The client has a large piece of glass in the left eye.What action by the nurse takes priority?&#10;A) Administer a tetanus booster shot.&#10;B) Ensure the client has a patent airway.&#10;C) Prepare to irrigate the client's eye.&#10;D) Turn the client on the unaffected side.

Accepted Answer

The answer of A client is brought to the emergency...

Deck 47: Care of Patients with Eye and Vision Problems