Deck 49: Care of Patients With Eye and Vision Problems

Question 1

Which statement made by a client after corneal transplantation indicates a need for further teaching?

A) "I will wear an eye shield at night for at least 1 month."
B) "I will avoid bending at the waist and straining when moving my bowels."
C) "I won't worry if I have increased tearing, because it is normal."
D) "I'll notify the ophthalmologist if any signs of rejection occur."

Answer 1

"I won't worry if I have increased tearing, because it is normal."

Question 2

The nurse assesses several clients.Which one is most likely to have secondary open-angle glaucoma?

A) Client with gradual onset of blurred vision
B) Client who has recently had eye surgery
C) Client who sees halos around lights
D) Client with reactive pupils and clear sclera

Answer 2

Client who has recently had eye surgery

Question 3

The nurse assesses a client post-cataract surgery and finds white,dry,crusty drainage on the client's eyelid and lashes.What does the nurse do next?

A) Obtain a specimen of the drainage for culture.
B) Clean away the drainage and apply the prescribed drops.
C) Contact the physician for an antibiotic order.
D) Arrange for the client to be seen by the ophthalmologist today.

Answer 3

Clean away the drainage and apply the prescribed drops.

Question 4

A client has been educated about activities that can increase intraocular pressure.Which statement indicates that the client requires further teaching?

A) "I will avoid wearing tight shirt collars and ties."
B) "I will take stool softeners daily to prevent straining."
C) "I will try not to sneeze, cough, or blow my nose."
D) "I will not put my arms above my head."

Question 5

In the emergency department,the nurse is caring for a client diagnosed with a hyphema.Which statement by the client indicates a need for further teaching?

A) "When I get home, I can lie flat in bed and turn from side to side."
B) "For a few days, I cannot even read a book or watch television."
C) "I will need to protect the eye with a patch and shield."
D) "I need to stay on bedrest and will try not to make any sudden movement."

Question 6

An older adult client who has a mature cataract in the right eye states,"Now I have lost the sight in my right eye because I waited too long for treatment." How does the nurse best respond to the client?

A) "Yes, this type of blindness could have been prevented by earlier treatment."
B) "It is fortunate you came for treatment in time to save the sight of your other eye."
C) "Nothing you could have done would have made any difference."
D) "Surgery can still save the sight in your eye with removal of the cataract."

Question 7

Which clinical manifestation alerts the nurse to the possibility of a vitreous humor hemorrhage?

A) Presence of a red reflex
B) Reddened whites of the eye
C) Red haze or floaters in the line of vision
D) Swelling of the upper and lower eyelids

Question 8

The nurse is teaching a client about home care after cataract surgery.Which statement indicates that the client requires further teaching?

A) "I am glad that I don't need an eye patch after the surgery."
B) "I will try a cool compress to decrease the swelling around the operated eye."
C) "Dark sunglasses will be necessary when I am in the sun."
D) "Pain, nausea, and vomiting are normal after this surgery."

Question 9

Which statement indicates that the client understands teaching about the use of aspirin post-cataract surgery?

A) "It may increase intraocular pressure after cataract surgery."
B) "It changes the ability of the blood to clot and increases the risk of bleeding."
C) "It reduces inflammation and might mask any symptoms of infection."
D) "It can cause nausea and vomiting and may increase intraocular pressure."

Question 10

Which is the most important information for the nurse to teach a client who is receiving cycloplegic drug therapy?

A) "Do not drive or operate machinery until the drug wears off."
B) "Use at least a 30 SPF sunscreen agent when going outdoors."
C) "Remain on bedrest for 24 hours in a prone position."
D) "Turn up the lights because acuity will be decreased in low-light environments."

Question 11

Which assessment alerts the nurse to the possible presence of a cataract in a client?

A) Loss of central vision
B) Loss of peripheral vision
C) Dull aching in the eye and brow areas
D) Blurred vision and reduced color perception

Question 12

The nurse is teaching a client how to apply eye medication.Which is the correct technique for applying ointment into the eye?

A) From the middle out
B) From the inner canthus to the outer canthus
C) From the outer canthus to the inner canthus
D) Against the inner aspect of the eyelid

Question 13

A client has just returned from having surgery,and sulfahexafluoride gas was used intraocularly.How does the nurse position the client?

A) Completely supine, with sandbags beside the head
B) On the nonoperative side in the Trendelenburg position
C) On the operative side in the Trendelenburg position
D) On the abdomen, with the affected eye up

Question 14

A client comes to the emergency department with periorbital ecchymosis of the right eye.Which is the nurse's priority action?

A) Apply an ice pack to the affected eye.
B) Patch the eye to prevent eye movement.
C) Assess the client's vision in both eyes.
D) Irrigate the affected eye with normal saline.

Question 15

A client is recovering from cataract surgery and needs medication to prevent a potential eye infection.Which drug does the nurse question administering to the client?

A) Tobramycin (Tobrex)
B) Apraclonidine (Iopidine)
C) Gentamicin (Genoptic)
D) Ciprofloxacin (Ciloxan)

Question 16

A client with macular degeneration would like to watch television.Where does the nurse place the television for best visualization of the screen?

A) As close to the client's face as possible
B) As far away as possible, with low lights
C) Directly in front of the client
D) On either side of the client

Question 17

The nurse is assessing a client who wishes to be considered as a potential donor for corneal transplantation.Which medical diagnosis at the time of death excludes the client from consideration?

A) Small cell lung cancer
B) Chronic heart failure
C) Profound nearsightedness
D) History of detached retina

Question 18

Which statement indicates that a client understands why his cataract surgery is being done first on the eye with the poorest vision?

A) "Insurance reimbursement dictates the timing of surgeries."
B) "The eye with poorer vision is at greater risk for permanent damage."
C) "The pressure in the poorer eye could increase, causing permanent damage."
D) "If a complication arises in that eye, I will still have some vision in the better eye."

Question 19

The nurse is providing discharge teaching for a client with posterior uveitis.Which is the most important precaution for the nurse to teach the client?

A) Correct technique for eyedrop instillation
B) Clinical manifestations of retinal hemorrhage
C) Correct technique for insertion of contact lenses
D) Proper timing of opioid analgesics

Question 20

A client is using an ophthalmic beta-blocking agent for the treatment of glaucoma.Which instruction does the nurse give to the client to prevent orthostatic hypotension?

A) "Change positions quickly after administering the drops."
B) "Take your pulse at least four times daily."
C) "Apply pressure to the inside corner of your eye when administering the drops."
D) "Lay down for 10 minutes after administering the drops."

Question 21

A client with acute-angle glaucoma has several medications ordered.Which medications does the nurse question?

A) Acetazolamide (Diamox)
B) Pilocarpine (Pilocar)
C) Atropine (Isopto Atropine)
D) Latanoprost (Xalatan)
E) Timolol (Timoptic)
F) Epinephrine

Question 22

A blind client is admitted to the hospital unit.Orientation to the unit includes which information?

A) Introduce the staff to the client.
B) Describe the room to the client using one reference point.
C) Walk the client to the bathroom and describe it.
D) Tell the client to use the call light if he or she wants to go to the bathroom.
E) Explain the routine of the unit and how to operate the bed controls.
F) Assist in putting the client's belongings away.

Question 23

A client just underwent a keratoplasty.Which activity does the nurse suggest that the client begin possibly 1 week after surgery?

A) Continue with salsa dance lessons.
B) Jog only one-half mile versus the usual 2 miles.
C) Return to employment as a receptionist.
D) Help the family move furniture from room to room.

Question 24

A client is having intraocular pressure measured for both eyes.Which response by the client best indicates that the client understands why this is necessary every year?

A) "Elevated eye pressure can cause high blood pressure."
B) "If eye pressure is too high, your eyes will dry out."
C) "Elevated eye pressure can press on blood vessels in the eye."
D) "Increased eye pressure causes the tear ducts to become blocked."

Question 25

A client has an eye prosthesis and needs to have it inserted into the eye socket.Place the following steps of how to insert an eye prosthesis in the correct order.(Select in order of priority.)

A) Wash your hands.
B) Explain the procedure to the client.
C) Remove the prosthesis from its container and rinse it with tepid water.
D) Cover the work area with a cloth or towel.
E) Don gloves.
F) Place the prosthesis between the thumb and forefinger of your dominant hand with the notched end of the prosthesis closest to the client's nose.
G) Insert the prosthesis with the top edge slipping under the upper lid.
H) Lift the client's upper lid using your nondominant hand.
I) Retract the lower lid slightly until the bottom edge of the prosthesis slips behind it.
J) Release your hand slowly.
K) Gently release the upper eyelid.

Question 26

A client has conjunctivitis in both eyes and is being treated with topical antibiotics.Which statement by the client indicates a need for further teaching?

A) "I'll avoid sharing washcloths or towels with other family members."
B) "I will wash my hands after applying the eye ointment to each eye."
C) "I will call the ophthalmologist if the drainage continues after the antibiotics are started."
D) "I'll use the same tube of topical ointment for each infected eye."

Question 27

The nurse is teaching a postoperative client who had a keratoplasty.Which responses by the client require further teaching about safety in the home?

A) "We use throw rugs in the bathroom."
B) "Our neighbors will be bringing food for a week."
C) "We may have two extension cords in the living room."
D) "Most of the furniture is placed against the wall, except for one rocking chair."
E) "Every room has at least one window."
F) "The hallway has low lighting."