Question 1

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?

Accepted Answer

The nurse's priority is to ensure the patient can administer eyedrops postprocedure, as this is crucial for preventing infection and promoting healing after cataract surgery.

Question 2

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

Accepted Answer

Phenylephrine can cause dizziness, lightheadedness, and drowsiness, which can make driving difficult, so it is important to advise the patient to avoid driving until the effects of the drug have worn off. Option B and C are incorrect because they are not common side effects of phenylephrine, and option D is also incorrect because sunlight can worsen the dilation of the pupils caused by phenylephrine, which can lead to temporary vision problems.

Question 3

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

Accepted Answer

The Ishihara test is a simple, non-invasive test done to detect color blindness. It is often used in screening tests for those who have been prescribed hydroxychloroquine, which is known to cause color vision changes. However, if the patient's symptoms persist, further testing may be required.

Question 4

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?

Accepted Answer

The sudden onset of "black spots and a curtain dropping" in the right eye is a classic symptom of a detached retina. Additional assessment such as a dilated eye exam or referral to an ophthalmologist would be necessary to confirm the diagnosis. Conjunctivitis and endophthalmitis would not typically present with these symptoms, and while a cataract can cause visual changes, it does not typically present with sudden onset or a curtain-like effect.

Question 5

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?

Accepted Answer

Floaters are small specks or particles that appear to float across the field of vision. They are common in most people and become more noticeable as people age. They may look like gnats or cobwebs and can be bothersome, but they are usually harmless. Conjunctivitis is inflammation of the conjunctiva, which causes redness, itchiness, and discharge. Strabismus is a condition in which the eyes do not align properly. Nystagmus is a condition in which the eyes make repetitive, uncontrolled movements.

Question 6

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

Accepted Answer

A tonometer is the instrument used to measure intraocular pressure, which is important in diagnosing and monitoring glaucoma. The other options (A, B, and D) are used for different aspects of eye assessment, such as testing visual acuity (Snellen chart), examining the retina and optic nerve (ophthalmoscope), and testing pupillary response (penlight).

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?. Select all that apply.

Accepted Answer

The answer of The nurse is teaching a community education...

Question 8

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

Accepted Answer

Timolol, a beta-adrenergic blocker, can exacerbate congestive heart failure (CHF) due to its systemic cardiovascular effects, making it potentially unsafe for a patient with CHF.

Question 9

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

Accepted Answer

Corrective surgery, specifically a surgical repair of the ectropion, is the most appropriate treatment option for this patient with continued eye dryness and corneal abrasions. The surgery can help to restore normal eyelid position, which may reduce dryness and abrasions. Corrective lenses may be helpful for some patients, but they are not the most appropriate treatment in this case. UV protective sunglasses and corneal transplant are not indicated for the treatment of ectropion.

Question 10

The nurse providing community education would discuss which techniques to reduce the risk of cataract development?. Select all that apply.

Accepted Answer

The answer of The nurse providing community education would discuss...

Question 11

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?

Accepted Answer

The best response is to explain that the risk of developing blindness is related to how long the patient has had diabetes and how well their blood sugar and hypertension are controlled. This helps the patient understand that controlling their diabetes is important for preventing complications such as blindness. Option B is true but does not fully address the patient's question. Option C is inaccurate as both type 1 and type 2 diabetes can lead to diabetic retinopathy. Option D is incorrect as laser photocoagulation surgery is a treatment for diabetic retinopathy, but it cannot cure it.

Question 12

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

Accepted Answer

The macula is responsible for central vision, so limited central vision would indicate a potential problem with this structure. The sclera is the white outer layer of the eye, the lens is responsible for focusing light onto the retina, and the extraocular muscles control eye movement and positioning. Limited central vision would not be directly associated with problems with these structures.

Question 13

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?

Accepted Answer

The answer of The nurse is assessing a patient who...

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."

Accepted Answer

The answer of A patient is being discharged after cataract...

Question 15

A patient has just returned from surgery for removal of a cataract. Which nursing interventions are indicated?. Select all that apply.

Accepted Answer

After cataract surgery, the patient should be positioned with the head of the bed elevated to reduce intraocular pressure (A). The patient should not lie on the affected side to avoid pressure on the operated eye (B is incorrect). The operative eye should be assessed for drainage to monitor for complications (C). Keeping the eye patch in place protects the eye and aids in healing (D). Monitoring the patient's pain level is important to manage discomfort and detect complications (E).

Question 16

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

Accepted Answer

Difficulty in reading the newspaper is a common symptom of accommodation problems, which may include difficulty focusing on near objects, blurred vision, and eye strain. Blinded by sunlight could be a symptom of light sensitivity, while trouble seeing at night may be indicative of night blindness. Difficulty distinguishing colors may suggest a problem with color vision.

Question 17

The nurse is performing the corneal light reflex as part of an eye assessment. Which actions are necessary?. Select all that apply.

Accepted Answer

The corneal light reflex test involves shining a light into the patient's eyes and observing the reflection in the pupils to assess eye alignment. Touching the cornea with a cotton wisp (C) is part of the corneal reflex test, not the corneal light reflex. Observing for blinking (D) is related to the corneal reflex test. Looking for a whitening of the red reflex (E) is part of assessing the ocular fundus, not the corneal light reflex.

Question 18

Which instructions would be appropriate for the nurse to give a patient with acute viral conjunctivitis?. Select all that apply.

Accepted Answer

The answer of Which instructions would be appropriate for the...

Question 19

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

Accepted Answer

Primary glaucoma is not related to other ocular conditions and is typically due to increased intraocular pressure without a known secondary cause.

Question 20

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?

Accepted Answer

The highest priority intervention for a newly diagnosed glaucoma patient should be to stress the importance of compliance with the glaucoma eyedrop regimen. Proper medication compliance is crucial to prevent further damage to the optic nerve and preserve the patient's vision. Assessing for fall injuries, discussing risk factors for developing glaucoma, and considering home maintenance issues are important interventions but are of lower priority compared to medication compliance.

Quiz 64: Caring for the Patient With Visual Disorders