Chapter 22(lewis): Nursing Management
Visual and Auditory Problems question
and ANSwers.
The nurse evaluates that wearing bifocals improved the patient's myopia and
presbyopia by assessing for
a.
strength of the eye muscles.
b.
both near and distant vision.
c.
cloudiness in the eye lenses.
d.
intraocular pressure changes. .ANS: B
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.
2. A nurse should instruct a patient with recurrent staphylococcal and seborrheic
blepharitis to
a.
irrigate the eyes with saline solution.
b.
apply cool compresses to the eyes three times daily.
c.
use a gentle baby shampoo to clean the lids as needed.
d.
schedule an appointment for surgical removal of the lesion. .ANS: C
Baby shampoo is used to soften and remove crusts associated with blepharitis. The
other interventions are not used in treating this disorder.
3. When assisting a blind patient in ambulating to the bathroom, the nurse should
a.
take the patient by the arm and lead the patient slowly to the bathroom.
b.
have the patient place a hand on the nurse's shoulder and guide the patient.
c.
stay beside the patient and describe any obstacles on the path to the bathroom.
d.
,walk slightly ahead of the patient and allow the patient to hold the nurse's elbow.
.ANS: D
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.
4. A nurse should include which instructions when teaching a patient with repeated
hordeolum how to prevent further infection?
a.
Apply cold compresses at the first sign of recurrence.
b.
Discard all open or used cosmetics applied near the eyes.
c.
Wash the scalp and eyebrows with an antiseborrheic shampoo.
d.
Be examined for recurrent sexually trANSmitted infections (STIs). .ANS: B
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.
5. The nurse developing a teaching plan for a patient with herpes simplex keratitis
should include which instruction?
a.
Apply antibiotic drops to the eye several times daily.
b.
Wash hands frequently and avoid touching the eyes.
c.
Apply a new occlusive dressing to the affected eye at bedtime.
d.
Use corticosteroid ophthalmic ointment to decrease inflammation. .ANS: B
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.
6. Which teaching point should the nurse plan to include when caring for a patient
whose vision is corrected to 20/200?
a.
How to access audio books
,b.
How to use a white cane safely
c.
Where Braille instruction is available
d.
Where to obtain specialized magnifiers .ANS: D
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.
7. 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?
a.
Discussing the need for sexually trANSmitted infection testing
b.
Applying topical corticosteroids to prevent further inflammation
c.
Assisting with applying for community visual rehabilitation services
d.
Educating about the use of antiviral eyedrops to treat the infection .ANS: A
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.
8. Which topic will the nurse teach after a patient has had outpatient cataract
surgery and lens implantation?
a.
Use of oral opioids for pain control
b.
Administration of corticosteroid eye drops
c.
Importance of coughing and deep breathing exercises
d.
Need for bed rest for the first 1 to 2 days after the surgery .ANS: B
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.
, 9. 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
a.
visual acuity.
b.
pupil reaction.
c.
color perception.
d.
peripheral vision. .ANS: D
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.
10. A patient with a right retinal detachment had a pneumatic retinopexy
procedure. Which information will be included in the discharge teaching plan?
a.
The purpose of maintaining the head in a prescribed position
b.
The use of eye patches to reduce movement of the operative eye
c.
The need to wear dark glasses to protect the eyes from bright light
d.
The procedure for dressing changes when the eye dressing is saturated .ANS: A
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.
11. 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?
a.
"I will need to use bright lights to read for at least the next week."
b.
"I will use drops to keep my pupils dilated until my appointment."
c.
"I will not use facial lotions near my eyes during the recovery period."
d.
"I will cover up with long-sleeved shirts and pants for the next 5 days." .ANS: D
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
Visual and Auditory Problems question
and ANSwers.
The nurse evaluates that wearing bifocals improved the patient's myopia and
presbyopia by assessing for
a.
strength of the eye muscles.
b.
both near and distant vision.
c.
cloudiness in the eye lenses.
d.
intraocular pressure changes. .ANS: B
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.
2. A nurse should instruct a patient with recurrent staphylococcal and seborrheic
blepharitis to
a.
irrigate the eyes with saline solution.
b.
apply cool compresses to the eyes three times daily.
c.
use a gentle baby shampoo to clean the lids as needed.
d.
schedule an appointment for surgical removal of the lesion. .ANS: C
Baby shampoo is used to soften and remove crusts associated with blepharitis. The
other interventions are not used in treating this disorder.
3. When assisting a blind patient in ambulating to the bathroom, the nurse should
a.
take the patient by the arm and lead the patient slowly to the bathroom.
b.
have the patient place a hand on the nurse's shoulder and guide the patient.
c.
stay beside the patient and describe any obstacles on the path to the bathroom.
d.
,walk slightly ahead of the patient and allow the patient to hold the nurse's elbow.
.ANS: D
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.
4. A nurse should include which instructions when teaching a patient with repeated
hordeolum how to prevent further infection?
a.
Apply cold compresses at the first sign of recurrence.
b.
Discard all open or used cosmetics applied near the eyes.
c.
Wash the scalp and eyebrows with an antiseborrheic shampoo.
d.
Be examined for recurrent sexually trANSmitted infections (STIs). .ANS: B
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.
5. The nurse developing a teaching plan for a patient with herpes simplex keratitis
should include which instruction?
a.
Apply antibiotic drops to the eye several times daily.
b.
Wash hands frequently and avoid touching the eyes.
c.
Apply a new occlusive dressing to the affected eye at bedtime.
d.
Use corticosteroid ophthalmic ointment to decrease inflammation. .ANS: B
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.
6. Which teaching point should the nurse plan to include when caring for a patient
whose vision is corrected to 20/200?
a.
How to access audio books
,b.
How to use a white cane safely
c.
Where Braille instruction is available
d.
Where to obtain specialized magnifiers .ANS: D
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.
7. 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?
a.
Discussing the need for sexually trANSmitted infection testing
b.
Applying topical corticosteroids to prevent further inflammation
c.
Assisting with applying for community visual rehabilitation services
d.
Educating about the use of antiviral eyedrops to treat the infection .ANS: A
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.
8. Which topic will the nurse teach after a patient has had outpatient cataract
surgery and lens implantation?
a.
Use of oral opioids for pain control
b.
Administration of corticosteroid eye drops
c.
Importance of coughing and deep breathing exercises
d.
Need for bed rest for the first 1 to 2 days after the surgery .ANS: B
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.
, 9. 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
a.
visual acuity.
b.
pupil reaction.
c.
color perception.
d.
peripheral vision. .ANS: D
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.
10. A patient with a right retinal detachment had a pneumatic retinopexy
procedure. Which information will be included in the discharge teaching plan?
a.
The purpose of maintaining the head in a prescribed position
b.
The use of eye patches to reduce movement of the operative eye
c.
The need to wear dark glasses to protect the eyes from bright light
d.
The procedure for dressing changes when the eye dressing is saturated .ANS: A
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.
11. 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?
a.
"I will need to use bright lights to read for at least the next week."
b.
"I will use drops to keep my pupils dilated until my appointment."
c.
"I will not use facial lotions near my eyes during the recovery period."
d.
"I will cover up with long-sleeved shirts and pants for the next 5 days." .ANS: D
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
