Med Surge 2- QUIZ 9 Chapter Questions & Answers Verified

Med Surge 2- QUIZ 9 Chapter Questions & Answers Verified 1. The difference between open-angle and angle-closure glaucoma is that the former type: a. Occurs secondarily to ocular inflammation or trauma b. Rarely causes early symptoms c. Is a hereditary structural defect d. Involves narrowing of the angle between the iris and the anterior chamber 2. The patient has had anterior nasal packing placed for severe epistaxis. The nurse notes that he is swallowing frequently and suspects that: a. he is bleeding. b. his throat is dry. c. he is having difficulty coping with the packing. d. he has excess saliva production. 3. When teaching the patient with Ménière's disease about managing the disease, the nurse will stress: a. using antiemetics sparingly. b. limiting fluid intake. c. staying active during the day. d. avoiding use of alcohol and tobacco. Use of alcohol and tobacco products affect the amount of fluid in the middle ear, making the symptoms of Ménière's worse. The patient with Ménière's disease should drink adequate fluid, use antiemetics as needed, and conserve energy during the day. D 4. When developing a nursing care plan for a tonsillectomy patient, an appropriate implementation is: a. taking aspirin to help with throat pain. b. frequent use of citrus juices, because vitamin C helps with healing. c. drinking 8 to 12 glasses of fluid daily. d. resuming activity as before surgery, with no restrictions. Drinking 8 to 12 glasses of fluid daily is recommended in the postoperative period to replenish fluid loss. No citrus juices or aspirin should be used. C 5. Which assessment alerts the nurse to the possible presence of a macular degeneration in a client? a. Blurred vision and pain b. Loss of central vision c. Dull aching in the eye and brow areas d. Loss of peripheral vision Macular degenerations produce loss of central vision. A 6. The nurse instructs a family member how to guide a visually impaired person when ambulating by: a. holding the visually impaired person by his or her non-dominant arm and walking side by side. b. holding the non-dominant hand, wrapping the arm around his or her waist, and walking side by side. c. allowing the visually impaired person to hold the shoulder of the helper and walk slightly behind the helper. d. allowing the visually impaired person to hold the helper's arm, with the helper slightly ahead. Allowing the visually impaired person to walk slightly behind the helper and holding the helper's arm is the most effective way to guide someone who is visually impaired. D 7. After ear surgery, patients are taught to: a. Cough as infrequently as possible b. Take medication to suppress coughing c. Open the mouth and nose while coughing d. Avoid coughing for the first week after surgery 8. A patient with glaucoma is scheduled for colon surgery. Which intervention is critical in the overall care of this patient? a. Obtain an order for continuation of glaucoma medication b. Ask the patient to send all medications home with a family member c. Determine how long the patient has had glaucoma d. Hold all medication before surgery 9. The nurse is assessing the blink reflex in a client who is blind. Which cranial nerve transmits the sensation experimented in the cornea? a. Common oculomotor. b. Trigeminal. c. Glossopharyngeal. d. Facial Air blowing suddenly at the eye should elicit the blink reflex as a protective response. The sensation is perceived through the trigeminal cranial nerve. B 10. A nurse who is applying eye drops to a client holds pressure against the corner of the eye nearest the nose after instilling the drops. The client asks what the nurse is doing. What response by the nurse is best? a. "This prevents contralateral eye absorption." b. "Doing this allows time for absorption." c. "I am stopping the naso-lacrimal duct drainage from your eye." d. "I am keeping the drops in the eye." This technique, called punctual occlusion, prevents eye drops from draining to the naso-lacrimal duct and being absorbed systemically. The other answers are inaccurate. C 11. After visual assessment using the Snellen chart, the nurse determines that a client has 20/40 vision. This means the patient: a. Can count the examiners' fingers at 20 and 40 feet b. Can read at 40 feet letters normally only read at 20 feet c. Sees hand movements at 20 feet but not at 40 feet d. Must be 20 feet from the chart to read letters normally read at 40 feet 12. A client has recently had cataract surgery. About which symptom does the nurse instruct the client to notify the health care provider? a. Seeing halos around lights b. Itching of the eye c. Swollen eyelid d. Increased tearing A reduction in vision after cataract surgery or seeing halos around the lights indicates a problem like increased intraoccular pressure, and the client should notify the provider immediately. Increased tearing, itching of the eye, and a swollen eyelid all are expected after cataract surgery. A 13. A nurse explains to a first-aid class that covering the uninjured eye is important when the affected eye has a penetrating injury. The reason for this action is to: a. Prevent excessive movement of the injured eye b. Prevent sympathetic ophthalmia c. Prevent corneal damage to both eyes d. Minimize increases in intraocular pressure in the injured eye 14. Which statement indicates that a client needs additional teaching about ear hygiene? a. "I will clean my ears with plain warm water and a washcloth every day." b. "I can rinse my ears with half-strength hydrogen peroxide if ear wax builds up." c. "I will use a cotton swab to get the extra water out of my ears after I swim." d. "I will wash my hands before I put in my earplugs at work." Cotton swabs should not be inserted into the ear canal because injury to the tympanic membrane can result. The cotton swab can push cerumen deeper into the ear canal, possibly resulting in impaction. Hands should always be washed before earplug insertion to prevent ear infection. Ears should be cleaned with plain warm water and a washcloth to prevent irritation of the ear canal. The ears may be safely rinsed with half-strength hydrogen peroxide to remove excess ear wax within the ear canal. C 15. The public health nurse refers the patient to an ophthalmologist for which visual outcome? a. 20/20 vision both eyes b. 20/20 vision OD, 20/30 vision OS c. 20/50 vision OD d. 20/15 vision OD, 20/20 vision OS 16. An appropriate nursing intervention for the patient after cataract surgery is to: a. Encourage coughing and deep breathing b. Position the patient on the operative side c. Instruct on a high-fiber diet and fluids d. Remove the metal shield at bedtime 17. A patient presents in the emergency room complaining of severe pain in his eye, and is seeing halos around lights and feeling nauseous. You suspect that he may be experiencing: a. glaucoma related retinal detachment. b. angle-closure glaucoma. c. open-angle glaucoma. d. obtuse-angle glaucoma. Sudden onset of acute eye pain with nausea and vomiting and halos around lights are all symptoms of angle-closure glaucoma. The acute pain is caused by sudden blockage of the fluid channels in the eye. B 18. The nurse is assessing a client for the possibility of lens opacity. Which assessment finding confirms this problem? a. Decreased central vision b. Positive corneal staining c. Absence of a red reflex d. Increased intraocular pressure The red reflex is elicited with an ophthalmoscope and represents reflection of the ophthalmoscopic light through the lens onto the vascular retina. The absence of a red reflex strongly indicates a lens opacity that does not allow light to penetrate through to the retina. The other answers are not related to lens opacity. Increased intraocular pressure is measured by tonometry and could indicate glaucoma. Decreased central vision is measured by a Snellen chart and a Jaeger card and indicates decreased visual acuity. Positive corneal staining with topical dye could indicate corneal abrasion. C 19. Which act on takes priority for the person with a positive Romberg test? 5 a. Teaching how to perform Valsalva's maneuver b. Standing in front of the patient and speaking clearly c. Removing cerumen from the ear canal daily d. Providing assistance with ambulation 20. In planning care for a child who has been diagnosed with a hearing impairment, and considering the impact of a hearing deficit, the nursing diagnosis that would be appropriate would be: a. Anxiety related to hearing impairment. b. Knowledge deficit related to hearing impairment. c. Risk for social isolation related to hearing impairment. d. Risk for injury related to hearing impairment. The loss of hearing and the mild stigma associated with hearing impairment puts the newly diagnosed child at risk for social isolation. C 21. The nurse is developing a teaching plan for a client with glaucoma. Which instruction should the nurse include in the plan of care? a. Avoid overuse of the eyes. b. Anticholinergic drugs should be avoided for life. c. Decrease the amount of salt in the diet. d. Decrease fluid intake to control the intraocular pressure Glaucoma usually requires life-long administration of medication to control the intraocular pressure and avoid vision loss, as anticholinergic should be avoided all times. B 22. The patient with glaucoma who is using a beta-adrenergic blocking agent, timolol (Timoptic) should be monitored for: a. sudden eye pain. b. blurred vision. c. bronchospasm d. hypertension. Beta-adrenergic blocking agents cause bronchospasm and bradycardia. C 23. History of which problem contraindicates the use of ear irrigation? a. Eardrum perforation b. Head injury c. Chronic severe earaches d. Hearing loss 24. The geriatric client tells you that her hearing loss has become more severe since the hearing aid got wet while cleaning it. The clinic nurse makes arrangement for an evaluation of the hearing aid by an: 6 a. audiologist. b. otologist. c. otolaryngologist. d. audiometrist. Audiologists assess patients for hearing aids. The other specialties are for ENT diseases. A 25. When accommodation is used as a diagnostic tool, the nurse asks the patient to: a. Alternately cover one eye and read a newspaper b. Move eyes to the six cardinal fields of gaze c. Describe areas of distortion in peripheral vision d. Focus on an object that is moved toward the patient's nose Focus on an object that is moved toward the patient's nose 7