ANP 650 MIDTERM EXAM LATEST ACTUAL EXAM TEST |/|\| |/|\| |/|\| ||/|\|| |/|\|| ||/|\||| ||/|\|||
BANK 100 QUESTIONS AND CORRECT DETAILED
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| |/|\||
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) | |/|\| |/|\| ||/|\|| ||/|\||| ||/|\|||
ALREADY GRADED A+ ||/|\||| ||/|\|||
1.A client is diagnosed with strabismus. Which of the following will the client most likely experience
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
with this disorder? ||/|\||| ||/|\|||
1. Nystagmus
2. Diplopia
3. Aphakic vision ||/|\|||
4. Ptosis - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Diplopia, or double vision, is the primary symptom of strabismus. Nystagmus is a disorder that causes
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
involuntarily rhythmic movements in the eye. Aphakic vision occurs when the lens of the eye is ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
removed. Ptosis is drooping of the eyelid. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2.A client is experiencing a gradual blurring of vision in both eyes not associated with any pain. The
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nurse suspects the client is experiencing:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. glaucoma.
2. cataracts.
3. macular degeneration. ||/|\|||
4. retinal detachment. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Cataracts occur as the opacity of the lens becomes cloudy, blurring the vision. It occurs in both
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
eyes but is usually worse in one eye. Gradual eye blurring is not associated with glaucoma, macular
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degeneration, or retinal detachment. ||/|\||| ||/|\||| ||/|\|||
3.The nurse should instruct a client, diagnosed with glaucoma, that the purpose of medication is to:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. help dry up excess secretions. ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. lower the intraocular pressure. ||/|\||| ||/|\||| ||/|\|||
3. strengthen the muscles of the eye. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. improve the vision in the eye. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
,Glaucoma is a disease that relates to the increase of intraocular pressure. The medication given will ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
decrease this intraocular pressure. Medication for glaucoma is not used to help dry up excess
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
secretions, strengthen the eye muscles, or improve vision. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4.After surgery to remove a cataract, which of the following should the nurse instruct the client?
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1. Be sure to follow the schedule for the prescribed eyedrop medication.
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2. Sleep on the right side to promote drainage. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. It is okay to rub the eye because the surgery was on the inside.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. This is an outpatient procedure, and there are no instructions for the patient. - answer-ANS:
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||/|\||| 1 Client education is extremely important in the aftercare of cataract surgery. There is a
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need to ||/|\|||
emphasize the postoperative care of eyedrop instillation. The client should not place any pressure ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
near or on the eye. Postoperative instructions are highly important for the client having an
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outpatient surgical procedure. ||/|\||| ||/|\|||
5. A tonometry test has been performed with a client and the results are 25 mmHg. The nurse know that:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. the reading is low and there is no problem. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. the reading is normal and nothing needs to be done at this time.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. the results are high and follow-up readings and tests are needed.
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4. the results are high and there is no cure to bring the pressure down. - answer-ANS: 3
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Several reading need to be taken throughout the day to establish the highest reading to be the
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treated pressure. Normal intraocular pressure ranges from 12 to 16 mmHg. The reading of 25
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mmHg is not low or normal. Medication can be prescribed to reduce the pressure.
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6. A client has been diagnosed with cataracts. The nurse realizes that the only treatment for this
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
disorder is? ||/|\|||
1. Medical management with eyedrops ||/|\||| ||/|\||| ||/|\|||
2. Surgical removal of the lens ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. Cryopexy
4. Phototherapy - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Surgical treatment for cataracts begins when vision is sufficiently impaired. The lens is removed and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the replacement artificial intraocular lens is put in place. Cataracts cannot be treated with medication
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
alone. Cryopexy and phototherapy are not used to treat cataracts. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
,7. Which of the following should the nurse assess in a client diagnosed with open-angle glaucoma?
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. Degree of lost vision ||/|\||| ||/|\||| ||/|\|||
2. Severity of headaches ||/|\||| ||/|\|||
3. Amount of blurred vision ||/|\||| ||/|\||| ||/|\|||
4. Date of onset - answer-ANS: 1 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Open-angle glaucoma is characterized by a gradual increase in pressure and a gradual loss of ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
vision. Closed-angle glaucoma presents with a sudden onset causing headache, blurred vision, and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
eye pain. ||/|\|||
8. A client is experiencing little flashes of lights and things floating in the visual field. The nurse suspects:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. cataracts.
2. glaucoma.
3. conjunctivitis.
4. retinal detachment. - answer-ANS: 4 ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Retinal detachment is clinically manifested by flashes and floaters in the visual field. Flashes of light
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
and floaters are not associated with cataracts, glaucoma, or conjunctivitis.
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9. A client tells the nurse that she sees a shadow that is slowing getting worse in her left eye. Which
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
||/|\||| of the following should the nurse do?
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. Instruct the client to return home to rest in bed. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. Encourage the client to continue with normal daily activities. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. Notify an ophthalmologist. ||/|\||| ||/|\|||
4. Encourage fluids and normal saline eyedrops. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
The nurse should notify an ophthalmologist with the clients symptoms. The onset of a shadow in
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the field of vision that will not dissipate is an indication of a detached retina. Retinal
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
detachments rarely self-repair, and the client will need surgery. The nurse should not instruct the ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
client to return home to rest in bed. The client should not be encouraged to continue with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
normal daily activities. Fluids and saline eyedrops will not help a detached retina.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
10. A client is experiencing a loss of central vision but not a loss of peripheral vision. The nurse
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
realizes the client should be evaluated for: ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. detached retina syndrome. ||/|\||| ||/|\|||
, 2. nystagmus.
3. macular degeneration. ||/|\|||
4. conjunctivitis. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\|||
Macular degeneration is a deterioration of part of the retina, causing loss of central vision but not
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
affecting peripheral vision. The loss of central vision is not typically seen in a detached retina,
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
nystagmus, or conjunctivitis. ||/|\||| ||/|\|||
11. A client is experiencing redness, burning, itching, and pain of the eyes. The nurse suspects the
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
client is experiencing: ||/|\||| ||/|\|||
1. blepharitis.
2. conjunctivitis.
3. keratitis.
4. iritis. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Clinical manifestations of conjunctivitis (pink eye) include watery eyes, redness, itching, and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
burning pain. Blepharitis is associated with a sticky exudate. Keratitis is associated with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
photophobia. Iritis is associated with blurred vision and photophobia. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
12. A client has been diagnosed as being legally blind. The nurse realizes this clients vision is:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. 20/200 or less in the better eye with correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. 20/200 or less in the worse eye without correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. 20/100 or less in the better eye without correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. 20/100 or less in the worse eye with correction. - answer-ANS: 1 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Legal blindness is defined as vision of 20/200 or less on a Snellen chart in the better eye with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
correction. The eye needs to have correction in order to be diagnosed as legally blind; therefore, ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the choice of 20/200 in the worse eye without correction would be incorrect. The vision
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
measurements of the other choices can be corrected with lenses and would not be categorized as ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
legal blindness. ||/|\|||
13. The nurse realizes that the best medication treatment for open-angle glaucoma would be:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. timolol (Timoptic) eyedrops. ||/|\||| ||/|\|||
2. latanoprost (Xalatan) eyedrops. ||/|\||| ||/|\|||
3. timolol (Timoptic) and Latanoprost (Xalatan) eyedrops. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. metoprolol oral medication. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
BANK 100 QUESTIONS AND CORRECT DETAILED
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| |/|\||
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) | |/|\| |/|\| ||/|\|| ||/|\||| ||/|\|||
ALREADY GRADED A+ ||/|\||| ||/|\|||
1.A client is diagnosed with strabismus. Which of the following will the client most likely experience
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
with this disorder? ||/|\||| ||/|\|||
1. Nystagmus
2. Diplopia
3. Aphakic vision ||/|\|||
4. Ptosis - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Diplopia, or double vision, is the primary symptom of strabismus. Nystagmus is a disorder that causes
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
involuntarily rhythmic movements in the eye. Aphakic vision occurs when the lens of the eye is ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
removed. Ptosis is drooping of the eyelid. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2.A client is experiencing a gradual blurring of vision in both eyes not associated with any pain. The
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
nurse suspects the client is experiencing:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. glaucoma.
2. cataracts.
3. macular degeneration. ||/|\|||
4. retinal detachment. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Cataracts occur as the opacity of the lens becomes cloudy, blurring the vision. It occurs in both
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
eyes but is usually worse in one eye. Gradual eye blurring is not associated with glaucoma, macular
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
degeneration, or retinal detachment. ||/|\||| ||/|\||| ||/|\|||
3.The nurse should instruct a client, diagnosed with glaucoma, that the purpose of medication is to:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. help dry up excess secretions. ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. lower the intraocular pressure. ||/|\||| ||/|\||| ||/|\|||
3. strengthen the muscles of the eye. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. improve the vision in the eye. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
,Glaucoma is a disease that relates to the increase of intraocular pressure. The medication given will ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
decrease this intraocular pressure. Medication for glaucoma is not used to help dry up excess
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
secretions, strengthen the eye muscles, or improve vision. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4.After surgery to remove a cataract, which of the following should the nurse instruct the client?
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. Be sure to follow the schedule for the prescribed eyedrop medication.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. Sleep on the right side to promote drainage. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. It is okay to rub the eye because the surgery was on the inside.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. This is an outpatient procedure, and there are no instructions for the patient. - answer-ANS:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
||/|\||| 1 Client education is extremely important in the aftercare of cataract surgery. There is a
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
need to ||/|\|||
emphasize the postoperative care of eyedrop instillation. The client should not place any pressure ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
near or on the eye. Postoperative instructions are highly important for the client having an
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
outpatient surgical procedure. ||/|\||| ||/|\|||
5. A tonometry test has been performed with a client and the results are 25 mmHg. The nurse know that:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. the reading is low and there is no problem. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. the reading is normal and nothing needs to be done at this time.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. the results are high and follow-up readings and tests are needed.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. the results are high and there is no cure to bring the pressure down. - answer-ANS: 3
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Several reading need to be taken throughout the day to establish the highest reading to be the
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
treated pressure. Normal intraocular pressure ranges from 12 to 16 mmHg. The reading of 25
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
mmHg is not low or normal. Medication can be prescribed to reduce the pressure.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
6. A client has been diagnosed with cataracts. The nurse realizes that the only treatment for this
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
disorder is? ||/|\|||
1. Medical management with eyedrops ||/|\||| ||/|\||| ||/|\|||
2. Surgical removal of the lens ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. Cryopexy
4. Phototherapy - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Surgical treatment for cataracts begins when vision is sufficiently impaired. The lens is removed and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the replacement artificial intraocular lens is put in place. Cataracts cannot be treated with medication
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
alone. Cryopexy and phototherapy are not used to treat cataracts. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
,7. Which of the following should the nurse assess in a client diagnosed with open-angle glaucoma?
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. Degree of lost vision ||/|\||| ||/|\||| ||/|\|||
2. Severity of headaches ||/|\||| ||/|\|||
3. Amount of blurred vision ||/|\||| ||/|\||| ||/|\|||
4. Date of onset - answer-ANS: 1 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Open-angle glaucoma is characterized by a gradual increase in pressure and a gradual loss of ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
vision. Closed-angle glaucoma presents with a sudden onset causing headache, blurred vision, and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
eye pain. ||/|\|||
8. A client is experiencing little flashes of lights and things floating in the visual field. The nurse suspects:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. cataracts.
2. glaucoma.
3. conjunctivitis.
4. retinal detachment. - answer-ANS: 4 ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Retinal detachment is clinically manifested by flashes and floaters in the visual field. Flashes of light
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
and floaters are not associated with cataracts, glaucoma, or conjunctivitis.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
9. A client tells the nurse that she sees a shadow that is slowing getting worse in her left eye. Which
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
||/|\||| of the following should the nurse do?
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. Instruct the client to return home to rest in bed. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. Encourage the client to continue with normal daily activities. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. Notify an ophthalmologist. ||/|\||| ||/|\|||
4. Encourage fluids and normal saline eyedrops. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
The nurse should notify an ophthalmologist with the clients symptoms. The onset of a shadow in
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the field of vision that will not dissipate is an indication of a detached retina. Retinal
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
detachments rarely self-repair, and the client will need surgery. The nurse should not instruct the ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
client to return home to rest in bed. The client should not be encouraged to continue with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
normal daily activities. Fluids and saline eyedrops will not help a detached retina.
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
10. A client is experiencing a loss of central vision but not a loss of peripheral vision. The nurse
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
realizes the client should be evaluated for: ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. detached retina syndrome. ||/|\||| ||/|\|||
, 2. nystagmus.
3. macular degeneration. ||/|\|||
4. conjunctivitis. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\|||
Macular degeneration is a deterioration of part of the retina, causing loss of central vision but not
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
affecting peripheral vision. The loss of central vision is not typically seen in a detached retina,
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
nystagmus, or conjunctivitis. ||/|\||| ||/|\|||
11. A client is experiencing redness, burning, itching, and pain of the eyes. The nurse suspects the
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
client is experiencing: ||/|\||| ||/|\|||
1. blepharitis.
2. conjunctivitis.
3. keratitis.
4. iritis. - answer-ANS: 2 ||/|\||| ||/|\||| ||/|\|||
Clinical manifestations of conjunctivitis (pink eye) include watery eyes, redness, itching, and
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
burning pain. Blepharitis is associated with a sticky exudate. Keratitis is associated with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
photophobia. Iritis is associated with blurred vision and photophobia. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
12. A client has been diagnosed as being legally blind. The nurse realizes this clients vision is:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. 20/200 or less in the better eye with correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
2. 20/200 or less in the worse eye without correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
3. 20/100 or less in the better eye without correction. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. 20/100 or less in the worse eye with correction. - answer-ANS: 1 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
Legal blindness is defined as vision of 20/200 or less on a Snellen chart in the better eye with
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
correction. The eye needs to have correction in order to be diagnosed as legally blind; therefore, ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
the choice of 20/200 in the worse eye without correction would be incorrect. The vision
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
measurements of the other choices can be corrected with lenses and would not be categorized as ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
legal blindness. ||/|\|||
13. The nurse realizes that the best medication treatment for open-angle glaucoma would be:
||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
1. timolol (Timoptic) eyedrops. ||/|\||| ||/|\|||
2. latanoprost (Xalatan) eyedrops. ||/|\||| ||/|\|||
3. timolol (Timoptic) and Latanoprost (Xalatan) eyedrops. ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
4. metoprolol oral medication. - answer-ANS: 3 ||/|\||| ||/|\||| ||/|\||| ||/|\||| ||/|\|||
