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A 56-year-old patient has come to the clinic for his routine eye examination and is told he needs bifocals. The patient asks the nurse what change in his eyes has caused his need for bifocals. How should the nurse respond?
- A. You know, you are getting older now and we change as we get older.
- B. The parts of our eyes age, just like the rest of us, and this is nothing to cause you to worry.
- C. There is a gradual thickening of the lens of the eye and it can limit the eyes ability for accommodation.
- D. The eye gets shorter, back to front, as we age and it changes how we see things.
Correct Answer: C
Rationale: Age-related lens thickening reduces accommodation, necessitating bifocals. The eye's shape does not shorten, and vague reassurances do not address the patient's question.
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A patient has been diagnosed with glaucoma and the nurse is preparing health education regarding the patients medication regimen. The patient states that she is eager to beat this disease and looks forward to the time that she will no longer require medication. How should the nurse best respond?
- A. You have a great attitude. This will likely shorten the amount of time that you need medications.
- B. In fact, glaucoma usually requires lifelong treatment with medications.
- C. Most people are treated until their intraocular pressure goes below 50 mm Hg.
- D. You can likely expect a minimum of 6 months of treatment.
Correct Answer: B
Rationale: Glaucoma typically requires lifelong medication to manage intraocular pressure. Normal pressure is 10-21 mm Hg, and treatment duration is not limited to 6 months.
A patient with glaucoma has presented for a scheduled clinic visit and tells the nurse that she has begun taking an herbal remedy for her condition that was recommended by a work colleague. What instruction should the nurse provide to the patient?
- A. The patient should discuss this new remedy with her ophthalmologist promptly.
- B. The patient should monitor her IOP closely for the next several weeks.
- C. The patient should do further research on the herbal remedy.
- D. The patient should report any adverse effects to her pharmacist.
Correct Answer: A
Rationale: Herbal remedies may interact with glaucoma treatment, so prompt discussion with the ophthalmologist is essential. Self-monitoring IOP is not feasible, and research or pharmacist reporting is secondary.
An older adult patient has been diagnosed with macular degeneration and the nurse is assessing him for changes in visual acuity since his last clinic visit. When assessing the patient for recent changes in visual acuity, the patient states that he sees the lines on an Amsler grid as being distorted. What is the nurses most appropriate response?
- A. Ask if the patient has been using OTC vasoconstrictors.
- B. Instruct the patient to repeat the test at different times of the day when at home.
- C. Arrange for the patient to visit his ophthalmologist.
- D. Encourage the patient to adhere to his prescribed drug regimen.
Correct Answer: C
Rationale: Amsler grid distortions in macular degeneration warrant immediate ophthalmologic evaluation. Vasoconstrictors, repeating tests, or drug adherence are not appropriate responses.
The nurse has taken shift report on her patients and has been told that one patient has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the patient?
- A. Ensure adequate lighting in the patients room.
- B. Provide a dimly lit room to aid vision by limiting contrast.
- C. Carefully point out color differences for the patient.
- D. Carefully point out fine details for the patient.
Correct Answer: A
Rationale: Rods are responsible for low-light vision, so adequate lighting compensates for rod impairment. Dim lighting worsens vision, and rods do not affect color or fine detail perception.
The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient?
- A. Provide instructions in simple, clear terms.
- B. Introduce herself in a firm, loud voice at the doorway of the room.
- C. Lightly touch the patients arm and then introduce herself.
- D. State her name and role immediately after entering the patients room.
Correct Answer: D
Rationale: Stating name and role first identifies the nurse without startling the blind patient. Simplifying instructions or using a loud voice is unnecessary, and touching before introducing may cause discomfort.