Nokea
A client has had a cataract extraction performed. Which statement would indicate that the client needs more teaching?
- A. I will take a stool softener daily.'
- B. I'm going to start doing calisthenic exercises as soon as I get home.'
- C. I'm going to my daughter's for a few weeks until I am recovered.'
- D. I am looking forward to watching television during my recovery period.'
Correct Answer: B
Rationale: Calisthenic exercises involving bending or lifting should be avoided post-cataract extraction to prevent increased intraocular pressure.
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The client is diagnosed with Ménière's disease. Which statement indicates the client understands the medical management for this disease?
- A. After intravenous antibiotic therapy, I will be cured.
- B. I will have to use a hearing aid for the rest of my life.
- C. I must adhere to a low-sodium diet, 2,000 mg/day.
- D. I should sleep with the head of my bed elevated.
Correct Answer: C
Rationale: A low-sodium diet (2,000 mg/day) reduces fluid retention in Ménière's disease, managing vertigo. Antibiotics are irrelevant, hearing aids are not always needed, and elevation is ineffective.
The client comes to the clinic and is diagnosed with otitis media. Which intervention should the clinic nurse include in the discharge teaching?
- A. Instruct the client not to take any over-the-counter pain medication.
- B. Encourage the client to apply cold packs to the affected ear.
- C. Tell the client to call the HCP if an abrupt relief of ear pain occurs.
- D. Wear a protective ear plug in the affected ear.
Correct Answer: C
Rationale: Abrupt pain relief in otitis media may indicate tympanic membrane rupture, requiring HCP notification. OTC pain meds are safe, cold packs are less effective, and ear plugs are unnecessary.
The emergency department nurse is assessing a client who has a needle in the sclera of the right eyeball just below the iris. Which should the nurse implement first?
- A. Remove the needle with tweezers.
- B. Notify an ophthalmologist to care for the client.
- C. Stabilize the right eye and place a patch over the left eye.
- D. Irrigate the right eye to wash the needle out of the eye.
Correct Answer: C
Rationale: Stabilizing the eye and patching the unaffected eye prevents movement and further damage until surgical removal. Removing the needle, notifying later, or irrigating risks harm.
The nurse completes an assessment of the older adult client. Which disorder should the nurse associate with the finding illustrated?
- A. Glaucoma
- B. Arcus senilis
- C. Cataract
- D. Mydriasis
Correct Answer: C
Rationale: The illustration shows opacity of the lens of the eye. The nurse should associate this finding with a cataract. Glaucoma causes increased pressure within the eye and is not visible. Arcus senilis is a bluish-white ring within the outer edge of the cornea, which is not present in this illustration. Mydriasis is constriction of the pupil, which is not present in the illustration.
The client with macular degeneration is told the condition is progressing to an advanced stage. Which findings should the nurse expect when completing the assessment? Select all that apply.
- A. Curtain appearance over part of the visual field
- B. Loss of peripheral vision in the affected eye
- C. Difficulty seeing in dimly lit environments
- D. Visual distortions in the central vision
- E. Clouding of the lens in both eyes
Correct Answer: C,D
Rationale: Difficulty seeing in dimly lit environments is from the slow breakdown of the outer layer of the retina and the formation of drusen within the macula. The macula is the area of central vision, and with macular degeneration, there is the loss or distortion of central vision. Curtain appearance is associated with retinal detachment, peripheral vision loss with glaucoma, and clouding of the lens with cataracts.