Nokea
A middle-aged client reports increasing difficulty reading newspaper print. Which of the following nursing explanations best describes this type of refractive error?
- A. Client is nearsighted.
- B. Lens has become cloudy and thick.
- C. Loss of elasticity of the lens.
- D. Floaters in the eye increase with age.
Correct Answer: C
Rationale: Presbyopia is a result of poor accommodation due to a loss of elasticity of the ciliary muscles and lens. Nearsighted refers to myopia. Cloudiness of lens is also associated with the aging process and does interfere with vision as a result of cataract formation. Floaters in the eyes are more apparent with aging but appear as dark spots.
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A nurse is caring for a client who has undergone enucleation. What complication of enucleation should be addressed by the nurse?
- A. Hypotension
- B. Nausea and vomiting
- C. Hemorrhage
- D. Pneumonia
Correct Answer: C
Rationale: The nurse should take measures to prevent hemorrhage, a complication of enucleation, by applying a pressure dressing. Nausea and vomiting are common side effects of surgery. Enucleation does not increase risk of developing hypotension or pneumonia.
Which technique would be most beneficial for ambulation of a client who is visually impaired?
- A. Speak before touching the client.
- B. Provide a detailed description of the room and walkway.
- C. Allow client to follow the nurse's lead.
- D. Provide the client with a guide dog.
Correct Answer: C
Rationale: A blind person feels more secure and safe when assisted by someone who is sighted. The nurse should walk slightly ahead while allowing the client to hold onto the nurse's upper arm or elbow. Speaking before touching is an important care action in dealing with clients who have impaired vision but does not assist in ambulation. Providing a detailed description of the room may allow the client an image of the surroundings but is not as helpful in initial ambulation. Finding a perfect fit between guide dog and client is a lengthy process and should be pursued upon request of client.
A client asks the nurse why miotic eye solutions were prescribed in the treatment of the client's glaucoma. Which is the best nursing rationale for the use of this medication?
- A. Constricts intraocular vessels
- B. Paralyzes ciliary muscles
- C. Constricts pupil
- D. Dilates the pupil
Correct Answer: C
Rationale: A miotic agent works by constricting the pupil and pulling the iris away from the drainage channels so that the aqueous fluid can escape. These medications increase outflow and decrease intraocular pressure. Cycloplegics paralyze the ciliary muscles of the eye. Mydriatics drugs are used to dilate the pupil and are contraindicated in glaucoma.
The client with chronic open-angle glaucoma is receiving timolol eye drops. Which evaluation finding would indicate to the nurse the treatment is working?
- A. Intraocular pressure 15 mm Hg
- B. Reduced peripheral vision
- C. Halos around lights
- D. Decrease in nausea and vomiting
Correct Answer: A
Rationale: Timolol is a beta-blocker that is used topically to decrease the flow rate of aqueous humor in the eye. As flow rate decreases, the intraocular pressure decreases. IOP of 12 to 21 mm Hg is within normal range. Reduced peripheral vision, halos around lights, and blurred vision are all symptoms of open-angle glaucoma. Nausea and vomiting are more likely to occur with acute angle-closure glaucoma.
A nurse is doing preoperative and postoperative teaching with a client who is undergoing cataract surgery. What is an important teaching point the nurse should emphasize to the client?
- A. Prepare for possible feelings of depression.
- B. Expect increased urine output.
- C. Eat soft, easily chewed food until healing is complete.
- D. Anticipate development of a periorbital hematoma.
Correct Answer: C
Rationale: Advise clients who have had cataract surgery to eat soft, easily chewed foods until healing is complete to avoid tearing from excessive facial movements. Clients who undergo cataract surgery do not become depressed, have increased urine output, or develop a periorbital hematoma.