Nokea
A nurse is caring for an older adult client with macular degeneration who has received injections of angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening?
- A. Blurred vision
- B. Burning sensation of the eyes
- C. Loss of peripheral field vision
- D. Central vision impairment
Correct Answer: D
Rationale: When the macula becomes irreparably damaged, central vision is lost and the client can only see images via peripheral field. Blurred vision is the initial symptom of the disease and does not signify worsening. Burning sensation is a common adverse reaction to the treatment injection.
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A nurse is assessing a client for a fracture to the bony orbit. What would the nurse document if the assessment for fracture was positive?
- A. There is excessive tearing.
- B. The client's vision is blurred.
- C. A rust ring is seen around the pupil.
- D. The client has diplopia.
Correct Answer: D
Rationale: If the bony orbit is fractured, the eyes may appear asymmetric, and the client has diplopia or double vision. Excessive tearing, presence of rust rings, or blurry vision do not indicate a fractured bony orbit.
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.
A nurse is caring for a client newly diagnosed with glaucoma. Which would be a priority in the nurse's teaching about maintaining normal pressure range in the eye?
- A. Increase fiber in the diet.
- B. Avoid reading.
- C. Eat small meals.
- D. Treat allergy symptoms promptly.
Correct Answer: A
Rationale: Adding fiber to the diet will increase ease of bowel movements and prevent constipation and straining, which can inadvertently increase intraocular pressure. Eating small meals is insignificant in maintaining intraocular pressure. Avoid over-the-counter treatment of cold and allergy symptoms if contains cholinergic blockers. Reading is not significant in changing intraocular pressure, but eye strain should be avoided.
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.
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.