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A patient has informed the home health nurse that she has recently noticed distortions when she looks at the Amsler grid that she has mounted on her refrigerator. What is the nurses most appropriate action?
- A. Reassure the patient that this is an age-related change in vision.
- B. Arrange for the patient to have her visual acuity assessed.
- C. Arrange for the patient to be assessed for macular degeneration.
- D. Facilitate tonometry testing.
Correct Answer: C
Rationale: Amsler grid distortions suggest macular degeneration, requiring prompt ophthalmologic evaluation. They are not age-related, and visual acuity or tonometry tests are less relevant.
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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.
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.
The nurse is administering eye drops to a patient with glaucoma. After instilling the patients first medication, how long should the nurse wait before instilling the patients second medication into the same eye?
- A. 30 seconds
- B. 1 minute
- C. 3 minutes
- D. 5 minutes
Correct Answer: D
Rationale: A 5-minute wait ensures adequate absorption of the first eye drop before administering the second, preventing dilution or reduced efficacy.
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.
The nurse is teaching a patient to care for her new ocular prosthesis. What should the nurse emphasize during the patients health education?
- A. The need to limit exposure to bright light
- B. The need to maintain a low Fowlers position when removing the prosthesis
- C. The need to perform thorough hand hygiene before handling the prosthesis
- D. The need to apply antiviral ointment to the prosthesis daily
Correct Answer: C
Rationale: Hand hygiene prevents infection when handling an ocular prosthesis. Bright light, low Fowlers position, and antiviral ointment are not relevant to prosthesis care.