Nokea
A patient is seen in the ophthalmology clinic and diagnosed with recurrent staphylococcal and seborrheic blepharitis. Which of the following topics should the nurse include in the teaching plan?
- A. Saline irrigation of the eyes
- B. Surgical removal of the lesion
- C. Using baby shampoo to clean the lids
- D. The use of cool compresses to the eyes
Correct Answer: C
Rationale: Baby shampoo is used to soften and remove crusts associated with blepharitis. The other interventions are not used in treating this disorder.
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A patient with hearing loss asks the nurse about the use of a cochlear implant. Which of the following information will the nurse include when replying to the patient?
- A. Cochlear implants require training in order to receive the full benefit.
- B. Cochlear implants are not useful for patients with congenital deafness.
- C. Cochlear implants are most helpful as an early intervention for presbycusis.
- D. Cochlear implants improve hearing in patients with conductive hearing loss.
Correct Answer: A
Rationale: Extensive rehabilitation is required after cochlear implants in order for patients to receive the maximum benefit. Hearing aids, rather than cochlear implants, are used initially for presbycusis. Cochlear implants are used for sensorineural hearing loss and would not be helpful for conductive loss. They are appropriate for some patients with congenital deafness.
The nurse is caring for a patient with neural presbycusis. Which of the following hearing changes should the nurse expect with this type of presbycusis?
- A. Loss of high-pitched sounds
- B. Loss of speech discrimination
- C. Uniform loss for all frequencies
- D. Range of hearing loss with low frequencies
Correct Answer: B
Rationale: The hearing change with a neural presbycusis is a loss of speech discrimination. Loss of high-pitched sounds accompanies a sensory presbycusis. A metabolic presbycusis has a hearing change that is uniform for all frequencies, accompanied by recruitment. A cochlear presbycusis has a hearing change that is a range of hearing loss that increases from low to high frequencies.
An older-adult patient with presbycusis is fitted with binaural hearing aids. Which of the following information should the nurse include when teaching the patient how to use the hearing aids?
- A. Experiment with volume and hearing ability in a quiet environment initially.
- B. Keep the volume low on the hearing aids for the first week while adjusting to them.
- C. Add the second hearing aid after making the initial adjustment to the first hearing aid.
- D. Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.
Correct Answer: A
Rationale: Initially the patient should use the hearing aids in a quiet environment like the home, experimenting with increasing and decreasing the volume as needed. There is no need to gradually increase the time of wear. The patient should experiment with the level of volume to find what works well in various situations. Both hearing aids should be used.
The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the right ear. Which of the following assessment data obtained by the nurse is of most concern?
- A. The patient has a temperature of 38.1°C (100.6°F).
- B. The patient reports mild ear pain.
- C. The patient has slight redness in the ear canal.
- D. The patient reports decreased hearing in the right ear.
Correct Answer: A
Rationale: A temperature of 38.1°C (100.6°F) after treatment for acute otitis media may indicate a persistent or worsening infection, requiring immediate attention. Mild ear pain, slight redness, and decreased hearing may be residual symptoms but are less concerning unless persistent or severe.
The nurse is caring for a patient with a left retinal detachment who had a pneumatic retinopexy procedure. Which of the following information should be included in the discharge teaching plan?
- A. The use of bilateral eye patches to reduce movement of the operative eye
- B. The need to wear dark or tinted glasses
- C. The procedure for sterile dressing changes
- D. The purpose of maintaining the head in a prescribed position for several weeks
Correct Answer: D
Rationale: Following pneumatic retinopexy, maintaining the head in a prescribed position is critical to keep the gas bubble in contact with the retinal tear, promoting reattachment. Bilateral eye patches are not typically used, dark glasses may be recommended for comfort but are not the focus, and sterile dressing changes are not standard for this procedure.