Nokea
A patient who had cataract extraction and intraocular lens implantation the previous day calls the eye clinic and gives the nurse all of this information. Which of the following information is the priority to communicate to the health care provider?
- A. The patient has eye pain rated at a 5 (on a 0-10 scale).
- B. The patient has questions about the ordered eye drops.
- C. The patient has poor depth perception when wearing an eye patch.
- D. The patient complains that the vision has 'not improved very much.'
Correct Answer: A
Rationale: Postoperative cataract surgery patients usually experience little or no pain, so pain at a 5 on a 10-point pain level may indicate complications such as hemorrhage, infection, or increased intraocular pressure. The other information given by the patient indicates a need for patient teaching but does not indicate that complications of the surgery may be occurring.
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The nurse is assessing a patient in the outpatient eye clinic who has myopia and presbyopia. Which of the following assessments should the nurse implement to evaluate the effectiveness of the prescribed bifocals?
- A. Strength of the eye muscles
- B. Both near and distant vision
- C. Cloudiness in the eye lenses
- D. Intraocular pressure changes
Correct Answer: B
Rationale: The lenses are prescribed to correct the patient's near and distant vision. The nurse also may assess for cloudiness of the lenses, increased intraocular pressure, and eye movement, but these data will not evaluate whether the patient's bifocals are effective.
The nurse is assessing the presence or absence of contact lenses in an unconscious patient. Which of the following directions should the nurse shine a pen light?
- A. Parallel to the eye
- B. At a 90-degree angle to the eye
- C. Obliquely into the eye
- D. Toward the centre of the nasal bridge
Correct Answer: C
Rationale: The nurse must know whether the patient has contact lenses in and assesses the eye by shining a light obliquely on the eyeball to help the nurse visualize a contact lens.
A patient with glaucoma who has been using timolol drops for several days tells the nurse that the eye drops cause eye burning and visual blurring. Which of the following is the best response by the nurse?
- A. These are normal adverse effects of the drug, which should become less bothersome over time.
- B. Discontinue the eye drops and report these symptoms to your healthcare provider immediately.
- C. Apply the drops in the evening to minimize the impact of visual blurring.
- D. Use artificial tears to reduce the burning sensation caused by the drops.
Correct Answer: A
Rationale: Burning and visual blurring are common side effects of timolol, a beta-blocker used for glaucoma, and typically diminish as the patient adjusts to the medication. Discontinuing the drops without medical advice is not recommended, as it may worsen glaucoma. Evening application or artificial tears may not address the underlying issue effectively.
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.
The nurse is caring for a patient with persistent otitis media. Which of the following findings should the nurse expect to assess?
- A. Ear pain
- B. Fever
- C. Hearing loss
- D. Tinnitus
- E. Fluid drainage from the ear
Correct Answer: A,C,E
Rationale: Persistent otitis media is characterized by ear pain, hearing loss, and potential fluid drainage from the ear. Fever may occur but is less consistent, and tinnitus is not a primary symptom unless associated with complications.