Nokea
A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common causes of blindness and visual impairment among adults over the age of 40? Select all that apply.
- A. Diabetic retinopathy
- B. Trauma
- C. Macular degeneration
- D. Cytomegalovirus
- E. Glaucoma
Correct Answer: A,C,E
Rationale: Diabetic retinopathy, macular degeneration, glaucoma, and cataracts are leading causes of blindness in adults over 40. Trauma and cytomegalovirus are less common.
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A patient got a sliver of glass in his eye when a glass container at work fell and shattered. The glass had to be surgically removed and the patient is about to be discharged home. The patient asks the nurse for a topical anesthetic for the pain in his eye. What should the nurse respond?
- A. Overuse of these drops could soften your cornea and damage your eye.
- B. You could lose the peripheral vision in your eye if you used these drops too much.
- C. Im sorry, this medication is considered a controlled substance and patients cannot take it home.
- D. I know these drops will make your eye feel better, but I cant let you take them home.
Correct Answer: A
Rationale: Topical anesthetics can soften the cornea with overuse, risking permanent damage. They are not controlled substances, and peripheral vision loss is not a primary concern.
A patient has had a sudden loss of vision after head trauma. How should the nurse best describe the placement of items on the dinner tray?
- A. Explain the location of items using clock cues.
- B. Explain that each of the items on the tray is clearly separated.
- C. Describe the location of items from the bottom of the plate to the top.
- D. Ask the patient to describe the location of items before confirming their location.
Correct Answer: A
Rationale: Clock cues (e.g., meat at 3 o'clock) effectively orient a visually impaired patient to tray items. Separation, top-to-bottom descriptions, or patient guesses are less practical.
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.
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 should recognize the greatest risk for the development of blindness in which of the following patients?
- A. A 58-year-old Caucasian woman with macular degeneration
- B. A 28-year-old Caucasian man with astigmatism
- C. A 58-year-old African American woman with hyperopia
- D. A 28-year-old African American man with myopia
Correct Answer: A
Rationale: Macular degeneration, prevalent in older adults, is a leading cause of blindness. Astigmatism, hyperopia, and myopia are refractive errors with lower blindness risk.