Nokea
An older adult client is scheduled for cataract surgery and asks the nurse, 'Will I need to wear thick lenses after surgery?' Which is an appropriate response from the nurse?
- A. An implanted lens has replaced the need for corrective glasses.
- B. Contact lenses are preferred by most clients after this surgery.
- C. They can make corrective lenses much thinner now.
- D. No lens is necessary with cataract surgery.
Correct Answer: A
Rationale: Vision is usually restored after cataract surgery with an intraocular lens implant. Contact lenses can be used but can be burdensome for older adults. Corrective glass lenses can cause a distortion of peripheral vision and only one lens is required (over operative eye). To restore vision after cataract surgery, a lens is required.
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An eighth-grade client visits the school nurse and reports having been to an eye doctor who identified an astigmatism and described it as a condition in which the eyeball is not shaped correctly. The client asks the nurse why both eyes look alike in the mirror if this is the case. What is the nurse's best response?
- A. Astigmatism means that the very front part of the eye is shaped differently than the very front part in most eyes.
- B. Astigmatism means that the overall shape of the eye resembles an olive more than most eyes.
- C. Astigmatism means that the inside of the eye is shaped differently than the inside of most eyes.
- D. Astigmatism means that the overall shape of your eye is shorter than most eyes.
Correct Answer: A
Rationale: Astigmatism is visual distortion caused by an irregularly shaped cornea. When the overall shape of the eye is like an olive, or more oblong, it results in myopia, not astigmatism, although both conditions may be present at once. The inside of the eye is not shaped differently in the client with an astigmatism. The overall shape of the eye being shorter results in hyperopia, not astigmatism.
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 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 caring for a client immediately following cataract removal. Which symptom would be most alarming to the nurse?
- A. Irritation in the operative eye
- B. Dilation of the pupil
- C. Dry, tickling cough
- D. Fever
Correct Answer: C
Rationale: Coughing can rise the intraocular pressure and should be avoided. A cough suppressant can be prescribed. The pupil was intentionally dilated during the surgical approach and will resolve. The client may complain of mild eye irritation in the immediate postoperative period. Fever can be a complication of cataract surgery but not expected in the immediate period postoperatively.
The nurse is teaching a parent how to instill drops in a 12-year-old child's eyes. Which action would the nurse instruct the parent to perform first?
- A. Close the eye gently.
- B. Tilt the head slightly backward.
- C. Instill the prescribed number of drops into the conjunctival pocket.
- D. Do not allow the tip of the container to touch the eye.
Correct Answer: B
Rationale: To instill eye drops, tilt the head slightly backward and toward the eye in which the medication is to be instilled. Do not allow the tip of the container to touch the eye. Instill the prescribed number of drops into the conjunctival pocket or apply a thin ribbon of ointment directly into the conjunctival pocket, beginning at the inner comer and moving outward. Close the eye gently.