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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.
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A patient has just arrived to the floor after an enucleation procedure following a workplace accident in which his left eye was irreparably damaged. Which of the following should the nurse prioritize during the patients immediate postoperative recovery?
- A. Teaching the patient about options for eye prostheses
- B. Teaching the patient to estimate depth and distance with the use of one eye
- C. Assessing and addressing the patients emotional needs
- D. Teaching the patient about his post-discharge medication regimen
Correct Answer: C
Rationale: Emotional support is critical after unexpected enucleation due to trauma. Teaching about prostheses, depth perception, or medications is important but secondary in the immediate postoperative period.
A patient is ready to be discharged home after a cataract extraction with intraocular lens implant and the nurse is reviewing signs and symptoms that need to be reported to the ophthalmologist immediately. Which of the patients statements best demonstrates an adequate understanding?
- A. I need to call the doctor if I get nauseated.
- B. I need to call the doctor if I have a light morning discharge.
- C. I need to call the doctor if I get a scratchy feeling.
- D. I need to call the doctor if I see flashing lights.
Correct Answer: D
Rationale: Flashing lights may signal retinal detachment, requiring immediate reporting post-cataract surgery. Nausea, mild discharge, and scratchiness are less concerning.
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.
The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient?
- A. Provide instructions in simple, clear terms.
- B. Introduce herself in a firm, loud voice at the doorway of the room.
- C. Lightly touch the patients arm and then introduce herself.
- D. State her name and role immediately after entering the patients room.
Correct Answer: D
Rationale: Stating name and role first identifies the nurse without startling the blind patient. Simplifying instructions or using a loud voice is unnecessary, and touching before introducing may cause discomfort.
A patient has lost most of her vision as a result of macular degeneration. When attempting to meet this patients psychosocial needs, what nursing action is most appropriate?
- A. Encourage the patient to focus on her use of her other senses.
- B. Assess and promote the patients coping skills during interactions with the patient.
- C. Emphasize that her lifestyle will be unchanged once she adapts to her vision loss.
- D. Promote the patients hope for recovery.
Correct Answer: B
Rationale: Promoting coping skills supports psychosocial adjustment to vision loss from macular degeneration. Focusing on other senses or promising unchanged lifestyle may minimize the loss, and recovery is unlikely.