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The camp nurse is caring for a patient who is complaining of bilateral eye pain after a campfire log exploded, sending sparks into the patient's eyes. Which of the following actions should the nurse take first?
- A. Apply ice packs to the eyes.
- B. Flush the eyes with sterile saline.
- C. Cover the eyes with dry sterile patches and protective eye shields.
- D. Apply antiseptic ophthalmic ointment from the first-aid kit to the eyes.
Correct Answer: C
Rationale: Emergency treatment of a burn or foreign-body injury to the eyes includes protecting the eyes from further injury by covering them with dry sterile dressings and protective shields. Flushing of the eyes immediately is indicated only for chemical exposure. Except in the case of chemical exposure, the nurse should not begin treatment until the patient has been assessed by a health care provider and orders are available.
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A patient has been seen at a clinic for repeated hordeolum of the eyes during the last 6 months. Which of the following actions should the nurse recommend to the patient to help prevent further infection?
- A. Apply cold compresses at the first sign of recurrence.
- B. Discard all open or used cosmetics used near the eyes.
- C. Wash the scalp and eyebrows with an anti-seborrheic shampoo.
- D. Seek evaluation for the presence of sexually transmitted infections (STIs).
Correct Answer: B
Rationale: Hordeolum (stye) is commonly caused by Staphylococcus aureus, which may be present in cosmetics that the patient is using. Warm compresses are recommended to treat hordeolum. Anti-seborrheic shampoos are recommended for seborrheic blepharitis. Patients with adult inclusion conjunctivitis, which is caused by Chlamydia trachomatis, should be referred for STD testing.
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 who had a stapedotomy yesterday. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. The patient complains of 'congestion' in the ear.
- B. The patient's oral temperature is 38°C (100.4°F).
- C. The patient reports mild dizziness when standing.
- D. The patient has slight redness at the surgical site.
Correct Answer: B
Rationale: An oral temperature of 38°C (100.4°F) after a stapedotomy may indicate a postoperative infection, which requires prompt reporting to the healthcare provider. Congestion, mild dizziness, and slight redness are less urgent, as they may be expected postoperative symptoms unless severe or persistent.
The nurse is reviewing a patient's medical record and notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. Which of the following parameters should the nurse assess?
- A. Visual acuity
- B. Pupil reaction
- C. Colour perception
- D. Peripheral vision
Correct Answer: D
Rationale: The patient's increased intraocular pressure indicates glaucoma, which decreases peripheral vision. Because central visual acuity is unchanged by glaucoma, assessment of visual acuity could be normal even if the patient has worsening glaucoma. Colour perception and pupil reaction to light are not affected by glaucoma.
Which of the following actions should the nurse take when communicating with a patient who has a moderate hearing loss?
- A. Overenunciate words.
- B. Speak normally but more slowly.
- C. Increase the volume when speaking.
- D. Use more facial expressions when talking.
Correct Answer: B
Rationale: Patient understanding of the nurse's speech will be enhanced by speaking at a normal tone, but more slowly. Increasing the volume, overenunciating, and exaggerating facial expressions will not improve the patient's ability to comprehend the nurse.