Nokea
The client diagnosed with glaucoma is prescribed a miotic cholinergic medication. Which data indicate the medication has been effective?
- A. No redness or irritation of the eyes.
- B. A decrease in intraocular pressure.
- C. The pupil reacts briskly to light.
- D. The client denies any type of floaters.
Correct Answer: B
Rationale: Miotic cholinergics (e.g., pilocarpine) reduce intraocular pressure in glaucoma by increasing aqueous outflow. Redness, pupil reaction, and floaters are not primary indicators.
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When planning care for a woman with myasthenia gravis, the nurse asks her what time of day she feels strongest. The nurse would expect which of the following replies?
- A. I can wash up and comb my hair before breakfast because I feel best in the morning.'
- B. I only feel good for about an hour after I take my medication.'
- C. I feel strongest in the evening, so I would prefer to take a shower before bedtime.'
- D. I feel best after lunch after I've been moving around a little.'
Correct Answer: A
Rationale: Muscle strength in myasthenia gravis is typically best in the morning, with weakness worsening throughout the day.
The client recently diagnosed with glaucoma tells the nurse, 'I'm having difficulty remembering to insert my eye drops. I don't have any pain or vision changes when I forget them.' Which statement is the best response?
- A. You should be diligent in inserting the eye drops; if not, then you will need surgery.
- B. You wouldn't have pain, but untreated glaucoma will eventually lead to vision loss.
- C. Tell me about your day; planning a time with a daily activity often helps as a reminder.
- D. I know this must be hard for you; not everyone is able to remember everything.
Correct Answer: C
Rationale: This is a broad opening statement and can assist the client to problem-solve an activity that could serve as a reminder to take the eye drops. The other statements are either belittling, partially incorrect, or do not help with adherence.
The nurse reviews the chart of the client diagnosed with closed-angle glaucoma. Which documented finding should the nurse question with the HCP?
- A. Sudden onset of eye pain
- B. Reduced central visual acuity
- C. Normal intraocular pressure
- D. Nausea and vomiting
Correct Answer: C
Rationale: Closed-angle glaucoma causes an increased, not normal, intraocular pressure. This documentation finding should be questioned. Sudden eye pain, reduced central visual acuity, and nausea and vomiting are consistent with closed-angle glaucoma.
The nurse telephones the client 1 day post-cataract surgery. Which client statement necessitates an evaluation by an ophthalmologist?
- A. My eye starts hurting about 4 hours after a pain pill.
- B. The redness in my eye is a little less than yesterday.
- C. There has never been any swelling around my eye.
- D. I can't see as well as I could yesterday after surgery.
Correct Answer: D
Rationale: A significant reduction in vision may indicate a complication such as infection or retinal detachment. Pain relieved by prescribed pain medication is within normal assessment parameters. Decreasing redness is within normal assessment parameters. No swelling is within normal assessment parameters.
The 65-year-old client is diagnosed with macular degeneration. Which statement by the client indicates the client needs more discharge teaching?
- A. I should use magnification devices as much as possible.
- B. I will look at my Amsler grid at least twice a week.
- C. I need to use low-watt light bulbs in my house.
- D. I am going to contact a low-vision center to evaluate my home.
Correct Answer: C
Rationale: Low-watt bulbs reduce visibility, counterproductive in macular degeneration. Magnification, Amsler grid monitoring (daily preferred), and low-vision centers are appropriate.