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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The client is diagnosed with glaucoma. Which symptom should the nurse expect the client to report?
- A. Loss of peripheral vision.
- B. Floating spots in the vision.
- C. A yellow haze around everything.
- D. A curtain coming across vision.
Correct Answer: A
Rationale: Glaucoma causes loss of peripheral vision due to optic nerve damage from increased intraocular pressure. Floaters suggest vitreous issues, yellow haze is unrelated, and a curtain indicates retinal detachment.
The nurse is questioning the client about vision changes. Which symptom indicates that the client may be developing a cataract?
- A. Blurred vision, worsening at night
- B. Shooting pain in the back of one eye
- C. Increased frequency of headaches
- D. Seeing spots in the vision field of one eye
Correct Answer: A
Rationale: The lens opacity from a developing cataract diminishes vision. Blurriness and decreased night vision are early symptoms. Shooting eye pain is often associated with a subarachnoid hemorrhage, not a cataract. Headaches are not associated with cataract formation. Floating dark spots in the vision field are associated with bleeding within the eye that occurs with detached retina.
The client tells the nurse about being diagnosed with 'wet type' macular degeneration. Which finding should the nurse expect to observe when examining the client's eyes using an ophthalmoscope?
- A. Growth of abnormal blood vessels in the macula has occurred.
- B. Structures in the macula have atrophied.
- C. The lens of the eye has become cloudy.
- D. The edge of the cornea has a thin grayish arc.
Correct Answer: A
Rationale: The 'wet type' of macular degeneration results from the growth of abnormal blood vessels in the macula. The blood vessels often leak fluid and blood. Atrophy occurs in dry macular degeneration, cloudy lens indicates cataract, and corneal arcus is a normal finding in older clients.
The nurse is concerned that the Caucasian client experiencing a stroke may have impaired hearing. Which observations of the client's behavior prompted this concern? Select all that apply.
- A. Nods and agrees to all statements made by the nurse
- B. Asks for more information about the therapy schedule
- C. Slow to respond verbally but answers questions appropriately
- D. Speaks in an excessively loud tone of voice
- E. Leans in toward the nurse when the nurse speaks
Correct Answer: A,D,E
Rationale: Nodding and agreeing to all statements, speaking loudly, and leaning toward the speaker suggest hearing impairment. Asking for schedule details and slow but appropriate responses do not indicate hearing issues.
A client who is recovering from a spinal cord injury complains of blurred vision and a severe headache. His blood pressure is 210/140. The most appropriate initial action for the nurse to take is to:
- A. check for bladder distention.
- B. place him in the Trendelenburg position.
- C. administer PRN pain medication.
- D. position him on his left side.
Correct Answer: A
Rationale: Symptoms suggest autonomic dysreflexia, often triggered by bladder distention, requiring immediate assessment and intervention.