Nokea
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.
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A 68-year-old woman is brought to the emergency room by ambulance. She was found by her husband slumped in her chair and unresponsive. Tentative diagnosis is cerebrovascular accident (CVA). The physician orders a 15% solution of mannitol IV. The nurse knows that this drug is given for what purpose?
- A. To increase urine output
- B. To dissolve clots
- C. To reduce blood pressure
- D. To decrease muscle spasms
Correct Answer: C
Rationale: Mannitol reduces intracranial pressure and blood pressure by promoting diuresis in CVA patients with cerebral edema.
Which behavior by the male client should make the nurse suspect the client has a hearing loss? Select all that apply.
- A. The client reports hearing voices in his head.
- B. The client becomes irritable very easily.
- C. The client has difficulty making decisions.
- D. The client’s wife reports he ignores her.
- E. The client does not dominate a conversation.
Correct Answer: B,D,E
Rationale: Irritability, ignoring others, and not dominating conversations suggest hearing loss due to social withdrawal or misunderstanding. Hearing voices is psychiatric, and decision-making is unrelated.
The client receives a prescription for sodium fluoride for otosclerosis and asks the nurse, 'What will this medication do for my ears?' Which response by the nurse is correct?
- A. Sodium fluoride prevents the breakdown of bone cells and hardens the bone in the ear.
- B. Sodium fluoride causes the breakdown of bone cells and softens the bone in the ear.
- C. Sodium fluoride blocks the effect of histamine and dries the fluid in the ear.
- D. Sodium fluoride causes the production of histamine and increases the fluid in the ear.
Correct Answer: A
Rationale: The medication, sodium fluoride, retards bone reabsorption (prevents the breakdown of bone cells) and promotes calcification (hardening) of the bony lesions in the ear.
The elderly client has undergone a right-eye cataract removal with an intraocular implant. Which discharge instructions should the nurse teach the client?
- A. Have the client demonstrate placing the otic drops in the ear.
- B. Teach the client to instill the eyedrops as prescribed.
- C. Remind the client to keep the lights in the home low at all times.
- D. Encourage the client to sleep on two pillows at night.
Correct Answer: B
Rationale: Instilling prescribed eyedrops (e.g., antibiotics, steroids) prevents infection and inflammation post-cataract surgery. Otic drops are irrelevant, low lights are unnecessary, and elevation is not standard.
The nurse speaks with the client who recently learned that cataracts are developing in both of the client's eyes. Which statement made by the client should the nurse correct?
- A. It is important that I schedule my surgery as soon as possible.
- B. Usually surgery is performed on each eye at different times.
- C. My own lens will be removed when I have cataract surgery.
- D. An intraocular lens may be inserted with the surgical procedure.
Correct Answer: A
Rationale: Although there is reduced vision with beginning cataract development, a person can wait until vision worsens before having surgery. When vision is reduced to the extent that ADLs are affected, surgery should be performed as soon as possible. If both eyes have cataracts, usually the eyes are treated in separate procedures. Surgery for a cataract involves removal of the client's lens, and in most situations, the lens is replaced with an intraocular lens.