Nokea
The client is scheduled for laser-assisted in situ keratomileusis (LASIK) surgery for severe myopia. Which instruction should the nurse discuss prior to the client's discharge from day surgery?
- A. Wear bilateral eye patches for three (3) days.
- B. Wear corrective lenses until the follow-up visit.
- C. Do not read any material for at least one (1) week.
- D. Teach the client how to instill corticosteroid ophthalmic drops.
Correct Answer: D
Rationale: Corticosteroid drops reduce inflammation post-LASIK, requiring teaching. Eye patches are not used, corrective lenses are unnecessary, and reading restrictions are shorter.
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The client asks the nurse about symptoms associated with retinal detachment. Which symptoms should the nurse identify? Select all that apply.
- A. Seeing bright flashes of light
- B. Shooting, throbbing eye pain
- C. Severe frontal headache
- D. Diminished visual acuity
- E. Seeing floating dark spots in the vision field
Correct Answer: A,D,E
Rationale: As the choroid and retina partially separate, the client notices flashes of light, decreased vision, and floating dark spots. Pain is not associated with retinal detachment due to few pain fibers in the retina. Headache is not associated with retinal detachment.
The emergency department nurse is assessing a client who has a needle in the sclera of the right eyeball just below the iris. Which should the nurse implement first?
- A. Remove the needle with tweezers.
- B. Notify an ophthalmologist to care for the client.
- C. Stabilize the right eye and place a patch over the left eye.
- D. Irrigate the right eye to wash the needle out of the eye.
Correct Answer: C
Rationale: Stabilizing the eye and patching the unaffected eye prevents movement and further damage until surgical removal. Removing the needle, notifying later, or irrigating risks harm.
Which signs/symptoms should the nurse expect to find when assessing the client with an acoustic neuroma?
- A. Incapacitating vertigo and otorrhea.
- B. Nystagmus and complaints of dizziness.
- C. Nausea and vomiting.
- D. Unilateral hearing loss and tinnitus.
Correct Answer: D
Rationale: Acoustic neuroma (vestibular schwannoma) causes unilateral hearing loss and tinnitus due to cranial nerve VIII compression. Vertigo, nystagmus, and nausea are less prominent; otorrhea is unrelated.
The day following a stapedectomy, the client tells the nurse that he cannot hear much in the operative ear and thinks the stapedectomy was a failure. What is the best response for the nurse to make?
- A. There is packing in your ear. You will not hear well for a few days.'
- B. The doctors have not yet turned on the stapes replacement.'
- C. You may not have hearing, but you will now be free of pain.'
- D. You seem upset that you aren't hearing well.'
Correct Answer: A
Rationale: Ear packing post-stapedectomy temporarily reduces hearing, which improves as packing is removed.
Which situation makes the nurse suspect the client has glaucoma?
- A. An automobile accident because the client did not see the car in the next lane.
- B. The cake tasted funny because the client could not read the recipe.
- C. The client has been wearing mismatched clothes and socks.
- D. The client ran a stoplight and hit a pedestrian walking in the crosswalk.
Correct Answer: A
Rationale: Not seeing a car in the next lane suggests peripheral vision loss, a hallmark of glaucoma. Taste, color perception, and stoplight issues are unrelated.