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The nurse is caring for a patient with a left retinal detachment who had a pneumatic retinopexy procedure. Which of the following information should be included in the discharge teaching plan?
- A. The use of bilateral eye patches to reduce movement of the operative eye
- B. The need to wear dark or tinted glasses
- C. The procedure for sterile dressing changes
- D. The purpose of maintaining the head in a prescribed position for several weeks
Correct Answer: D
Rationale: Following pneumatic retinopexy, maintaining the head in a prescribed position is critical to keep the gas bubble in contact with the retinal tear, promoting reattachment. Bilateral eye patches are not typically used, dark glasses may be recommended for comfort but are not the focus, and sterile dressing changes are not standard for this procedure.
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The nurse is assessing the presence or absence of contact lenses in an unconscious patient. Which of the following directions should the nurse shine a pen light?
- A. Parallel to the eye
- B. At a 90-degree angle to the eye
- C. Obliquely into the eye
- D. Toward the centre of the nasal bridge
Correct Answer: C
Rationale: The nurse must know whether the patient has contact lenses in and assesses the eye by shining a light obliquely on the eyeball to help the nurse visualize a contact lens.
Which of the following actions is an example of an approach magnification?
- A. Using a telescopic lens
- B. Sitting closer to a television while watching it
- C. Using a black-tipped felt marker when writing
- D. Reading books with large-type print
Correct Answer: B
Rationale: Approach magnification is a simple but sometimes overlooked technique for enhancing the patient's residual vision. The nurse can recommend that the patient sit closer to the television or hold books closer to the eyes, which the patient may be reluctant to do unless encouraged. Using a telescopic lens is an optical device. Using a black-tipped marker to write is a contrast enhancement technique. Reading large-type print books may be helpful but is not an approach magnification action unless the book was brought close to the eyes, which is not indicated in the answer choice.
Which of the following assessment findings in a patient who was struck in the right eye with a baseball is a priority for the nurse to communicate to the health care provider in the emergency department?
- A. The patient complains of a right-sided headache.
- B. The sclerae on the right eye have broken blood vessels.
- C. The area around the right eye is bruised and tender to the touch.
- D. The patient complains of 'a curtain' blocking part of the visual field.
Correct Answer: D
Rationale: The patient's sensation that a curtain is coming across the field of vision suggests retinal detachment and the need for rapid action to prevent blindness. The other findings would be expected with the patient's history of being hit in the eye with a ball.
Which of the following actions should the nurse take when assisting a totally blind patient to walk to the bathroom?
- A. Take the patient by the arm and lead the patient slowly to the bathroom.
- B. Have the patient place a hand on the nurse's shoulder and guide the patient.
- C. Stay beside the patient and describe any obstacles on the path to the bathroom.
- D. Walk slightly ahead of the patient and allow the patient to hold the nurse's elbow.
Correct Answer: D
Rationale: When using the sighted-guide technique, the nurse walks slightly in front and to the side of the patient and has the patient hold the nurse's elbow. The other techniques are not as safe in assisting a blind patient.
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.