Nokea
The nurse is caring for a patient with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which of these actions should be included in the plan of care?
- A. Discussing the need for sexually transmitted infection testing
- B. Applying topical corticosteroids to prevent further inflammation
- C. Assisting with applying for community visual rehabilitation services
- D. Educating about the use of antiviral eye drops to treat the infection
Correct Answer: A
Rationale: Patients with AIC have a high risk for concurrent genital Chlamydia infection and should be referred for STI testing. AIC is treated with antibiotics, antiviral and corticosteroid medications are not appropriate therapies. Although some types of Chlamydia infection do cause blindness, AIC does not lead to blindness, so referral for visual rehabilitation is not appropriate.
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The nurse is caring for a patient who had a stapedotomy yesterday. Which of the following findings is most important for the nurse to communicate to the health care provider?
- A. The patient complains of 'congestion' in the ear.
- B. The patient's oral temperature is 38°C (100.4°F).
- C. The patient reports mild dizziness when standing.
- D. The patient has slight redness at the surgical site.
Correct Answer: B
Rationale: An oral temperature of 38°C (100.4°F) after a stapedotomy may indicate a postoperative infection, which requires prompt reporting to the healthcare provider. Congestion, mild dizziness, and slight redness are less urgent, as they may be expected postoperative symptoms unless severe or persistent.
Which of the following nursing diagnoses is priority when caring for a patient who is experiencing an acute attack of Méni?¨re's disease?
- A. Risk for falls as evidenced by impaired balance
- B. Impaired verbal communication related to vulnerability (tinnitus)
- C. Bathing self-care deficit related to weakness (vertigo)
- D. Imbalanced nutrition: less than body requirements related to insufficient dietary intake (nausea)
Correct Answer: A
Rationale: All the nursing diagnoses are appropriate, but because sudden acute attacks of vertigo, the major focus of nursing care is to prevent injuries associated with impaired balance.
These medications are prescribed by the health care provider for a patient who has just been admitted to hospital with acute angle-closure glaucoma. Which of the following medications should the nurse give first?
- A. Morphine sulphate 4 mg intravenously
- B. Betaxolol 1 drop in each eye
- C. Acetazolamide 250 mg orally
- D. Mannitol 100 mg intravenously
Correct Answer: D
Rationale: The most immediate concern for the patient is to lower intraocular pressure, which will occur most rapidly with IV administration of a hyperosmolar diuretic such as mannitol. The other medications also are appropriate for a patient with glaucoma but would not be the first medication administered.
Which of the following information should the nurse include when teaching a patient with keratitis caused by herpes simplex type 1?
- A. Application of corticosteroid ophthalmic ointment to the eyes
- B. Application of povidone-iodine gel around the eye
- C. Avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs)
- D. Importance of taking all of the ordered oral acyclovir
Correct Answer: D
Rationale: Oral acyclovir may be ordered for herpes simplex infections. Corticosteroid ointments are usually contraindicated because they prolong the course of the infection. Although povidone-iodine gel may be applied to the skin around the eyes for herpes zoster (varicella) infections, it is not used for herpes simplex infections. NSAIDs can be used to treat the pain associated with keratitis.
The charge nurse observes a newly hired nurse caring for a patient who has just arrived in the postanesthesia care unit after having right cataract removal and an intraocular lens implant. Which of the following interventions requires that the charge nurse intervene?
- A. The nurse leaves the eye shield in place.
- B. The nurse encourages the patient to cough.
- C. The nurse elevates the patient's head to 45 degrees.
- D. The nurse applies corticosteroid drops to the right eye.
Correct Answer: B
Rationale: Because coughing will increase intraocular pressure, patients are generally taught to avoid coughing during the acute postoperative time. The other actions are appropriate for a patient after having this surgery.