Nokea
The nurse is caring for a patient with age-related macular degeneration who has just had photodynamic therapy. Which of the following statements by the patient indicates that the discharge teaching has been effective?
- A. I will need to use bright lights to read for at least the next week.
- B. I will use drops to keep my pupils dilated until my appointment.
- C. I will not use facial lotions near my eyes during the recovery period.
- D. I will keep covered with long-sleeve shirts and pants for the next 5 days.
Correct Answer: D
Rationale: The photosensitizing drug used for photodynamic therapy is activated by exposure to bright light and can cause burns in areas exposed to light for 5 days after the treatment. There are no restrictions on use of facial lotions, medications to keep the pupils dilated are not appropriate, and bright lights would increase the risk for damage caused by the treatment.
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A patient is seen in the ophthalmology clinic and diagnosed with recurrent staphylococcal and seborrheic blepharitis. Which of the following topics should the nurse include in the teaching plan?
- A. Saline irrigation of the eyes
- B. Surgical removal of the lesion
- C. Using baby shampoo to clean the lids
- D. The use of cool compresses to the eyes
Correct Answer: C
Rationale: Baby shampoo is used to soften and remove crusts associated with blepharitis. The other interventions are not used in treating this disorder.
Which of the following topics will the nurse include in patient teaching following outpatient cataract surgery and lens implantation?
- A. Use of oral opioids for pain control
- B. Administration of antibiotic eye drops
- C. Importance of coughing and deep-breathing exercises
- D. Need for bed rest for the first 24 hours after the surgery
Correct Answer: B
Rationale: Antibiotic and corticosteroid eye drops are commonly prescribed after cataract surgery, and the patient should be able to administer them using safe technique. Pain is not expected after cataract surgery and opioids will not be needed. Coughing and deep-breathing exercises are not needed since a general anaesthetic agent is not used. There is no bed rest restriction after cataract surgery.
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 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.
To decrease the risk for future hearing loss, which of the following actions should the nurse working with college students at the on-campus health clinic implement?
- A. Arrange to include otoscopic examinations for all patients.
- B. Administer rubella immunizations to all students at the clinic.
- C. Discuss the importance of limiting exposure to very high amplified music.
- D. Teach patients to regularly irrigate the ear to decrease cerumen impaction.
Correct Answer: C
Rationale: Exposure to high amplified music is a significant risk factor for hearing loss in young adults. Otoscopic exams and cerumen irrigation do not directly prevent hearing loss, and rubella immunization is unrelated to noise-induced hearing damage.