Nokea
The nurse is obtaining a health history from an older-adult patient, who is new to the eye clinic and who has glaucoma. Which of the following information given by the patient will have the most implications for the patient's treatment?
- A. I use Aspirin when I have a sinus headache.'
- B. I have had frequent episodes of conjunctivitis.'
- C. I take metoprolol daily for angina.'
- D. I have not had an eye examination for 10 years.'
Correct Answer: C
Rationale: It is important to note whether the patient takes any β-adrenergic blockers because this category of medications also is used to treat glaucoma, and there may be an increase in adverse effects. The use of Aspirin does not increase intraocular pressure and is safe for patients with glaucoma. Although older patients should have yearly eye examinations, the treatment for this patient will not be affected by the 10-year gap in eye care. Conjunctivitis does not increase the risk for glaucoma.
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Which of the following actions should the nurse include in the plan of care for a patient who has vestibular disease?
- A. Check Rinne's and Weber's tests.
- B. Face the patient when speaking.
- C. Enunciate clearly when speaking.
- D. Monitor the patient's ability to ambulate safely.
Correct Answer: D
Rationale: Vestibular disease affects balance so the nurse should monitor the patient during activities that require balance. The other actions might be used for patients with hearing disorders.
The nurse is assessing an older-adult patient for the presence of presbyopia. Which of the following equipment will the nurse need to obtain before the examination?
- A. Penlight
- B. Tono-pen
- C. Jaeger chart
- D. Snellen chart
Correct Answer: C
Rationale: Presbyopia is the normal loss of near vision that occurs with age and is assessed using a Jaeger chart. This assessment should begin after 40 years of age. The Snellen chart, penlight, and the Tono-pen are used when assessing for other visual disorders.
The nurse is conducting an auditory assessment with a patient. Which of the following findings should the nurse document as normal?
- A. Ability to hear low whisper at 30 cm
- B. Rinne's test results: bone conduction is better than air conduction
- C. Weber's test results - no lateralization
- D. Curved cone light reflex
- E. Symmetrical location of ears
Correct Answer: A,C,E
Rationale: Normal findings in the physical assessment of the auditory system include ears symmetrical in location and shape, auricles and tragus nontender, without lesions; clear canal and tympanic membrane intact, landmarks and light reflex intact; ability to hear low whispers at 30 cm and no lateralization Weber's test result. Rinne's test result for a normal finding is that air conduction is better than bone conduction.
The nurse is performing an eye examination on a patient and is assessing for accommodation. Which of the following actions should the nurse implement?
- A. Cover one eye for 1 minute and note the pupil reaction when the cover is removed.
- B. Shine a light into the patient's eye and assess the pupil response in the opposite eye.
- C. Observe the pupils when the patient focuses on a distant object and then on a close object.
- D. Touch the patient's pupil with a small piece of sterile cotton and watch for a blink reaction.
Correct Answer: C
Rationale: Accommodation is defined as the ability of the lens to adjust to various distances. The other nursing actions also may be part of the eye examination, but they do not test for accommodation.
The nurse is obtaining a health history from a middle-aged adult patient. Which of the following patient statements is most important to communicate to the health care provider?
- A. My vision seems blurry now when I read.'
- B. I have noticed that my eyes are drier now.'
- C. It is hard for me to see when I drive at night.'
- D. The peripheral part of my vision is decreased.'
Correct Answer: D
Rationale: The decrease in peripheral vision may indicate glaucoma, which is not a normal visual change associated with aging and requires rapid treatment. The other patient statements indicate visual conditions (presbyopia, dryness, and lens opacity) that are considered a normal part of aging.