Nokea
The nurse is preparing a patient in the eye clinic for refractometry. Which of the following information should the nurse include in patient teaching?
- A. You will need to wear sunglasses for a few hours after the exam.'
- B. The surface of your eye will be numb while the doctor does the exam.'
- C. You should not take any of your eye medicines before the examination.'
- D. The doctor will shine a bright light into your eye during the examination.'
Correct Answer: A
Rationale: The pupil is dilated by using cycloplegic medications during refractometry. This effect will last several hours and cause photophobia. The other teaching would not be appropriate for a patient who was having refractometry.
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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 obtaining a nursing history from a patient when the patient indicates symptoms of dizziness when bending over and nausea and dizziness associated with physical activities. Which of the following topics should the nurse include in this patient's teaching plan?
- A. Tympanometry
- B. Rotary chair testing
- C. Pure-tone audiometry
- D. Bone-conduction testing
Correct Answer: B
Rationale: The patient's clinical manifestations of dizziness and nausea suggest a disorder of the labyrinth, which controls balance and contains three semicircular canals and the vestibule. Rotary chair testing is used to test vestibular function. The other tests are used to test for problems with hearing.
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.
The nurse is taking a health history of a new patient at the ear clinic and the patient states, 'I always sleep with the radio on.' Which of the following questions is most appropriate to obtain more information about possible hearing problems?
- A. Do you grind your teeth at night?'
- B. What time do you usually fall asleep?'
- C. Have you noticed any ringing in your ears?'
- D. Are you ever dizzy when you are lying down?'
Correct Answer: C
Rationale: Patients with tinnitus may use masking techniques, such as playing a radio, to block out the ringing in the ears. The responses 'Do you grind your teeth at night?' and 'Are you dizzy when lying down?' would be used to obtain information about other ear problems, such as vestibular disorders and referred temporomandibular joint (TMJ) pain. The response 'What time do you usually fall asleep?' would not be helpful in assessing problems with the patient's ears.
The nurse in the eye clinic is examining an older-adult patient who says 'I see small spots that move around in front of my eyes.' Which of the following actions should the nurse take first?
- A. Immediately have the ophthalmologist evaluate the patient.
- B. Explain that spots and 'floaters' are a normal part of aging.
- C. Inform the patient that these spots may indicate damage to the retina.
- D. Use an ophthalmoscope to examine the posterior chamber of the eyes.
Correct Answer: D
Rationale: Although 'floaters' are usually caused by vitreous liquefaction and are common in aging patients, they can be caused by hemorrhage into the vitreous humour or by retinal tears, so the nurse's first action will be to examine the retina and posterior chamber. Although the ophthalmologist will examine the patient, the presence of spots or floaters in a 65-year-old is not an emergency. The spots may indicate retinal damage, but the nurse should assess the eye further before discussing this with the patient.