Nokea
The nurse is questioning the client about vision changes. Which symptom indicates that the client may be developing a cataract?
- A. Blurred vision, worsening at night
- B. Shooting pain in the back of one eye
- C. Increased frequency of headaches
- D. Seeing spots in the vision field of one eye
Correct Answer: A
Rationale: The lens opacity from a developing cataract diminishes vision. Blurriness and decreased night vision are early symptoms. Shooting eye pain is often associated with a subarachnoid hemorrhage, not a cataract. Headaches are not associated with cataract formation. Floating dark spots in the vision field are associated with bleeding within the eye that occurs with detached retina.
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The nurse telephones the client 1 day post-cataract surgery. Which client statement necessitates an evaluation by an ophthalmologist?
- A. My eye starts hurting about 4 hours after a pain pill.
- B. The redness in my eye is a little less than yesterday.
- C. There has never been any swelling around my eye.
- D. I can't see as well as I could yesterday after surgery.
Correct Answer: D
Rationale: A significant reduction in vision may indicate a complication such as infection or retinal detachment. Pain relieved by prescribed pain medication is within normal assessment parameters. Decreasing redness is within normal assessment parameters. No swelling is within normal assessment parameters.
The client diagnosed with chronic otitis media is scheduled for a mastoidectomy. Which discharge teaching should the nurse discuss with the client?
- A. Instruct the client to blow the nose with the mouth closed.
- B. Explain the client will never be able to hear from the ear.
- C. Instill ophthalmic drops in both ears and then insert a cotton ball.
- D. Do not allow water to enter the ear for six (6) weeks.
Correct Answer: D
Rationale: Keeping the ear dry for six weeks prevents infection post-mastoidectomy. Blowing the nose closed increases pressure, hearing loss is not guaranteed, and ophthalmic drops are incorrect.
Which intervention should the nurse include when conducting an in-service to the ancillary nursing staff on caring for elderly clients addressing normal developmental sensory changes?
- A. Ensure curtains are open when having the client read written material.
- B. Provide a variety of written material when discussing a procedure.
- C. Assist the client when getting out of the bed and sitting in the chair.
- D. Request a telephone for the hearing impaired for all elderly clients.
Correct Answer: A
Rationale: Open curtains maximize light, compensating for age-related vision decline. Varied materials, mobility assistance, and hearing-impaired phones are less universally applicable.
The client is diagnosed with glaucoma. Which symptom should the nurse expect the client to report?
- A. Loss of peripheral vision.
- B. Floating spots in the vision.
- C. A yellow haze around everything.
- D. A curtain coming across vision.
Correct Answer: A
Rationale: Glaucoma causes loss of peripheral vision due to optic nerve damage from increased intraocular pressure. Floaters suggest vitreous issues, yellow haze is unrelated, and a curtain indicates retinal detachment.
The client recently diagnosed with age-related macular degeneration (AMD) in both eyes returns to the clinic for a follow-up appointment. Which assessment will the nurse be certain to include during the visit?
- A. Stools for occult blood
- B. Blood glucose levels
- C. Screening for depression
- D. Screening for hearing loss
Correct Answer: C
Rationale: The nurse should assess for depression because loss of vision can affect functional ability, mood, and quality of life. Depression frequently develops within a few months after AMD is diagnosed in both eyes. GI bleeding, blood glucose, and hearing loss are not directly related to AMD.