Nokea
The nurse should recognize the greatest risk for the development of blindness in which of the following patients?
- A. A 58-year-old Caucasian woman with macular degeneration
- B. A 28-year-old Caucasian man with astigmatism
- C. A 58-year-old African American woman with hyperopia
- D. A 28-year-old African American man with myopia
Correct Answer: A
Rationale: Macular degeneration, prevalent in older adults, is a leading cause of blindness. Astigmatism, hyperopia, and myopia are refractive errors with lower blindness risk.
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The nurse has taken shift report on her patients and has been told that one patient has an ocular condition that has primarily affected the rods in his eyes. Considering this information, what should the nurse do while caring for the patient?
- A. Ensure adequate lighting in the patients room.
- B. Provide a dimly lit room to aid vision by limiting contrast.
- C. Carefully point out color differences for the patient.
- D. Carefully point out fine details for the patient.
Correct Answer: A
Rationale: Rods are responsible for low-light vision, so adequate lighting compensates for rod impairment. Dim lighting worsens vision, and rods do not affect color or fine detail perception.
The nurses assessment of a patient with significant visual losses reveals that the patient cannot count fingers. How should the nurse proceed with assessment of the patients visual acuity?
- A. Assess the patients vision using a Snellen chart.
- B. Determine whether the patient is able to see the nurses hand motion.
- C. Perform a detailed examination of the patients external eye structures.
- D. Palpate the patients periocular regions.
Correct Answer: B
Rationale: If the patient cannot count fingers, testing hand motion detection is the next step to assess visual acuity. Snellen charts require better vision, and external exams or palpation do not measure acuity.
Several residents of a long-term care facility have developed signs and symptoms of viral conjunctivitis. What is the most appropriate action of the nurse who oversees care in the facility?
- A. Arrange for the administration of prophylactic antibiotics to unaffected residents.
- B. Instill normal saline into the eyes of affected residents two to three times daily.
- C. Swab the conjunctiva of unaffected residents for culture and sensitivity testing.
- D. Isolate affected residents from residents who have not developed conjunctivitis.
Correct Answer: D
Rationale: Isolating affected residents prevents the spread of viral conjunctivitis. Antibiotics, saline flushes, and swabbing unaffected residents are ineffective or unnecessary.
A patient got a sliver of glass in his eye when a glass container at work fell and shattered. The glass had to be surgically removed and the patient is about to be discharged home. The patient asks the nurse for a topical anesthetic for the pain in his eye. What should the nurse respond?
- A. Overuse of these drops could soften your cornea and damage your eye.
- B. You could lose the peripheral vision in your eye if you used these drops too much.
- C. Im sorry, this medication is considered a controlled substance and patients cannot take it home.
- D. I know these drops will make your eye feel better, but I cant let you take them home.
Correct Answer: A
Rationale: Topical anesthetics can soften the cornea with overuse, risking permanent damage. They are not controlled substances, and peripheral vision loss is not a primary concern.
A patient has just returned to the surgical floor after undergoing a retinal detachment repair. The postoperative orders specify that the patient should be kept in a prone position until otherwise ordered. What should the nurse do?
- A. Call the physician and ask for the order to be confirmed.
- B. Follow the order because this position will help keep the retinal repair intact.
- C. Instruct the patient to maintain this position to prevent bleeding.
- D. Reposition the patient after the first dressing change.
Correct Answer: B
Rationale: The prone position allows the gas bubble in pneumatic retinopexy to press against the retinal break, aiding reattachment. It does not prevent bleeding, and repositioning or confirmation is unnecessary.