Nokea
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.
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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.
The 65-year-old client is diagnosed with macular degeneration. Which statement by the client indicates the client needs more discharge teaching?
- A. I should use magnification devices as much as possible.
- B. I will look at my Amsler grid at least twice a week.
- C. I need to use low-watt light bulbs in my house.
- D. I am going to contact a low-vision center to evaluate my home.
Correct Answer: C
Rationale: Low-watt bulbs reduce visibility, counterproductive in macular degeneration. Magnification, Amsler grid monitoring (daily preferred), and low-vision centers are appropriate.
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.
Which teaching instruction should the nurse discuss with students who are on the high school swim team when discussing how to prevent external otitis?
- A. Do not wear tight-fitting swim caps.
- B. Avoid using silicone ear plugs while swimming.
- C. Use a drying agent in the ear after swimming.
- D. Insert a bulb syringe into each ear to remove excess water.
Correct Answer: C
Rationale: A drying agent (e.g., alcohol-based drops) prevents external otitis by removing moisture. Swim caps and ear plugs are protective, and bulb syringes risk trauma.
The elderly client has undergone a right-eye cataract removal with an intraocular implant. Which discharge instructions should the nurse teach the client?
- A. Have the client demonstrate placing the otic drops in the ear.
- B. Teach the client to instill the eyedrops as prescribed.
- C. Remind the client to keep the lights in the home low at all times.
- D. Encourage the client to sleep on two pillows at night.
Correct Answer: B
Rationale: Instilling prescribed eyedrops (e.g., antibiotics, steroids) prevents infection and inflammation post-cataract surgery. Otic drops are irrelevant, low lights are unnecessary, and elevation is not standard.