Nokea
Which common characteristic of open-angle glaucoma is this client most likely to report?
- A. Itching and burning eyes
- B. Lddedness to the reading
- C. Seeing halos around lights
- D. Loss of peripheral vision
Correct Answer: D
Rationale: Open-angle glaucoma typically causes gradual loss of peripheral vision.
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The nurse is explaining facelift (rhytidectomy) surgery to the client and describing the site where the incision is most commonly made. Place an X on the site where the incision most commonly used for rhytidectomy is made.
- A. An incision either in front or in back of the ear is made during rhytidectomy to remove excess skin and treat muscle laxity of the face.
Correct Answer: A
Rationale: An incision either in front or in back of the ear is made during rhytidectomy to remove excess skin and treat muscle laxity of the face. Incisions in the forehead and periorbital area are for blepharoplasty and browlift. Head and neck reconstruction utilizes the chin site.
The school nurse is preparing to teach a health promotion class to high school seniors. Which information regarding self-care should be included in the teaching?
- A. Wear a sunscreen with a protection factor of 10 or less when in the sun.
- B. Try to stay out of the sun between 0300 and 0500 daily.
- C. Perform a thorough skin check monthly.
- D. Remember caps and long sleeves do not help prevent skin cancer.
Correct Answer: C
Rationale: Monthly skin checks detect early skin cancer changes. SPF 10 is inadequate, 0300–0500 is nighttime, and caps/long sleeves are protective.
When describing the examination procedure to the client, which statement by the nurse is most accurate?
- A. You'll read words that are the size of newsprint.
- B. You'll read letters from a distance of 20 feet to mears.
- C. You'll look at a color picture and identify an image.
- D. You'll look at a screen and tell me when an object appears.
Correct Answer: B
Rationale: The Snellen chart involves reading letters from 20 feet to assess visual acuity.
The client is complaining of severe itching following a course of antibiotics. Which independent nursing action should the nurse implement?
- A. Refer to an allergy specialist to begin desensitization.
- B. Use a tar-preparation gel after each shower or bath.
- C. Keep the covers tightly around the client at night.
- D. Take baths with an OTC colloidal oatmeal preparation.
Correct Answer: D
Rationale: Colloidal oatmeal baths relieve itching, an independent nursing action. Specialist referral, tar gels, and tight covers are inappropriate or dependent.
The client comes into the emergency department in severe pain and reports that a pot of boiling hot water accidentally spilled on his lower legs. The assessment reveals blistered, mottled red skin, and both feet are edematous. Which depth of burn should the nurse document?
- A. Superficial partial thickness.
- B. Deep partial thickness.
- C. Full thickness.
- D. First degree.
Correct Answer: B
Rationale: Blistered, mottled red skin with edema indicates deep partial-thickness burns, affecting the dermis with severe pain. Superficial partial thickness has no blisters, full thickness is painless and leathery, and first degree is superficial with erythema.